#BehindTheScope with Consultant Urologist, Dr Fiona Wu

Urologists are medical doctors are specialised in conditions that affect the urinary tract (kidney, ureters, bladder, urethra, and prostate in men) in both the young and old, as well as diseases that affect the reproductive system.

In light of International Women’s Day, we’d like to feature Consultant Urologist Dr Fiona Wu, a doctor dedicated to empowering women to seek the healthcare they need and deserve. In this #BehindTheScope interview, we get up close and personal with Dr Fiona Wu, as she provides some insight into her profession and passion.

1. Why did you decide to become a doctor?

It’s the easiest job to be able to help people in general. In my younger years, as a JC student, it was hard to make a career choice — but I ultimately chose a tough but very fulfilling job.

2. Why did you choose your specialty?

I chose to specialise in Urology because it’s such an exciting field with many innovations, and there is instant gratification when the patients get well fast.

3. What do you look forward to everyday before heading out to your clinic?

The most satisfying thing is seeing my patients get well, of course!

It’s very gratifying to be able to help patients regain continence — especially since women often consider urinary incontinence as something as “natural” as our skin sagging or bones getting weaker — but that’s not true. Many conditions causing these symptoms (like the inability to hold urine) are very treatable. You can gain control of your life again, and I enjoy helping people achieve that.

For male patients, it’s really fulfilling when they can pee well after their treatments for enlarged prostates or other voiding problems.

4. What is one common misconception the general public has about your specialty? What’s one thing you wish the public would realise about it?

There’s a common misconception that only male patients have to see a urologist and females only see gynaecologists! As a urologist, we see both genders, and we can treat both.

5. Why did you decide to set up a private healthcare centre as compared to other healthcare settings?

I chose to start Aare Urocare because I can provide treatments in a more timely, personalised and effective way. As my clinic has most of the equipment required for a diagnosis, patients are able to save time and costs after the consultation.

6. What is the most memorable moment in your career?

One of the most memorable moments was when I spent a year in Switzerland for my fellowship. Living and working in Europe was a real eye-opener!

Due to cultural differences, the Europeans are generally more independent when they have urological conditions, and I learnt how to teach our local patients about self-care and self-motivation. Also, doing complex cases with my mentors was really stressful and challenging but very rewarding and enriching at the same time.

7. What piece of healthcare advice would you give to Singaporeans?

Being proactive and taking ownership of your health also means listening to your body well. Look out for signs and symptoms and visit your doctor to get checked if you experience any symptoms that concern you. Often, many of these conditions are treatable and outcomes are best when the problems are addressed early.

Please take care of your health and take responsibility for it! Know your conditions and understand the treatment plans and medications!

8. What do you like to do when you aren’t working?

Can I just say sleeping? *laughs* Well, I like to exercise on days when I’m not so tired, and holidays overseas are always good for the soul.

About Dr Fiona Wu

Dr Fiona Wu is the Medical Director & Consultant Urologist at Aare Urocare in Gleneagles Hospital, Singapore. She has been a practitioner in the field for over 15 years, and her clinical interests include female urology, neuro-urology and reconstructive urology. She believes strongly in treating urinary incontinence in holistic ways using minimally invasive methods.

UTIs: Uro or Gynae?

What is a UTI?

A Urinary Tract Infection or UTI refers to the infection of any part of your urinary system. This system comprises the kidneys, ureters, bladder and urethra. If you have UTIs in the kidney, it will be called Pyelonephritis. If you have UTI in the bladder, it will be known as Cystitis. UTI originating in the urethra will then be known as Urethritis.

UTIs can also be further classified into two categories:

Uncomplicated UTI

Uncomplicated UTIs are more likely to occur in women. These women are usually young, sexually active and have no structural abnormalities in their genitourinary tract.

Usually, uncomplicated UTIs go away without treatment and are confined to the lower urinary tract.

