Urology may not be as familiar to the public—or even to primary care providers—when compared to heart disease or breast care.
Ask any urologist, however, and they will emphasize the importance in educating communities about urological health, because it could prevent chronic illness and even cancer.
“Urology often is seen as a ‘when we need you, we’ll find you’ area of medicine. However, if men and women understand the benefits of exploring a basic entryway into urology early when problems arise, we can help improve their quality of life,” said R. Scott Owens, MD, UPMC Urology of Central PA.
The most common urological conditions include voiding issues for men due to a large prostate, otherwise known as benign prostate hyperplasia (BPH). For women, it’s typically stress or urge incontinence. The origin of the problem can vary according to the person’s age, health history and lifestyle, and can greatly impact your quality of life.
For men with BPH, presenting symptoms are frequency, urgency, hesitancy and getting up at night to urinate. This condition typically emerges in a man’s fifth decade and becomes worse with age, necessitating some form of intervention. Urologists will treat it in several different ways.
Medications known as alpha blockers help to relax the prostate muscle and reduce symptoms, while other medications help reduce the size of the prostate as a second line treatment. For men who do not improve, urologists suggest minimally invasive and surgical procedures such as a prostate urethral lift or a high-pressure steam procedure.
For the more invasive but definitive treatment, a transurethral resection of the prostate (TURP), robotic prostatectomy, or a new emerging technology called Aquablation are recommended.
For women suffering from incontinence, treatment depends upon the type of incontinence.
Stress incontinence typically occurs from either childbirth or aging. Symptoms include leakage with coughing, sneezing and physical activity. Biofeedback or pelvic floor muscle rehabilitation, whereby patients work on strengthening their pelvic floor muscles help manage it, but if it continues, the recommendation is a urethral sling.
For urge incontinence, also known as OAB, medications and procedures aim to relax the bladder muscle and reduce symptoms. Urologists also offer Botox injections or insert a bladder stimulator.
Another common condition impacting both genders is kidney stones. Their causes are multifactorial and range from diet and dehydration to obesity and certain metabolic risk factors. The size of the stone, its location, and the clinical scenario will dictate whether it requires intervention. Smaller stones can be passed on their own, while larger ones usually require ureteroscopy (scope procedure) and lithotripsy (to break them up). Both are minimally invasive procedures and effective.
Despite the commonality of kidney stones and urinary issues, urological cancers are a primary concern since they present in a similar population and many times without obvious symptoms.
Managing benign conditions is important. However, cancers of the urinary tract make up a significant part of urologists’ work. Prostate cancer, for example, is the second leading cause of death for men and one that remains asymptomatic until advanced.
“My colleagues and I truly believe in the value of the PSA (prostate-specific antigen blood test) as an important screening tool, along with the rectal exam, to detect an early-stage cancer,” Owens said.
If caught early, survival rates are promising with either radiation or surgery. Additionally, there are alternative methods assessing the cancer’s aggressiveness through genomics and diagnostics, which can lead to active surveillance. This is a newly adopted, conservative approach for early-stage prostate cancer that allows providers to monitor the patient with both PSAs and MRIs, and intervene when progression of the disease occurs.
Bladder cancer is another malignancy managed and treated by urologists. It occurs in both men and women, and the typical signs are blood in the urine, as well as voiding symptoms such as frequency, burning and urgency. Symptoms are intermittent and mimic infections or other conditions. As a result, patients may ignore them. Bladder cancer is the fourth leading cancer among men and women and nearly 90% curable when caught early and therefore, one more reason to seek urological care.
Combining knowledge about urological health and transparent communication helps patients and providers make informed, shared decisions. Over the years, these efforts have contributed to successful patient outcomes.
UPMC in Central PA offers a full range of urological procedures. For more information about locations, services and providers, visit www.UPMC.com/CentralPaUrology.
Kendra Ferguson is a communications specialist, Central PA Region, for UPMC.
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