Urologists specialise in treating the urinary tract, which is split into two sections – the upper urinary tract (Kidney and Ureters) and the lower urinary tract (Bladder and Urethra). Urologists also treat all parts of the male reproductive system and matters concerning the female reproductive and urinary tract.
Abnormalities in your kidneys can represent more significant damage to the urinary tract. Early identification through a comprehensive urinary screening addresses kidney complications as soon as possible and provides the best platform for a healthy urinary tract.
1. Experiencing pelvic pain
Pelvic pain scales from various degrees of severity; some are not worrisome, while others may demand medical attention. This pain can stem from abnormalities in your urinary tract, reproductive organs, or digestive tract.
In the realm of urology, pelvic pain can be representative of multiple issues, most commonly a urinary tract infection (UTI) which may display symptoms such as pain while urinating, visually bloody or cloudy urine and burning or pain while urinating.
Pelvic pain can also indicate the development of issues such as kidney stones or an early indicator of a sexually transmitted disease such as gonorrhoea.
Following the diagnosis of your pelvic pain, urologists can provide multiple comprehensive treatments tailored to your needs.
2. If you suspect kidney stones
Kidney stones (Renal Calculi) vary in size, but their presence is rarely felt until they cause a blockage. The size of these stones being passed naturally also decreases as they get more prominent in size, with rocks about 5-10 mm only having a 50% chance of being expelled naturally.
Some indicators of such stones developing include observing bloody or cloudy urine with a foul smell, nausea and vomiting, difficulty with urine flow, abdominal or back pain.
Four primary categories of kidney stones are initially treated by an alteration in dietary habits but have unique treatments to help aid their removal.
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Calcium oxalate stones
Prescription of alkalinising agents which prohibit the formation and growth of calcium crystals. Thiazide diuretics are a viable means to calcium oxalate stones as they reduce calcium in the urine and prevent stone recurrence.
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Urate (Uric acid) stones
Medications to treat uric acid stones depend on stabilising the body’s disparity between the acid and alkali. Drugs such as allopurinol reduce uric acid levels in the blood.
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Struvite stones
Struvite stones rarely pass through the body, and surgical processes may be necessary to break down larger rocks or remove them entirely. Surgical management requires complete stone removal, usually with procedures such as percutaneous nephrolithotomy (PCNL).
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Cystine stones
Cystine stones are formed with the excessive accumulation of cystine in the urine, causing kidney stones to develop in the urinary tract. Medications either lower urine acidity or prevent larger stones’ development.
3. A Urinary Tract Infection (UTI)
A urinary tract infection (UTI) is an infection in the urinary system. It is most prevalent in the lower urinary tract, primarily affecting the bladder. This condition is significantly more prevalent in females, who are around 30 times more likely to be diagnosed.
A UTI is often not immediately identifiable, but symptoms such as pain in the lower part of the abdomen, discoloured urine and increased rate of urination call for a urologist’s attention. Ignoring these signs can cause the infection to spread to the kidneys, potentially leading to kidney damage or even liver failure.
In rare cases, ignored UTIs can become life-threatening if the infection seeps into the bloodstream and affects the entire body, leading to a condition called sepsis, which can lead to tissue damage, organ failure, and death.
4. You’re urinating a lot or leaking urine
Urination is an indicator of the body expelling waste fluids called urea and keeps chemicals and water in the body in balance.
Urinating about six times a day following the consumption of 2 litres of water is a healthy frequency, but regularly urinating more than seven times in 24 hours after the consumption of 2 litres of water is a warning sign of underlying urinary problems.
Several factors, such as increased fluid intake, consumption of beverages that increase urine production and certain medications, can explain the increase in urination frequency, but regularly exceeding this average number may indicate serious issues.
An overactive bladder can be cured in multiple ways, with mild cases being treated with reduced consumption of coffee, tea, alcohol, and tobacco.
Oral medication can also solve these issues efficiently if patients do not have narrow-angle glaucoma, delayed gastric emptying or urinary retention.
In some resistant cases, your urologist may recommend neurotoxin injections to block nerve impulses from the bladder, preventing involuntary contractions.
5. You’re unable to urinate
Conversely, an inability to urinate or an interrupted urine stream may also warrant a visit to the urologist. Urinary retention symptoms include:
- The inability to urinate
- A slow urine stream
- Difficulty starting the flow of urine (hesitancy)
- Frequent urination in small amounts
- The inability to completely empty your bladder
The inability to urinate, or urinary retention, may indicate a blockage along the urinary tract that prevents urine (partially or fully) from leaving your bladder or urethra. Other reasons may be the bladder muscle’s inability to create a strong enough force to expel urine properly.
Depending on the cause, your urologist may recommend treatment to remove the blockage or strengthen the muscles needed for proper bladder contraction.
6. Fever and Chills
When accompanied by other urinary symptoms, minor fevers and chills can suggest a bladder or kidney infection, and the increased severity of these symptoms can indicate that the disease has spread to the kidneys.
Your urologists or kidney specialists here in Singapore will require a urine sample to perform a urinalysis and clean-catch urine culture to diagnose the infection and determine the best treatment procedure. Imaging tests such as CT and kidney scans also help urologists rule out problems in your urinary system.
Following the diagnosis and identification of the scale of damage, your urologist will implement an optimal protocol for you. You may be prescribed antibiotics for mild symptoms or recurrent infections.
Severe instances of a kidney infection may require hospitalisation if you have trouble consuming the medication prescribed or cannot drink enough fluids.
Specific individuals, like older adults, who have separate urinary issues or have medical problems such as diabetes and spinal cord injury and pregnant women who display illness indicators are also likely to be hospitalised.
Most UTIs are cured quickly, with bladder infection symptoms being cured after around 48 hours and kidney infection symptoms disappearing after a week.
When to seek immediate treatment
Few urological symptoms command immediate attention, but some telling signs require close attention.
These include the excretion of blood, severe abdominal pain and extended fever.
Acute urinary retention, the sudden inability to urinate, can cause severe pain and can be attributed to issues such as obstruction in the bladder or the urethra or disruption in communication between the nervous system and the bladder.
These symptoms can stem from multiple causes, such as prostate cancer and UTIs.
Blood in the semen, noticeable lumps in the testicle and redness can be indicative of testicular torsion, where blood vessels to the testicles twist and cut off blood flow, potentially leading to tissue death which leads the penis to atrophy and die.
What to expect during your urology appointment
You will be expected to provide a urine sample during your first appointment. Your urologist will inquire about your medical history and dietary habits, the dosages of your current medication and family history of infection.
You may be subject to a physical exam and may undergo a genital exam as well. This may include a prostate assessment for men and a pelvic exam for women. Sonography is the most common procedure used by urologists, but diagnostic tests such as CT scans and MRIs may be used.
If you experience any of the aforementioned symptoms, do visit a urologist. It is important to remember that no urinary issue is too small. At Aare Urocare, Dr Fiona Wu will work with you on getting to the root cause of your condition and create a personalised treatment plan.