Understanding Urinary Tract Disorders and Related Cancers: Symptoms, Diagnosis, and Treatment

Among the health problems that a person can face, at least once in their lifetime, are urinary tract disorders.

In the case of women, urinary tract infections are mainly represented by bladder infections, so-called cystitis. The explanation for the fact that women are affected by this type of infection more frequently than men is an anatomical one: a woman’s urethra is five times shorter than a man’s urethra. The urethra, that channel through which urine accumulated in the bladder is eliminated, can also be an access path for bacteria in the urinary system.

Although these types of lower urinary tract infections are common and fairly trivial at first, if neglected or not treated properly, they can progress up the urinary tract and cause infectious damage to the kidneys. The following are indications that such an infection has worsened: an altered general condition, a high temperature, as well as lumbar (back) and abdominal pain. In the late stages, when the infection affects the kidneys, affecting the urine collection system at this level (pyelonephritis), the phenomenon of generalized infection can be reached by transfer into the bloodstream (septicemia). This situation occurs rarely, but it is a medical emergency and, in the absence of appropriate therapeutic measures, can lead to death.

That is why, to avoid complications, it is important to contact the doctor from the first symptoms when a urinary infection is suspected. Self-medication is not a correct approach in such situations, because the random or unfounded use of antibiotics will lead to the development of antibiotic resistance and, implicitly, the ineffectiveness of the treatment.

A person can be considered to be experiencing a recurrent urinary tract infection if they have had three episodes of diagnosed disease over the course of a year or two such episodes within a six-month period.

Prostatitis

The prostate is about the size of a walnut and is located just below the bladder. This gland, specific to the male sex, also plays a role in reproduction, by secreting seminal fluid, which favors the movement of spermatozoa. Infections located at this level can be of several types, depending on the cause and the duration of the manifestation: acute or chronic bacterial prostatitis, chronic prostatitis (chronic pelvic pain syndrome – when no infectious or other cause has been identified) and asymptomatic inflammatory prostatitis (when inflammation occurs in the absence of symptoms).

In many cases, prostate infections are manifested by frequent and difficult urination, local pain, abdominal discomfort at the trouser belt line. The affected person must go to the doctor as soon as possible if he can no longer urinate, if he has become painful to urinate and has a fever, if he urinates with blood and if he has severe pain in the genital area.

The urological consultation and the treatment prescribed after it cannot be replaced by the independent administration of dietary supplements or other means of alternative treatment with the advertised effects of improving the functions of the prostate (there are a lot of advertisements on TV in this regard). If not treated properly, prostatitis can recur in a high percentage, and maintaining an inflammatory state of the prostate will lead to complications.

Prostate cancer

Prostate cancer generally occurs after the age of 50. The disease can appear even earlier if there are first-degree relatives with this type of cancer in the family.

Early diagnosis of prostate cancer is of paramount importance, considering the fact that surgical treatment performed in early stages can lead to cure in 85-90% of cases, with an average survival time of up to 15 years. Without treatment, a man with prostate cancer has a survival prognosis of about three years.

Since this cancer does not show symptoms until the late stages, in most cases, it is very important to monitor the health of the prostate by measuring the value of the prostate specific antigen (PSA). PSA is the most important marker widely available for detecting prostate cancer and also has utility in monitoring the condition. But elevated PSA values ​​are not only specific for prostate cancer, but can also be found in other conditions (prostate adenoma, acute or chronic prostatitis). Therefore, the recommendations of the practice guidelines are that urologists determine the need to perform this analysis following discussion with patients.

International recommendations for the early detection of prostate cancer include, in the case of men over 50 years of age, PSA testing, supplemented by a rectal examination of the prostate.

At younger ages (40-45 years), PSA testing is indicated only in those cases with a family history of prostate cancer (first-degree relatives). Also, having an annual prostate ultrasound after the age of 40 is an effective way of screening.

Bladder cancer

Bladder cancer forms from bladder cells that undergo genetic mutations.

Bleeding in the urine (hematuria) – visible to the naked eye or detected in the urine test – may suggest the presence of bladder cancer; painful urination, frequent urination, and a feeling of incomplete emptying of the bladder may indicate cancer at this level. Men are three times more likely than women to develop this type of cancer. People who smoke are also more vulnerable to developing bladder cancer. Also, studies show that this type of cancer mainly manifests itself after the age of 55.

A definite diagnosis can be obtained by performing an abdominal ultrasound and following an inspection with a video camera of the inside of the bladder (cystoscopy). Bladder tumors are not always aggressive, but if they are not treated from the beginning, they will recur or turn into invasive cancers, which metastasize to other organs or tissues (lungs, liver, bones).

Kidney cancer

Men are twice as likely as women to get this disease. Kidney cancer occurs predominantly in the 65-74 age group, according to studies. And this type of cancer can be manifested by bleeding in the urine, but also by high blood pressure, back pain, slightly elevated temperature, anemia, fatigue, bone pain, etc. Smokers, people suffering from obesity and those exposed to radiation are categories at high risk of developing kidney cancer.

Renal cancer has a poor response to cytostatic treatment, and radiotherapy is ineffective. Recently, some classes of drugs have appeared that have shown higher effectiveness, but even so, surgical treatment remains the best option. But only if the disease is identified in the early stages are there real chances of cure. Carrying out an imaging investigation (ultrasound, MRI), after the age of 40, is a solution to discover this type of cancer early.

Informative material created by Dr. Cornoiu Cristina, family medicine specialist, Family Planning Cabinet within the Târgu-Jiu County Emergency Hospital