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Pollakiuria, a narrow stream of urine, urinating several times a night, burning during micturition? Disturbing symptoms from the genitourinary system should not be taken lightly. Besides cystitis, they can suggest serious diseases …
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The pandemic has moved other diseases to the background. Many of us, fearing coronavirus infection, avoided medical facilities and continued the treatment without a follow-up without reflection. Today, more and more often it talks about the long-term growing health, i.e. everything that is related to the lack of diagnostics and limited access to health care in the years 2020-2021. It is estimated that the number of urological procedures performed decreased by approx. 30-60%. compared to the number of patients operated in 2019. The decrease also applies to diagnostics: AOS consultations, diagnostic tests performed (USG, CT, MRI, cystoscopy, prostate biopsy). Undiagnosed patients have not been “magically healed”, but will return to their doctors in a relatively worse condition. Hence, urologists and urooncologists have been appealing to patients who experience disturbing symptoms for a long time to contact a doctor.
Especially since prostate cancer is the most commonly diagnosed male cancer. A threat for today and tomorrow, given that the risk of developing the disease increases with age, and we are an aging society. Unfortunately, since 2015, unlike the rest of Europe, we have seen an increase in mortality from prostate cancer. The main reasons are “male resistance”, i.e. the reluctance of Polish men to undergo preventive examinations, as well as the insidious nature of the disease itself.
Prostate cancer does not always hurt – it can have unusual symptoms that are easy to ignore, reducing your chances of recovery. However, prophylaxis comes to our aid. If you experience problems with urination, such as pollakiuria, urge to urinate, burning during voiding, a narrow stream of urine, blood in the urine, be sure to see a doctor.
Problems with urinating can have many causes – cystitis, diabetes, benign prostatic hyperplasia, bladder cancer and prostate cancer are just some of them. We suggest what tests you need to do regardless of the pandemic:
Morphology
It is the basic diagnostic test that allows you to assess the general health of the patient. In the blood taken from a vein, not only the concentration of hemoglobin or the number of red cells (erythrocytes) and white cells (leukocytes) is measured – you can determine some of their properties (such as the size of blood cells or the degree of oxygen saturation), but also the detailed proportions between them. Deviations in the results, depending on the type and number of parameters that are not within the norm, may indicate various diseases. In prostate cancer and associated bladder bleeding, the number of red blood cells may be reduced. In turn, with inflammation of the lower urinary tract, the number of leukocytes increases.
Serum creatinine test
Creatinine is an organic compound formed as a result of metabolic changes, mainly in skeletal muscles. Its level is determined in the diagnosis or monitoring of kidney diseases (inflammation due to infectious diseases, poisoning, congenital abnormalities), as well as in the case of suspicion of nephrotoxin poisoning. The material collected from the patient is venous blood, and the test itself is recommended to be performed prophylactically once a year. Elevated serum creatinine levels may indicate renal dysfunction, including acute renal failure, ketoacidosis, chronic kidney disease, heart failure, and multiple organ failure.
Urine test
This is another simple study that can reveal a lot about the condition of our body. Normal urine is acidic (pH 4,8 to 7,4), possibly neutral (pH 7). An alkaline reaction may indicate a bacterial urinary tract infection. Its color is also important – the correct one is straw-colored and transparent. Normal urine does not contain glucose, protein, ketone bodies, bacteria, and bile pigments. Red color indicates the presence of erythrocytes, i.e. red blood cells, which can occur in prostate cancer. If the urine is cloudy, there may be crystals or leukocytes (white blood cells) in it. Glucosuria is a common symptom of diabetes. On the other hand, foamy urine may be associated with excessive protein secretion indicating nephrotic syndrome. The test also includes the relative density of urine. Elevated values may indicate dehydration of the patient or the presence of abnormal substances in the sample. In turn, decreased density may be a symptom of renal failure.
PSA
One of the most frequently used tools for diagnosing prostate disease is a blood test, which measures the concentration of prostate specific antigen (PSA). Its too high level indicates disorders within the organ. The cause may be a cancer of the prostate gland, but also its infection or mild enlargement. PSA norms change with age, but in general the result should not exceed 4 ng / ml. It is assumed that the PSA test should be performed by every man over the age of 45, while men who carry the BRCA2 mutation, which increases the risk of prostate cancer, and who have a family history of prostate cancer, should perform the first PSA test after the age of 40 . The test should be repeated once a year.
Per rectum examination
It is fearsome, embarrassing and resistant, but is almost painless and only lasts a few minutes. What is very important, it is used in many fields of medicine. It is a routine urological procedure in men – it allows to assess both the prostate gland and detect its possible enlargement (which is important both in the diagnosis of benign prostatic hyperplasia and prostate cancer), as well as to examine the vas deferens and seminal vesicles. If the PSA level results are above the norm and the rectal examiner finds any abnormalities, the patient is referred for a prostate biopsy.
Ultrasound of the urinary system
Ultrasound examination of the urinary tract facilitates the diagnosis of diseases of the urinary system that are hazardous to health. The image obtained thanks to ultrasound waves allows to assess the condition of the urinary tract, kidneys, bladder and prostate gland. The most common indications for the examination are abnormal results of a general urine test, pollakiuria, increased urination at night, hematuria, abdominal pain, epigastric pain, and lumbar pain. While the ultrasound examination of the kidneys does not require special preparation on the part of the patient, in the case of ultrasound examination of the prostate and bladder, it is crucial to fill the bladder as much as possible.
Urodynamic examination
It is not the most pleasant – it is performed with the use of special catheters, which during the examination are inserted through the urethra into the bladder and through the rectum into the bowel bowel. However, it allows for a comprehensive assessment of the function of the bladder and urethra. The most common indications for urodynamic examination are: pollakiuria, urgency, post-voiding urine retention, weakened urine stream, urinary retention, urinary incontinence. It is usually preceded by a urine examination and ultrasound of the urinary system.
Cystoscopy
It is one of the diagnostic tools in the prevention and diagnosis of bladder cancer, most often affecting men aged 50-80 years. In addition, this test is performed in the diagnosis of diseases such as urinary incontinence, hematuria, bladder stones, and chronic unexplained urinary tract infections. It involves placing a special speculum in the urethra and bladder, called a cystoscope. During the examination, the bladder is filled with a fluid that facilitates the assessment of any abnormalities. During cystoscopy, it is possible to perform a bladder biopsy, remove some tumors, crush and remove stones in the bladder.