Bladder Cancer in Women
Bladder cancer is a common cancer in the U.S. affecting 65,000 and resulting in 14,000 annual deaths of both women and men. Most of the facts regarding the presentation, diagnosis, and treatment are very similar in both sexes but there are a few very important differences.
Bladder cancer begins with a localized growth of the inner wall of the bladder. Over time, it can form a tumor or mass which invades the local muscular bladder wall, spreads to the regional lymph nodes, and then the bones, liver, and lungs.
Risk factors for bladder cancer in women may include:
The most significant risk factor for bladder cancer in both women and men is cigarette smoking, accounting for a third to a half of the diagnosed female bladder cancers. This has been attributed to the cancer-promoting cigarette toxins in the urine stored in the bladder and in contact with the bladder walls prior to being excreted. Family history may also play a role in the incidence and prevalence of the disease.
Symptoms of bladder cancer include:
Bladder cancer is found two to four times less frequently in women than in men. Women, however, are often diagnosed at a later, more advanced stage of the disease with less favorable treatment outcomes. The symptoms of bladder cancer can mimic the blood spotting of menstruation or a simple urinary tract infection, common in many women, resulting in a delay in diagnosis.
These can be features of both urinary tract infection and bladder cancer, requiring a doctor to determine the cause through careful examination and testing.
AUCNY urologists may use a combination of methods to determine the specific cause:
Diagnosis, as with most diseases, starts with a detailed history and physical examination. Your AUCNY doctor will question you about:
Then, the doctor will perform a physical examination of your body with special emphasis upon the affected areas.
Diagnostic Testing:
Diagnostic testing may follow, consisting of blood and urine testing, accompanied by the utilization of imaging techniques. These may include:
Treatment:
As with many cancers, treatment may involve:
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Kidney Stones in Women
Kidney stones are painful and affect some 11% of men and 6% of women during their lifetime. The causes, symptoms, and treatments are the same for men and women with only minor differences.
Kidney stones occur when the urine becomes excessively concentrated with a substance (calcium, uric acid, oxalate, or struvite) which then, instead of staying dissolved in the urine solution, crystallizes out of the urine solution onto the wall of the kidney inner surface. It may pass or descend into one of the two ureters, the thin tubes which pass the urine from the kidney into the bladder, as a very small crystal. This sharp and abrasive crystal greatly irritates the inner wall of the ureter causing severe symptoms and a reflexive cramping or spasm of the smooth muscle wall of the tube. It may also block the ureter obstructing the flow of urine, causing the urine to back up into the kidney and painfully result in kidney damage called hydronephrosis.
If the crystal or stone is small, less than 5mm or 1/5 inch, it has a 90% chance of passing from the kidney, through the ureter, and into the bladder on its own. Doubling the crystal size to 10mm or 2/5 inch reduces the chance of spontaneous passage to 10 to 25% without medical intervention.
If waiting for a stone to pass fails, we can treat kidney stones by using shock wave lithotripsy, ureteroscopy, percutaneous nephrolithotomy or open surgery. In any case, we have a variety of tools with which to help male and female patients with kidney stones.
Symptoms of kidney or ureter stones include:
Causes and risk factors for stone formation include:
To diagnose your AUCNY urologist will use some of the following:
Treatment for small stones may consist of the following:
For larger kidney stones that will not pass on their own, other treatments that may be offered by your AUCNY doctor are:
Microscopic Hematuria in Women
Microscopic hematuria is a common condition where a relatively small number of blood cells leak into the urine from the bloodstream in such a small amount that they are only visible under a microscope. This contrasts with urine which is visibly red or red-spotted due to a relatively large number of cells and is termed gross hematuria. Your AUCNY urologist will determine the specific cause of the microscopic hematuria and decide whether it is a symptom of a benign or more serious condition.
Some of the more frequent causes of microscopic hematuria in women are:
Risk factors for microscopic hematuria may include:
AUCNY urologists may use a combination of methods to determine the specific cause:
Treatment:
Once your AUCNY doctor reviews your tests, they will determine the specific cause your problem. Treatment plans are based upon the cause and vary from no treatment for benign conditions to prescription medications or surgical intervention for more serious diagnoses.
Pelvic Organ Prolapse in Women
Pelvic organ prolapse occurs when the muscles and ligaments which normally suspend a women’s pelvic organs weaken over time, can no longer adequately lift the organ weight, and allows for sagging of the organs into the vagina. While sagging of the bladder is the most commonly seen form, the uterus, rectum, bowel, or vaginal wall may also be involved.
Pelvic organ prolapse symptoms may include:
Risk factors for pelvic organ prolapse include:
Diagnosing pelvic organ prolapse:
Diagnosis is often made with an initial visit with a simple history and physical examination, but sometimes various imaging techniques are used as well.
Treatment:
Stress Urinary Incontinence for Women
Stress urinary incontinence is a specific but common type of urinary incontinence, most often seen in women. Whereas urinary incontinence is the term used to describe the uncontrollable leaking of urine, stress urinary incontinence is the leakage due to pelvic muscle weakness. It is often experienced with the increased abdominal pressure associated with the physical activity of exercise, laughing, sneezing, or coughing. It can range in severity from mild to severe and is commonly found in older women. Overactive bladder and overflow incontinence are other types of urinary incontinence.
Risk factors:
AUCNY urologists may use a combination of methods to determine the specific cause:
Treatments:
Urinary Incontinence (UI) in Women
Urinary incontinence, experienced by up to one third of women, is the uncontrollable leaking of urine. This is often caused by the pelvic muscle weakness, failure of the muscles of the body of the bladder to remain relaxed and permit urine storage or the muscles of the neck of the bladder (called the sphincter) to remain contracted and act as a closed spigot preventing urine leakage. There are four main types of UI, although combinations are also common:
Risk factors:
AUCNY urologists may use a combination of methods to determine the specific cause:
Treatments:
Urinary Tract Infection in Women (UTI)
The urine is normally sterile (without bacteria or yeast) and travels from the left and right kidneys where it is made, down a left and right-side tube called a ureter, to a single central bladder where it is stored until it is eliminated from the body through the urethra. A urinary tract infection occurs when bacteria or yeast enter the urethra from outside the body, travel against the flow of urine up to the bladder, and then may ascend the ureters to infect the kidneys themselves. About 60% of women but only 12% of men will experience a UTI during their lifetime. Women are much more prone to UTI than men due to the short length of the urethra permitting easier access of external bacteria to the bladder. A woman having a UTI will show a greater incidence of subsequent UTI with some 80% having a second episode within 18 months.
Risk factors include:
Symptoms may include:
Diagnosis:
Treatment: