Don't neglect those signs

By Roshan Peiris

"Don't ever neglect if you find blood in the urine. It is an alarming symptom which you must worry about," he said.

Blood in the urine is sometimes visible to the naked eye where blood passes with urine -medically termed 'frank haematuria'. Sometimes a significant number of blood cells can be spotted when the urine is examined under the microscope- medically termed 'microscopic haematuria.' 

There are a number of causes for blood to pass with urine. An infection of the urinary tract due to pyelonephritis, cystitis or prostatitis is the primary cause. 

Stones in the urinary tract or tumours in the urinary tract called urinary tract malignancy could also cause this symptom. 

Other diseases of the kidneys such as glomerulonephritis or cystic diseases of the kidneys and finally the effect of some drugs or bleeding disorders in the urinary tract can also bring about this condition.

The common sites of malignancy in the urinary tract are kidneys, bladder and among men, the prostate gland. 

Dr. Wijewardena said several investigations have to be done when this complication arises.

First the urine should be examined under a microscope to assess the presence of red blood cells.It is important that subsequent negative tests for red cells do not obviate a diagnostic screen as tumours are known to sometimes give intermittent bleeding.

The next investigation, the doctor said, is the quantitative study of protein excretion in the urine. 

A scan and x-ray of the urinary tract are also necessary.They are important to diagnose urinary tract malignancy. In Cystoscopy, a telescopic camera examination of the urinary passage and the bladder are done. This investigation is mandatory to diagnose bladder tumours. 

In kidney and bladder malignancy the standard treatment is to perform open surgery to remove the affected kidney.This is called Radical Nephrectomy.

The initial treatment for bladder tumour is surgery. This is done by using a telescopic camera via the urinary passage to remove the tumour of the bladder. In some cases, the whole bladder has to be removed through open surgery. 

The most important step after surgery the doctor stressed, is the follow up carried out with the combined consultation of the surgeon and the oncologist -the cancer specialist. 

The prostate gland found only in men is situated around the urinary passage. Most enlarged prostates are not malignant. "However the symptoms caused by the enlarged prostate can be the same as those of a malignant prostate." 

The symptoms are difficulty in passing urine, delay in passing urine, increased frequency in passing urine and occasional passing of blood with the urine. 

The doctor sometimes identifies malignant prostate through rectal examination. To be absolutely sure the test is done on the tissue removed from the prostate gland through a biopsy. 

The treatment consists of different modalities. The necessary approach is decided by the joint consultation of the urologist and oncologist. It could be radiation, surgery or drugs. 

Listen to your team mates

Your Health 

By Dr. Sanjiva Wijesinha

It was certainly a match that went through to a nail-biting finish - as well as being a match full of incidents.

But it was a game that brought home, above all, the importance of teamwork - of each member of the team contributing his talent, in his own way. There was Sanath Jayasuriya with his swashbuckling sixes and fours that gave our team the initial impetus for victory. There was young Mahela Jayawardena who rose to the occasion.

And there was that shrewdest of captains, Arjuna Ranatunga, putting to use all the experience and cunning he has acquired over the years. 

Sadly, such teamwork as our cricketers displayed in Australia is often lacking when it comes to matters of men's health in this country.

If we men want to be healthy, we must work as part of a team - with our doctors as well as our families. 

We males are notorious in neglecting our health. Just because many years ago we played cricket for our school or ran the 400 metres in our teens, we labour under the delusion that we are "fit", and will continue to be fit for the next fifty years after we leave school. We concentrate on our beef, our buth-curry and even our beer (not to mention our cigarettes), neglecting our exercise and putting on weight in all the wrong places - and then disbelieve our doctors when we are told that we have developed high blood pressure or diabetes or heart disease .

Even when we get a chest pain, we don't take it seriously - dismissing the wife's advice to get it checked by the doctor ("This is just a muscle pain, men - no need to worry the doctor"). After all, what self-respecting Sri Lankan male takes his wife's advice about looking after his health seriously? The moral of the story is this - if you have any unusual symptoms like chest pain, loss of weight, bleeding when you have a motion etc. don't neglect them. The other members of your health care team are waiting to help you.

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