Here you will find a list of Urologic Conditions. Click the Tabs to find out more.
Here you will find a list of Urologic Conditions. Click the Tabs to find out more.
The prostate is the gland below a man’s bladder that produces fluid for semen. Prostate cancer is common among older men. It is rare in men younger than 40. Risk factors for developing prostate cancer include being over 65 years of age, family history, being African-American, and some genetic changes.
Your doctor will diagnose prostate cancer by feeling the prostate through the wall of the rectum or doing a blood test for prostate-specific antigen (PSA). Other tests include ultrasound, x-rays, or a biopsy.
Treatment often depends on the stage of the cancer. How fast the cancer grows and how different it is from surrounding tissue helps determine the stage. Men with prostate cancer have many treatment options. The treatment that’s best for one man may not be best for another. The options include watchful waiting, surgery, radiation therapy, hormone therapy, and chemotherapy. You may have a combination of treatments.
The bladder is a hollow organ in your lower abdomen that stores urine. Bladder cancer occurs in the lining of the bladder. It is the sixth most common type of cancer in the United States.
Smoking is a major risk factor for bladder cancer. Exposure to certain chemicals in the workplace is another. People with a family history of bladder cancer or who are older, white or male have a higher risk.
Treatments for bladder cancer include surgery, radiation, chemotherapy and biologic therapy. Biologic therapy, or immunotherapy, boosts your body’s own ability to fight cancer.
Also called: Overactive bladder
Urinary incontinence is loss of bladder control. Symptoms can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age.
Most bladder control problems happen when muscles are too weak or too active. If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh or lift a heavy object. This is stress incontinence. If bladder muscles become too active, you may feel a strong urge to go to the bathroom when you have little urine in your bladder. This is urge incontinence or overactive bladder. There are other causes of incontinence, such as prostate problems and nerve damage.
Treatment depends on the type of problem you have and what best fits your lifestyle. It may include simple exercises, medicines, special devices or procedures prescribed by your doctor, or surgery.
Also called: Nephrolithiasis
A kidney stone is a solid piece of material that forms in the kidney from substances in the urine. It may be as small as a grain of sand or as large as a pearl. Most kidney stones pass out of the body without help from a doctor. But sometimes a stone will not go away. It may get stuck in the urinary tract, block the flow of urine and cause great pain.
The following may be signs of kidney stones that need a doctor’s help:
Also called: Hypernephroma, Renal cancer
You have two kidneys. They are fist-sized organs on either side of your backbone above your waist. The tubes inside filter and clean your blood, taking out waste products and making urine. Kidney cancer forms in the lining of tiny tubes inside your kidneys. It happens most often in people over 40. Risk factors include smoking, having certain genetic conditions and misusing pain medicines for a long time.
Often, kidney cancer doesn’t have early symptoms. However, see your health care provider if you notice
The prostate is a male reproductive gland that produces the fluid that carries sperm during ejaculation. It surrounds the urethra, the tube through which urine passes out of the body.
An enlarged prostate means the gland has grown bigger. Prostate enlargement happens to almost all men as they get older. As the gland grows, it can press on the urethra and cause urination and bladder problems.
An enlarged prostate is often called benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy. It is not cancer, and it does not raise your risk for prostate cancer.
The actual cause of prostate enlargement is unknown. Factors linked to aging and the testicles themselves may play a role in the growth of the gland. Men who have had their testicles removed at a young age (for example, as a result of testicular cancer) do not develop BPH.
Similarly, if the testicles are removed after a man develops BPH, the prostate begins to shrink in size.
Some facts about prostate enlargement:
The likelihood of developing an enlarged prostate increases with age.
BPH is so common that it has been said all men will have an enlarged prostate if they live long enough.
A small amount of prostate enlargement is present in many men over age 40 and more than 90% of men over age 80.
No risk factors have been identified other than having normally functioning testicles.
Less than half of all men with BPH have symptoms of the disease, which include:
After taking a complete medical history, your doctor will perform a digital rectal exam to feel the prostate gland. The following tests may also be performed:
In addition, you may be asked to complete a form to evaluate the severity of your symptoms and their impact on your daily life. Your score may be compared to past records to determine if the condition is getting worse.
The choice of a treatment is based on the severity of your symptoms, the extent to which they affect your daily life, and the presence of any other medical conditions. Treatment options include “watchful waiting,” lifestyle changes, medication, or surgery.
