UROLOGICAL SYMPTOMS
Symptom refers to any organic phenomenon evidencing the presence of a pathological condition.
It constitutes an indication that something abnormal occurs.
Symptoms vary according to the disease, although different diseases may share symptoms.
Genitourinary diseases may result in the following conditions:
Symptoms from localized or reported pain
- Hematuria
- Frequent urination
- Nocturia
- Urgency
- Dysuria
- Urinary incontinence
- Enuresis (bed wetting)
- Oliguria (low output of urine) or anuria (non-passage of urine)
- Polyuria (excessive urination volume)
- Pyuria
Symptoms related to the reproductive system
Symptoms related to sexual problems
- Erectile dysfunction
- Premature ejaculation
- Low sex drive
- Inability to ejaculate
- Painful sexual intercourse
Systemic symptoms
Fever
source: www.texasmedclinic.com
Fever is the rise in body temperature, often due to a disease.
It is a sign that “something is not right” with our system.
Fever, in combination with other urinary tract symptoms, can help diagnose the cause of the infection.
For example, acute pyelonephritis or prostatitis can cause fever, often accompanied with shivering.
Kidney cancer may also be the cause of fever.
However, the absence of fever cannot exclude the presence of an infection. For example, chronic pyelonephritis does not cause fever.
Weight loss
Weight loss can occur in advanced stages of urinary tract cancer.
But, it may also take place in the event of kidney failure caused by a urinary tract obstruction or infection.
In children, growth failure (weight and height lower than mean age values) may be due to a urinary tract obstruction or infection.
Malaise
General malaise can be observed in cases of cancer, chronic pyelonephritis and kidney failure.
Anorexia
An eating disorder characterized by lack of appetite or food aversion.
It may be caused by organic diseases, such as malignant neoplasias or psychological causes.
Most urinary tract diseases manifesting with anorexia are caused by neoplasms or infections.
Symptoms from localized or reported pain
Renal colic
source: patients.uroweb.org
A severe pain due to the dilation of the kidney and/or the ureter.
It has a sudden onset, with no preceding symptoms.
It starts in the kidney region and may extend to the side and lower part of the abdomen, as far as the genitalia.
The pain comes in waves (colicky pain) which are due to ureteral peristalsis, but it may also be continuous.
The patient hurts and experiences severe discomfort and cannot find a comfortable position to relieve the pain.
Renal colic can be associated with:
- Nausea
- Sweating
- Meteorism (abdominal bloating)
Bladder pain
source: www.urologyfortmyers.com
It may be due to several conditions, such as:
- Urinary tract infection
- Interstitial cystitis
Symptoms change depending on how full the bladder is.
Orchiodynia (painful testicles)
source: www.healthtap.com
Orchiodynia refers to a sense of discomfort or pain localized on one or both testicles.
The cause of the pain may be localized to a single testicle or be referred from other organs, e.g. the kidneys.
Several diseases can cause testicular pain.
It is extremely important that emergencies, such as testicular torsion and acute epididymitis, are diagnosed early and treated.
Testicular pain may manifest as acute or chronic, intermittent or permanent.
Chronic testicular pain can be caused by the following conditions:
- Varicocele
- Hydrocele
- Testicular cancer
Prostatodynia (painful prostate)
Prostatodynia is characterized by symptoms originating in the prostate or its neighboring organs.
The following may co-exist:
- Dysuria
- Orchiodynia (testicular pain)
- Painful ejaculation
Hematuria
source: www.drugs.com
This refers to the presence of blood in the urine.
It is divided into:
- Microscopic hematuria: it means that erythrocytes (red blood cells) are visible to the naked eye but only under the microscope during urinalysis
- Macroscopic hematuria: it means that erythrocytes are found in high concentrations and the urine takes on a red color
Hematuria may be caused by:
- Urinary tract infection
- Urinary lithiasis
- Bladder cancer
- Prostatic cancer
- Anticoagulant medication
- Blood disorders
- Urinary tract trauma
Frequent urination
The need to urinate frequently during the day (usually more than 8 times in 24 hours).
It is characterized by low urine volume (less than 200 mL each time).
Nocturia
Frequent urination during the night which disturbs the sleep.
It develops both in men and women with aging, and can severely impact patient quality of life.
The reasons for nocturia can be:
- Prostate hypertrophy
- Increased fluid or alcohol intake
- Medications, e.g. diuretics
- Diabetes mellitus or insipidus
- Heart failure
- Sleep apnea
- Insomnia
- Depression
- Hyperactive bladder
Urgency
source: www.ccmurology.com
Urgency is the sudden and strong desire to void, which cannot be postponed.
It may be accompanied by frequent voiding and urge incontinence.
Urgency causes can be:
- Urinary tract infection
- Hyperactive bladder
- Bladder cancer
- Urinary tract stones
- Interstitial cystitis
Dysuria
It involves difficulty and pain during voiding.
Dysuria causes are:
- Urinary tract infection
- Prostate hypertrophy
- Urinary lithiasis
- Interstitial cystitis
- Bladder cancer
- Bladder or prostate radiotherapy
- Prostatitis
Urinary incontinence
Urinary incontinence is the sudden and involuntary leakage of urine.
It occurs with equal prevalence in both genders, but it is more common in women.
