What are the common urological symptoms you should not ignore?
Mr Hama Attar, Consultant Urological Surgeon and Senior Clinical Lecturer, explains more about the urinary system and highlights the symptoms you should never ignore.
Urological symptoms are common, and many are caused by conditions that are straightforward to diagnose and treat. However, changes in urinary or sexual health should not be dismissed as an inevitable part of ageing or assumed to be temporary.
The urinary system, which includes the kidneys, ureters, bladder and urethra, can be affected by a wide range of conditions. In men, urological health also encompasses the prostate, testes and other parts of the reproductive system. Symptoms such as blood in the urine, difficulty urinating, recurrent urinary tract infections (UTIs) or persistent pain can have a variety of causes. While these symptoms do not necessarily indicate a serious condition, they should be assessed by a specialist, particularly if they are new, persistent or worsening.
Understanding what is normal, when to seek advice, and which symptoms warrant further investigation can help ensure problems are identified and treated as early as possible.
Mr Hama Attar, Consultant Urological Surgeon and Senior Clinical Lecturer, explains more about the urinary system and highlights the symptoms you should never ignore.
Haematuria (blood in the urine)
Seeing blood in the urine, known medically as haematuria, is a symptom that should always be assessed. The urine may appear pink, red or brown, and blood clots can occasionally be seen. In some cases, however, blood is only detected microscopically through a urine test.
Haematuria can occur as a result of benign conditions such as urinary tract infections (UTIs), kidney or bladder stones, and benign prostate enlargement. However, it can also be an early sign of a urinary tract cancer.
Importantly, blood in the urine is not always accompanied by pain. This means that even if an individual feels completely well, visible blood in the urine should never be ignored.
Approximately one in five people who can see blood in their urine are found to have a urological cancer, while around one in 20 people with microscopic blood detected on testing have a urological cancer. Smoking further increases the risk, particularly for bladder cancer.
Anyone with haematuria should undergo appropriate investigation. Depending on the symptoms and associated risk factors, this may include urine and blood tests, imaging such as an ultrasound or CT scan, and a cystoscopy, which uses a small camera to examine the bladder.
New onset of urinary symptoms
Changes in how often or how easily an individual passes urine are particularly common in later life, especially in men.
Symptoms can include:
- Needing to pass urine more frequently (daytime frequency)
- Waking several times during the night to urinate (nocturia)
- Difficulty starting urination (hesitancy)
- A weak or interrupted urinary stream (intermittency)
- Straining to pass urine (straining)
- A feeling that the bladder has not completely emptied (incomplete bladder emptying)
- Urgency or difficulty holding urine leading to leakage (urgency and incontinence)
- Dribbling after urination (post micturition dribble)
In men, these symptoms are often associated with benign prostate enlargement, also known as benign prostatic hyperplasia (BPH). An enlarged prostate can gradually narrow the water pipe (urethra) and make it harder for the bladder to empty.
However, similar symptoms can have other causes, including urinary infections, urethral narrowing or, less commonly, prostate or bladder cancer.
An assessment can help establish the underlying cause rather than simply treating the symptoms. Treatment depends on the diagnosis and severity of the symptoms. Some people may benefit from lifestyle changes or medications, while others may require minimally invasive procedures.
Recurrent urinary tract infections
Urinary tract infections (UTIs) can cause burning/ stinging when passing urine, increased frequency, urgency, lower abdominal discomfort and sometimes blood in the urine.
While an isolated UTI is common, recurrent infections need further investigations, particularly in men or in patients who experience repeated episodes despite appropriate treatment.
There can be several causes for recurrent infections, including incomplete bladder emptying, urinary stones, prostatic conditions, or other abnormalities of the urinary tract. Identifying and treating the underlying cause is important in preventing further infections.
Kidney and urinary stones
Kidney stones form when minerals and salts in the urine crystallise, precipitate and form hard deposits. Small stones may pass without treatment, but larger stones can become impacted in the urinary tract.
Typical symptoms can include severe pain in the loin area (usually referred to as ureteric colic), pain that travels towards the groin, nausea or vomiting, blood in the urine and urinary symptoms.
Some stones can be managed conservatively, while others may require medications or procedures to remove them. Treatment depends on factors such as the size and location of the stone and whether it is causing an obstruction or infection.
Severe pain accompanied by fever, chills or feeling significantly unwell requires urgent medical assessment because an infected, obstructed urinary system can become a serious condition.
Erectile dysfunction
Erectile dysfunction (ED) is common, but it is not simply an inevitable part of ageing.
Difficulty achieving or maintaining an erection can have many causes, including vascular disease, ischaemic heart disease, diabetes, hormonal factors, side effects of medications, psychological factors and other medical conditions.
Persistent erectile dysfunction can sometimes be an early indicator of underlying cardiovascular or metabolic diseases.
It is therefore worth discussing with a specialist rather than relying solely on treatments purchased without medical assessment. Urologists can assess possible underlying causes and discuss appropriate treatment options.
Testicular symptoms and lumps
A new lump, swelling, change in the size or shape of a testicle, or persistent discomfort should be urgently assessed.
Many testicular lumps are caused by benign conditions (e.g. cysts), but testicular cancer can occur in younger men and is often highly treatable when detected early.
Testicular cancer usually presents with a painless lump which increases rapidly in size.
Sudden and severe testicular pain is different: it can be a sign of testicular torsion (twisting of the testis around itself leading to interruption of its blood supply), which is an emergency requiring immediate urological assessment.
When should you seek medical advice?
Seek a urological advice if any of the symptoms below develops:
- Blood in urine
- Persistent or worsening urinary symptoms including difficulty in passing urine
- Recurrent urinary infections (UTIs)
- Persistent pain in your kidney, bladder, pelvic or genital area
- A new testicular lump or swelling especially if painless
- Persistent erectile dysfunction
Some symptoms require more urgent attention. Inability to pass urine, severe flank pain with fever or chills, significant bleeding with clots, or sudden severe testicular pain should be assessed promptly.
But it is important to know that these symptoms do not usually indicate cancer and reaching an accurate diagnosis is important to decide on the subsequent steps in treating them.
Urological care at Cromwell Hospital
At Cromwell Hospital, our specialist urology team offers comprehensive assessment, diagnosis and treatment for a wide range of urological conditions, from urinary tract infections, kidney stones and enlarged prostate to urological cancers affecting the prostate, bladder, kidneys and testes. Using advanced diagnostics, specialist pathways and innovative treatments, including minimally invasive and robotic surgery, we provide personalised care tailored to each patient's needs. For those diagnosed with urological cancer, our multidisciplinary team approach ensures every patient benefits from expert input and access to world-class treatment options.
