Ask a Urologist: Dr Ronny Tan from Mount Elizabeth Orchard Hospital Singapore

Ask a Doctor ForumCategory: UrologyAsk a Urologist: Dr Ronny Tan from Mount Elizabeth Orchard Hospital Singapore
Dr Ronny Tan asked 2 years ago

I am a Consultant Urologist and Andrologist who is trained locally and board certified by the Specialist Accreditation Board. I sub-specialize in Andrology, Male Subfertilty, Sexual Medicine and Urological Prosthetic Surgery and is the first Singaporean to be fellowship trained in USA in this niche specialty, having spent one year undergoing a SMSNA (Sexual Medicine Society of North America)- accredited clinical fellowship in Tulane University, New Orleans, Louisiana.

During my fellowship at Tulane, I implanted the latest Titan Touch penile implant from Coloplast as well as the quadratic urethral sling. I was one of the first to start using intralesional injections for the treatment of Peyronie’s disease and reported on the efficacy of the second generation PDE5 inhibitor for treatment of erectile dysfunction. I was one of the first to use UroLift, a novel minimally invasive treatment for benign enlargement of the prostate or BPH, when this modality of treatment started in the USA in 2014.

Prior to starting my private practice at Advanced Urology Associates, I was the Director of Andrology in Tan Tock Seng Hospital and helmed the Complex Erectile Dysfunction Clinic. I pioneered the use of low-intensity extracorporeal shockwave therapy (LiESWT) for erectile dysfunction in restructured hospitals and was the first to report the efficacy of this modality of treatment for local patients.

I am proficient in the placement of urethral slings, artificial urinary sphincters for the treatment of stress urinary incontinence as well as penile prosthesis (ranging from malleable to inflatable) for the treatment of erectile dysfunction. I am also trained in the single-incision concomitant placement of prostheses for both erectile dysfunction and stress urinary incontinence. Urological prosthetic surgeries are all performed as day surgical procedures with patients only having to stay overnight in the hospital.

I was also one of the first urologists in the department who started the clinical service using high power greenlight laser vaporisation for treating benign prostate enlargement and serves as the department proctoring surgeon for the procedure. I placed the first UroLift prostatic urethral lift implant in Singapore at Mount Elizabeth Hospital on 16 October 2019.

I offer minimally-invasive treatment for BPH ranging from UroLift to Rezum to Prolieve. I have a keen interest in the management of penile deformities, ranging from frenulum brevie to congenital penile curvatures to Peyronie’s disease. I also offer evaluation for male subfertility and am trained in sperm retrieval techniques ranging from percutaneous sperm aspiration, microsurgical TESE to electro-ejaculation. I offer microsurgical varicocelectomy for the treatment of inferior sperm parameters due to varicoceles.

I also offer treatment for urinary tract stones (kidney, ureter, bladder) ranging from extracorporeal shockwave lithotripsy (ESWL) to ureteroscopic laser lithotripsy to percutaneous nephrolithotripsy (PCNL). With regards to medical education, I served as Clinical Core Faculty of the NHG Urology Residency Program and have trained many urology specialists. I was an Adjunct Assistant Professor of the Lee Kong Chian School of Medicine, Nanyang Technological University as well as a Senior Lecturer of the Yong Loo Lin School of Medicine, National University of Singapore. I was also awarded “Best Teacher” numerous times for my passion and dedication for teaching medical students and young specialists in training.

I am an advocate for Men's Health and is currently the Vice-President of the Singapore Society for Men's Health and the Secretary of the Society for Continence Singapore.

Learn more about me here: https://patients.smarterhealth.sg/specialist-doctor/ronny-tan/

I am excited to be here to share/discuss Urological Health with everyone. I will be actively answering questions. Whether you've got questions on male fertility, sexual health and medicine, erectile dysfunction, penile implants and prostheses, prostate enlargement or penile deformities, ask me anything!

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19 Answers
Edward L answered 2 years ago

Doctor, I feel throbbing pain in my lower abdomen, above my penis. That area is swollen and hard. The pain gets worse when I urinate, and the swelling makes me uncomfortable during sexual intercourse. What examination should I undergo? Is an ultrasound enough? And does this condition sound like it's something serious?

Dr Ronny Tan replied 2 years ago

Fullness in the area described could mean either a full bladder or possible urinary tract infection (either cystitis or prostatitis).
I would recommend getting a urine test to rule out infection first. I would also personally perform ultrasound of the bladder and prostate to further evaluate this problem.

Sam answered 2 years ago

There are bruises on my testicles. I noticed blood when I touched the bruises. However, there is no blood in my urine. When I sit down or do more vigorous activities, the bruises give me pain and cause me dizziness. Is this a serious disease?

Dr Ronny Tan replied 2 years ago

I believe you are referring to bleeding and bruising over the scrotal skin. Any form of bleeding from the skin is not normal and should be evaluated by a doctor.

Zhen Rong answered 2 years ago

What is the average volume of sperm for a man? I noticed that when I ejaculate, the volume does not seem normal. Will this affect my family planning in future?

