Ask the Urologist

Q. What if I see blood in my urine? Is it serious?

A. Sometimes we digest things that have dyes that can appear as if there is blood in the urine. An in-office urinalysis will help determine whether or not there is truly blood in the urine, also known as hematuria.  Hematuria can be caused by inflammation of the bladder or prostate, kidneys stones or even cancer.  Because of the possibility of cancer, even intermittent or periodic hematuria should be investigated by an urologist, if there are no known causes. A preliminary risk assessment by an urologist will then determine which additional tests may need to be ordered.

Q. I suffer from kidney stones, and have been drinking a lot of water but it’s not helping. Is there some other natural approach I can try before medications or medical procedures?

A. Patients who make kidney stones constantly make sand in their urine all the time. Water and other “natural” remedies can lessen the growth of a grain of sand to stone, but, unfortunately, under the right conditions, a stone can still occur in less than two hours.  After assessing the metabolic cause of stones, precise treatment is simple and 90% effective. The tendency to have stones can occur at any time, especially when most inconvenient. Thus, a urologic evaluation is key to preventing stone formation most of time. Don’t ignore the symptoms.  Stones can result in a trip to the emergency department and even an emergency surgery, which means at least a week or two of missed work and other activities.  More importantly, urologic evaluation and care can prevent long term damage to the kidneys.

Q. I'm only 46 and I've noticed that sometimes when I sneeze, I have a little urine leakage. Is this normal?

A. If no urinary urgency exists, this can be stress incontinence, which can be verified by a simple office procedure. The treatment depends on severity of the anatomic defect noted. Urgency and associated incontinence may be an overactive bladder (OAB) and can be treated with simple medications.

Q. My husband is 54 and has to get up one or two times a night to go to the bathroom. He says it's part of aging. Is this normal at his age?

A. Getting up at night, or nocturia, is not normal and it is not a sign of aging. In men after age 45, the most common cause of nocturia is prostate enlargement (EP or BPH). Over time it can lead to other lower urinary tract symptoms (LUTS) such as decreased force of urinary stream, urgency, inadequate emptying, and frequency. About 90% of the time LUTS are progressive as BPH is a progressive disease. Thus, early treatment will improve your quality of life. Simple medications can shrink the prostate and alleviate LUTS and prostatic obstruction, preventing UTIs, urinary retention, the need for catherization and the need for subsequent surgery by 70%.

Q. How do I know the difference between a urinary tract infection and a bladder infection?

A. A bladder infection is by definition the most common urinary tract infection (UTI). Recurrent bladder infections are 90% preventable. Other UTIs also include: Prostate infections, kidney infections, and blockage of any part of the urinary tract causing infected urine. With flank pain and fever, kidney infections can spread bacteria into the blood system causing life threatening sepsis.