If you are over 60, you are more likely to have symptoms. But many men with an enlarged prostate have only minor symptoms. Self-care steps are often enough to make you feel better.
If you have BPH, you should have a yearly exam to monitor the progression of your symptoms and determine if any changes in treatment are necessary.
For mild symptoms:
Alpha 1-blockers (doxazosin, prazosin, tamsulosin, terazosin, and alfuzosin) are a class of medications also used to treat high blood pressure. These medications relax the muscles of the bladder neck and prostate. This allows easier urination. Most people treated with alpha 1-blocker medication find that it helps their symptoms.
Finasteride and dutasteride lower levels of hormones produced by the prostate, reduce the size of the prostate gland, increase urine flow rate, and decrease symptoms of BPH. It may take 3 to 6 months before you notice much improvement in your symptoms. Potential side effects related to the use of finasteride and dutasteride include decreased sex drive and impotence.
Antibiotics may be prescribed to treat chronic prostatitis (inflammation of the prostate), which may accompany BPH. Some men note relief of their BPH symptoms after a course of antibiotics.
Many herbs have been tried for treating an enlarged prostate. Saw palmetto has been used by millions of men to ease BPH symptoms and is often recommended as an alternative to medication. Some studies have shown that it helps with symptoms, but there is evidence that this popular herb is no better than a dummy pill in relieving the signs and symptoms of BPH. Further studies are needed. If you use saw palmetto and think it works, ask your doctor if you should still take it.
Prostate surgery may be recommended if you have:
The choice of a specific surgical procedure is usually based on the severity of your symptoms and the size and shape of your prostate gland.
Transurethral resection of the prostate (TURP): This is the most common and most proven surgical treatment for BPH. TURP is performed by inserting a scope through the penis and removing the prostate piece by piece.
Transurethral incision of the prostate (TUIP): This procedure is similar to TURP, but is usually performed in men who have a smaller prostate. It is usually performed without the need for a hospital stay. Like TURP, a scope is inserted through the penis until the prostate is reached. Then, rather than removing the prostate, a small incision is made in the prostate tissue to enlarge the opening of the urethra and bladder outlet.
Simple prostatectomy: An open prostatectomy is usually performed using general or spinal anesthesia. An incision is made through the abdomen or perineum (the area behind the scrotum). Only the inner part of the prostate gland is removed. The outer portion is left behind. This is a lengthy procedure, and it usually requires a hospital stay of 5 to 10 days.
Most men who have prostate surgery have improvement in urine flow rates and symptoms. See prostate removal for a description of complications.
Other, less-invasive procedures are available. These use different forms of heat to destroy prostate tissue. None have been proven to be better than TURP. Patients who receive these less-invasive procedures are more likely to need surgery again after 5 or 10 years. However, these procedures may be a choice for:
Younger men (many of the less-invasive procedures carry a lower risk for impotence and incontinence than TURP, although the risk with TURP is not very high)
Patients with severe medical conditions, including uncontrolled diabetes, cirrhosis, alcoholism, psychosis, and serious lung, kidney, or heart disease
Men who are taking blood-thinning drugs
Another form of treatment is prostatic stents.
See: BPH support groups
Men who have had long-standing BPH with a gradual increase in symptoms may develop:
Sudden inability to urinate
Urinary tract infections
Damage to the kidneys
Blood in the urine
Even after surgical treatment, a recurrence of BPH may develop over time.
When to Contact a Medical Professional
Call your doctor right away if you have:
Less urine than usual
Fever or chills
Back, side, or abdominal pain
Blood or pus in your urine
Also call your doctor if:
Your bladder does not feel completely empty after you urinate
You take medications that may cause urinary problems, like diuretics, antihistamines, antidepressants, or sedatives. Do NOT stop or adjust your medications on your own without talking to your doctor
You have taken self-care measures for 2 months without relief
BPH; Benign prostatic hypertrophy (hyperplasia); Prostate – enlarged
The human body functions within a relatively narrow range of normal. When chemicals such as hormones fall outside those normal levels, there can be consequences that affect the body at a cellular, organ, or systemic (body-wide) level.
