Dr Joshua Matu Reveals How Modern Urology Frees Patients From Uncomfortable Catheters Forever

By Hassan Wekesa - Editor

Kenya, 5 September 2026 - When you enter his facility in the morning, patients are waiting for their turn to see him. Dr Joshua Matu is a urologist, a doctor who has specialised in the treatment of the kidneys, the bladder, the prostate, kidney stones, and fertility in men.

Dr Matu has been attending to patients with urological disorders for decades. He runs a urology clinic at the Professor Nelson Awori Centre in Upper Hill, Nairobi, and also runs Jordan Hospital in Kitui County.

To become a urologist, one first has to train in General Surgery and then sub-specialise further in urology.

You must be knowing someone within your locality who experiences excruciating pain because it is hard for them to pass urine.

There are factual stories of people moving from one hospital to another where they get MR scans done and get treated, but the pain still persists. Without proper treatment, the problem persists.

To understand more about urinary tract infections (UTIs) and other urological disorders, Dawan Africa spoke to Dr Matu. He demystifies terminologies related to the urinary tract and also discusses trends in the medical field.

Dr Matu is also a laparoscopic surgeon. Laparoscopic surgery is minimal access surgery such that if you want to treat a patient who has a problem somewhere, you do not need to open him or her fully. You just need to make a small opening in the heart, the chest, the skull or any other part of the body to access where the problem is, treat the patient from there, and then exit through the same small opening.

He says that with technology, there is now robotic surgery, which is still minimal access surgery, but the surgeon does not need to be where the patient is. This means a surgeon can operate on a patient in Europe while he or she is in Nairobi using the medical satellite in space. In the surgeon’s office, there is a console.

Back to UTIs and other urological disorders, there are many patients out there who are experiencing various challenges.

Question: What is your name and what you have specialised in?

Doctor: My name is Dr Joshua Matu. I am a Urologist. Urologist is somebody who has specialised in the treatment of the kidneys and the bladder, and the prostates, kidney stones and fertility in men. You first do General Surgery training then you go and subspecialise further in Urology to become a Urologist.

Question: What do you deal with specifically? Is it Genitourinary system?

Doctor: It is Genitourinary system. We are called Genitourinary surgeons. Genitalia-urinary system.

Question: Let us go with statistics of people with urinary system disorders in Kenya. Do you have any information about that and those who seek treatment?

Doctor: You know disorders are many types. Basically of course very many persons. I don't deal with percentage. It depends on the age group. In the childhood, there is the problem caused by the urinary disorders, like children who wet the beds. You have seen children who wet the bed. That is a disorder. There are also children who are born with the defect in advance like by the age of two months, they are unable to pass urine. If you come to teenagehood, there is a problem with passage in these other children who get some infection. They get trauma at the urethra and the genitalia. They get involved in accident and the urethra is injured. And now the early adulthood, those are the guys now who
get a problem with passing urine either because of infection or trauma. Then
the elderly now 50 years and above. Those are the people who get problems with
prostate disease and bladder disease because of ageing process. So it depends
on which age bracket, but the patients are so many.

Question: Perfect! I just wanted to get the age brackets of those most affected
with these urinary system disorders. Any additional information regarding that?

Doctor: Let us talk about men. From the age of 50 years, 40% of those patients will have the problem of urine outflow. From the age of 60 years, 50% will get a problem with urine outflow. From the age of 70 years, over 60% of those men will have a problem to pass urine and this is because that is when the prostate disease starts to cause what? To increase in size. By the time you are 80 years, over 80% of those persons have a problem passing urine. They are the ones who can't withhold urine for long. They continue passing urine every now
and then. When they pass urine they feel the bladder is not empty.

Question: Reading about some disorders, I came across medical terms such
as polyuria, dysuria, pollakiuria, tenesmus, leucorrhea, menorrhagia,
dysmenorrhea, impotence, frigidity, and of course menstrual cramps which they
were saying is more related to dysmenorrhea. Would you give us the meaning of
those terminologies?