Complicated UTI

Complicated UTIs commonly refer to UTIs that:

Happen two or more times in six months or three or more times in a year
Occur with a structural abnormality in the genitourinary tract
Lead to more severe outcomes than patients without any identified risk factors
Cannot be cured with a single course of antibiotics
Occur in a person who has conditions which affect the immune system (e.g. HIV)

UTI Symptoms

Symptoms of UTIs generally are the same across all UTI types and categories. These include:

Urinating more frequently, even when there are only a few drops of urine
A burning sensation when peeing
The sensation of a full bladder, even after urinating
Abdominal pain
Cloudy, bloody urine
Urine that smells very fishy

When should I see a doctor for my UTI?

Generally, UTIs go away on their own. The real issue starts if and when untreated UTI spreads to other parts of the urinary tract. For example, if UTI spreads to the kidneys, immediate medical attention is needed before kidney failure occurs. Apart from the symptoms mentioned above, you may experience:

Chills
Fever
Abdominal pain
Back pain
Vomiting

UTI in the kidney can be dangerous as the infection can permanently damage your kidneys or spread to the bloodstream (sepsis). Complications of sepsis include excessive blood clotting, which can rupture blood vessels or cause tissue death in essential organs.

Hence, it is paramount to get immediate medical care if you experience the symptoms above.

How do UTIs happen?

UTI is caused by a bacterial infection, the most common being Escherichia coli (E. Coli)

Usually, the bacteria is transferred from the anus to the urethra when one wipes from back to front.

Other bacteria which may cause UTIs include mycoplasma and chlamydia. These bacterial infections are sexually transmitted, so when the infection is detected in either partner, both need to undergo medical treatment to avoid recurrent UTIs.

If you are a woman who has reached menopause, your risk of getting a UTI is also higher as the hormonal imbalances in your body may affect the balance of bacteria in your urinary tract, causing UTI.

Can children get UTIs?

For children, UTIs usually signify more serious conditions such as urinary reflux. Urinary reflux refers to the backflow of urine to the kidneys due to a dysfunctional bladder valve. This increases the risk of a kidney infection in the child, which can be fatal.

Since urinary reflux runs in families, it is important to screen children early if a close relative has the same condition.

Can UTIs go away on their own?

Most uncomplicated UTIs can go away on their own in about a week. However, the recovery rate greatly depends on the individual, where some might never recover from UTIs unless they receive medical treatment.

These cases of long-term UTIs are dangerous, as the infection may spread to the kidneys to cause pyelonephritis or sepsis.

Since one cannot tell which kind of UTI is affecting the individual, it would be advisable to seek treatment immediately when you see signs of a UTI. If it is an uncomplicated UTI, medical treatment will help you recover quicker than without it.

So which doctor do I consult?

First, we should ask ourselves a few questions:

Do I have a frequent urge to pee?
Do I experience pelvic pain?
Does my urine smell weird,
or do I have any of the UTI symptoms mentioned above?

If you experience only these symptoms, it may be ideal to visit a Urologist.

However, you may also experience additional symptoms such as:

Frothy, bright yellow, pink, brown coloured, cheese-curd-like, or fishy-smelling vaginal discharge
Excessive or unexpected vaginal bleeding
Vaginal itching

If so, then a Gynaecologist would be ideal.

Urologist vs. Gynaecologist

Gynaecologist

A Gynaecologist is a doctor who specialises in female reproductive health and disease which affects the female reproductive system. Organs of the female reproductive system include:

Vagina
Uterus
Ovaries
Cervix
Breasts

To diagnose gynaecological conditions, Gynaecologists will need to know what symptoms you have experienced and conduct a series of diagnostic tests. These tests may include hysteroscopy, Pap smears, mammograms and bone density tests.

Some examples of gynaecological conditions include:

Cervical Dysplasia
Menstrual Disorders
Polycystic Ovarian Syndrome
Vaginal Prolapse

After arriving at a diagnosis, your Gynaecologist will work out an appropriate treatment plan for you based on your condition.

