Urological Pathology Diseases

Prostate cancer develops in the prostate gland of the male reproductive system. Prostate cancer is one of the most common types of cancers occurring in men, especially men over the age of 50. Most prostate cancers are slow-growing, and few cases are aggressive. Symptoms of prostate cancer are similar to those of BPH and include pain or difficulty urinating, blood in the urine or semen, pain in the lower back, hips, or thighs, pelvic discomfort, and erectile dysfunction; though few if any symptoms are present in the early stages of prostate cancer. Men with an immediate family history of prostate cancer are at a much greater risk for developing the disease.

 

Screening for prostate cancer can be done through a digital rectal exam (DRE), a prostate-specific antigen (PSA) blood test, or through a transrectal ultrasound (TRUS). Confirmation of prostate cancer can only be done through a prostate biopsy. Prostate biopsies can also provide information about any cancer cells that are found, providing insight for the cancer’s prognosis and treatment options.

 

Benign prostate hyperplasia (BPH) is benign (non-cancerous) swelling of the prostate. Swelling of the prostate may cause the construction of the urinary tract, leading to difficult or painful urination and urinal hesitancy. These symptoms can lead to increased urinary tract infections, urinary retention, and insomnia. BPH may lead to an increase in prostate-specific antigen (PSA), but does not increase the risk of prostate cancer. BPH commonly occurs in males as they age, whether or not treatment is needed is dependent on the severity of symptoms and patient preferences.

 

Prostatitis is inflammation of the prostate, which may or may not occur due to an infection. Prostatitis may cause pain or difficulty urinating, abdominal, groin, or lower back pain, painful organisms, or pain or discomfort of the penis or testicles. There are several types of prostatitis including acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis not caused by bacteria, and asymptomatic prostatitis.

 

Acute bacterial prostatitis is caused by a sudden onset of infection and typically presents with flu-like symptoms in addition to prostatitis symptoms. This type of prostatitis is generally more severe and may require hospitalized treatment. Chronic bacterial prostatitis occurs with recurring urinary tract infections (UTIs) that have entered the prostate. Symptoms are similar to acute bacterial prostatitis, but less severe and fluctuate in intensity. Chronic prostatitis not caused by bacteria is the most common form of prostatitis, there is no sign of bacteria in the urine, but patients experience other signs and symptoms of inflammation. This type of prostatitis is also known as chronic pelvic pain syndrome. Symptoms may be consistent, or vary over time, and may improve without treatment. Asymptomatic prostatitis does not present any noticeable symptoms and does not require treatment.

 

Bladder cancer develops when abnormal cells uncontrollably multiply in the bladder, these cells form mutations, do not die when they are supposed to, and may create a tumor. Where cancer originates determines the type of bladder cancer, including transitional cell carcinoma (originating in cells which line the bladder wall), squamous cell carcinoma (squamous cells are present with infection or irritation of the bladder, such as in a parasitic infection), and adenocarcinoma (beginning in the bladder’s mucus-secreting glands). Transitional cell carcinoma is the most common form of bladder cancer.

 

The most common symptom of bladder cancer is hematuria, or blood in the urine. Other symptoms may be frequent or painful urination, the urge to urinate without being able to, and lower back or pelvic pain. While the cause of bladder cancer is not always known, there are many known linkages such as smoking, parasites, and chemical exposure. The risk of developing bladder cancer is also increased as a person ages, is more common in men, and is a recurring form of cancer.

 

Screening for bladder cancer may be done through cytoscopy (a narrow tube with a lens and light is inserted into the urethra), a biopsy (a cell sample is taken from the bladder during cytoscopy), urine cytology (cells in the urine are examined under a microscope), or imaging tests (examination of the urinary tract structure). If diagnosed with bladder cancer, the staging of the cancer is determined, and treatment options developed depending on the patient’s specific diagnosis.

 

Cystitis is inflammation of the bladder, often resulting from a urinary tract infection (UTI). Cystitis may also result from a reaction to drugs, radiation, or environmental irritants such as spermicide or the use of a catheter. Symptoms of cystitis include a strong urge to urinate, painful or burning urination, frequently passing small amounts of urine, hematuria, cloudy or strong-smelling urine, or pelvic discomfort.

 

Interstitial cystitis, also known as painful bladder syndrome, is chronic (continuing or recurring) bladder inflammation which may cause pain and/or frequent and urgent urination. The cause of interstitial cystitis is unknown but may derive from heredity, infection, allergy, or an autoimmune reaction. The symptoms may vary over time and also include pelvic pain and pain during intercourse.

 

Hematuria is the presence of blood in urine, it may be gross (seen by the naked eye), or microscopic (visible only under a microscope). In gross hematuria, the urine may be pink, red, or brown. Hematuria has several causes including urinary tract infections (UTIs), kidney infection, kidney stones, enlarged prostate, kidney disease, cancer, hereditary disorders, injury, medication, or strenuous exercise.

 

The overactive bladder has the symptom of urgency and/or frequency of urination and may lead to incontinence. An overactive bladder causes these symptoms because the bladder involuntarily contracts, creating a sense of needing to urinate. Overactive bladder may be caused by neurological disorders, high urine production, medications, urinary tract infections, an enlarged prostate, or excess consumption of caffeine or alcohol.

 

Urinary incontinence is any involuntary leakage of urine due to a loss of bladder control. There are several kinds of urinary incontinence: stress incontinence (loss of urine with stress on the bladder such as sneezing or exercising), urge incontinence (sudden urge to urinate followed by involuntary urination), overflow incontinence (frequent dribbling of urine, resulting from an inability to empty the bladder), functional incontinence (physical or mental impairment), mixed incontinence (symptoms of more than one type of urinary incontinence), and total incontinence (continuous or period leaking of urine in large volume).

 

Kidneys are a bean-shaped organ about the size of your fist. They are located behind the abdominal organs, one on each side of the spine. There are two major forms of kidney cancer, renal cell carcinoma (RCC) and urothelial cell carcinoma (UCC). These different forms of kidney cancer are named for the different cells that develop cancer. RCC develops in the lining of the small tubes of the kidney and UCC develops in the lining of the kidney. RCC accounts for about 80% of kidney cancers, UCC making up the majority of the additional 20%.

 

Symptoms rarely develop in early stages of kidney cancer, but can later include blood in the urine, back pain, weight loss, fatigue, and fever. Risk factors for developing kidney cancer include older age, smoking, obesity, high blood pressure, treatment for kidney failure, Von Hippel-Lindau disease, and hereditary papillary renal cell carcinoma.

 

Kidney cancer may be screened for and diagnosed by a combination of blood and urine tests, imaging tests, or tissue biopsy. Staging of kidney cancer is typically done through imaging tests such as a CT scan. Treatment options depend on overall health, type and stage of kidney cancer.

 

Kidney stones are hard, small deposits that form in the kidneys, they are made of concentrated and crystallized minerals from the urine. Stones may pass without difficulty if small enough, but once they reach about 3mm in diameter, their passing can obstruct the ureter and become painful. There are several types of kidney stones, classified by the minerals they are formed from including calcium stones, uric acid stones, cystine stones, struvite stones (result from infection), and other rare forms.

 

Symptoms of kidney stones include painful urination, back or side pain, cloudy or foul-smelling urine, frequent urination, fever and chills, and pink, red, or brown urine. Pain may move as the stones move through the urinary tract. Risk factors for developing kidney stones include a family or personal history, age over 40, being male, dehydration, obesity, digestive diseases and surgery, certain medical conditions, and diets high in protein, sodium or sugar. Treatment, management, and prevention depend on the cause and type of kidney stone.