Urology in Metro Manila

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 Metro Manila?

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 Metro Manila 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 Metro Manila

About Manila

Manila is the capital of the Philippines and is divided into 16 districts; it is one of the densest and populated cities of the world. Each district has its own history and cultural legacy. The city was under the rule of Spanish conquerors for almost three centuries. You can see the remains of that era in the ruins of the historical buildings. Today, the City is very modern with tall skyscrapers and modern architecture.

The Philippines is developing into one of the top countries in the world for medical tourism. Approximately 15 million people globally travel to other countries in search of quality medical care at affordable prices. Manila is a favorite destination due to the following reasons:

• It provides state-of-the-art procedures at affordable prices.
• With excellent infrastructure, the City can handle the large numbers of foreigners who visit Manila.
• The Hospital and clinic staff are very competent, friendly, and educated and have a good knowledge of English to communicate with their patients.  
• The doctors are very well-qualified and hold international certifications.
• The city has a reputation in providing excellent post-surgical care by the nurses and physiotherapists.
• The Medical Industry provides many alternative therapies at some of the best spa resorts. You can combine a surgical procedure with alternative healing therapies at the same time.

Popular Areas in Manila

Manila Bay has many tourist spots and you will find many monuments that depict the Spanish occupation of the country. There are many Baroque Colonial Churches that will enable you to appreciate the artistic designs.

The National Museum of the Philippines, Bahay Chinoy, the National Art Gallery, and the Metropolitan Museum of Manila are some of the popular museums that you must visit in Manila. Rizal Park also known as Luneta is a historical urban park that is worth visiting.

There are also many organized tours that can help you get the best out of your sightseeing, for example, the Intramuros Tour, Rizal Park Tour, or the Skyscraper Gazing Tour and more.

Manila is a very modern contemporary city as the historical buildings have been replaced by modern architecture with better planning and layout and the buildings are earthquake resistant.

The city has many cultural and religious festivals throughout the year. There are plenty of shops, both big and small where you can buy branded goods at affordable prices.

Weather and Climate in Manila

The Philippines is a tropical country and in Manila, you will not experience too much temperature variations. January is the coolest month while May is the warmest month. The average temperature remains between 14°C and 38°C. The rainy season is between May and November. The rest of the months are dry. Manila is a humid city and bad weather such as Typhoons may occur during the months of June and September.

Getting around in Manila

People traveling from nearby countries such as Malaysia and Indonesia can use the City’s sea entry points. For all other passengers, the best option is to take the air route.

The Ninoy Aquino International Airport is the City’s major international airport. It has four different terminals that connect via bus transfers. If you are taking a connecting flight, remember to keep some time as a buffer, as transfers may force you to travel through the busy streets of Manila. Terminal 1 caters to International flights and Philippine Airlines uses T2 and domestic carriers and international carriers use T3 with budget carriers largely using T4.

You can take a bus from the airport to the city. Taxis have meters and you can hail a cab outside the airport. Buses and small vans or jeepneys are popular modes of transport within the city.

Manila has three light rail systems and one heavy train line. The light rail systems are the LRT-1, LRT-2, and MRT-3. You can also use the pedicabs and tricycles for shorter distances. In some areas, you can even find horse-driven carriages called calesa.

Tourist Visas in Manila

The visa process is not a very complex system as the Philippines has a visa waiver program for certain countries. All European nations, South American countries, and many others form part of this program. Citizens from these countries can stay in Manila for up to 30 days, whereas nationals from Brazil and Israel may stay in Manila for 59 days. Hong Kong, Macau, and Portugal residents can stay for 14 days without a visa. Tourists belonging to other countries need to apply for a visa to enter the Philippines, in the consulate in their respective countries.

You must also have a valid return ticket. Passport must also be valid for at least six months and beyond to stay in the country. Visa-exempt people may extend their stay by one or two months after which they will have to apply for a visa.

Additional Information

• The currency of the Philippines is Peso (symbol: ₱). It is strong in the world market and the usual exchange rate is 1 Dollar equals 50 Pesos. Dollars are easy to exchange compared to other currencies.
• Credit cards are acceptable in almost every place. The city also has many ATMs from where you can withdraw money without difficulty. However, ATMs will charge you a minimal exchange fee on foreign cards.
• Bargaining and negotiating are acceptable in most places and it can get you better deals.
• Restaurants may add a service charge of up to 10%. You can pay a cash tip of 5 to 10 %. People often round off the taxi fare.
• Manila is a city full of people who speak English proficiently. Filipino and English are the two official languages. Filipino is a variety of Tagalog, Austronesian languages.
• Hindu, Muslim, Buddhism, and Christian religions have left their mark on the Philippines at different periods. Today, a majority of the population is Roman Catholic.
• There are many public holidays in Manila. Some of the important ones are Christmas Eve, Christmas, Eid al-Fitr (Ramadan), Labor Day, New Year, and Good Friday, etc. The Independence Day falls on June 12th and Manila Day on 24th June.