Ask a Urologist: Dr Lincoln Tan from Gleneagles Hospital Singapore

Ask a Doctor ForumCategory: UrologyAsk a Urologist: Dr Lincoln Tan from Gleneagles Hospital Singapore
dr. Lincoln Tan asked 2 years ago
I am Dr Lincoln Tan, a Consultant Urologist, and accredited Robotic Surgeon based in Gleneagles Hospital Singapore. Prior to my private practice, I was the former Director of Urologic Oncology at the National University Hospital (NUH) and National Cancer Institute of Singapore (NCIS). I am currently Visiting Consultant at NUH. I am trained in all aspects of open and endoscopic urology and specialise in the minimally invasive treatment of urologic cancers. My particular interests are in laparoscopic and robotic-assisted surgery, particularly for the management of prostate and kidney cancer. My subspecialty interest is in the care of men with all stages of prostate cancer, especially in advanced prostate cancer diagnostics to reduce unnecessary prostate biopsies, and the performance of safer, more accurate prostate biopsies. I was one of the first doctors to introduce free hand office based transperineal prostate biopsies into Singapore. Transperineal prostate biopsies are safer than the standard transrectal biopsies performed in most centres. My clinic is currently the only centre offering freehand transperineal MRI-guided targeted prostate biopsies in Singapore. I was the principal investigator in the first study in South East Asia to validate the use of the Prostate Health Index test to better risk stratify men at risk of prostate cancer, reducing unnecessary prostate biopsies. I am available for teleconsultation and second opinions for complex cancer-related and other urological conditions. My experience includes:
  • Graduated medical school at the National University of Singapore (NUS) in 2001
  • Postgraduate surgical degrees from the Royal College of Surgeons of Edinburgh in 2006, and Royal College of Physicians and Surgeons of Glasgow in 2011
  • Masters in Surgery from National University of Singapore (NUS) in 2007
  • Completed Advanced Specialty Training at NUH
  • College of Surgeons Gold Medal from the Academy of Medicine Singapore, awarded to the top Advanced Urological Trainee
  • Completed my fellowship in Urologic Oncology and Laparoscopic and Tele-Robotic Urologic Surgery at the Royal Melbourne Hospital and Peter MacCallum Cancer Centre in Australia in 2013
Learn more about me here: I am excited to be here to share/discuss Urological Health with everyone. Ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
40 Answers
Siska Meylia answered 2 years ago
Doctor, my father is 78 years old. He urinates quite often, every 15-30 minutes. Sometimes he can’t hold in his pee. What do you think the cause is, Doctor? What is the treatment option? Thank you for your help, Doc.
dr. Lincoln Tan replied 2 years ago

There are many causes for frequent urination in an elderly man. The most common is an enlarged prostate causing blockage of the urine flow. This can cause incomplete emptying of the bladder and also irritation of the bladder, leading to frequent urination with strong urge. Urine infections, bladder or prostate cancer, or bladder stones can also cause frequent urination. I recommend he sees a urologist to determine the cause as the treatment is different for the different causes.

Narsudi answered 2 years ago
Doctor, I am male. I feel like there is an obstruction which makes my urine clog up. Sometimes it is painful. People have suggested that I drink a lot of water. Is that true? Or is taking medication necessary?
dr. Lincoln Tan replied 2 years ago

The flow of urine can be blocked by swelling of the prostate or a scar of the urethra. Drinking more water will not solve either problem. You will need to be seen by a urologist to determine the cause of the blockage, as treatment is different for these two causes.

Winarti answered 2 years ago
Doctor, I have a 21 month old toddler. She urinates frequently with the frequency being every 15 minutes. Sometimes it is a continuous stream, sometimes it's just a few droplets. She often strains to urinate. What do you think the problem is, Doctor? Thank you so much..
dr. Lincoln Tan replied 2 years ago

If there is an increase in urinary frequency, it may be caused by a urine infection. I would suggest she be seen by a paediatrician to check for that.

Koesmara answered 2 years ago
Doctor, how much is the cost of medicine to treat a swollen prostate?
dr. Lincoln Tan replied 2 years ago

There are 2 types of medication for an enlarged prostate:

Alpha blockers – these are medications to relax the tight prostate. They work within 1-3 days and you should notice a smoother quicker urine flow. Examples are Harnal/ Flomax, Xatral, Flomax, Hytrin, Cadura

5 alpha reductase inhibitors – these are medications that make the prostate smaller. These take 6-12 months to work, and can shrink the prostate by up to 50%. It typically takes 6 months to notice an improvement in symptoms.

Cost of the medications depends on the brand and where you buy the medicine. I suggest you check with your local pharmacy or doctor.

david eben ezer siahaan answered 2 years ago
Good evening, Doctor. My mother is 63 and has a history of kidney stones. The CT scan result shows a staghorn kidney on the left with pelvocaliectasis and there are signs of chronic nephropathy on her left kidney. The doctor suggested that the best way is nephrectomy for her left kidney. Is that true, Doctor? Please give your advice. Thanks
dr. Lincoln Tan replied 2 years ago

Untreated staghorn stone can lead to severe infection which can be life-threatening, especially in an elderly person. The choice of treatment is between a nephrectomy (removal of kidney) or percutaneous surgery to remove the stone (PCNL), provided the patient is fit enough for surgery.

The decision lies on these factors:
1. How much residual function there is left in the left kidney? This can be estimated by looking at the thickness of the kidney tissue – if its very thin , there is likely to be insignificant function left, and the kidney should be removed.
If there is a reasonable thickness of kidney tissue on the CT scan – a DMSA or MAG3 renogram scan can determine the relative function of the left kidney in relation the right kidney. If the left kidney has differential function of at least 25%, it may be worthwhile to consider saving the kidney

2. How extensive will the surgery be to remove the staghorn stone?
Surgery to remove the stone can take few hours and have significant blood loss and risk of infection, which the patient may not be able to tolerate.

In summary, the kidney should only be saved if theres reasonable function and the patient can tolerate stone removal surgery. Otherwise, the safest course will be to remove the kidney.

Purnomo Adi answered 2 years ago
Doctor, my right testicle bag is swollen. It doesn’t hurt and my urine still flows smoothly. What is the solution?
dr. Lincoln Tan replied 2 years ago

A swollen right testis can be due to a testis growth which can be due to infection or cancer. Or it can be due to fluid around the testis -which is called a hydrocele, or a hernia.

A physical examination by an experienced doctor or an ultrasound of the testis will determine the diagnosis, and the solution will be based on the diagnosis:

1- Testis infection —> antibiotics
2. Testis tumour —> surgery to remove the testis
3. Hydrocele—> surgery to drain the fluid and repair the hydrocele.
4. Hernia —> surgery to repair the hernia

Charles Wiryanto answered 2 years ago
I feel itchy and hot and it hurts when I urinate. It has been a week since this has occurred - today, I saw white liquid emerging from my penis - it's not sperm though. Is this dangerous?
dr. Lincoln Tan replied 2 years ago

These symptoms suggest an infection of either the urethra or prostate, and may be from a sexually transmitted infection.

These conditions will not go away without treatment with antibiotics.

X answered 2 years ago
I am a 20 something year old male and often masturbate. When I masturbate too much, I feel a burning sensation whenever I urinate post-masturbation. The sensation goes away the day after. Could this be a sign of infection and/or blisters, Doctor?
dr. Lincoln Tan replied 2 years ago

Overly vigorous masturbation can cause trauma to the urethra, and this can cause some discomfort when you urinate. The fact that it gets better the next day shows that it is not an infection. I would suggest more gentle masturbation technique – consider a combination of gentle stroking of the penis shaft with gentle rubbing of the penis head and frenulum rather than vigorous pulling up and down stroking of the penis shaft.

Peter Ronovan answered 2 years ago
Doctor, which medicines can cure premature ejaculation without making the heart beat faster? Thank you
dr. Lincoln Tan replied 2 years ago

The most effective treatment for premature ejaculation is dapoxetine (Priligy). This is not associated with an increased heart rate.

Alternative treatments include applying a numbing gel (lignocaine gel) to numb this penis before sex. This should not increase the heart rate.

Troutje Turangan answered 2 years ago
Hello doctor. What is the medicine for a kidney tumor? Thank you
dr. Lincoln Tan replied 2 years ago

The only curative treatment for kidney cancer that has not spread outside of the kidney is surgery. Surgery can be just to remove the tumour if it is small (partial nephrectomy) or removal of the whole kidney (radical nephrectomy). No other treatments including medication/ radiotherapy Is curative for this stage of kidney cancer.

For metastatic kidney cancer that has spread outside of the kidney to other part of the body , there are many medication to control this and the choice will depend on an in-depth review of your health and cancer status with a medical oncologist.

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