×

HOW TO REGISTER

1 Click on login. Fill in your username & password.
2 OR Click on Don't have an account to create one.
3 Fill in the registration form.

If you still have problems, please let us know, by sending an email to info@kaus.co.ke Thank you!

OFFICE HOURS

Mon-Fri 8:00AM - 5:00PM

SIGN IN YOUR ACCOUNT TO HAVE ACCESS TO DIFFERENT FEATURES

CREATE AN ACCOUNT FORGOT YOUR PASSWORD?

FORGOT YOUR DETAILS?

AAH, WAIT, I REMEMBER NOW!

CREATE ACCOUNT

ALREADY HAVE AN ACCOUNT?

Kenya Association of Urological Surgeons

QUESTIONS? CALL: +254-726 830 732
  • SUPPORT
  • LOGIN
  • Home
  • About Us
    • Officials
    • Membership
  • Patients
    • Urological Conditions
  • News & Updates
  • Professionals
    • Urology Consumables
    • Urology Journals
    • Videos
    • Calendar
  • Upcoming Event
    • Conference Details
  • Past Events
  • Gallery
    • Urology Surgical Camp 2019
    • Conference Gallery 2018
    • Conference Gallery 2021
  • Contact Us
  • Home
  • Bladder
  • Archive from category "Bladder"

Category: Bladder

Transurethral Resection (TUR) for Bladder Cancer

Friday, 21 April 2017 by kaus

Transurethral Resection (TUR) for Bladder Cancer

Transurethral resection (TUR) of the bladder is a surgical procedure that is used both to diagnose bladder cancer and to remove cancerous tissue from the bladder. This procedure is also called a TURBT (transurethral resection for bladder tumor). General anesthesia or spinal anesthesia is often used.

During TUR surgery, a cystoscope is passed into the bladder through the urethra. A tool called a resectoscope is used to remove the cancer for biopsy and to burn away any remaining cancer cells.

 

Bladder cancer can come back after this surgery, so repeat TURs are sometimes needed.

What To Expect After Surgery

Following surgery, a catheter may be placed in the urethra to help stop bleeding and to prevent blockage of the urethra. When the bleeding has stopped, the catheter is removed. You may need to stay in the hospital 1 to 4 days.

You may feel the need to urinate frequently for a while after the surgery, but this should improve over time. You may have blood in your urine for up to 2 to 3 weeks following surgery.

You may be instructed to avoid strenuous activity for about 3 weeks following TUR.

Why It Is Done

TUR can be used to diagnose, stage, and treat bladder cancer.

  • Diagnosis. TUR is used to examine the inside of the bladder to see whether there are cancer cells in the bladder.
  • Staging. TUR can determine whether cancers are growing into the bladder wall.
  • Treatment. One or more small tumors can be removed from inside the bladder during TUR.

How Well It Works

TUR is the most common and effective treatment for early-stage bladder cancer. It may also be effective for more advanced cancer if all the cancer is removed and biopsies show that no cancer cells remain.

Risks

The risks of TUR include:

  • Bleeding.
  • Bladder infection (cystitis).
  • Perforation of the wall of the bladder.
  • Blood in the urine (hematuria).
  • Blockage of the urethra by blood clots in the bladder.

What To Think About

Treatment with TUR may be followed by chemotherapy or immunotherapy.

Credit: By Healthwise Staff – WebMD

Transurethral Resection
Read more
  • Published in Bladder, Videos
No Comments

Urinary Incontinence

Friday, 14 April 2017 by kaus
  • Published in Bladder, Patients
No Comments

Urinary infection (adult)

Thursday, 13 April 2017 by kaus

What should I do if I think I have a urinary infection?

If you have pain in the bladder area (pictured below), pain when passing urine, a need to urinate frequently or urine that is dark or strong-smelling, especially if you have a fever of 38ºC or more, you should contact your GP for further advice.

These symptoms are all non-specific. They can be caused by many other conditions such as sexually-transmitted infection, vaginal thrush (in women), chemical irritants (soap & deodorants), stones (in the kidney, ureter or bladder), interstitial cystitis, bladder cancer or inflammation in the prostate gland (prostatitis).

It is, therefore, important that you see your GP to arrange appropriate investigations to establish the exact cause of your symptoms. Failure to treat a bladder infection promptly can cause infection to spread to the kidneys. In severe cases, this may result in blood poisoning (septicaemia).

What are the facts about urinary infection?

