Page 7 - Urological Health

What tests do I have to do?

When presenting with blood in the urine, tests are usually recommended to assess the urine, the
kidneys and the bladder.
• Urine tests include a dipstick test to look at the amount of blood and whether any clues to
inflammation of the kidney can be found.
• Urine culture will assess for an infection.

• Urine cytology tests will look for abnormal cells that are worrisome for cancer.
• An ultrasound, CT or MRI scan will usually be recommended as the best way to see the
kidneys in detail.

• Many patients will be recommended for cystoscopy, in which a small camera is passed
through the urethra into the bladder – the best way to look at the bladder lining to check
for any abnormalities.

2. Why do I have to go to the bathroom so often?

We take for granted that our bladder habits are very predictable and regular – they don’t interfere with
our day-to-day lives. When something feels abnormal about our voiding, it can negatively affect our
UNDER REVIEW
lives. Two common abnormal feelings are (1) having to urinate very frequently or (2) having to urinate
very suddenly. These issues can be very frustrating, especially if there is no bathroom nearby.

There are a number of causes that can affect your bladder’s ability to completely fill without
signalling to us that we need to urinate. Thankfully there are effective treatments to deal with
these causes.

One of the most obvious causes of urinary frequency is a bladder infection or cystitis.You feel this
as bladder discomfort between your navel and pelvic bone, frequent or urgent voiding and burning
pain with urination.
The bladder can also be overactive for a number of other reasons. Please see the Urinary Tract
Infections chapter for more information. Urologists have long recognized the phenomenon of
overactive bladder (OAB) in women, and are becoming more aware of it in men as well.
Urinary frequency (urinating a lot) and urinary urgency (sudden feeling of having to go to the
bathroom) are symptoms of OAB. The reasons for it are not well understood, but in these patients the
bladder seems to have a “mind of its own,” and will create the desire to urinate very frequently. It can
be treated with behavioural techniques known as bladder training,or withacommon class of
medications called anticholinergics,whichreduce the spasticityof the bladder muscle in these cases.
Urinary frequency is also common in men with benign prostate enlargement, who may have
difficulty fully emptying their bladders. People with“lazy” bladders may also have the same sensation,
because the bladder will become full sooner than if it had been able to empty completely.

Your urologist will also keep in mind that less common causes of overactivity in the bladder might
have a neurological cause in the brain or spinal cord. Your doctor may ask some questions about
seemingly unrelated neurological symptoms to better assess this.

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