Kidney stones occur when salts in the urine form into solid crystals or ‘stones’. These stones can block the normal urine flow, and can be accompanied by severe pain. Kidney stones can also cause infection, and even kidney damage or failure in severe cases. There are several types of kidney stones, with the most common being what are known as calcium stones.
Symptoms, causes and diagnosis
Symptoms may include severe gripping pain in the back, blood in the urine, passing small stones in the urine, and a fever if infection is present. It’s also important to note that some people with kidney stones do not experience any symptoms at all.
Causes of kidney stones include high levels of calcium and other substances in the urine, as well as certain medications and medical conditions.
Diagnosis may be done by ultrasound, CT scan or x-ray. Stones that are passed in the urine can also be examined by a physician or kidney stone specialist to determine what category they fit into.
Kidney stone treatments
Kidney stone treatments vary, and will depend on the size and type of stone, and what problems it is causing for the patient.
In many cases, no treatment is necessary, as the patient will pass the stones in the urine. Pain relief might be required, and if pain is particularly severe, hospitalisation and strong medication might be necessary.
Kidney stone removal by open surgery is rarely used in Australia, usually being reserved for severe cases such as those where large obstructive stones are present, and / or there is a risk of complications such as organ damage.
Since the prostate is one of the organs mostly involved in urinary and reproductive health issues among men, promoting awareness of prostate diseases is a significant step for prevention. Some prostate conditions, although benign and non-cancerous, may be potential risk factors of prostate cancer. At Katelaris Urology, we aim to help raise men’s knowledge and awareness about prostatic diseases for better prostate health and improved overall wellness.
Let’s look into the two most common non-cancerous prostate problems.
Prostatitis
Inflammation of the prostate may be bacterial or non-bacterial in nature, and occurs mostly in young and middle-aged men. Bacterial prostatitis can be due to leakage of infectious microbes into the gland, from the urethra and rectum. Chronic prostatitis, also referred to as chronic pelvic pain syndrome, is not caused by bacterial infection and usually has no known specific cause. Common risk factors of prostatitis include: recent urinary tract infection, anal intercourse, usage of a urinary catheter, urinary tract abnormalities, and local trauma in the pelvic region.
Signs and symptoms
An affected person may experience pain and difficulty upon urination; discomfort and pain in the groin, testicles, rectum, pelvis or lower back; fever; body malaise; urinary urgency; painful orgasms; erectile dysfunction; and haematuria (blood in the urine).
Diagnosis and treatment
A digital rectal examination is performed to assess a tender and swollen prostate. In this procedure, a physician inserts a lubricated, gloved finger into the rectum and gently palpates the gland to check the degree of pain and inflammation. Testing of blood, urine, semen and prostatic fluid specimens and imaging procedures such as bladder ultrasound and cystoscopy may also be performed to further confirm diagnosis.
Antibiotics are prescribed to kill bacteria if infection is present. Analgesics and anti-inflammatory medications are used to address the pain and discomfort from accompanying symptoms. Alpha-adrenergic blocking agents (medicines that relax the bladder and prostate muscle fibres) may also be used to lessen urinary symptoms and improve bladder emptying and urine flow.
Benign Prostatic Hyperplasia (BPH)
A common condition among older men, primarily those over 40 years old, Benign Prostatic Hyperplasia (BPH) is a non-cancerous growth of the prostate gland. It is highly treatable and non-life-threatening, but may cause major discomforts if left untreated. Nearly all men experience this as part of the ageing process. It remains unclear what actually causes BPH, but researchers link it to the hormonal and cellular changes as men age. Since the prostate surrounds the urethra, enlargement of the gland may compress the urinary tube, disrupting normal urine flow.
Signs and symptoms
BPH is accompanied by lower urinary tract symptoms (LUTS) classified into two. Voiding or obstructive lower urinary tract symptoms are caused by the narrowing of the urethra from the enlargement. A patient experiences urinary retention, incontinence, a weak and dribbling stream of urine, and difficulty and pain upon urination.
When the urethra narrows, the bladder may also thicken. Storage or irritative lower urinary tract symptoms are due to the thickening of the bladder wall, resulting to a smaller bladder with lesser storage capacity. Urinary urgency, frequency and nocturia (frequent urination at night) can be expected.
Other symptoms include haematuria and pain in the perineal region. Some men who have prostate enlargement experience only a few symptoms or none at all.
Diagnosis and Treatment
After taking a detailed medical history, a digital rectal exam may be performed. A urine flow test or urinary incontinence assessment may also be done to evaluate how urination is affected. A prostate-specific antigen (PSA) blood test is usually included to determine the possible presence of cancerous cells. If cancer is suspected, a biopsy, cystoscopy and transrectal ultrasound may be done.
If the enlargement is benign and symptoms are mild, pharmaceutical or surgical treatment may not be required, but certain lifestyle changes must be observed, such as reducing caffeine and alcohol intake, limiting fluid intake up to 2L per day, staying active, and maintaining a healthy weight. An annual exam is required for monitoring.
For moderate to severe symptoms, alpha-adrenergic blocking agents are used to improve urine flow, along with drugs that may reduce the size of the enlarged gland. Surgery may be prescribed if severe urinary complications occur, such as kidney and bladder damage.
Here at Katelaris Urology, our experienced and pre-eminent urologist, Dr. Katelaris will help you manage prostate problems with the use of the latest and most innovative technologies for urological medical-surgical care, including robotic prostatectomy. Call us now and book a consultation appointment.
We also offer surgical reproductive health procedures such as male vasectomy and reversal and prosthetic surgery for erectile dysfunction.