  • Most urine infections are caused by bacteria (such as E coli, pictured above the right-hand links column) which come from your bowel
  • In women, the urethra (water pipe) is very close to the anus making it easy for bacteria to reach the bladder and cause infection
  • Most women have at least one attack of urinary infection during their lifetime and 20% of women suffer repeated attacks. This is more likely in women who are pregnant, sexually-active or postmenopausal
  • Cystitis in men and children is more serious because it is often caused by underlying problems such as an enlarged prostate, prostatitis or inherited abnormalities
  • Mild urinary infections usually clear within a few days and may not always require treatment with antibiotics
  • Untreated, more severe infections can involve the kidneys and may even spread into the bloodstream
  • Recurrent urinary infections in women can often be managed by simple, “self-help” measures

What should I expect when I visit my GP?

Your GP should work through a recommended scheme of assessment for suspected urinary infection. This will normally include one or all of the following:

1. A full history

Your GP will take a full urological history with special attention to previous urinary infections, periods of dehydration, your sexual activity, any intake of acidic or spicy foods and any relevant past medical problems.

2. A physical examination

A general physical examination, including rectal examination (in men) and vaginal examination (in women) will normally be performed. Your blood pressure will be measured as part of this assessment.

3. Additional tests

The usual tests performed are:

a. General blood tests

The actual tests performed will be left to your GP’s discretion. It is usual to measure kidney function and to check the blood cells for anaemia or other problems.

b. Urine Tests

A simple dipstick test of the urine may confirm that an infection. It is likely that urine will also be sent to the laboratory for culture to confirm any infection and to find out which antibiotics need to be used (culture & sensitivity assessment).

c. Other specific tests

If you have any discharge (from the penis or vagina), swabs may be taken for culture.

Your GP may also arrange an ultrasound scan of your kidneys and bladder. This is not needed for a first infection in a woman but is usually performed for:

  • recurrent infections in women (more than 3 attacks per year)
  • all infections in men
  • infections which have spread to the kidneys
  • pregnant women
  • diabetics
  • patients with known neurological problems
  • patients with known abnormalities of the urinary tract
  • patients taking drugs which suppress the immune syste

If you fall into any of these groups, your GP will then arrange a formal referral to a urologist for further investigation. This may involve examination of the bladder as well as the investigations mentioned above.

What treatments are available for this problem?

General measures

Mild urinary infections can sometimes be cured by drinking plenty (6-8 glasses) of water daily and relieving any discomfort with simple painkillers (aspirin, paracetamol). It is, however, best to see your GP for advice especially if this is your first urinary infection.

If your symptoms are clearly caused by sexual intercourse (so-called “honeymoon cystitis”), you should refrain from sex until your infection has cleared completely.

If your symptoms worsen despite these measures, you should contact your GP immediately.

Antibiotics

More severe infections usually require treatment with antibiotics. Your GP will normally prescribe an antibiotic (pictured) on a “best guess” policy, taking into account any allergies you may have. The drug given initially may need to be changed. This will depend on the results of laboratory culture and on the sensitivity of any bacteria to the antibiotic already prescribed. Even if no bacteria are grown from your urine sample, there is good evidence that antibiotics can be helpful in curing your symptoms. You will normally be asked to provide a further urine specimen 7-14 days after you have completed your course of antibiotics. This is important to ensure that there is no infection remaining and that any abnormal white cells or red cells in the urine have been eliminated. If they have not, further investigations may be needed to exclude problems such as stones, bladder cancer or tuberculosis.

Surgery

Surgery is rarely indicated for urinary infection unless there is an underlying causative condition which requires surgical relief.

  • In patients (especially children) shown to have reflux of infected urine back from the bladder to the kidneys, surgery may be recommended to stop the reflux.
  • In some women after the menopause, ultrasound shows poor bladder emptying with a large residual urine and inspection of the bladder with stretching of the neck of the bladder under a brief general anaesthetic may be helpful. Hormone replacement therapy (HRT) using tablets, creams or pessaries may be prescribed after the procedure, to prevent the problem from recurring.

How can I prevent further attacks of infection?

If you suffer from repeated attacks of urinary infection, especially in women, your GP or urologist may recommend that you take low-dose antibiotics for 3-6 months

As an alternative to long-term antibiotics, you may find it helpful to take cranberry juice or tablets. Cranberry preparations have been shown, scientifically, to reduce recurrent infections. Some patients find tablets more palatable than juice. There are also a number of measures you can do for yourself to prevent further infections.

adulturinary infection
Read more
  • Published in Bladder, Patients
No Comments

Urinary infection (child)

Wednesday, 12 April 2017 by kaus

What causes a urinary infection?