Dr Ronny Tan replied 2 years ago

The amount of semen that a man ejaculates would range from 1.5 ml to 8 ml.
Being able to ejaculate seminal fluid does not necessarily mean that the fluid contains sperms.
95 percent in terms of volume of the seminal fluid is contributed by the prostate gland and seminal vesicles and the seminal fluid would be made up of nutrients to keep the sperms alive.
Sperms are formed in the testicles and are mixed together with the seminal fluid during ejaculation and they only make up 5 percent in terms of volume.
There is no way one can tell with the naked eye if the ejaculated fluid contains sperms. A man will not be able to father a child naturally if he does not have sperms in his ejaculate.

The most straightforward way to assess the ejaculated seminal fluid is to do a semen analysis. The man just has to ejaculate into a container and the fluid will be sent to the andrology laboratory and results regarding the presence of sperm, number of sperms/millilitre, motility (how fast the sperms swim) and morphology (appearance of the sperm) will be made known. Only then can the urologist counsel regarding the probability of being able to father a child.

Ishete answered 2 years ago

A few days ago, after sexual activity, I felt a piercing pain from my testicles and when I observed them in the mirror, I noticed a small tear in the sac. Should I wait for it to heal by itself or is it better that I see a doctor?

Dr Ronny Tan replied 2 years ago

The scrotal skin has very good blood supply and tends to heal relatively quickly with no real complications.
However, if the muscle layer below the skin is injured, there can be internal bleeding and this can result in a huge haematoma (blood clot) which can cause significant swelling of the entire scrotum.
Things to look out for would be:
1. Persistent bleeding
2. Increased swelling over the site of injury or involving the scrotal skin surrounding the injury
3. Increased pain over the area
4. Fever

If you are worried, just get a urologist’s opinion.

Wei hao answered 2 years ago

If I feel pain below the testicles, does it mean anything? I feel the pain whenever I use pressure to urine.

Dr Ronny Tan replied 2 years ago

Pain below the testicles could mean pain arising in the perineum, which is the area between the scrotum and the anus. Perineal pain is a sign of inflammation in the prostate or the urethra.
Owing to your urinary symptoms, it is likely there is inflammation in your prostate gland, what we refer to as prostatitis.
A trip down to the urologist’s office is definitely recommended.

Raffe answered 2 years ago

I always drink a lot of water, but why is my urine so yellow in color and warm? Is this a sign of dehydration or is it a more serious condition?

Dr Ronny Tan replied 2 years ago

The normal colour of urine can range from clear to yellow and in general the urine will be at room temperature and hence warmer than the environmental temperature in general. When you are dehydrated, the colour of the urine will be a darker shade of yellow. Any other color of the urine would not be normal and you should seek medical attention. If you are concerned that the urine looks like blood, you would need to see a urologist urgently.

Joshua answered 2 years ago

I often experience what people would call pre-cum even without stimulus. The sensation is like an urge to urinate and the fluid will sit on the tip of my penis. Is this normal? Should I consider further examination?

Dr Ronny Tan replied 2 years ago

A man has periurethral glands that produce secretions to keep the urethra moist. It is common to have these secretions appearing at the tip of the penis from time to time, even without sexual stimulus.
However, if you also experience a burning sensation along the urethra, you should seek medical attention.

Ramil answered 1 year ago

My penis head is numb and unresponsive to touch. However, I am not sure if this is a condition I should be worried about as I still get an erection every morning when I wake up. Is this normal?

Dr Ronny Tan replied 1 year ago

It is good that you still have morning erections. At least that shows your testosterone levels are likely to be in the normal range with good peaks in the morning.

Decreased sensation of the glans or the head of the penis is definitely not normal and you should see a urologist.

Glenn answered 1 year ago

Whenever my penis is erect, my foreskin hurts from being pulled back. The pain is sometimes so bad I cannot function in bed. Is such a problem common in men and do i need to consider a circumcision?

Dr Ronny Tan replied 1 year ago

It is likely that you have a tight foreskin, also known as phimosis. Phimosis is a common issue in men and oftens hinders proper personal hygiene especially if you are unable to completely retract the foreskin to expose the glans or head of the penis to clean it adequately. Some men with phimosis also find that the foreskin is so tight that they experience pain during erections or when they are having intercourse. If your foreskin is tight enough to affect your sexual function, you should see a urologist to consider circumcision.

Soon Yee answered 1 year ago

Doctor, is a curved penis normal? I am a 22 year old male and I am worried about my penis curving to the left. Will it affect my sexual performance and is there a need to ‘straighten’ it?

Dr Ronny Tan replied 1 year ago

Not all men with penile curvatures need to be straightened out (pun intended). The common causes of penile curvatures can range from frenulum breve (tight frenulum of the penis) to congenital penile curvature (penis is curved since young) to Peyronie’s disease (wound healing disorder, often accompanied by a lump along the penile shaft). However if the curvature affects sexual function in terms of making penetrative intercourse difficult, causing pain to yourself or your partner during the act, you should see a urologist who has experience dealing with penile curvatures.

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