Urology in Bali

Urology is a branch of medicine that deals with the diseases of the female and male urinary tract (kidneys, ureters, bladder, and urethra). This branch of medicine also deals with male reproductive organs (testes, epididymis, vas deferens, seminal vesicles, prostate, and penis).

Urology has a number of sub-disciplines, including:

• Endourology – this sub-discipline of urology deals with the closed manipulation of the urinary tract. It includes all minimally invasive urologic surgical procedures, such as prostate surgery and stone removal surgery.
• Urologic oncology – this focuses on the treatment of malignant genitourinary diseases, such as cancer of the bladder, prostate, kidney, ureters, adrenal glands, testicles, or penis.
• Neurourology – this deals with the treatment of conditions involving the nervous control of the genitourinary system or abnormal urination.
• Pediatric urology – this focuses on urologic disorders in children, such as congenital abnormalities of the genitourinary tract, cryptorchidism (undescended testes), underdeveloped genitalia, enuresis, and vesicoureteral reflux.
• Andrology – this deals with disorders of the male reproductive system, such as ejaculatory disorders, erectile dysfunction, vasectomy reversal, and infertility.
• Reconstructive urology – this is a highly specialized field of male urology that deals with the reconstruction of both the structure and function of the genitourinary tract.
• Female urology – this deals with conditions of a woman’s reproductive and urinary tract, such as pelvic organ prolapse, overactive bladder, and urinary incontinence.

Medical professionals specializing in the field of urology are called urologists. Urologists can diagnose and treat diseases of the urinary tract in both women and men, as well as diagnosing and treating any problems in men’s reproductive tract. In some cases, urologists may also perform surgery. In the case of certain conditions, urologists may need to work in conjunction with medical professionals who specializes in other fields, such as oncologist, radiotherapists, nephrologist, and gynecologist.

Urologists can treat the following conditions:

In men:

• Prostate gland enlargement
• Cancers of the penis, bladder, testicles, kidneys, and adrenal and prostate glands
• Erectile dysfunction
• Infertility
• Kidney diseases
• Kidney stones
• Interstitial cystitis, also known as painful bladder syndrome
• Prostatitis
• Varicoceles, or enlarged veins in the scrotum
• Urinary tract infections (UTIs)

In women:

• Cancer of the kidneys, bladder, and adrenal glands
• Bladder prolapse, or a condition in which the bladder drops into the vagina
• Kidney stones
• Interstitial cystitis
• Overactive bladder
• Urinary incontinence
• UTIs

In children:

• Blockages and other problems with the urinary tract structure
• Bed-wetting
• Undescended testicles

What does Urology Involve?

During your first appointment, your urologist may ask you questions about your health history, any medicines you take, and your current symptoms. Your urologist may do a physical exam that includes a rectal and genital exam. They may also do some tests, such as:

• Imaging tests, such as MRI scans, CT scans, or ultrasound to help them locate the problem.
• A urine test to check for bacteria or other signs of disease.
• A cystoscope (a long, thin tube with a camera on its end) to see inside the urinary tract and take a sample of tissue for testing.
• A biopsy to check for cancer and other disorders.
• Urodynamic testing to check how fast the urine leaves your body, how much pressure there is in your bladder, and how much urine remains in your bladder after urinating.

After your urologist makes a diagnosis, the treatment will depend on your specific condition. It may include the use of medications and surgery.

Types of medication include:

• Hormone treatment for prostate cancer
• Antibiotics for infections
• Phosphodiesterase 5 (PDE5) inhibitors for erectile dysfunction
• Chemotherapy drugs for cancer
• Drugs that act on the smooth muscle of the bladder to help reduce urinary incontinence.

