Your questions,answered clearly

No. You can book a private consultation directly, without a GP letter. If you're using health insurance, your insurer may ask for a GP referral and a pre-authorisation code, so check with them first.

If you already have a referral letter, scan reports or test results, please bring or send them. Book online

Same-week appointments are usually available, especially for blood in the urine, a raised PSA or a newly found kidney mass. Mr Sri sees patients at four London hospitals: Nuffield Health Parkside in Wimbledon, New Victoria Hospital (Bupa) in Kingston, HCA Princess Grace in Marylebone and Welbeck on Harley Street.

If your concern is urgent, mention it when you book and the private office will prioritise you.

Yes. Video consultations work well for discussing results, reviewing scans and second opinions, and suit patients who live outside London. If you need an examination or tests, these can be arranged afterwards.

It helps to bring:

• recent blood tests, including PSA and kidney function
• scan reports, and the images on disc or by link if you have them, even from another provider
• any biopsy results
• a list of your current medicines
• your GP letter, if you have one
• your insurance details and pre-authorisation number, if you're insured

You may be asked for a urine sample, so it's worth arriving with a comfortably full bladder.

Your first consultation usually lasts 20 to 30 minutes. Mr Sri goes through your symptoms, history and any previous tests, and examines you if needed.

You'll leave knowing which tests are recommended, the likely diagnosis and your treatment options, including timelines and recovery. There's never pressure to decide on the day.

Yes, and they're a large part of Mr Sri's practice. Patients most often ask whether a kidney tumour can be removed while keeping the kidney, whether nerve-sparing prostate surgery is possible, how surgery compares with radiotherapy, or whether robotic reconstruction is feasible. Opinions are given honestly, and if your current plan is right, he'll tell you.

How second opinions work

Urine tests, blood tests and urine flow tests can usually be done on the day. A flexible cystoscopy (a camera check of the bladder under local anaesthetic) is usually arranged as a closely following appointment.

Prostate biopsy, robotic surgery and laser prostate treatment need separate booking and a pre-operative assessment, but can usually be arranged promptly.

Robotic surgery uses the da Vinci system. The surgeon sits at a console and controls small wristed instruments inside the body through keyhole incisions, with magnified 3D vision and filtered, steady movements.

Compared with open surgery, it means less blood loss, less pain, a lower infection risk and a faster recovery. Compared with standard keyhole surgery, it allows finer stitching and dissection, which matters most in nerve-sparing prostatectomy, kidney-sparing surgery and reconstruction.

Mr Sri performs over 225 robotic operations a year, has done more than 900 as a consultant, and leads the RCS-accredited robotic fellowship at St George's. See all treatments

Most people needing kidney cancer surgery, prostate cancer surgery or urinary reconstruction are suitable. It depends on the tumour's size, position and stage, your kidney function and your general health, and is decided after reviewing your scans.

Mr Sri accepts patients who have been told elsewhere that robotic or kidney-sparing surgery isn't possible. A significant part of his practice is complex cases declined for kidney-sparing surgery at their original centre.

Most patients are up and walking on the day of surgery or the next morning, eating within hours, and go home after one night. Most are back to light activity within one to two weeks and to their normal routine within two to four weeks.

• Robotic partial nephrectomy: median hospital stay of one day, normal activity at two to three weeks
• Robotic prostatectomy: one night in hospital, catheter for about a week, normal activity at two to four weeks
• Robotic pyeloplasty or ureteric repair: one to two nights, with a temporary stent for four to six weeks

Detailed guides: prostatectomy recovery and kidney surgery recovery.

All surgery carries risks, though robotic surgery generally compares well with open or standard keyhole surgery for the same operation. General risks include bleeding, infection, injury to nearby structures, anaesthetic complications and blood clots. Risks specific to your operation are explained at consultation and again before surgery.

From Mr Sri's audited robotic series to the end of 2025: a 97% trifecta rate in robotic partial nephrectomy (clear margins, no major complications and the kidney's blood supply paused for under 25 minutes), and no conversions to open surgery across his robotic prostatectomy, partial nephrectomy, nephroureterectomy and reconstructive practice.

The first step is a specialist review of your scans. Most kidney masses need a dedicated CT or MRI to characterise them before any decision is made. Some are harmless, such as cysts or angiomyolipomas, but most solid kidney masses are kidney cancer. Even so, there's rarely a need to rush into surgery before the full picture is clear.

You'll get a clear explanation of what's been found, which tests are needed, and whether surveillance, robotic surgery or another approach suits you best. Kidney cyst or kidney tumour?

Possibly, and it's worth asking. Many patients told their tumour isn't suitable for kidney-sparing surgery turn out to be good candidates when reviewed by a high-volume specialist.

48% of the tumours Mr Sri treats with kidney preservation are in the highest complexity group (RENAL score above 10). In his series, operations planned as kidney-sparing have had to be converted to full kidney removal in only 0.3% of cases. Keeping kidney function matters for decades, lowering the long-term risk of kidney disease, heart disease and dialysis.

What a high RENAL score means · Second opinions

Most robotic kidney surgery goes through the abdomen, working around the bowel. The retroperitoneal approach reaches the kidney directly from the back without entering the abdominal cavity. Because the bowel is left alone, eating and bowel function usually return faster, and it gives a direct route to tumours at the back or top of the kidney.

