The 65-year-old European had ignored his urinary issues and also the blood in urine. And then there was intermittent fever. After prolonged exposure to sub-zero temperatures, he came to India for treatment. Soon, he was in an emergency department with his bladder blocked and severe bleeding that produced blood clots. A CT scan found that his enlarged prostate had completely blocked his urinary system, leading to infections and bleeding.
Doctors used a cystoscope to remove the blood clots and stopped the bleeding with laser treatment. He was given intravenous antibiotics to fight the infection. Once his condition stabilised, a TURis (transurethral resection in saline) bipolar endoscopic procedure was done to remove the prostate gland. The treatment progressed smoothly and he left the hospital within 72 hours without any pain or problems.
This case shows the need for regular check-ups and testing to identify issues caused by enlarged prostates.
People tend to overlook urinary health during winter because they think symptoms decrease in this season. But, research shows that cold temperatures make urinary symptoms and infections worse. The body responds to cold temperatures by sending more blood to vital organs and less to the skin layers. More urine is produced becaue of reduced sweating in winter, which puts extra stress on the urinary system.
The symptoms of urinary issues become more severe for men with enlarged prostates when their urinary outlet function declines. An extreme prostate blockage makes it hard for the body to handle extra urine which leads to problems with urinary retention and infections. Women, after menopause, face increased infection and urine leakage risks because of their thinner urethra and weaker pelvic floor muscles. Diabetes makes people more likely to develop infections because it weakens their ability to fight diseases. The immune system weakens during winter because of viral infections and makes people more likely to develop urinary infections.
People with urinary infections experience pain during urination and they need to go to the bathroom often and urgently, especially at night―urine production increases at night because of lower temperatures. In extreme cases, there is fever along with pain on the flanks and blood in urine.
Doctors use multiple tests like urine analysis and cultivation to detect urinary infections alongside blood counts and creatinine tests. Abdominal and pelvic ultrasound scans combined with a measurement of left-over urine show how severe urinary retention has become. Doctors recommend PSA (prostate-specific antigen) testing in male patients to screen for prostate cancer.
Doctors treat urinary issues by selecting antibiotics from culture results, besides managing diabetes and giving patients enough fluids to drink. They also prescribe alpha-blockers and dutasteride to treat prostatic enlargement. When urinary retention becomes life-threatening, doctors need to put in a catheter to empty the bladder. After treating the infection, doctors perform endoscopic bipolar or laser surgery to offer permanent relief. Medical technology in endourology now enables safe procedures that produce minimal scarring with no pain and quick healing.
The female anatomy makes women more likely to experience repeated urinary infections. The way women experience kidney stone symptoms and receive diagnosis matches how males experience these issues. Doctors need to perform cystoscopy after treatment to detect and treat any problems with the bladder or urethra. They prescribe antibiotics over an extended period to stop future infections. Women past menopause might need hormone replacement therapy through estradiol gels or creams, plus progesterone supplements.
Keeping enough warmth in your body helps prevent winter-related urinary problems. People with diabetes or prostate issues plus frequent urinary infections must get professional help and stay in touch with their doctors. Successful diabetes control helps stop infections from developing. Reducing caffeine and alcohol consumption helps lower winter urinary strain since people tend to drink more in cold weather which produces more urine. Smoking damages the bladder tissue and boosts the chances of bladder cancer development.
Maintaining proper hydration habits and scheduled bathroom visits help protect you from bladder infections. When urine remains in the bladder for too long it creates a favourable environment for bacteria to multiply. You need to take good care of your genital area by gently washing from front to back and also use smooth cotton underwear to stop infections.
The writer is chief urologist, Manipal Hospital, Donapaula, Goa.