Some of the most common types of surgery include:

• A cystectomy, which is a procedure to remove the bladder. This procedure is used to treat cancer.
• A kidney transplant, which involves replacing a damaged or diseased kidney with a healthy one.
• Extracorporeal shock-wave lithotripsy, which is used to break up kidney stones so they can be removed more easily.
• A repair of damage to the urinary tract due to injury.
• A procedure to open a blockage.
• A repair of urinary organs that are not well-formed.
• A prostatectomy, which is used to remove all or part of the prostate gland. This procedure is performed to treat prostate cancer.
• Transurethral needle ablation of the prostate, which removes excess tissue from an enlarged prostate.
• Transurethral resection of the prostate, which involves the removal of excess tissue from an enlarged prostate.
• A sling procedure, which uses strips of mesh in order to support the urethra and keep it closed. This procedure can treat urinary incontinence.
• A ureteroscopy, which involves the removal of stones in the kidneys and ureter using a scope.
• A vasectomy, which is a procedure to cut and tie the vas deferens, or the tubes that carry sperm. This is done to prevent pregnancy.
• A nephrectomy, which involves removing a kidney to treat cancer.

The surgery can be performed in one of two ways: open through a large incision, laparoscopically through several tiny incisions. Both methods are usually performed under general anesthesia. In some cases, local anesthetic may be used instead.

How Long Should I Stay in Bali?

Depending on the procedure you will have, you may be able to leave the hospital on the same day or you will have to stay for up to 5 days. In general, it is highly advisable that you stay in Bali for several days following your procedure for initial recovery and to attend scheduled follow-up checkups. For surgical procedures, you may need to stay in the country for at least 10 to 14 days.

What's the Recovery Time?

The recovery time varies, depending on the procedure you have, the reason why you need the procedure, and your overall health. For surgical procedures, it may take about one to six weeks until you can go back to your full activity. For non-surgical procedures, you may be allowed to go back to your normal routine within several days. Your urologist will give you a detailed recovery timeline, which includes the time you can go back to work, normal activity, and strenuous activities, such as exercise and heavy lifting.

What About Aftercare?

Your urologist will give you a set of instructions for your aftercare. The instruction may include a diet plan, exercise, restrictions, and medication to take, and wound care. It is important that you follow every instruction closely. After surgery, you will be encouraged to do some light exercise, such as walking, to help your healing process. You may also need to eat easily digestible food until you are recovered.

Depending on your specific condition, you may need to attend regular checkups following your treatment. For instance, if you had cancer treatment, your doctor will suggest you attend a checkup once or twice a year to ensure that cancer has not come back.

What's the Success Rate?

The field of urology is at the forefront of research and innovation. Due to its constant advancement, the procedures are becoming more effective and safer. Each urological treatment is also known to offer high success rates. However, any procedure comes with risks, such as infection, bleeding, and damage to nearby organs. Therefore, it is important that you choose a skilled and experienced urologist.

Are there Alternatives to Urology?

If you have any injury or disease in your urinary tract and/or reproductive organ (for men), there is no other alternative besides visiting a urology department. However, if your disease is found to be caused by other problems, the doctor will refer you to a relevant doctor.

Urology in and around Bali

About Bali

Bali is an Indonesian province located on the west side of the Lesser Sunda Islands. It is the country’s main tourist hotspot that attracts millions of tourists each year. The beaches are tranquil and perfect for any sun-seeker, the marine life is one of the most diverse in the world, the culture is beautiful, and the mountains are covered in lush jungles and great for hiking. In addition to the natural and cultural beauty, there are myriad of things that tourists can do here, from yoga, partying, surfing, to horseback riding.

Bali is not only full of fascinating beaches, but this tropical paradise also boasts many high-quality medical facilities offering various types of treatments. The island continues to upgrade its infrastructure and develop its medical centers to compete with neighboring countries, such as Singapore and Thailand. Medical tourists are able to avail of a wide range of treatments including cosmetic surgery and at affordable rates. The medical centers have modern equipment, and there is little to no waiting time for almost every procedure. Additionally, the island is also equipped with exclusive yoga centers, Bali-traditional spas, and Jamu traditional medicinal herbs.

