Conditions
Bladder Cancer | Erectile Dysfunction | Incontinence | Infertility | Kidney Tumors | Overactive Bladder
Prostate Cancer | Prostate Enlargement (BPH) | Stone Disease (Kidney & Ureteral) | Urinary Tract Infection (UTI)
Bladder Cancer
Bladder Cancer is cancer that forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation.
Most symptoms of bladder cancer can occur with non-cancerous conditions, so it is important to get yourself evaluated if symptoms persist. Some bladder cancer symptoms include:
- Blood in urine
- Frequent urination
- Painful urination
- Urgent urination
- Abdominal pain
- Anemia
- Bone pain or tenderness
- Fatigue
- Urinary incontinence
- Weight loss
Erectile Dysfunction
Erectile Dysfunction (ED) is the inability of a man to achieve or maintain an erection sufficient for his sexual needs or the needs of his partner. Most men experience this at some point in their lives, usually by age 40.
Some men, however, experience chronic, complete erectile dysfunction (impotence), and others, partial or brief erections. Frequent erectile dysfunction can cause emotional and relationship problems, and often leads to diminished self-esteem. Erectile dysfunction has many causes, most of which are treatable, and is not an inevitable consequence of aging.
According to the National Institutes of Health, approximately 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED on a long-term basis.
Physical causes of erectile dysfunction can include:
- Alcohol and tobacco use
- Fatigue
- Brain or spinal-cord injuries
- Hypogonadism (which leads to lower testosterone levels)
- Liver or kidney failure
- Multiple sclerosis
- Parkinson's disease
- Radiation therapy to the testicles
- Stroke
- Some types of prostate or bladder surgery
Incontinence
Incontinence is any involuntary leakage of urine. It is a common and distressing problem, which may have a significant impact on quality of life. There are several different types of urinary incontinence.
Stress incontinence may happen when there is an increase in abdominal pressure such as when you exercise, laugh, sneeze, or cough. Urine leaks due to weakened pelvic floor muscles and tissues. Causes of stress incontinence include:
- Multiple pregnancies and child births, which cause stretching and damage
- Being overweight
- Genetic weakness
- Radiation therapy
Urge incontinence is often called "overactive bladder.” With urge incontinence you have an urgent need to go to the bathroom, often leaking urine. Causes of urge incontinence include:
- Damage to bladder's nerves
- Damage to nervous system
- Damage to muscles
Overflow incontinence occurs when you are not able to completely empty your bladder when you urinate. This type of urinary incontinence is most common in men. Causes of overflow incontinence are:
- Weak bladder muscles
- Blockage of urethra / prostate enlargement
- Certain medical conditions including tumors
Functional incontinence occurs when physical problems such as arthritis or dementia prevent you from getting to the bathroom.
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, some which may be bypassed with medical intervention.
Treatment depends on the cause of infertility and may involve:
- Education and counseling
- Medical procedures such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
- Medicines to treat infections and clotting disorders, or promote ovulation
Causes of infertility include a wide range of both physical and emotional factors. A couple's infertility may be due to female factors, male factors, or both.
Male Infertility
For men, the most common cause of male infertility is a varicocele. This is when the veins in the scrotum are enlarged on one or both sides. This heats the inside of the scrotum and may affect sperm production. A blockage in a man's reproductive system may cause male infertility. Some medicines can also cause infertility. Other causes of male infertility may include:
- Low sperm count
- Sperm that are abnormally shaped or that don't move correctly
- Un-descended testicle
- Underlying medical problem
- Varicoceles
Azoospermia or "No Sperm in the Ejaculate" – Q&A with Dr. Honig
Kidney Tumors
Kidney tumors, also known as renal tumors, are growths that can be benign or malignant (cancerous). Several types of cancer can develop in the kidneys. Renal cell carcinoma (RCC), the most common form, accounts for approximately 85% of all cases. In RCC, cancerous (malignant) cells develop in the lining of the kidney's tubules and grow into a mass called a tumor. In most cases, a single tumor develops, although more than one tumor can develop within one or both kidneys. The primary symptoms of kidney cancer are:
- Abdominal mass or lump
- Blood in the urine
- Fever
- High blood pressure
- Pain in the side (flank) or lower back not associated with injury
- Persistent fatigue
- Rapid, unexplained weight loss
- Swelling (edema) in the legs and ankles
Treatment usually involves surgical removal of the kidney, ureter, and portion of the bladder connecting to the ureter. Depending on the stage of the cancer, chemotherapy and radiation may be used as adjuvant treatments.
Overactive Bladder
An overactive bladder is a condition that results from sudden, involuntary contraction of the muscle in the wall of the urinary bladder. Overactive bladder causes a sudden and unstoppable need to urinate (urinary urgency). Overactive bladder is also referred to as urge incontinence and is a form of urinary incontinence (unintentional loss of urine). Overactive bladder is especially common in older adults and affects an estimated one in 11 adults in the United States.