Urinary infection occurs when bacteria enter the the urinary tract via the bladder and multiply to cause an infection. In children, bacteria may move from the bladder to the kidney(s), as a result of ureterovesical reflux.

Is a urinary infection important or serious in children?

  • Urinary infections can make children feel very ill with non-specific symptoms such as vomiting, abdominal pain and a high temperature
  • Renal scarIf infection enters the kidney(s) by reflux, the infection may cause a scar to form in the kidney(s)
  • Scarring of the kidney (pictured) due to infection is permanent. This can cause problems with kidney function and may cause high blood pressure in later life
  • Urinary infections in children must be treated without delay to prevent scarring
  • Urinary infections may be an indicator of problems (abnormalities) within the urinary tract. These abnormalities may be a risk factor for future problems, including further infections

How will I know if my child has a urinary infection?

Symptoms of urinary infection may vary considerably with age. Infection may occur without the “fishy” smell and burning pain which adults often experience. In babies and young infants, urinary infection often has very non-specific features. If your child has a temperature without any obvious reason (such as a cold or cough), you should try to collect a urine specimen so that infection can be ruled out.

Symptoms in infancy:

  • High temperature (fever)
  • Tiredness
  • Irritability
  • Poor feeding
  • Smelly nappies
  • Vomiting
  • Abdominal pain (“tummy ache”)

Symptoms in childhood:   

  • High temperature (fever)
  • Increased frequency of passing urine
  • Tiredness
  • Vomiting and / or diarrhoea
  • Being “off their food”
  • Abdominal pain (“tummy ache”)
  • Back pain
  • Bed wetting (when previously dry)
  • Smelly or bloody urine
  • Pain when passing urine

How will a urinary infection be confirmed?

A sample of your child’s urine will need to be collected to look for signs of infection & dehydration. How the urine sample is collected will depend on your child’s age and how ill he/she is

The following headings describe the common ways in which urine can be collected from a child:

1. The older child who is toilet trained

a. Mid-stream urine (MSU) collection

  • The child’s genitalia are cleaned with warm, soapy water
  • The child begins to pass urine into the toilet
  • Part way through passing urine, a specimen is collected into a sterile container
  • The last part of the urine is then passed into the toilet again

2. The non-toilet trained child

a. “Clean catch collection” (preferred because of the low risk of contamination from skin or bowel motions)

  • The child’s genitalia are cleaned with warm, soapy water
  • Part way through passing urine, the collection is made in a container held under the child, without touching the child’s skin

b. Urine collection bagUrine collecton bag

  • The child’s genitalia are cleaned with warm, soapy water and dried
  • A special collection bag is stuck over the child’s urethral opening (“water passage”)
  • As soon as urine enters the bag, the bag is promptly removed & the urine transferred into a sterile container
  • If the collection is contaminated by bowel motions, the whole process must be started again

3. Very ill children (or those in whom it is difficult to catch a urine sample)

a. Specimen collection from a urinary catheter

  • The child’s genitalia are cleaned with saline (salt solution)
  • A small catheter is inserted into the bladder, through the urethra, by a doctor or nurse
  • A specimen of the drained urine is collected in a sterile container
  • The catheter is removed

b. Specimen collection from a suprapubic aspirateSuprapubic aspiration

  • The skin in the lower part of the child’s abdomen (“tummy”) is cleaned with an antiseptic solution
  • A fine needle is passed through the skin directly into the child’s bladder
  • The aspirated urine is placed into a sterile container and the needle is removed

Collecting a urine sample from a child who is not toilet trained can be difficult and frustrating. Whilst using a collection bag may seem simple, this specimen is easily contaminated and the results are not as accurate as midstream or clean catch samples. Your Specialist Nurse, GP or Health Visitor can help you learn more about this.

How will my child’s urine infection be treated?

In babies and infants who are unwell, your doctor will not normally wait for the laboratory results to become available (this can take up to 48 hours) but will start treatment immediately with antibiotics. It may be necessary to change the antibiotic if your child is showing no improvement or if the laboratory results show that a different antibiotic would be better.

To clear the infection, it is very important that your child takes all the antibiotic medicine exactly as prescribed.

In most children, the fact that the child has improved is sufficient to say that the infection has cleared. In a few children (especially those with known abnormalities in the urinary tract), it is important that a further urine sample is collected and sent to the laboratory after the antibiotics have finished. This will confirm that the infection has been completely cleared. In these cases, it is best sent three days after the antibiotic course has been completed. If any traces of infection are found, the infection can come back again.

