Symptoms And Concerns

URINARY PROBLEMS (LOWER URINARY TRACT SYMPTOMS)

Lower urinary tract symptoms (LUTS) are symptoms related to the lower urinary tract – the bladder, prostate or urethra. They are common as you get older but can happen when you’re young and can affect both men and women.

Symptoms may include:

• Going to the toilet frequently
• Feeling an urgent need to urinate
• Waking from sleep to pass urine
• Sensation of incomplete emptying of the bladder
• Straining to urinate
• Weak stream
• A longer than usual wait for the stream to begin
• Dribbling after urinating
• A stop/start stream
• Sudden intense urge to urinate, followed by urinating without control

These symptoms are not just a normal part of ageing and it is important to see a doctor if you notice any change in your urination and particularly if your symptoms affect your quality of life or interfere with daily activities.

A detailed history, careful examination and some basic tests will provide insight into the cause of your symptoms.

BLOOD IN THE URINE (VISIBLE OR NON-VISIBLE)

Commonly referred to as haematuria, blood in the urine may be visible to the naked eye or detected during laboratory testing. It could be a sign of a problem anywhere in the urinary tract and therefore should be investigated.

The most common cause of blood in the urine in the UK is infection (cystitis) but could also be related to cancer of the bladder, ureter or kidney.

All patients with blooding the urine should be throughly investigated to include a physical examination, urine sample sent for microscopy, culture and sensitivity (to evaluate for infection), urine cytology (to evaluate for cancerous cells in the urine), imaging (Ultrasound scan or CT scan) and a flexible cystoscopy (telescopic examination of the bladder).

We aim to provide you with a fast track service to ensure you are fully informed and to the options available to you.

BLOOD IN SEMEN

Blood in the semen (haematospermia) is common between the ages of 30 to 40, or if you are over 50 and have benign prostatic enlargement. The commonest causes are low grade infection, recent urological procedure, prostate cancer and less common infections such as tuberculosis or schistosomiasis.

Blood in the semen often seems frightening and worrying but it’s rarely because of anything serious. It usually resolves spontaneously but may need a course of antibiotics or anti-inflammatory medication.

If you are experiencing any episodes of blood in your semen, please seek your GP’s advice.

UNABLE TO PASS URINE

An inability to pass urine (Acute urinary retention) often occurs without warning. It can affect anyone, however, men in their sixties are more susceptible, primarily because of an enlarged prostate. Women can also be affected by urinary retention if you have a condition called Cystocele. This is where the bladder moves out of its normal position and bulges onto the vagina. Urinary retention also occurs when the lower part of the colon starts to sag, a condition called Rectocele.

Symptoms of urinary retention include:

• Painful, inability to urinate
• Severe pain in the lower abdomen
• Bloating of the abdomen

Acute urinary retention is a medical emergency and requires prompt treatment. If you are experiencing symptoms, you should seek an urgent medical review.

MY PSA (PROSTATE-SPECIFIC ANTIGEN) IS RAISED

Prostate-specific antigen (PSA) is a protein produced by the prostate gland. It is produced by both cancerous and non-cancerous prostate tissue. Elevated levels could result from an enlarged prostate, inflamed or infected prostate (prostatitis) or from prostate cancer.

If you wish to have a test done or discuss the result of a test, then please contact us for a consultation.

BACK / FLANK PAIN

There are multiple causes of pain over the flank / back region. Pain may originate from the kidneys, other causes include musculoskeletal problems such as muscle strain or a pinched nerve. Symptoms may include sudden onset excruciating kidney pain associated with blood in the urine, fever, chills, nausea and vomiting.

Causes of flank / back pain relating to the urinary tract:

• Kidney stones (renal / ureteric colic)
• Kidney infection (Pyelonephritis)
• Kidney cancer
• Obstructed kidney

If you are experiencing any of the above symptoms, you should seek urgent medical attention for investigations and treatment.

SCROTAL LUMP (TESTICULAR TUMOUR / HYDROCELE / EPIDIDYMAL CYST / VARICOCELE)

Lumps and swellings in the testicles are relatively common and can be due to a number of different causes. If you have noticed you have developed swollen testicles (either one or both), a change in the shape or the way your testicles feel, any pain or discomfort in the testicles then it is imperative you seek urgent medical advice.

SUDDEN ONSET SCROTAL PAIN (TESTICULAR TORSION / EPIDIDYMO-ORCHITIS)

Testicular torsion is a medical emergency and requires urgent attention and possible surgery. It happens when the spermatic cord, which provides blood flow to the testicle, rotates and becomes twisted. This cuts off the blood supply to the testicle and causes severe pain and swelling. Seek emergency care if you have sudden or severe testicular pain. Prompt treatment can prevent severe damage or loss of your testicle.

Epididymo-orchitis is a condition characterised by pain and swelling of the scrotum caused by infection and inflammation in the epididymis and/or testicle. In men under the age of 35 years it is usually caused by a sexually transmitted infection (STI) in the water pipe e.g. chlamydia or gonorrhoea and can be treated effectively with a course of antibiotics. Prompt medical assessment is needed to make sure you do not have testicular torsion.