The urinary tract is responsible for the body’s production of urine for the removal of waste from the body. It includes your kidney, ureters, bladder, and urethra. Urological conditions include:
- Prostate enlargement from benign prostatic hyperplasia (BPH)
- Bladder control problems from urinary incontinence due to pelvic floor dysfunction
- Hematuria (blood in the urine)
- Infections of the urinary tract
- Vesicoureteral reflux (urine inappropriately moving from the bladder back into the ureter)
- Kidney stones
These conditions require attention by your nephrologist usually in cooperation with urology.
Benign prostatic hyperplasia (BPH)
BPH is a condition that involves an enlarged prostate that presses into the urethra and can lead to retention of urine within the bladder.
Symptoms of BPH:
- Trouble starting to urinate
- A urine stream that starts and stops unintentionally
- Weak urine flow
- Increased urgency
- Inability to fully empty leading to a frequent sensation to urinate.
Risk factors for BPH:
- Aging
- Obesity
- Family history
BPH can lead to bladder damage, infection, and cause hematuria (blood in the urine) and kidney damage. Treatment options include lifestyle modifications, medications, and surgery.
Pelvic floor dysfunction
Pelvic floor dysfunction is a condition that can affect females characterized by the inability to relax and coordinate the muscles in the pelvic floor.
Symptoms of pelvic floor dysfunction:
- Sensations of incomplete emptying of the bladder leading to an increased urgency to urinate
- Painful urination
- Constipation
- Pain or pressure in the vagina or rectum
- Muscle spasms in the pelvis
- Leaking stool or urine (incontinence)
Causes of pelvic floor dysfunction:
- Obesity
- Advancing age
- Childbirth
- Pelvic surgery
Treatments for pelvic floor dysfunction:
Treatments include pelvic floor physical therapy and behavioral modifications including keeping a healthy weight, avoiding constipation, smoking cessation, and pelvic floor exercises.
Hematuria
Hematuria is the presence of blood in the urine. Gross hematuria is when the blood is in a quantity to change the color of the urine whereas microscopic hematuria is when the blood cells can only be seen under a microscope.
Causes of hematuria:
There are several causes for blood in the urine may include, but not limited to:
- Kidney stones
- Infection of the bladder, kidney, or prostate
- Bladder or kidney cancer
Presence of blood in your urine, especially if painless, should be evaluated by a nephrologist usually in partnership with a urologist.
Vesicoureteral reflux (VUR)
VUR is when urine flows in the wrong direction after entering the bladder. Some urine flows back towards the kidneys and this can increase your risk of developing a urinary tract infection (UTI). VUR can be due to a functional abnormality of the ureter or secondary, due to blockage or narrowing in the bladder or urethra.
Frequently, VUR is diagnosed and treated in childhood, but VUR can be suspected in adults with frequent UTIs and can predispose patients to develop infections of the kidney – pyelonephritis, high blood pressure, and impaired renal function.
The function of emptying the bladder may become dysfunctional as well. Disorders that can predispose to this condition include long-term uncontrolled diabetes, nerve injury, long-term untreated retention of urine which causes the muscles of the bladder to stretch, or recurrent infections. Bladder dysfunction can be diagnosed with imaging and a procedure that measures various pressures in the bladder prior to and during urination.
In summary, from a long-term health and lifestyle standpoint speak to your provider if you notice any changes in sensation or difficulties with urination or if you notice a discoloration of your urine because further testing may be required and interventions may be needed to ameliorate the condition to promote overall kidney health.