Mr Sri is one of a small group of surgeons in Europe who use it as their standard approach. He introduced it to South West London and has published long-term results in the Journal of Robotic Surgery. More about operating from behind

For most men, especially with cancer confined to the prostate, there's time to understand your options before deciding. There's rarely a need to act immediately.

The first step is a consultation to go through your biopsy, MRI and PSA, and explain your cancer's grade, stage and risk group. Options may include active surveillance, robotic surgery, radiotherapy or, for some men, focal therapy, and each is discussed honestly. Prostate cancer care

Not necessarily. PSA can also rise with an enlarged prostate, inflammation, infection or vigorous exercise before the test. A raised PSA needs specialist assessment, but it isn't a diagnosis.

The recommended pathway is a prostate MRI first, then a targeted transperineal biopsy only if the MRI shows it's needed. This avoids unnecessary biopsies while still finding cancers that matter. Raised PSA · Understanding your MRI result

Mr Sri performs both and recommends the one that suits your cancer, prostate size and anatomy. Retzius-sparing surgery can speed up the return of urinary control, while the standard approach gives better access for some higher-risk cancers or larger prostates. He'll explain which he recommends for you, and why. Retzius-sparing explained

Some leakage is common in the first weeks after the catheter comes out, but most men regain good control with time and pelvic floor exercises, which start before surgery.

In Mr Sri's audited series, over 90% of men are dry or leaking minimally one year after nerve-sparing robotic prostatectomy. He expects most patients to be dry at night and using a single pad for safety by six weeks, which is ahead of typical recovery. 10 recovery tips

Recovery of erections depends on your age, your function beforehand, and whether the nerves could be spared. Nerve-sparing is used whenever it's safe for cancer control, and the robot's precision helps.

Recovery is gradual, often taking months to a year or more. Starting penile rehabilitation early improves long-term results, and Mr Sri works with specialist andrology colleagues on this. Erectile recovery after surgery

For most localised prostate cancers, robotic surgery and radiotherapy control the cancer about equally well. The choice depends on your cancer, your health, which side effects matter most to you, and the treatment journey you prefer.

Surgery mainly affects continence and erections. Radiotherapy mainly affects the bowel and bladder, with erection problems developing over time. Neither is better for everyone. Where radiotherapy suits you best, Mr Sri refers you directly to specialist oncology colleagues. Prostatectomy or radiotherapy?

The choice depends on your prostate size, symptoms, whether preserving ejaculation matters to you, your recovery preferences and your fitness for anaesthetic. The main options are:

• Rezum (water vapour): day case under local anaesthetic, usually preserves ejaculation, for prostates of 30 to 80ml
• Aquablation (robotic waterjet): overnight stay, low risk to ejaculation, for prostates of 60 to 150ml
• GreenLight laser: day case, a good option for men on blood thinners
• TURP: the long-established benchmark, overnight stay
• HoLEP: the greatest symptom improvement and lowest re-treatment rate, suits prostates over 80ml, overnight stay

Full comparison of the options

TURP, HoLEP and GreenLight often cause retrograde ejaculation, where semen goes into the bladder rather than out. It isn't harmful, but matters to men who value natural ejaculation or fertility.

Rezum and Aquablation are designed to reduce this risk. Erections are generally not significantly affected by any of these procedures. Your priorities are discussed so the procedure fits you.

It should always be checked. Most causes are harmless, such as infection, stones or benign bladder conditions, but blood in the urine can be an early sign of bladder or kidney cancer. Mr Sri's haematuria clinic follows NICE guidance, with urine tests, scans and a flexible cystoscopy, and same-week appointments. Haematuria clinic

Vasectomy divides the tubes that carry sperm, for permanent contraception. It's a day-case procedure under local or general anaesthetic, taking 15 to 30 minutes, after a consultation beforehand. A semen test at 12 to 16 weeks confirms success, and you need other contraception until then. Reversal is possible but can't be guaranteed to work. Vasectomy

Two or more infections in six months, or three in a year, should be investigated for an underlying cause rather than treated with repeated antibiotics. Assessment includes urine cultures, a check of bladder emptying, kidney imaging and a flexible cystoscopy. If no cause is found, there are effective prevention strategies, including vaginal oestrogen for post-menopausal women and non-antibiotic options. Recurrent UTIs

For self-pay patients, a new consultation is £350 and a follow-up is £250. Tests and procedures are quoted separately, and charges such as laboratory or histology fees are billed by the relevant service. Everything is explained in advance.

Mr Sri is recognised by all major UK insurers, including Bupa, AXA Health, Aviva, Vitality, WPA and Cigna. Robotic surgery for kidney and prostate cancer is covered by most policies when clinically needed. For some complex robotic operations, your insurer may need to approve additional fees in advance.

Before your consultation, contact your insurer to confirm your cover and get a pre-authorisation number. The private office and hospital billing team can help with any questions.

Yes, self-pay patients are very welcome. For surgery, a fixed-price package covering the operation, anaesthetic and hospital stay is usually available, so you know the cost before you commit.

Yes. All care follows UK medical confidentiality standards and GMC guidance. Nothing is shared with anyone, including your GP, without your consent, although sharing a letter with your GP is recommended so your records stay complete.