Doctor: Yes. I will just give you an overview of those medical terms. They sound very difficult, but they are very simple. We just give them very difficult terms so we appear as very learned persons, but they are so simple. Polyuria is a condition where you pass abnormally large volumes of urine. It occurs when you have a problem with blood sugars or hormonal problems. If you are having pain when you are passing urine, you say you have dysuria – you have an infection along the urinary tract. Oliguria is a condition where you don't pass any urine or it is small volume of urine - meaning your kidneys are not making enough urine. Pollakiuria means abnormally frequent urination daytime, and tenesmus is the feeling of being unable to completely empty the bladder. Leokorrhea is the flow of whitish or greenish discharge from the vagina. If one is experiencing frigidity, it means they are not becoming sexually excited.

Impotence affects men. You may have a problem with erection, but you are fertile. If you are not able to initiate, maintain, and sustain an erection, then you are impotent.

However, you may be impotent, but you are still fertile such that you are still producing sperms. A case is where someone gets a spinal injury - because of the involvement of the spine and the nerves, you may not be able to initiate and maintain an erection, but you are still fertile. You are just producing sperms. It is not every person who is impotent is infertile. Infertility is whereby you are not able to make somebody conceive.

Question: Can you tell us more about Catheter treatment?

Doctor: When I was training General Surgery, there were very few Urologists in Kenya to
attend to these patients. To be sincere, treatment options were not the best. What we were to do is, a patient comes; a mzee (an old man) comes with a dangling catheter, greyish, darkish, dark urine, dirty bag and the rest and then the much you could do was to change the catheter then to tell him to go home and hope for him to come again if he was lucky enough to be alive. In the 1990s, there were only about two or three Urologists in Kenya. The most painful thing you would ever do to a man is to put a foreign body to his urethra and tell him to carry that weight. It is painful and uncomfortable. Even if you put a catheter to a lady, it is very painful. The catheter also exposes a patient to infection and complications.

Question: Do women have urine disorder challenge?

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Doctor: The commonest problem of urine disorder in women is incontinence. Incontinence is your inability to control the micturation or (normal) passage of urine. You find that ladies sometimes at the age of 40 years or so, their pelvic muscles get weak because of the nature of their work, because of delivery and those kinds of stuff. So, the bladder becomes relaxed such that they cough they leak urine, when they laugh they leak urine. That is incontinence. There could be stress incontinence such that when you lift something up, the urine generally leaks. This means that people with this disorder when they get the desire to
pass urine, they can’t hold it back. It goes. This is the highest incontinence and commonest problem with urine outflow in women because their urethra or passage canal of urine is very short compared to men. They don’t have restriction, but the ability to hold urine is determined, by the flow muscle or the perennial muscles.

When perennial muscles are interrupted or they are not tightening up, they get a problem – the ability to control micturation.

Question: Are there cases of women who experience difficulty in passing urine?

Doctor: Most women who seek medical attention at our facility come with complaints of difficulty in passing urine due to stenosis, the narrowing of meatus. Urethral dilation is usually done as a corrective measure to such patients. Others come with blocked fallopian tubes, having had several years of marriage without bearing children or conceiving.

Question: What is prostate?

Doctor: In men, the story is different. Essentially every man has a prostate gland. Even a two-year-old child. This gland is very important because it makes you potent. It is the one which makes you have children. Upto the age of 40 years it is perfect. The normal size of
prostate gland is 25 grammes, but from the age of 45 years it starts to increase in size irrespective of your financial status, your political affiliation, or your religious basis or any other demographic reference. We can say it is the only organ which increases in size when the rest of the body is decreasing in size. By the time a man is 70 years old, all the other parts are very small, but this gland is bigger. Now when it grows bigger, it causes lower
urinary tract symptoms. You are not able to hold your urine for long time, so you get frequency of micturation. You are not able to empty your bladder fully and now those are symptoms which come with large prostate until the worst scenario is when it blocks completely and you are not able to pass any urine and you say you have acute recession. That is the spectra in men. It is quite different with the spectra in women who don’t have a prostate.

Question: Tell us more about Laparoscopic surgery. What is it?