Blood tests used to measure testosterone are usually performed in the morning. Testosterone sampling is difficult since the levels normally tend to bounce around a fair bit during the course of the day. The normal value for total testosterone in males is 270-1070 ng/dl. However, this depends to some extent on the individual laboratory being used, and the range can vary as a result. In women, there is debate about the accuracy of testosterone measurements, because the circulating values are so much lower than in males and are harder to accurately measure.
With advancing age, in both men and women, the amount of testosterone the body produces gradually falls. Free testosterone levels can be measured and normal levels depend upon an individual’s age. Interestingly, menopause itself does not seem to play a role in a reduction of testosterone levels in women beyond that of advancing age.
What are the causes of low testosterone?
Low testosterone levels may be caused by a number of factors. For example – there may be a problem at the level of the hypothalamus or pituitary to produce appropriate amounts of LH and FSH to stimulate testosterone production. Another possibility is that the organs that make testosterone do not function normally or are not able to respond to stimulation by the brain. Also, as mentioned, changes in SHBG can account for the amount of testosterone that is available to exert its effects.
When the problem is in the organs that produce testosterone (the ovaries or testes, for the most part), it is called a “primary” problem”. In medical terminology, the decrease in normal testosterone production is called “hypogonadism.”
When the problem is related to the pituitary and its ability to regulate testosterone, it is called “secondary hypogonadism,” and
If the problem is thought to be at the level of the hypothalamus, it is called “tertiary hypogonadism.”
Also called: ED, Impotence
Erectile dysfunction (ED) is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But male sexual dysfunction is not a natural part of aging.
Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don’t see your doctor, these problems will go untreated.
Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight or stopping smoking may also help.
On this page:
What is the urinary tract?
What causes urinary retention?
What are the symptoms of urinary retention?
How is urinary retention diagnosed?
How is urinary retention treated?
What are the complications of urinary retention?
What are the complications of treatments for urinary retention?
Urinary retention is the inability to empty the bladder. With chronic urinary retention, you may be able to urinate, but you have trouble starting a stream or emptying your bladder completely. You may urinate frequently; you may feel an urgent need to urinate but have little success when you get to the toilet; or you may feel you still have to go after you’ve finished urinating. With acute urinary retention, you can’t urinate at all, even though you have a full bladder. Acute urinary retention is a medical emergency requiring prompt action. Chronic urinary retention may not seem life threatening, but it can lead to serious problems and should also receive attention from a health professional.
Anyone can experience urinary retention, but it is most common in men in their fifties and sixties because of prostate enlargement. A woman may experience urinary retention if her bladder sags or moves out of the normal position, a condition called cystocele. The bladder can also sag or be pulled out of position by a sagging of the lower part of the colon, a condition called rectocele. Some people have urinary retention from rectoceles. People of all ages and both sexes can have nerve disease or nerve damage that interferes with bladder function.
The urinary tract consists of the organs, tubes, and muscles that work together to make, move, store, and release urine. The upper urinary tract includes the kidneys, which filter wastes and extra fluid from the blood, and the ureters, which carry urine from the kidneys to the bladder. The lower urinary tract includes the bladder, a balloon-shaped muscle that stores urine, and the urethra, a tube that carries urine from the bladder to the outside of the body during urination. If the urinary system is healthy, the bladder can hold up to 16 ounces-2 cups-of urine comfortably for 2 to 5 hours.
Muscles called sphincters squeeze shut the tubes from the bladder to help keep urine from leaking. The sphincter muscles close tightly like a rubber band around the opening of the bladder, which leads into the urethra.
Nerves in the bladder tell you when it is time to urinate. As the bladder first fills with urine, you may notice a feeling that you need to go. The sensation to urinate becomes stronger as the bladder continues to fill. As it reaches its limit, nerves from the bladder send a message to the brain that the bladder is full and the urge to empty your bladder intensifies.
When you urinate, the brain signals the bladder muscle to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax. As these muscles relax, urine exits the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs.
Urinary retention can be caused by an obstruction in the urinary tract or by nerve problems that interfere with signals between the brain and the bladder. If the nerves aren’t working properly, the brain may not get the message that the bladder is full. Even if you know that your bladder is full, the bladder muscle that squeezes urine out may not get the signal that it is time to push, or the sphincter muscles may not get the signal that it is time to relax. A weak bladder muscle can also cause retention.
Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are:
In addition, some children are born with nerve problems that can keep the bladder from releasing urine.
As a man ages, his prostate gland may enlarge. Doctors call the condition benign prostatic hyperplasia (BPH), or benign prostatic hypertrophy.
As the prostate enlarges, the layer of tissue surrounding it stops it from expanding, causing the gland to press against the urethra like a clamp on a garden hose. As a result, the bladder wall becomes thicker and irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination. Eventually, the bladder weakens and loses the ability to empty itself, so urine remains in the bladder.
Infections cause swelling and irritation, or inflammation. A urinary tract infection (UTI) may cause retention if the urethra becomes inflamed and swells shut.
During surgery, anesthesia is often administered to block pain signals, and fluid is given intravenously to compensate for possible blood loss. The combination may result in a full bladder with impaired nerve function. Consequently, many patients have urinary retention after surgery.
Many medicines work by calming overactive nerve signals. Various classes of drugs that block various signals may be used to treat allergies, stomach cramps, muscle spasms, anxiety, or depression. Some medicines are used to treat urinary incontinence and overactive bladder. The drugs that may cause urinary retention include:
A stone formed anywhere in the urinary tract may become lodged in the bladder. If the stone is large enough, it can block the opening to the urethra like a bathtub plug.
A cystocele occurs when the wall between a woman’s bladder and her vagina weakens and allows the bladder to droop into the vagina. The abnormal position of the bladder may cause urine to remain trapped. In a rectocele, the rectum droops into the back wall of the vagina. Cystocele and rectocele are often the results of a dropping of the pelvic support floor for the bladder. This sagging can pull the bladder out of position and cause urinary problems such as incontinence or urinary retention.
A hard stool in the rectum may push against the bladder and urethra, causing the urethra to be pinched shut, especially if a rectocele is present.
A stricture is a narrowing or closure of a tube. Men may have a narrowing of the urethra, usually caused by scarring after a trauma to the penis. Infection is a less common cause of scarring and closure in the urethra.
Acute urinary retention causes great discomfort, and even pain. You feel an urgent need to urinate but you simply can’t. The lower belly is bloated.
Chronic urinary retention, by comparison, causes mild but constant discomfort. You have difficulty starting a stream of urine. Once started, the flow is weak. You may need to go frequently, and once you finish, you still feel the need to urinate. You may dribble between trips to the toilet because your bladder is constantly full, a condition called overflow incontinence.
Your doctor will order a number of tests to diagnose your condition.
A physician will suspect urinary retention by your symptoms and will attempt to confirm the diagnosis with a physical examination of the lower abdomen. The physician may be able to feel the distended bladder by lightly tapping on your lower belly. Tapping or striking for diagnostic purposes is called percussing.
A urine sample will be examined for signs of infection, which may be a cause or a result of urinary retention.
A bladder scan uses a portable ultrasound device that can determine how much urine is in your bladder. You will be asked to urinate, and then your doctor or nurse will use the bladder scan to determine the post-void residual (PVR). The word residual refers to the amount of urine left in the bladder after urination. If you typically have a PVR of 100 milliliters or more, you are considered to have chronic urinary retention.
Your doctor may use a cystoscope to see inside your bladder and urethra. The cystoscope has lenses like a telescope or microscope. These lenses let the doctor focus on the inner surfaces of the urinary tract.
Some cystoscopes use optical fibers made of flexible glass that carry an image from the tip of the instrument to a viewing piece at the other end. The fiber-optic cystoscope is as thin as a pencil and has a light at the tip. The doctor can use the cystoscope to find and perhaps remove a stone that may be blocking the bladder opening. The device can help the doctor identify narrowing of the urethra from prostate enlargement or UTI.
A conventional x ray may show a spot where the urinary tract is narrowed or obstructed. It may show that the bladder is out of its normal position. CT scans use multiple x-ray images to construct a better view of internal organs, which may help find stones or other obstructions.
Men may be given a blood test to measure their PSA, a substance in the blood that may indicate prostate cancer or other prostate problems. A high PSA score may prompt further tests, such as a transrectal ultrasound, with or without biopsy of the prostate.