Popular Areas in Bali

• Seminyak is known to be the most luxurious area in Bali. Tourists will find many fashionable boutiques, upscale restaurants, and exclusive clubs. In the afternoon, tourists can soak up the sun while sipping a cocktail in one of its famous beach clubs or take a beginner surfing lesson at one of its beaches. The main beach is Petitenget Beach where tourists can enjoy magical sunsets or swim in its warm waters. The area is also home to Bali’s best cafés, which makes café hopping a must-do event.  
• The Nusa Islands is located around 20 kilometers offshore from the main island and can only be accessed by boat. It consists of three islands: Lembongan, Ceningan, and Penida. The most popular and the closest to the main island of Bali is Nusa Lembongan. The biggest is Nusa Penida and the smallest is Nusa Ceningan. The three islands offer tranquil and almost-empty beaches, which is perfect for anyone who wishes to stay away from crowds.  
• Ubud is the island’s jungle paradise that still retains numerous aspects of traditional Balinese. It is the place for tourists who wants to immerse in Bali’s culture and nature. There are various beautiful temples, dance shows, and historical sites within the area. The most popular place is Ubud Monkey Forest or the Sacred Monkey Forest Sanctuary, which is a sacred temple, an evocative jungle, and natural habitat of monkeys.
• Sanur is Bali’s earliest beach resort and is located on the eastern side of the island; it contains some of the island’s first hotels. The area is known to be family-friendly as well as one of the best places to enjoy Bali’s magnificent sunrises. Sanur is very quiet which makes it the perfect place for relaxation. Wander around for a day and you will find many major cultural landmarks hidden in plain sight.
• Canggu is famous for its green rice fields, dark sandy beaches, and healthy food. This up-and-coming area is also filled with cool cafes and vegan restaurants. It is also a prime spot for surfing since the beaches have massive shore breaks. One of the most famous places in the area is the Pura Tanah Lot Temple as it is a famous seaside religious site located on top of a rock formation, which offers a picturesque view.

Weather and Climate in Bali

Bali enjoys warm and comfortable weather all year round. The tropical island experiences two seasons: dry and wet. The dry season starts in April and ends in October. The average temperatures during this season are between 23 °C to 31 °C. June to August are the driest months, making them the best months to visit the island. The wet season is from November to March. Expect to find many rainy days during the wet season. The temperatures are generally similar to the dry season, but the humidity will increase significantly. 

Getting Around in Bali

I Gusti Ngurah Rai International Airport is the main gateway to Bali and it is located 13 kilometers south of Denpasar and is the second busiest airport in Indonesia. The airport has international connections with major cities around the globe, including Bangkok, Melbourne, Moscow, and Guangzhou. It also serves domestic flights to many regions within Indonesia. The most affordable way to travel to and from Bali is by flying with budget airlines, such as AirAsia, Citilink, and Lion Air. 

There are several ways to get around Bali. Most of the transportation options are very affordable. Hiring a motorcycle is the fastest option, but if you do not like the idea of driving by yourself, you can try the motorcycle taxis known as ‘ojek,’ which can be hailed directly from the streets or by using apps such as Grab and Go-Jek (similar to Uber). The apps also provide private cars and food delivery. Taxis are widely available and run on a meter. The most reliable taxi companies are Blue Bird and Express.

Tourist Visas in Bali

Indonesia is known to be a visa-friendly country since most developed countries can enter without a visa. The country allows a citizen of 170 countries to enter and stay for up to 30 days. Citizens of Japan, the United Kingdom, the United States, and 65 other countries can apply for a visa on arrival. It is best to check at the nearest Indonesia Embassy or Consulate to find out if you need a visa or not. All visitors are required to have a visa valid for at least 6 months. 

Additional Information

1. Local Currency: Indonesian Rupiah (Rp) is the official currency, and $1 converts to Rp14.000.
2. Money & Payments: Tourists will find ATMs that accept international cards almost everywhere (mostly Visa and MasterCard). Credit and debit cards are accepted in many shops, restaurants, and hotels. Tipping is not expected but will be greatly appreciated. 
3. Local Language: The official language is Bahasa Indonesia, and most people will also speak Balinese. English is widely spoken, especially in tourist areas.
4. Local Culture and Religion: Most people in Bali follows Hinduism, and almost every aspect on the island is submerged with the Hindu faith. There is also a large group of Muslims as well as small group groups of Christian and Buddhists. 
5. Public Holidays: Bali celebrates major religious holidays, including Nyepi (Silent Day), Eid Mubarak, Christmas, and Vesak.