Urology in South Africa

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 South Africa?

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 South Africa 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 South Africa

About South Africa

South Africa is home to some of the world's most luxurious private game reserves and lodges. Wildlife lovers come here from all corners of the globe in search of the "Big Five": lion, buffalo, leopard, rhino, and elephants. Coral reefs, shark dives, dragon-backed mountain ranges, white-water rafting, and golden beaches lapped by legendary surf breaks are some of South Africa's many other attractions. Traveling around this vast land and touring the vibrant cities, visitors can learn about the nation's turbulent history. Travelers coming to South Africa for medical treatments do so for cost savings, advanced medical technology, and the internationally qualified and skilled doctors. The country welcomes an ever-increasing number of medical tourists each year, many of which travel for Urology procedures. Medical Tourists travel from all across the globe, particularly from African countries with an inferior healthcare system. Popular destinations include the capital city, Pretoria, neighboring Johannesburg, and the stunning Cape Town.

Popular Parts of South Africa

With more than 57 million inhabitants, South Africa is the world’s 24th most populous nation. It is a multiethnic society with a large variety of cultures, languages, and religions. Known for its exhilarating outdoor adventure, fascinating wildlife, magnificent landscapes, and opulent history makes South Africa a truly magical destination

• Cape Town is the oldest city and the legislative capital of South Africa. This pleasant city has a lot to offer as you can Hike the Table Mountain, take a wine tour, cruise to Robben Island, relax on beautiful beaches, visit District Six Museum, discover Kirstenbosch Botanical Gardens, and watch the Boulders Penguin Colony or shop in trendy markets. 
• Johannesburg is the largest and the most populous city. It is changing rapidly into an ultra-modern metropolis. Other than being an urban city, it also boasts a rich history. Tourists can visit the Apartheid Museum to learn more about the country’s difficult past through exhibitions. Other museums such as MOAD and MuseuMAfriCA are also worth a visit to view the city’s art and history.
• Durban is a cosmopolitan city with sunny beaches and charming Afro-Indian culture. There are more Indian nationals residing in this city than any other country outside of India. It is the place to go if you want to see marine life. Visit uShaka Marine World where you can snorkel, dive, and interact with animals. 
• Pretoria is a scenic city and you will find various historic buildings with astounding architecture such as the Voortrekker Monument, Union Buildings, and Church Square with its statue of Paul Kruger. Those who are looking for some outdoor activities can explore Pretoria National Botanical Garden and Rietvlei Nature Reserve for some wildlife viewing.
• Kruger National Park is one of the largest national parks and one of the most exciting safari destinations in the world. Here you can view all of Africa’s safari species such as Lion, Elephant, Rhino, Leopard, Buffalo, Hippo, and Giraffe along with more than 100 mammal species and 500 varieties of bird.

Weather and Climate in South Africa

South Africa’s climate is determined by its situation in the Southern Hemisphere’s subtropical zone and between the Atlantic and Indian Oceans. The country is a year-round destination thanks to its varying regional climates. May to September is the Dry Season with little to no rain. The days are mostly sunny, but it gets cold in the evenings and mornings. The average temperature during this season is around 14 °C with June to August as the coldest months. The wet season starts in October and ends in April. There will be occasional short rain showers in the afternoon. The average temperature during the wet season is around 20 °C, but it can also be as high as 35 °C, especially in December, January, and February.

Getting Around in South Africa

The main and the busiest airport in South Africa is the O.R. Tambo International Airport. The airport is located in Kempton Park, near Johannesburg and Pretoria. It serves as the primary domestic and international gateway to and from South Africa. The airport operates flights to other cities in South Africa as well as numerous major cities in the world including London, Singapore, Sydney, Abu Dhabi, and Atlanta. There are also two other major international airports: Cape Town International and King Shaka International. The inexpensive way to travel around the country is by flying with budget airlines such as FlySadair, Kalula.com, and Mango.

South Africa has an excellent infrastructure and is easy to navigate. However, if you wish to visit several cities, expect to have at least one long-distance trip. You can travel around by bus, train, or rental car. There are several long-distance bus companies you can choose, such as Intercape, Translux, and Greyhound. The buses are relatively affordable and safe. They are generally equipped with air-conditioning and an onboard toilet. For short-distance travel, Baz Bus is the best choice. A one-way ticket fare starts at around 500 ZAR.

Although trains are slow, they are less expensive than flights and more comfortable than buses. Shosholoza Meyl long-distance trains serve Cape Town, Johannesburg, Durban, Bloemfontein, and several other major cities. This train is very affordable with tickets costing as low as 400 ZAR for a sleeper train. If you’re looking for a more luxurious train, try the Blue Train which offers comfortable compartments, good food, and wine for around 18,300 ZAR. 

Taxis are available to get around major cities. Tourists can hail one directly from the streets. However, since the taxi ranks are not common, it is best to call for one. The base fare can be different in every city, ranging between 11 ZAR to 20 ZAR. 

Tourist Visas in South Africa

A valid visa is required if you wish to visit South Africa. Citizens of more than 60 countries can enter and stay for up to 90 days. Other countries not listed in the visa exemption agreement must apply and obtain a visa to the nearest South Africa embassy or consulate. All visitors must hold a passport valid for at least 30 days after the expiration of their intended visit, and the passport must have at least two unused pages. 

Additional Information

1. Local Currency: South African Rand (ZAR) is the official currency. 1 USD converts to 14 ZAR.
2. Money & Payments: Tourists can find ATMs all around the country. Credit Cards are widely accepted. However, since South Africa has a reputation for scams, you should inform your bank about your travel plans to avoid declined transactions. It is also advisable to always bring some cash with you. Tipping is expected here and you can tip around 10% to 15% of the bill in restaurants and cafes and the standard tip in hotels is 10 to 20 ZAR. 
3. Local Language: There are 11 official languages in the country, including Zulu, Xhosa, Afrikaans, Northern Sotho, Tswana, Southern Sotho, Tsonga, Swazi, Venda, Southern Ndebele, and English. Zulu is the most widely spoken language.
4. Local Culture and Religion: As a secular state, South Africa has a diverse religious population. Most of the population follows Christianity. Other religions such as the traditional African religion, Islam, Hinduism, and Judaism are also freely practiced.
5. Public Holidays: The country has 12 public holidays such as New Year’s Day, Good Friday, Freedom Day, and Christmas Day.