Stone Disease | Kidney Tumors | Interstitial Cystitis | Incontinence | Genitourinary (GU) Trauma
Stone Disease
Kidney stones are small, hard deposits made of acid salts and mineral. A kidney stone may not cause any symptoms until it moves into the ureter. Symptoms include severe side and back pain (below the ribs), pain when urinating, a persistent urge to urinate, nausea and vomiting. Although there is no single thing that can cause a kidney stone to develop, several factors can make one susceptible to kidney stones, including a family history of kidney stones, dehydration and obesity. Men are more likely to develop kidney stones.
While passing kidney stones can be painful, they typically do not cause permanent damage. Aside from drinking plenty of water and taking pain medicine, treatment is seldom necessary. However, we can use laser treatment, which inserts a scope into the bladder and ureter. A laser is used to break up the stones so they can be passed more easily. Extracorporeal shock wave lithotripsy (ESWL) is a procedure most frequently used, where shock waves travel through the skin and tissues until they reach the denser stones. The stones are broken down during this process, so that they can be easily passed through the urinary tract. The most intense treatment is a nephrolithotomy procedure. A surgeon will make a small incision in your back to access the kidney. A thin tube is placed into the incision, and a probe is used to fish out the stones.
Kidney Tumors
Kidney tumors originate in the kidneys, the bean-shaped organs located on opposite sides of your spine. Many kidney cancers are detected during procedures for other diseases or condition because signs and symptoms typically do not show up in the earlier stages of kidney cancer.
Kidney cancer is diagnosed through a series of tests such as blood, urine, imaging, ultrasound and biopsy. Biopsy is generally avoided when possible, since the first line of defense against kidney cancer is removal surgery. Additional CT scans may be required post diagnosis in order to determine what stage your cancer is in.
Stages of Kidney Cancer
- Stage I
During stage one, the tumor remains confided to the kidney. - Stage II
During stage two, the tumor has grown larger than in stage one, but it still has not spread beyond the kidney. - Stage III
During stage three, the cancer has expanded beyond the kidney and invaded the surrounding tissues, glands or lymph nodes. - Stage IV
During stage four, cancer cells have spread far beyond the kidneys and have invaded the lymph nodes and other vital organs, such as the liver, the brain, the lungs, etc.
Your treatment options will be determined on an individual basis, depending on what stage your cancer is in when it is detected. Procedures available to you may also be determined by other factors, such as your overall health.
Interstitial Cystitis
Interstitial cystitis is a chronic disorder affecting the bladder. Also known as painful bladder syndrome, this condition can affect persons of all ages. However, women are more likely to be diagnosed with this condition.
Symptoms
- chronic pelvic pain
- an urgent and persistent need to urinate
- pain during intercourse
- frequent urination; often in small amounts
Discomfort in the pelvis area can range from a mild burning feeling to severe pain.
Symptoms can vary over time, and flare up in response to common triggers, such as stress, exercise, menstruation, sitting for a long period of time, or sexual activity.
Even though the symptoms of interstitial cystitis are similar to a urinary tract infection, when a urine specimen is taken, no bacteria are present. However, if you have interstitial cystitis and you get a urinary tract infection, your interstitial cystitis symptoms may get worse.
Among other reasons, interstitial cystitis can occur due to a defect in the functioning of the bladder. Normally in adults, the bladder expands until it gets full, and then signals then brain that it's time to urinate. If you have interstitial cystitis, in some way, these signals get mixed up. Thus you feel like you have to urinate more often and in smaller amounts. In some cases, interstitial cystitis can occur if there is a defect in the protective lining of the bladder, the epithelium. A leak in the epithelium, for example, can enable toxic substances in urine to irritate the wall of your bladder. Allergy, infection and heredity may contribute to interstitial cystitis. This fact, however, has not been proved.
Interstitial cystitis affects relationships, causes emotional stress and depression, and can have a negative impact on your overall quality of life. Although, there is no cure for interstitial cystitis, there are treatments available that can relieve symptoms.
Treatment options include oral medications designed to alleviate pain and decrease urinary urgency and frequency, as well as nerve stimulation, during which mild electrical impulses are used to alleviate pelvic pain and decrease urinary frequency. Surgery may also be an option, but it is only considered after other treatments have failed.
Even though there is no scientific research to suggest that dietary choices can cause interstitial cystitis, it may be helpful to avoid foods known to irritate the bladder, like carbonated beverages, caffeine, citrus products, and foods containing large amounts of vitamin C.
Also, to help reduce urinary frequency, it may be helpful if you time how often you urinate. Instead of going when you feel the urge, begin going every half-hour, whether you actually have to urinate or not. Then you should gradually wait longer between visits.
Learning to control the urge to urinate can reduce frequency as well. You can do this by practicing slow and deep breathing, or other relaxation methods.
Other self-care methods that may be beneficial include:
- Wearing loose clothing. Avoid belts or any clothing that places pressure on your abdomen.
- Reducing stress using low-impact exercise, visualization or other methods.
- Doing pelvic floor exercises to gently stretch and strengthen the pelvic floor muscles.
- Stop smoking
- Doing easy stretching exercises.
If you have interstitial cystitis, establishing a support system of family and friends can help you cope with your condition. Perhaps most importantly, find a urologist who is sincerely concerned about your condition and quality of life, who will work with you to help reduce your symptoms.
Incontinence
Even though urinary incontinence is an embarrassing condition, it is also very common. More prevalent with age, urinary incontinence is a condition where bladder control is lost. Indicators of urinary incontinence range from spotting to mild leaking to uncontainable urination.
Urinary incontinence can be categorized as either "stress incontinence" or "overactive bladder".
- Stress incontinence is caused when the muscles that close off the bladder are weakened and don't function properly. Patients may experience mild leaking during activities that add pressure to the bladder, like lifting heavy objects, coughing, sneezing, laughing or exercising.
- Overactive bladder is caused when the muscles that close off the bladder are too active, giving the urge to urinate even when there is very little urine in the bladder. Sometimes the urge is so strong and comes on so quickly that the patient doesn't have time to reach a bathroom.
The treatment for urinary incontinence depends on the type of incontinence and the severity of the condition. Treatments include: pelvic floor muscle exercises to strengthen the muscles, bladder training to delay urination after you get the sudden urge, medications, surgery or wearing pads, adult diapers, protective clothing, etc. Be sure to speak to your doctor to see which treatment method is right for you.
Genitourinary (GU) Trauma
Genitourinary trauma is an injury to the external genitals, bladder or kidney. The most frequent GU trauma occurs to the kidney. The injuries usually occur from blunt force - car wrecks, for example - or other accidents, including but not limited to stabbings, gunshot wounds, surgical complications and infections.
Other common problems, which are sometimes complicated, include genital abnormalities. These are usually noticed and diagnosed during childhood. While urologists focus on surgical treatments, they also have vast knowledge of internal medicine and gynecology in order to treat these reproductive problems.
From a kidney infection to a genital abnormality which requires reconstructive surgery, it is best to have an examination by a urologist. These doctors have extensive education, training and daily experience in effectively diagnosing and treating urological problems.