Urology Clinic

Urinary Tract Infection

Urinary tract infections may include infections of the kidney, ureters or urinary bladder.  They are caused by bacteria or fungus.

Bacteria usually enter the body through the urethra, and spread from the bladder towards the kidneys.  The most common bacteria to affect the urinary tract is E.coli, which is a bacteria normally found at the perianal region.  Infections are more common in females than in males due to the following reasons:

• The urethra in females is in closer proximity to the perianal region, allowing easier access of bacteria into the urethra.
• The urethra in females is shorter, increasing the risk for entrance of bacteria into the urinary bladder.
• Wrong method of perineal care, such as wiping from the back to the front.
• Vaginal secretions can be a medium for bacterial growth.
• Sexual intercourse is another way for bacteria to enter the urinary tract.

Kidney Infection

Infection of the collecting system of the kidneys can cause back or flank pains, blood-tinged urine or swelling of the body.  If untreated, kidney infections can spread to the rest of the body through the blood stream (sepsis) and can be fatal.

Kidney Stones

Kidney stones usually form from precipitation of calcium and other minerals. The size and shape of the stones differ according to content of the stones.  They are most commonly found in the ureters, and occur more commonly in males.   The exact cause of stones is not clear; however certain factors are related to stone formation such as dehydration, urinary tract infections, patients with bedridden condition. Stones in the kidney may not cause any symptoms; however patients may experience blood urine and severe flank pain when stones travel down the ureters.  If stones completely occlude the ureters, the doctor may consider surgery or lithotripsy to remove the stones.

Cancer of the Kidneys

The exact cause of cancer of the kidneys is uncertain; however smoking is one of the risk factors.  Kidney cancer can spread to the liver, brain and bones even before any symptoms are observed.  The symptoms may be vague, such as bloody urine, back or flank pain.

Cancer of the Urinary Bladder

The exact cause of cancer of the urinary bladder is also uncertain.  However, smoking and prolonged contact with certain chemicals are strong risk factors.  The patient may be asymptomatic during the early stages of the disease.  During later stages, the patient may experience bloody urine, decreased urine, and increased frequency of urination at night, body malaise or pain.  The doctor may consider surgery, radiotherapy or chemotherapy, or combinations of these therapies as appropriate.

Signs and Symptoms of urinary tract disease include the following:

• Bloody urine (hematuria)
• Pus in the urine (pyuria)
• Difficulty of urination (dysuria)
• Frequent urination
• Frequent urination at night (nocturia)
• Decreased amount of urine (oliguria) or no urine output (anuria)
• Sensation of urine urgency
• Urinary incontinence
• Back pain or flank pain, possible nausea or vomiting
• Body malaise or fatigue

Disease of the urinary tract may also secondarily affect the heart and lungs, causing signs and symptoms like high blood pressure, body swelling or difficulty breathing (dyspnea).

Laboratory Investigations  

Your doctor may order the following laboratory tests according to your symptoms:

• Urine analysis. This a basic test, and the most commonly ordered test for evaluating the urinary tract.
• Urine culture and sensitivity. This test is usually ordered if the urine analysis shows an abnormal number of white blood cells.
• Blood tests to evaluate kidney function.
• Plain x-ray films of the kidney, ureters and bladder (KUB) or special films such as intravenous pyelograms.
• Ultrasound of the kidneys and urinary bladder.
• CT scan of the urinary tract system.
• Cystoscopy. A procedure that is used to look at the bladder and urethra, collect urine samples or samples of the bladder lining.
• Biopsy of any abnormal masses in the urinary tract.

Prostate Specific Antigen (PSA) to evaluate the prostate gland, and possible biopsy of the prostate gland in cases with high PSA levels.