Recurrent cystitis or urinary tract infection

A urinary tract infection (UTI) denotes infection of the bladder (cystitis) or urethra (tube that carries urine from the bladder to the outside), with symptoms and patterns well described in resources such as the urology overview of UTIs. They are extremely common and account for about 8 million visits to health care providers each year. They are common in women and the lifetime risk of developing a urinary infection is 50%. UTIs are rare in men and when they do occur it is important that they are thoroughly investigated.

Symptoms may include:

• Cloudy, foul smelling urine that may contain blood.
• The need to pass urine more frequently than usual and symptoms of urgency.
• Burning sensation when urinating.
• Lower abdominal pain or discomfort.

UTIs are normally treated with a course of antibiotics and symptoms usually improve within 24 hours. Those with recurrent infections require a more in depth assessment and investigations.

Mr Khan can offer a dedicated treatment strategy to manage your symptoms and may include dietary and lifestyle advice, drug therapy, bladder instillations to promote the natural defences of the bladder and surgery

Overactive Bladder

Overactive bladder (OAB) is a common condition that affects both men and women and is usually the result of bladder instability, with characteristic symptoms outlined in medical resources like this clinical overview of OAB. Often no cause is found and it is not due to urine infection or an enlarged prostate.

Symptoms vary from person to person and may include:

• Frequency – going to the toilet more than 6-7 times per day. Often it can be a lot more than that.
• Urgency – sudden desire to pass urine that is difficult to defer.
• Nocturia – waking up at night to urinate.
• Urge incontinence – urine leakage that occurs before you are able to get to the toilet.

OAB is a chronic condition but can be managed with lifestyle modifications, pelvic floor exercises, medication or minimally invasive treatments such as botox injections.

Please feel free to book an appointment with Mr Khan if you would like a medical opinion on your symptoms.

Interstitial cystitis (also known as Painful Bladder Syndrome)

Interstitial cystitis (IC) is a poorly understood condition that causes long-term pelvic pain and discomfort. It can affect both men and women, and its complex presentation is discussed in resources such as this IC information page. Symptoms are often debilitating and can affect lifestyle, work and emotional health.

No one really knows the causes of IC although several theories have been postulated and often no triggering factor is identified.

Symptoms vary from person to person and may include:

• Lower abdominal pain/bladder pain that may be constant or intermittent.
• Frequent need to urinate and often passing only small amounts.
• Urgent need to urinate that is difficult to defer.
• Blood in the urine and stinging or burning.
• Pain that worsens during menstruation in women.
• Scrotal and penile pain.

There is no one test that is specific for the diagnosis of IC and it is important to exclude other causes for these symptoms with investigations. Once a diagnosis is established it is important to note that there is no cure for IC and the goal of treatment is to relieve symptoms. Because IC is a chronic condition, most patients will need to continue treatment indefinitely to keep the symptoms from returning.

Mr Khan can offer a dedicated treatment strategy to mange your symptoms and may include a combination of lifestyle changes, medication and minimally invasive surgical procedures.

Urinary incontinence

Urinary incontinence (the loss of bladder control) is a very common problem affecting 1 in 3 people over the age of 60. It is more common in women and can occur in men who have had prostate surgery. The different types of incontinence are outlined in references such as this incontinence overview, and each can significantly affect a patient’s quality of life, confidence and social wellbeing.

Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently.

Types of urinary incontinence include:

• Stress incontinence – Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing or exercising.
• Urge incontinence – You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night.
• Mixed incontinence – You experience more than one type of urinary incontinence.

Mr Khan can offer a comprehensive assessment of your symptoms and treatment options that may include lifestyle changes, bladder retraining, pelvic floor exercises, medication and surgery. Please feel free to book a consultation with us if you would like a medical opinion.

Bladder cancer

Approximately 10,000 new cases of bladder cancer are diagnosed in the UK each year. The condition’s causes, risk factors and symptom patterns are described in clinical references such as this bladder cancer explainer. Risk factors include smoking, chemical exposure, chronic irritation to the lining of the bladder, and previous pelvic radiotherapy.

Symptoms of bladder cancer typically include blood in the urine (haematuria) that may be visible or non-visible. Other symptoms include frequency and urgency to pass urine.

After an initial consultation and examination, further tests are needed to diagnose bladder cancer and may include blood and urine tests, a scan of the bladder and kidneys and a camera investigation (flexible cystoscopy) to inspect the lining of the bladder.

If a growth is discovered at the time of the flexible cystoscopy, your urologist will recommend a surgical procedure to have the tumour scraped away using an instrument passed through the urethra (trans-urethral bladder tumour resection or TURBT).

The tumour is then sent for analysis and further treatment is dependant on the stage and grade of the disease. Treatments include either local chemotherapy placed in the bladder for early stage disease or radiotherapy and major surgery for more advanced disease.