What To Expect At Your First Visit To The Urologist

Medically reviewed by Mr Maneesh Ghei, Consultant Urological Surgeon (GMC: 5208045). Last reviewed June 2026.

Your first urologist visit can feel daunting, particularly if you are coming in with a symptom you have been worrying about for a while. Most patients arrive not quite knowing what to expect, and that uncertainty makes the anxiety worse. What actually happens at a urology appointment is far more straightforward than most people anticipate. Being prepared makes a significant difference. This guide explains exactly what to expect, step by step, so you arrive informed and ready.

Why would you need to see a urologist?

Urology covers conditions affecting the kidneys, bladder, ureters, urethra, and in men, the prostate and male reproductive system. The most common reasons people see a urologist for the first time include:

• Lower urinary tract symptoms (LUTS): difficulty passing urine, poor flow, frequency, urgency, or getting up at night to urinate
• Blood in urine (haematuria): visible or detected on dipstick, always needing formal investigation — read our guide on whether a UTI can cause blood in urine and when haematuria signals something more serious
• Prostate concerns: elevated PSA, symptoms of prostate enlargement, or prostate cancer screening
• Kidney stones: loin pain, renal colic, or stones found on imaging
• Urinary infections: particularly recurrent UTIs that have not resolved with GP-prescribed antibiotics
• Bladder problems: incontinence, overactive bladder, or bladder pain
• Male sexual health: erectile dysfunction, ejaculatory problems, or scrotal pain
• Testicular lumps or changes: any new lump or change in a testicle requires prompt assessment

You can be referred by your GP, or you can self-refer to a private urologist directly without a referral. At Urocare London, the majority of patients self-refer. They have a symptom they want assessed promptly rather than waiting for the NHS pathway.

How should you prepare for your first urology appointment?

Write down your symptoms. Note when each symptom started, how often it occurs, whether it is getting better or worse, and anything that makes it better or worse. If your main concern is urinary symptoms, keep a 24-hour bladder diary in the days before your appointment. Note every time you pass urine and roughly how much you drink. This gives the urologist much more to work with than a general description of “going a lot.”

Bring a medication list. Include everything you take, including over-the-counter drugs and supplements. Several common medications affect urinary function directly: alpha-blockers, anticholinergics, diuretics, and some blood pressure drugs can all influence symptoms. Some medications also affect PSA levels and need to be factored into interpretation of test results.

Bring any previous test results. If you have had a PSA test, urine test, ultrasound, or imaging done by your GP, bring the results or ask for them to be forwarded. Previous urology investigations are valuable context.

Avoid ejaculation for 48 hours before the appointment if a PSA test is likely. This is particularly relevant for men coming in for prostate assessment, as ejaculation temporarily raises PSA levels.

Come with a full bladder if you have been asked to. This is sometimes requested in advance for flow rate testing or bladder ultrasound.

What happens at the appointment itself?

Medical history and symptom review

The consultation starts with a detailed conversation. Mr Ghei will ask about your current symptoms, how long you have had them, any previous relevant medical history, medications, and family history where relevant. This is not a quick form-filling exercise. The history is where most of the clinical picture is built. Do not edit what you say for embarrassment; urologists deal with these symptoms every day and need the full picture to help you.

Patients often ask me how to describe their symptoms if they are not sure of the right words. My answer is always the same: describe what you experience in your own language. “I feel like I cannot get started” or “I go every hour but not much comes out” tells me more than a patient trying to use medical terminology they are not certain of.

Physical examination

A physical examination will be performed if it is relevant to your symptoms. For most urological conditions, this is focused, not a full-body check. You will be given full privacy and the examination will be explained before it happens.

For men with prostate symptoms, a digital rectal examination (DRE) may be performed. This involves the urologist examining the prostate through the rectum to assess its size, shape, and texture. It is brief, mildly uncomfortable, and clinically important. It can detect prostate enlargement and occasionally identify suspicious areas that warrant further investigation. Many men are anxious about this examination in advance and find it considerably less uncomfortable than expected.

For bladder and urinary symptoms, the examination may include palpation of the abdomen and assessment of the suprapubic area. For scrotal or testicular concerns, a testicular examination will be performed.

Same-day tests

• Urine analysis (dipstick and midstream culture): standard for any urinary symptoms, checks for blood, protein, glucose, nitrites, and infection markers
• PSA blood test: for men with prostate symptoms or those attending for prostate screening
• Uroflowmetry (flow rate test): you urinate into a flow meter to measure the rate and pattern of your urine stream; takes under five minutes and is entirely non-invasive
• Post-void residual ultrasound: a small, handheld ultrasound probe on the lower abdomen measures how much urine remains in the bladder after voiding; takes about two minutes and is painless
• Scrotal or renal ultrasound: if indicated by symptoms, can be arranged same-day or at a follow-up

What happens after your appointment?