Urologist

A Urologist treats both males and females when they face issues in the genitourinary tract. This system comprises the kidneys, ureters, bladder and urethra. Symptoms of urological conditions are generally pee-related and can sometimes extend to pelvic pain.

If your Urologist suspects you have a urological condition, they will first need to run some tests to diagnose you. These tests include:

Urine cultures
Urinalysis
Imaging scans
Uroflowmetry
Cytoscopies

If your urologist confirms that you have a UTI, the treatments which you could be given include:

Antibiotics
Hormonal medication
Intravesical therapy
Surgical procedures

Of course, urological conditions are not just limited to UTIs. Bladder cancer, kidney and ureteral stones are all conditions that a Urologist can diagnose and treat. To do so, your Urologist might need to run further diagnostic tests like blood tests or do a biopsy.

Summary

It can be tough to know when to see a Gynaecologist or Urologist, as symptoms of gynecologic conditions can overlap with those of a UTI. In these situations, the key to choosing the right specialist involves considering any other symptoms present and undergoing more tests.

If you are unsure about where and how to find a doctor for your UTI, try Beyond Medical Assistance! This platform was built to assist in your medical enquiries and help you book appointments with the right doctor. Our knowledgeable healthcare management team has more than 40 years of combined medical experience and would be glad to assist you in your healthcare journey.

References

Bandukwala, N. Q. (2022, January 18). Urine Culture Test: Purpose, Duration, Levels of Bacteria in Urine. WebMD. Retrieved May 17, 2022, from https://www.webmd.com/a-to-z-guides/what-is-urine-culture

Bhandari, T. (2017, March 30). Vaginal bacteria can trigger recurrent UTIs, study shows – Washington University School of Medicine in St. Louis. Washington University School of Medicine in St. Louis. Retrieved May 17, 2022, from https://medicine.wustl.edu/news/vaginal-bacteria-can-trigger-recurrent-utis-study-shows/

Brennan, D. (2021, June 29). What Is a Gynecologist? What They Do, When You Need One, and What to Expect. WebMD. Retrieved May 17, 2022, from https://www.webmd.com/women/what-is-gynecologist

Essential oils for UTIs: Do they work? (n.d.). Medical News Today. Retrieved May 17, 2022, from https://www.medicalnewstoday.com/articles/321582#essential-oils-for-a-uti

Intravesical Treatment for Recurrent UTI (2022). AARE Urology. Retrieved May 20, 2022, from https://aareurology.sg/services/intravesical-treatment-for-recurrent-uti/

Lyons, G. (n.d.). Pelvic Pain & Abdominal Pain in Women: Causes, Symptoms. K Health. Retrieved May 18, 2022, from https://khealth.com/learn/symptom/abdominal-pain/

The Research Institute of Asian Women. (n.d.). Asian Women - The Research Institute of Asian Women. Retrieved May 18, 2022, from http://www.e-asianwomen.org/_common/do.php?a=full&b=21&bidx=146&aidx=1688

Roedersheimer, R. (2021, May 9). Urologist or Gynecologist? Here are the Conditions They Treat. The Urology Group. Retrieved May 17, 2022, from https://www.urologygroup.com/urologist-or-gynecologist/

Urinary Tract Infection (UTI) (2022). AARE Urology. Retrieved May 20, 2022, from https://aareurology.sg/conditions/urinary-tract-infection-uti/

Urinary tract infections (UTI). (2018, May 25). Better Health Channel. Retrieved May 17, 2022, from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/urinary-tract-infections-uti

Urinary tract infection (UTI) - Diagnosis and treatment. (2021, April 23). Mayo Clinic. Retrieved May 17, 2022, from https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453

Watson, S. (n.d.). Cranberry Juice for UTIs: Can Cranberries Help Prevent UTIs? WebMD. Retrieved May 17, 2022, from https://www.webmd.com/a-to-z-guides/cranberries-for-uti-protection