Urology

Recurrent urinary tract infections are a common clinical problem, especially in women, and they are often associated with bleeding. It is important to remember that they can be the presenting feature of bladder cancer – even when there is no visible haematuria, which might otherwise suggest an underlying problem. Chronic retention of urine in elderly men is usually due to benign prostatic hyperplasia, which causes progressive build-up of urine within the bladder with overflow incontinence, usually at night, that often is not associated with a sensation of bladder fullness. It typically develops gradually over several months and can lead to bilateral hydronephrosis with renal impairment. This problem needs urgent urological referral for catheterisation. Sudden onset loin pain is commonly caused by urological pathologies such as ureteric colic or urinary tract infection. In women, ovarian pathology is another cause, as is musculoskeletal pain.