Published on 27 October 2022

    Your urological system is a complex and beautiful thing, but sometimes problems crop up. Our experts weigh in on three common conditions.

    Your urinary system is one of the hardest working parts of your body, managing and eliminating waste through your urine. For most people, small problems may crop up at some point in their lives – so it’s useful to understand what these problems are and how to deal with them. 

    The team at the National University Hospital (NUH) Specialist Urology Centre shared their expertise on some common urological problems they see. 

    Urinary stones

    Urinary stones are “small, hard deposits of minerals and acid salts that can form inside the kidneys or urinary bladder”, said Dr Kelven Chen, Associate Consultant, Department of Urology, NUH. They are more common among men and become more likely as you get older. In fact, between 5-25% of the population will suffer from them in their lifetimes. 

    So how can you tell if you have them? According to Dr Chen, the most common symptoms are pain in your loin which may move towards the groin, pain while urinating, and blood in the urine. You may experience nausea as well. If the stones are causing an infection, you may also have a fever.

    While some stones will pass naturally as you urinate, you should speak to your doctor if you are having these symptoms. Diagnosis involves imaging studies to confirm the presence of the stones. Depending on their size and location, they may be left to pass on their own, broken up by shockwaves or a laser, or have to be removed surgically. 

    Like many conditions, being careful with your diet is a great way to lower your risk: you can lower your salt and meat intake while increasing fluid intake, making sure you always stay hydrated.

    Prostate cancer

    Prostate cancer is the second most common cancer in men, but it is also one of the most treatable of cancers, especially when caught early. The prostate is the gland which produces a fluid that nourishes sperm. 

    Dr Wang Ziting, also Associate Consultant at NUH’s Department of Urology, explained how prostate cancer is detected and treated. Firstly, she stated that there is very little evidence of lifestyle factors impacting the development of prostate cancer. The biggest risk factor is simply getting older, while significant family history (or being of African or Caribbean descent) can also increase your risk. If you have a family history of the disease, you should talk to your doctor about it at your next check-up. 

    There are symptoms that can be an indication of prostate cancer that may aid detection, but before you get alarmed, these can also be an indication of many more minor conditions such as urinary tract infections or urinary stones: for instance, difficulty passing urine, slow or strained urination, blood in the urine, or frequent urination. If you are experiencing any of these symptoms, you should check with your doctor for the presence of prostate cancer or other issues.

    As the risk gets much greater with age, regular checks should be carried out on men over 50 or those with a significant family history. These checks will include a physical exam and possibly an ultrasound or a blood test called a prostate-specific antigen test (PSA). You may also need a biopsy or MRI to confirm the diagnosis. 

    According to Dr Wang, the 5-year survival rate for prostate cancer when caught early is excellent. However, survival rates for men who are diagnosed with prostate cancer that has spread to other organs tend to be much lower.

    Dr Wang reiterated that “because prostate cancer is very discoverable and treatable, it generally leads to better outcomes when detected at an early stage”. 

    For early-stage, localised, less aggressive tumours, active surveillance will be carried out to avoid treatment issues. If treatment is required, surgery and radiotherapy are good options. 

    If you are diagnosed with late-stage prostate cancer, there are still good treatment options available. These might include injections to reduce testosterone levels, chemotherapy, or radiotherapy. 

    Erectile dysfunction

    Another common urological issue affecting men is erectile dysfunction. Dr Chia Jun Yang, Associate Consultant, shared about the many possible causes for this problem and the wide range of treatment options available.

    First of all, erectile dysfunction is not something to be ashamed of. It affects up to 50% of men aged between 40 to 70 years old. While there are many causes for erectile dysfunction, fortunately there are also several ways to treat it. 

    Causes for erectile dysfunction include lifestyle factors, cardiovascular risk factors, hormonal disturbances, and psychological causes such as anxiety or stress. It may also be a side effect from various medications. 

    During a visit to the clinic or hospital, your doctor will first aim to identify the cause and severity of the condition. This would include simple blood tests to check for cardiovascular risk factors and hormonal disturbances. 

    Depending on the severity of your condition, there are a variety of steps you can take. The first step is likely to include lifestyle changes: cutting down smoking, alcohol, fatty foods and exercising regularly, for instance. The next line of treatment is medication, of which there are several options available.

    If the medications are not effective, there are various simple procedures that can be tried. These include shockwave therapy, vacuum erection devices, and injections. Shockwave therapy uses low intensity shockwaves to grow new blood vessels and promote blood flow to the penis. Vacuum erection devices work by creating a negative pressure to draw blood to the penis. Injections use a small diabetic needle to deliver medication directly to the penis. 

    Finally, there is also the option of inserting a penile prosthesis, either a bendable or an inflatable prosthesis. 

    “Erectile dysfunction, while being a common condition, has fortunately several treatment options available,” concluded Dr Chia.

    Dr Kelven Chen, Associate Consultant, Department of Urology, NUH; Dr Wang Ziting, Associate Consultant, Department of Urology, NUH and Associate Consultant, Division of Surgical Oncology, NCIS, and Dr Chia Jun Yang, Associate Consultant, Department of Urology, NUH.

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