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A urinary tract infection is defined as the presence of invasive bacteria in the urinary system, together with signs of inflammation, such as high temperature and local pain.
Urinary tract infections may be located in the lower urinary tract (bladder and urethra), or the upper urinary system, affecting one or both kidneys. A kidney infection is also known as pyelonephritis.
Infections of the lower urinary tract are characterised by localised pain, which increases when urinating, and sometimes by cloudy or dark urine, usually without high temperatures.
Kidney infections (pyelonephritis) are characterised by high temperatures, acute local pain in the lower back, and pain or irritation when urinating.
Urinary tract infection is characterised by the presence of local pain (lower abdomen or lumbar region), which increases when urinating. The urine is often cloudy, or dark if it contains blood. There may be high fever, especially in the case of pyelonephritis (an infection of the upper urinary tract).
It can affect people at any age, from early childhood to old age. It is more frequent among women and there are factors that make people vulnerable to it (pregnancy for women and enlarged prostate for men) as well as urological anomalies (pre-existing malformation or presence of kidney stones).
Urinary infections are diagnosed by examining urine under the microscope (sediment) to see whether it contains white blood cells and/or bacteria, and by cultivating the bacteria in a microbiological culture to identify the strain and determine the most appropriate antibiotic for treatment (antibiotic susceptibility testing).
Urinary tract infections are usually treated with antibiotics. Treatment is oral in the case of lower-tract infection.
For upper-tract infections (pyelonephritis) it is usually intravenous, although in some cases outpatient oral treatment may be administered.
The standard tests are urine sediment and culture (urine culture with antibiotic susceptibility testing). An ultrasound scan may be indicated for examining the kidney and urinary tract and identifying obstructions or kidney stones that may have brought about the infection.
Ultrasounds are also used to assess the state of the kidneys. A general analysis may also be indicated to see how the urinary tract infection is affecting the rest of the body, and specifically the renal function.
Urinary tract infection can be prevented by frequent urination (every 2 to 3 hours) and, above all, by avoiding the habit of holding in urine, and by going to the toilet whenever the bladder feels full, without waiting too long.
Urology, General Hospital
Prostate cancer is one of the most frequent cancers in the male population. This is the most frequent malign tumour in the male urogenital system and the second cause of death from cancer in men after lung cancer, with a mortality rate of 12%.
If there is any suspicion, due to symptoms or high PSA levels, a rectal examination will be performed along with a new serum PSA analysis. If the rectal exam is positive (if a nodule or hardening of the prostrate is detected) a biopsy will be carried out. If the rectal examination is negative, the PSA levels will be assessed, to determine whether to carry out a biopsy or not. The PSA is used as a filter for the general population, in order to enable early diagnosis of prostate cancer.
It is a good tumour marker, because it increases when the prostatic glands break down due to tumour growth. As it is also present in normal prostates and it also increases in the benign growth of the prostate, it must always be interpreted in each patient's individual context. An increase in PSA is not a synonym for prostate cancer, and a rectal examination and ultrasound scan should always be carried out. The final diagnosis is given only by a biopsy.
It is often asymptomatic and the first warning sign is high PSA levels. Patients may also present tiredness, loss of appetite and weight loss. Local alterations are also frequent: urinary obstruction, urinary retention, presence of blood in the urine, urinary infections. In the case of spreading, bone pain is frequent.
The typical profile is a male between 50 and 70 years old, in whom benign prostate growth may coexist.
Diagnosis of prostate cancer is carried out using serum PSA, rectal examination and an ecodirected prostate biopsy.
When prostate cancer is localised and low-risk, it can be treated through extirpation and radiotherapy. In the case of spreading, treatment through radiotherapy and hormones will be assessed, in order to stop tumour growth. Occasionally, if the patient is elderly, the development of the cancer will be closely monitored before extirpation, as in some cases, it poses no short-term threat to their survival.
Rectal examination, determination of serum PSA, prostate biopsy.
Survival rates for prostate cancer depend on the state at the time of diagnosis; it is quite favourable in local states, less so in advanced states and worse once it has spread. Periodic prostate evaluation by primary care doctors is therefore indicated.
Analytical testing provides a lot of information which enables the origin and severity of the kidney disease to be established. A kidney biopsy allows a microscopic study that is often essential. Genetic testing also provides very important information.
These tests serve to determine the origin of the kidney disease. There are many causes that may be genetic or acquired via a bacterial or viral infection, or resulting from a metabolic disease (diabetes) or an autoimmune disease such as lupus.
In addition to blood and urine tests, a kidney biopsy and/or a genetic analysis, imaging tests can also be useful.
A kidney biopsy may produce minimal bleeding that almost always stops by itself. If it doesn't, it can be controlled using an interventional radiology procedure, whereby the kidney is catheterised to close the area of bleeding. Genetic testing is increasingly used to decrease the need for a kidney biopsy. However, kidney biopsy continues to be the main diagnostic method for kidney disease.
If you are concerned or have any of the symptoms listed below, it is important that you see a doctor.
It is important for young men to perform regular self-examinations; especially those who are considered to be at risk of contracting testicular cancer.
A testicular self-examination can help a man detect any changes in their testicles on time. This means that if treatment is needed, it can be started as soon as possible.
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