The doctor may ask for a prostate fluid sample to check for prostatitis-inflammation of the prostate-a condition that can cause the prostate to swell and pinch the urethra. The doctor will obtain the sample by inserting a gloved finger into the rectum and massaging the prostate until fluid drains through the urethra. A doctor will not massage a prostate for prostatic fluid if urinary retention is suspected as the primary diagnosis. Only when urinary retention is ruled out would the doctor do this test.
Urodynamic tests include different techniques to measure the bladder’s ability to empty steadily and completely. In a pressure flow study, you will be asked to empty your bladder so that a special catheter can measure the pressure required to start a stream. This pressure flow study helps to identify bladder outlet obstruction from prostate enlargement or cystocele.
If your doctor or nurse thinks your urinary problem is related to nerve damage, you may be given an electromyography. This test measures the muscle activity in the urethral sphincter using sensors placed on the skin near the urethra and rectum. Sometimes the sensors are on the urethral or rectal catheter. A catheter is a thin, flexible tube that can be guided into openings of the body. Muscle activity is recorded on a machine. The patterns of the impulses will show whether the messages sent to the bladder and urethra are coordinated correctly.
With acute urinary retention, treatment begins with the insertion of a catheter through the urethra to drain the bladder. This initial treatment relieves the immediate distress of a full bladder and prevents permanent bladder damage. Long-term treatment for any case of urinary retention depends on the cause.
The cause of acute urinary retention may be temporary. For example, if you have retention after surgery, you will probably regain your ability to urinate after the effects of the anesthesia wear off. In such cases, you may need to have a catheter inserted once or twice with no other treatment required after you have shown you can urinate on your own.
If you have chronic urinary retention, or if acute retention appears to become chronic, further treatment will be necessary. You may need to continue using a catheter if other options do not work for you. You may be taught to catheterize yourself as needed. You will need to learn sterile technique to avoid UTIs.
The treatments for prostate enlargement range from medication to surgery. For more information, see the fact sheet Prostate Enlargement: Benign Prostatic Hyperplasia from the National Kidney and Urologic Diseases Information Clearinghouse.
Women may need surgery to lift a fallen bladder or rectum. The most common procedure for cystocele and rectocele repair is for the surgeon to make an incision in the wall of the vagina to find the defect or hole in the membrane-a wall of tissue called fascia-that normally separates the vagina from the other pelvic organs. The surgeon places sutures in the fascia to close up the defect, then closes the incision in the vaginal wall with more stitches, removing any excess tissue. These suturing steps tighten the layers of tissue that separate the organs, creating more support for the pelvic organs.
If a man is diagnosed with urethral stricture, a doctor can perform a procedure called dilation, in which increasingly wider tubes are inserted into the urethra to widen the stricture. An alternate method is to inflate a small balloon at the end of a catheter inside the urethra.
A surgeon can repair a stricture by performing an internal urethrotomy. The surgeon advances a catheter up to the stricture and uses a knife or laser to make an incision that opens the stricture.
Another treatment for urethral stricture in men is placement of a wire mesh tube, called a stent, to keep the passage open.
Urine is normally sterile, and the normal flow of urine usually prevents bacteria from growing in the urinary tract. When urine stays in the bladder, however, bacteria have a chance to grow and infect the urinary tract.
If the bladder becomes stretched too far or for long periods, the muscle may be permanently damaged and lose its ability to contract.
If urine backs up into the kidneys, permanent kidney damage can lead to reduced kidney function and chronic kidney disease. If you lose too much of your kidney function, you will need dialysis or a kidney transplant to stay alive.
What are the complications of treatments for urinary retention?
Placement of a urinary catheter provides an opportunity for bacteria to enter the urinary tract. Bacteria may come from the patient’s anus and perineum or from the health worker’s hands. Health workers must take great care, using sterile technique, when placing a catheter. If you are performing clean intermittent catheterization, you must follow the same sterile procedures every time you handle the catheter.
Transurethral surgery to treat an enlarged prostate may result in loss of bladder control or erection problems in some men. These problems are usually temporary. Most men recover their bladder control in a few weeks or months, and most recover their sexual function within 1 year after the operation.
The urinary system consists of the kidneys, ureters, bladder and urethra. Infections of the urinary tract (UTIs) are the second most common type of infection in the body. You may have a UTI if you notice:
If you think you have a UTI, it is important to see your doctor. Your doctor can tell if you have a UTI by testing a sample of your urine. Treatment with medicines to kill the infection will make it better, often in one or two days.