Types of urinary incontinence:
- Stress incontinence: in this case, urine leakage results from activities which give rise to intraabdominal pressure, such as working out, coughing or sneezing.
- Urge incontinence: it refers to urine leakage following a sudden and strong desire to urinate that cannot be delayed
- Overflow incontinence: it is a consequence of chronic urinary retention and/or flaccid bladder that dilates and overflows
- Continuous incontinence: it may be attributed to a fistula, anal weakness after an injury or congenital defects
Enuresis (bed wetting)
It refers to urine leakage during bedtime.
It is a normal phenomenon during the first 2 to 3 years of life, but it becomes a problem after the age of 5.
It may be due to late neuromuscular maturation or a symptom of an organic condition.
Oliguria (low output of urine) or anuria (non-passage of urine)
Oliguria is when urine volume is less than 400 mL in 24 hours.
Anuria is when urine volume is less than 100 mL in 24 hours (in adults).
The above conditions may be due to:
- Dehydration
- Heart failure
- Kidney failure
- Stones causing obstruction
- Medication
- Sepsis
Polyuria (excessive urination volume)
Polyuria is the production of more than 2 liters of urine in 24 hours.
It is accompanied by frequent, normal volume voiding.
Polyuria may be caused by:
- Diabetes mellitus
- Diabetes insipidus
- Excess fluid intake
- Diuretics
- Coffee or alcohol
Pyuria
Pyuria is characterized by the presence of pyocytes (pus cells) in the urine.
It can be:
- Microscopic: when pyocytes are visible only under the microscope
- Macroscopic: when pyocyte concentration is elevated and makes urine cloudy
The causes of pyuria can be:
- Urinary tract infections
- Urinary tract lithiasis
- Urinary tract tuberculosis
- Foreign bodies, e.g. urinary catheters
Urethral discharge
Urethral discharge constitutes one of the most common urological symptoms in men.
It may be attributed to microorganisms causing urethritis, such as gonococcus and chlamydia.
Skin lesions
Skin lesions in the external genitalia may be due to:
- HPV causing the development of genital warts
- Genital herpes
- Syphilis
- Chancroid
- Penile cancer
- Allergies
- Systemic skin conditions
Hemospermia (blood in the semen)
Hemospermia refers to the presence of blood in the semen.
It is a symptom which worries the patient, yet it is not usually attributed to a severe condition.
It mostly occurs in patients aged 30-40
Hemospermia causes
Semen, or sperm, is the product of several male reproductive organs (testicles, epididymides, seminal vesicles and prostate).
Blood may originate in any of the aforementioned organs.
In a high percentage of patients, the cause of hemospermia is not identified.
Common hemospermia causes are:
- Inflammation of the prostate (prostatitis) or seminal vesicles
- Prostate cancer
- Reproductive system trauma
- Transrectal prostate biopsy
- Transrectal prostatectomy
- Urinary lithiasis
- Blood clotting disorders
- Tuberculosis
- Anticoagulants
Gynecomastia
Gynecomastia is usually idiopathic, i.e. of unknown cause.
It commonly affects elderly men, and especially those who are on estrogens for the treatment of their prostate cancer.
It may also develop in patients with:
- Testicular cancer
- Certain endocrine conditions
- Hereditary syndromes
Erectile dysfunction
Erectile dysfunction is the inability to achieve and maintain adequate erection that allows for a satisfying sexual activity.
It may be occasional or permanent, with or without distinct causes.
It is not life-threatening, yet it may negatively affect the quality of life of both patients and their partners.
Erectile dysfunction causes may be organic or psychological.
Premature ejaculation
It is the persistent and recurrent ejaculation with minimal sexual stimulation within one minute from the beginning of vaginal penetration, before the patient controls it or wishes it.
It may be caused by organic or psychological conditions.
Low sex drive
It refers to a condition characterized by low sexual desire for intimacy and contact.
It affects women more often than men.
It is often due to hormonal disorders resulting in lower levels of androgens in the system.
Androgens affect sex drive both in men and women.
Occasionally, the problem may be due to some other sexual dysfunction, e.g. erectile dysfunction in men or pain during intercourse in women.
Other causes of low sex drive include:
- Mistaken beliefs on sexuality
- Depression
- Stress
- Low self-esteem
- Certain medications
- Chronic diseases
- Drug abuse
Inability to ejaculate
It is a pathological condition characterized by the inability to ejaculate, despite the adequate stimulation of the penis during sexual contact or masturbation.
It may be caused by:
- Sexual inhibition
- Certain medications, such as antidepressants
- Nervous system diseases, such as multiple sclerosis
- Prostatectomy
- Ejaculatory duct obstruction
- Spinal injuries
Painful sexual intercourse
Painful sexual intercourse is mainly due to 2 pathological conditions:
Vaginismus: permanent or repeated difficulty with finger/penis/object penetration of the vagina, despite the woman’s willingness
Dyspareunia: permanent or occasional pain while attempting to penetrate the vagina or after sexual intercourse
The causes of the above conditions may be organic or psychological.
Organic causes include:
- Endometriosis
- Genital inflammations
- Genital skin diseases
- Menopause-associated vaginal atrophy
Psychological causes include:
- The woman being fearful of vaginal penetration
- Depression
- Stress disorders
- Low self-esteem
- Relationship problems
- Poor physical appearance