Will my child need further tests?

In a child over one year of age, additional investigations are not necessary unless the infections keep recurring or the bacteria found are unusual

It is normally recommended that children who have had a urinary infection before their first birthday should have an ultrasound scan of their kidneys, ureters and bladder. This is because a urinary infection can be the first clue to the presence of an underlying physical problem within the urinary tract. If any abnormality on the ultrasound is found, or if the infecting bacteria are unusual in any way, other tests and investigations may be needed

How can my child & I prevent further urinary infections?

  • Ensure your child drinks plenty of fluids throughout the day so that he/she actually need to pass urine more frequently and the urine is lighter in colour (more dilute). Drinks should be water or water-based (e.g, squash) rather than tea/coffee/fizzy drinks
  • Include a glass of cranberry juice in your child’s diet every day
  • Ensure that your child goes to the toilet to empty his/her bladder regularly (e.g. on waking, mid-morning, lunch, mid-afternoon, teatime & before bed)
  • Change nappies regularly
  • Teach girls to wipe from front to back after passing urine so that germs from the anus do not enter the urethra
  • Avoid scented soaps, bubble baths and hair washing with shampoo in the bath
  • Encourage your child to wear only cotton underwear
  • Ensure your child has a healthy diet
  • Bio-yogurt may help by increasing “good bacteria”
  • Constipation should be avoided. Ensure that your doctors are aware of any problems with constipation so that it can be treated immediately
  • Follow the advice given to you about antibiotic treatment

Your doctors may decide that, to help prevent further infection, your child needs “prophylactic” antibiotics. This is a smaller dose than is used to treat an actual infection. It is intended to prevent infection from becoming established. Prophylactic antibiotics are best taken at bedtime.

childrenurinary infection
Read more
  • Published in Bladder, Kidneys, Patients
No Comments

Blood in the urine (haematuria)

Wednesday, 10 August 2016 by kaus

What should I do if I have blood in my urine?

If you see blood in your urine, with or without symptoms of cystitis, you should contact your GP immediately for further advice

Your GP will normally investigate blood in the urine as a matter of urgency. Most GPs will perform some simple, baseline tests. You may be commenced on antibiotics to treat a presumed infection. However, if the urine test result comes back showing no evidence of infection, you will normally be referred to your local urology department for more detailed investigations using the “2-week wait” (fast-track) system.

What are the facts about blood in the urine?

  • The commonest cause of blood in the urine in the UK is infection (cystitis)
  • Proven blood in the urine, whether visible or non-visible (found on a urine test), should always be investigated
  • 1 in 5 adults with visible blood in the urine and 1 in 12 adults with non-visible blood in the urine are subsequently discovered to have bladder cancer
  • Children with blood in the urine rarely have cancer – they usually have infection in the bladder or kidney inflammation (nephritis).
  • A “one-off” finding of a small trace of blood in the urine on routine testing may not be significant
  • Some drugs (e.g. rifampicin, nitrofurantoin) and foodstuffs (e.g. beetroot) can turn the urine red and mimic blood in the urine

What should I expect when I visit my GP?

Your GP should work through a recommended scheme of assessment for patients with blood in the urine. This will normally include some or all of the following:

1. A full history

Your GP will ask you questions about any recent symptoms, any associated matters (including any drugs you are taking) and will enquire about smoking habits. Exposure to industrial chemicals or to substances that may be related to bladder cancer development are also important. You should inform your GP if you are taking blood-thinning drugs (warfarin, dicoumarin) or if you take anti-platelet treatment (aspirin, dipyridamole, clopidogrel). If the bleeding is painless and associated with clots of blood in the urine, it is likely that he/she will arrange urgent referral to a urologist.

2. A physical examination

Rectal examinationA general physical examination will be performed, together with a rectal or vaginal examination. Your blood pressure may be measured as part of this examination.

3. Additional tests

The usual tests performed are:

a. General blood tests

The actual tests performed will be left to your GP’s discretion. It is common to measure kidney function, clotting factors, prostate-specific antigen (PSA) and to check the blood cells for anaemia or other problems.

b. Urine testing

A urine test will normally be sent for infection. Your GP may commence you on antibiotics whilst awaiting the result of this test. Fresh urine may also be sent to the laboratory for microscopic examination and to look for cancerous cells. Your GP may arrange a 24-hour urine collection to measure your urine protein levels.

c. Other specific tests

Your GP may arrange an ultrasound scan of your kidneys and bladder, pictured right (or a CT scan of your abdomen) although this is usually performed in the urology department.