The symptoms of an overactive bladder include frequent urination, urgency of urination, and urge incontinence. Overactive bladder may cause significant social, psychological, occupational, domestic, physical, and sexual problems. These symptoms should not be considered a normal part of aging.
The term “pelvic floor” refers to the group of muscles that form a sling or hammock across the opening of a woman's pelvis. These muscles, together with their surrounding tissues, keep all of the pelvic organs in place so that the organs can function correctly. A pelvic floor disorder occurs when the pelvic muscles and connective tissue in the pelvis weaken or are injured. An estimated one-third of all U.S. women are affected by one type of pelvic floor disorder in her lifetime. Disorders may result from pelvic surgery, radiation treatments, and, in some cases, pregnancy or vaginal delivery of a child.
A pelvic organ prolapse occurs when the pelvic muscles and tissue become weak and can no longer hold the organs in place correctly. In uterine prolapse, the uterus can press down on the vagina, causing it to invert, or even to come out through the vaginal opening. In vaginal prolapse, the top of the vagina loses support and can drop through the vaginal opening.
Symptoms of pelvic organ prolapse include:
- feeling of heaviness or fullness or as if something falling out of the vagina
- pulling or aching or a “bulge” in the lower abdomen or pelvis
- kinking in the urethra, making it harder for a woman to empty her bladder completely, cause urinary tract infections
Prostate Cancer
Prostate cancer is cancer that grows in prostate gland, a small, walnut-sized structure that makes up part of a man's reproductive system. It wraps around the urethra, the tube that carries urine out of the body.
With the emergence of PSA (Prostate-Specific Antigen) testing, most prostate cancers are now found before they cause symptoms. Additionally, while most of the symptoms listed below can be associated with prostate cancer, they are more likely to be associated with non-cancerous conditions. Symptoms of prostate cancer include:
- Urinary hesitancy (delayed or slowed start of urinary stream)
- Urinary dribbling, especially immediately after urinating
- Urinary retention
- Pain with urination
- Pain with ejaculation
- Lower back pain
- Pain with bowel movement
(These are not symptoms of the cancer itself. Instead, they are the symptoms of the blockage from the cancer growth within the prostate and surrounding tissues.)
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Prostate Enlargement (BPH)
Prostate enlargement, also known as BPH (Benign Prostatic Hyperplasia), is the enlargement of the prostate gland and is very common in older men. Generally, as men grow older, the prostate continues to grow, which can result in urine flow obstruction. BPH is non-cancerous, but it can lead to urinary problems such as possible urinary tract infection, bladder stones, blood in the urine and, in some extreme cases, kidney failure.
BPH can be a progressive disease, especially if left untreated. Incomplete voiding results in stasis of bacteria in the bladder residue and an increased risk of urinary tract infections. Urinary bladder stones are formed from the crystallization of salts in the residual urine. Urinary retention, acute or chronic, is another form of progression. Acute urinary retention is the inability to void, while in chronic urinary retention the residual urinary volume gradually increases, and the bladder distends. Some patients that suffer from chronic urinary retention may eventually progress to renal failure, a condition termed obstructive uropathy.
Stone Disease (Kidney and Ureteral)
Kidney stones (calculi) are hardened mineral deposits that form in the kidney. They originate as microscopic particles or crystals and develop into stones over time. The medical term for this condition is nephrolithiasis, or renal stone disease.
The kidneys filter waste products from the blood and add them to the urine that the kidneys produce. When waste materials in the urine do not dissolve completely, crystals and kidney stones may form.
Stones may pass out of the kidney, become lodged in the tube that carries urine from the kidney to the bladder (ureter), and cause severe pain that begins in the lower back and radiates to the groin. A lodged stone can block the flow of urine, causing pressure to build in the affected ureter and kidney. Increased pressure results in stretching and spasm, which cause the severe pain.
If a stone needs treatment, the goal of treatment is to completely remove the stone that has been diagnosed and is causing symptoms. Treatment methods usually are chosen based on the location of the stone. For kidney stones, treatment may include:
- Shock wave lithotripsy: a noninvasive method using energy to fragment stones
- Percutaneous (through the skin) lithotripsy: an endoscope is inserted into the kidney with energy applied directly to the stone
- Open surgery with an incision
Urinary Tract Infection (UTI)
A urinary tract infection is an infection that begins in your urinary system. Your urinary system is composed of the kidneys, ureters, bladder and urethra. Any part of your urinary system can become infected, but most infections involve the lower urinary tract, the urethra and the bladder. Women are at greater risk of developing a urinary tract infection than are men. A urinary tract infection limited to your bladder can be painful and annoying. However, serious consequences can occur if a urinary tract infection spreads to your kidneys. Symptoms of urinary tract infections include:
- Cloudy urine
- Foul or strong urine odor
- Frequent or urgent need to urinate
- Low fever (not everyone will have a fever) / Need to urinate at night
- Pain or burning with urination
- Painful sexual intercourse
- Pressure in the lower pelvis
Antibiotics are the typical treatment for a urinary tract infection. However if the infection spreads to the kidneys further medical treatment is needed.