By the end of your first appointment, you should have a clear clinical summary and a defined next step. This might be:

• A prescription to start immediately
• A referral letter for MRI or CT scanning
• A date for a procedure such as flexible cystoscopy or biopsy
• A follow-up appointment in four to six weeks after treatment to review response
• Reassurance that no further investigation is needed, with clear parameters for when to return

You should never leave a urology appointment without knowing what happens next. If you are unclear, ask before you leave.

What conditions does a urologist treat?

• Prostate conditions: BPH, prostatitis, prostate cancer (from screening and diagnosis through to treatment planning and surveillance)
• Bladder conditions: overactive bladder, recurrent UTIs, bladder cancer, interstitial cystitis
• Kidney stones: diagnosis, acute management, and definitive treatment including lithotripsy and ureteroscopy
• Haematuria (blood in urine): full workup including flexible cystoscopy and CT urogram
• Male sexual health: erectile dysfunction, ejaculatory disorders, testosterone assessment
• Scrotal and testicular conditions: hydrocele, varicocele, epididymo-orchitis, testicular lumps
• Urethral stricture: narrowing of the urethra causing difficulty urinating

Do you need to be embarrassed about urological symptoms?

This comes up in almost every first appointment. Not as a question, but as an observation that the patient has been putting off coming in because the symptom felt too embarrassing to discuss. Difficulty urinating, erectile problems, blood in urine, scrotal pain: these are the most common conditions in a urology practice. There is nothing you can describe that has not been heard many times before, and there is no clinical judgement attached to the symptoms themselves.

The only judgement that matters is whether the symptom is being investigated early enough. The patients whose conditions are hardest to manage are invariably those who waited too long before seeking assessment.

Frequently Asked Questions

Do I need a GP referral to see a urologist?

No. You can self-refer directly to a private urologist without a GP referral. At Urocare London, most patients contact us directly. If you have existing test results from your GP (PSA, urine tests, ultrasound reports), bring them along as they provide useful context, but they are not a requirement to book.

How long does a first urology appointment last?

A first appointment with Mr Ghei typically lasts 30 to 60 minutes, depending on the complexity of your symptoms and whether same-day tests are carried out. Allow an hour. Follow-up appointments are shorter, usually 20 to 30 minutes.

Will I need a rectal examination at my first appointment?

Not necessarily. It depends on your symptoms. If you are attending for prostate-related concerns, a digital rectal examination (DRE) is part of the standard assessment. It will be discussed and explained before it takes place, and you can ask questions beforehand. For the majority of patients, it is considerably less uncomfortable than anticipated.

Can I bring someone with me to the appointment?

Yes. You are welcome to bring a partner, family member, or friend. They can accompany you throughout the consultation or wait in reception, depending on your preference. Some patients find it helpful to have someone with them to help remember what was discussed, particularly if the appointment covers a new diagnosis or a treatment decision.

What tests are typically done at a first urology appointment?

This depends on your reason for attending. Common same-day tests include urine analysis, PSA blood test, uroflowmetry (flow rate), and post-void residual bladder scan. Imaging such as ultrasound, CT, or MRI is usually arranged as a separate appointment rather than done at the first consultation.

Will I get results at my first appointment?

Some results (urine dipstick, flow rate, bladder scan) are immediate and discussed the same day. Blood test results such as PSA typically take 24 to 48 hours from a laboratory. Imaging results depend on when the scan is done and may be discussed at a follow-up appointment or communicated by phone or letter.

What should I wear to a urology appointment?

Comfortable, easy-to-remove clothing. You may be asked to provide a urine sample and possibly to change into a gown for part of the examination. There are no other specific requirements.

Is everything discussed at my urology appointment confidential?

Yes. Everything disclosed during your appointment is subject to the same medical confidentiality as any other clinical consultation. Your records are not shared without your explicit consent, except in specific legal or safeguarding circumstances which would be explained to you if they arose.

What is the difference between a urologist and a GP for urinary problems?

A GP is trained to manage a wide range of conditions and will often handle initial assessment of urinary symptoms, prescribe antibiotics for uncomplicated UTIs, and request initial blood tests. A urologist is a surgical specialist in the urinary tract and male reproductive system, with access to specialised investigations (cystoscopy, urodynamics, MRI, biopsy) and procedures that GPs cannot perform. For persistent, recurrent, or complex urological symptoms, direct access to a urologist gives faster, more definitive answers.

Sources

• NHS: Urology overview
• BAUS: Patient information on urological conditions
• NICE guideline NG131: Prostate cancer diagnosis and management

This article is for information only and is not a substitute for personalised medical advice. If you have urological symptoms that concern you, seek assessment from your GP or a consultant urologist.

About the Author

Mr Maneesh Ghei, Consultant Urological Surgeon (GMC: 5208045)

Mr Maneesh Ghei is a consultant urological surgeon with NHS and private practice across four London hospitals. He specialises in the diagnosis and management of prostate conditions including BPH, prostatitis and prostate cancer, as well as urinary symptoms, kidney stones and male sexual health. Mr Ghei sees new patients privately with same-week availability. No GP referral is required. Book a prostate screening consultation.