What could have caused the blood in my urine?

50% (half) of patients with visible blood in the urine will have an underlying cause identified but, with non-visible blood in the urine, only 10% will have a cause identified

Although there are many potential causes for blood in the urine, those most often identified are:

  • Bladder infection
  • Cancers of the bladder (pictured), kidney or prostate
  • Stones in the kidneys or bladder
  • Inflammation of the kidneys (nephritis)
  • Urinary tract injuries
  • Blood disorders (e.g. sickle cell disease, clotting disorders, anticoagulant and anti-platelet drugs)
  • Other causes, including less common infections (e,g. TB, schistosomiasis)

What happens next?

Assessment of the cause of blood in the urine at hospital (usually in a so-called Haematuria Clinic) may not identify a definite cause but it will, normally, rule out significant causes which require further urological treatment

Your GP may decide that you do not require any further tests at this stage. In this case, you should have regular monitoring to assess the following, which may be signs that re-investigation is needed:

  • the development of other urinary symptoms
  • further episodes of blood in the urine
  • increasing levels of protein in your urine
  • progressive deterioration in your kidney function
  • the development of hypertension (high blood pressure)

Your GP will arrange urgent referral to the Haematuria Clinic of your local urology unit:

  • if you have visible blood in the urine in the absence of infection
  • if the blood fails to clear following antibiotic treatment for urinary infection
  • if you have non-visible bleeding but significant urinary symptoms
  • if you have persistent non-visible bleeding and you are over the age of 40 years

This will involve a prolonged outpatient appointment when some or all of the following assessments will be performed:

  • Detailed questioning about your urinary tract and any related symptoms
  • A physical examination (including rectal or vaginal examination)
  • Blood tests (if not already performed by your GP)
  • Examination of the urine for cancer cells (if not already performed by your GP)
  • X-rays or scans

This may involve one or more of the following:

  • X-rays or scans

This may involve one or more of the following:

  • CT scan
  • ultrasound scan
  • intravenous urogram (IVU)

IVU and CT scanning involve an iodine-based injection. You must inform the staff if you have a history of allergy to iodine or to previous X-ray injections.

A flexible cystoscopy

It is performed under antibiotic cover & local anaesthetic using a small, flexible telescope which allows the clinic doctor to see inside your bladder (pictured). If you have concerns about this or have experienced problems with local anaesthetic in the past, you should ask about having your examination under a brief general anaesthetic (i.e. whilst you are asleep). When your tests have been completed, the medical staff will advise you on what to do next:

If an abnormality requiring further treatment is detected, the medical staff will advise you on what treatment is necessary and what this would involve (e.g. admission for telescopic removal of a bladder tumour).

Telescopic removal of a bladder tumour(video courtesy of Dr Manoj Talwar)

If no specific abnormality is found, you should keep a careful eye on your symptoms and report any further bleeding to your GP who will be informed of the result of your assessment.

Blood in the urinehaematuria
Read more
  • Published in Bladder, Patients
No Comments

Recent Posts

  • Transurethral Resection (TUR) for Bladder Cancer

    Transurethral Resection (TUR) for Bladder Cance...
  • Holmium Laser Enucleation Of The Prostate

    Holmium Laser Enucleation of the prostate (HoLE...
  • Transurethral Resection of the Prostate (TURP)

    What is a transurethral resection of the prosta...
  • TURis Plasma Vaporization

    Where and what is the Prostate Gland? The Prost...
  • Urinary Incontinence

    Incontinence can be divided broadly into the fo...

Archives

  • April 2017
  • December 2016
  • August 2016
  • April 2016
  • August 2015
  • August 2014
  • September 2011

Categories

  • Bladder
  • Kidneys
  • News
  • Patients
  • Prostate
  • Videos

Useful links

Urological & Kidney Concerns
National Library of Medicine
International Society for Sexual and Impotence Research
Mayoclinic
International Continence Society

NEWSLETTER SIGNUP

By subscribing to our mailing list you will always be update with the latest news from us.

We never spam!

GET IN TOUCH

Tel: +254-20-2424159
Email: 'info@kaus.or.ke'
Kenya Association of Urological Surgeons
P.O. BOX 30270 - 00100,Nairobi, Kenya
Open in Google Maps
  • GET SOCIAL

© Kenya Association of Urological Surgeons. Design by Groundup Marketing.

TOP
X