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Symptoms & Possible Diagnosis

Outlined below are the most common symptoms which would require consultation with a urologist. These symptoms are by no means diagnostic, nor conclusive enough and require proper assessment and further investigations to arrive at the right diagnosis.

Disclaimer: This list of possible diagnosis are the most common pertaining to the symptom listed above, but are by no means, exhaustive and complete.

Blood in the urine

Bloody urine is always considered a significant urological problem that needs further evaluation, especially so in anyone > 50 years of age because urinary tract cancers need to be excluded. Investigations include ultrasound, xrays and even a cystoscopy.

• Tumour / cancer
• Stone
• Infection

Pain in the loin

Pain over the loin can be severe and usually indicates the problem is in the kidney. If the pain is colicky (spasmodic) in nature, the most common cause is an obstructing kidney stone. Investigations include urine tests, ultrasound and xrays.

• Stone in the kidney
• Infection in kidney
• Tumour in kidney

Pain in the groin

Pain over the groin can originate from the bladder or prostate. It can also radiate up from a lesion in the scrotum. A physical examination is needed, followed by urine tests and ultrasound.

• Stone in ureter or bladder
• Infection in prostate (in males)
• Infection of bladder
• Hernia
• Varicocoele

Frequent urination

Passing urine too often can be disturbing and disrupting. The underlying causes can be bladder infection, obstruction or an ‘over-sensitive’ bladder. Investigations include urine tests, ultrasound and uroflow study.

• Enlarged prostate (in males)
• Overactive bladder
• Infection of bladder or urethra

Pain during urination

Pain during urination is a distressing symptom. Infection is the most common cause, although there is also a need to exclude any bladder stone. Investigations needed are urine tests, ultrasound and xrays.

• Infection of bladder
• Infection in prostate (in males)
• Stone in bladder

Uncontrolled leakage of urine, including dribbling

Incontinence affects one’s quality of life. It can be corrected provided the underlying cause is determined. A physical examination is needed, followed by urine tests and uroflow study.

• Pelvic floor defect
• Enlarged prostate (in males)
• Overactive bladder
• Hypotonic (weak) bladder

Lump in the scrotum

Scrotal lumps are always abnormal. To tell where they arise from, a physical examination is needed, followed by ultrasound. Surgical removal for histological confirmation is usually needed.

• Cancer of testis
• Cyst in epididymis
• Hydrocoele
• Hernia

Pain in the scrotum

Pain in the scrotum can be disabling. If torsion testis is suspected, it is important to seek early treatment because of the risk of gangrene. Physical examination and ultrasound will help distinguish the causes.

• Infection of testis/epididymis
• Torsion testis
• Varicocoele

Raised PSA (>4 ug/L)

Prostate specific antigen is a tumour marker found in the blood and is used to detect early prostate cancer. However, it is not specific enough in that it can also be elevated by infection and benign enlargement. A biopsy done under transrectal ultrasound guidance is the best way of differentiating the cause for a raised PSA level.

• Prostate cancer
• Benign enlargement of prostate (BPH)
• Chronic prostate infection

Sediments in urine

Sediments in the urine is a non-specific observation. It represent dead cells that have shed into the urine. As such, investigations are needed to sort out the underlying cause. These investigations include urine and blood tests and ultrasound / xrays.

• Stone
• Infection of bladder
• Infection of prostate (in males)
• Kidney failure

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