Doctor: Laparoscopic surgery is the current mode of treatment. It is called the minimal access surgery. Minimal access surgery such that if we use the analogy of a building, you don't necessarily need to go through the main door. You go through the key holes, the small openings. If you want to treat a patient who has a problem somewhere, you don't need to open him or her fully.

You just need to make the small opening in the heart or in the chest or in the skull and be able to access where the problem is and now you treat him or her from there and then you exit through the same small opening. That is called the minimal access surgery. In so doing, there is minimal trauma in the patient and the patient recovers well and the outcome is good. Now, that is the basic of Laparoscopic surgery. Now that is even more. Note that they have gone further and built Robotic surgery. Robotic surgery such that it is still minimal access surgery, but the surgeon doesn't need to be where the patient is. You can operate on a patient who is in America when you are in Europe. You can operate on a patient in Europe when you are in Nairobi using the medical satellite in the space. Where the surgeon stays in his or her office, there is a console controlling the robot hands. Now where the patient in the theatre is, there is that communication between the theatre nurses, the theatre assistant, and the surgeon who doesn't need to be there and then there is the realtime
actualisation of the image. When the patient is in the theatre and is placed on a couch, you can see the patient is lying on the couch. And you give instructions what will be done, when you are not there; and then you will operate on that patient when you are not there; using now the console in your office and the small buttons. Those buttons once you move them, they transmit the same message to that theatre. You will be seeing the movements on your
screen. It is precise.

Question: Is that Artificial Intelligence?

Doctor: Well, it is not artificial intelligence because you are the one who is doing it. So that is it. Then there is now the treatment to do with the prostate disease, all other treatments and conditions where we use natural opening. It is still minimal access. You know we are still talking of minimal access where you are using the keyhole. The keyhole is not the main door, but you still go to the house. Right? This is called natural opening transillumination surgery or surgery through the natural openings, where you don't operate; you don't make incision or what anywhere at all such that if you got a problem in the bladder, we don't cut you anywhere, but we go through the natural opening; the urethra to where the problem is, we remove it and we come out. If you have a problem in the kidney, we go through the urethra, all the way to the kidney them you remove the problem, then you come out. You don't cut anywhere. You are using natural opening. That way the recovery is faster and it
is perfect. If you have a problem in the gall bladder, we don't need now to use laparoscopic. We can go through the natural opening; through the mouth, through the stomach, into the gall bladder, or you can go through the anus up then you to the gall bladder, such that you don't have any incision. That is natural opening. So laparoscopic is basically, minimal access surgery, where you apply it, but you don't traumatise the patient.

Question: What is the difference between endoscopic surgery and laparoscopic surgery?

Doctor: Laparoscopic surgery is the minimal access surgery such that if you want to treat a patient who has a problem somewhere, you don't need to open him fully. All you need to do is to make a small opening and be able to access where the problem is and you treat the
patient from there and then you exit through the same small opening.

While both endoscopic surgery and laparoscopic surgery are minimal access surgeries, the difference is that in the former, you use natural opening while in the latter, the surgeon creates a small incision, where to put the camera through. In both procedures you use the camera and hand instruments. In Laparoscopy, the camera goes through an incision - a port.

In endoscopy, you use the natural opening. You don’t make incision. So if it is the gut you use the mouth in endoscopic surgery - the so called oesophago-gastro-duodenoscopy (OGD). If is in the bladder, you use the urethra.

With technology, there is now robotic surgery such that it is still minimal access surgery, but the surgeon doesn't need to be where the patient is. Kenya has picked up, but in Africa, South Africa are way ahead. I did robotic surgery in India. I did very many cases there.

This means a surgeon can operate on a patient in Europe when he or she is in say Nairobi using the medical satellite in the space. In the surgeon's office, there is a console.

Question: What is your request to the government?

Doctor: Kenya is headed in the right direction as far as the medical field is concerned. I
urge the government to come in and support urologists and gynaecologists. We
need more Da Vinci surgical system. More robotic surgical system will enable us share the skills with fellow surgeons and help in training.

Question: What matters to you most?

Doctor: It is always good to attend to patients with urological and fertility problems, ENT, cleft lip and palate repair, and orthopedic cases. Seeing a patient recover is every doctor's joy.