August 9, Kathmandu.
Experts have stated that if blood is seen in the urine of individuals over 50 years of age, it should not be taken lightly and a urologist should be consulted immediately.
Dr. Vijayaman Singh Katwal, a urologist and kidney transplant surgeon at Kathmandu Medical College (KMC) Hospital, said that the presence of blood in urine could be a sign of bladder, kidney, or urinary tract cancer, thus timely testing is essential.
In an interview with ICT Frame Magazine, Dr. Katwal also stated that if blood appears in the urine, especially in individuals who smoke, the possibility of cancer should be taken seriously. According to him, even if blood is seen only once without burning sensation during urination or infection, individuals over 50 should consult a doctor immediately.
He said,‘If blood is seen in the urine of a person over 50 years old, it is very dangerous. There is a chance of bladder cancer, or kidney, urinary tract, or bladder cancer. If people smoke and blood is seen in their urine, there’s a maximum chance that it might be cancer.’
He explained that urology treats all problems related to the process of urine formation in the kidneys, its passage through the urinary tract to the bladder, and its exit from the body. He stated that among the most common urological problems seen in Nepal are kidney stones and prostate problems that appear in men as they age.
Prostate Problems May Increase After Age 60
According to Dr. Katwal, as age advances, especially after 60, the prostate gland in men can gradually enlarge. When the prostate starts pressing the urinary tract from all sides, problems such as a weak urine stream, incomplete urination, frequent infections, and having to wake up many times at night to urinate may occur.
Similarly, he said that problems like inability to hold urine after feeling the urge, needing to go to the toilet immediately, and wetting clothes if unable to reach on time, could also be related to the prostate.
Although no single exact cause for prostate enlargement has been proven, he stated that age-related changes are the primary reason.
‘When the passage becomes narrow, the urine flow becomes weak. The bladder doesn’t empty completely. A little urine remains. People feel like their bladder hasn’t emptied fully. And then, there are frequent infections in the urine,’he said.
Important Role of Water in Kidney Stones
Doctors recommend consuming sufficient water and fluids to prevent kidney stone formation. He stated that one should drink enough water to produce about 1.5 liters of urine daily, and for that, typically about 2.5 to 3 liters of water or fluids can be consumed per day.
He also mentioned that liquids like tea, coffee, and lentil soup can be included in this.
He explained that not drinking enough water can lead to the accumulation of various salts and minerals in the urine, forming stones. He said that adequate water helps ‘flush’ the body’s urinary system, thereby reducing the risk of stones.
He said,‘Our estimate is that if one consumes around 2.5 to 3 liters of water or fluids per day, it will produce about 1.5 liters of urine. It’s not just water; tea, coffee, lentil soup, all combined to reach around three liters will provide a minimum flush.’
He stated that individuals who consume fast food and excessively salty foods, have low physical activity, and do not drink enough water may have a higher risk of kidney stones.
Many Who Have Had Stones Once May Get Them Again
According to Dr. Katwal, approximately 50 percent of individuals who have had kidney stones once have a chance of recurrence at some point in their life. For some, the problem may reappear within a few months, while for others, stones may form again after eight to ten years.
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He stated that individuals who develop stones at a young age may have an even higher chance of recurrence in the future. He added that stones can also form due to hormones that increase calcium levels in the body, uric acid, diet, and the very structure of the kidneys.
He said,‘A person who has had stones once has a chance of getting them again throughout their life. 50 out of 100 people will get stones again. For some, it happens in six-seven months, or a year, while for others, it happens in eight-ten years. But 50 percent have a chance of recurrent stones.’
He stated that not only the size of the stone but also its structure and width determine the likelihood of it passing out naturally. While long but narrow stones can pass relatively easily, round and wide stones, like corn kernels, are difficult to pass.
Higher Urinary Tract Infections in Women
Dr. Katwal stated that the main reason for higher urinary tract infections in women compared to men is the proximity of the urethra and anus.
He advised women to keep their genitals clean, drink enough water, and avoid the habit of holding urine for too long.
‘In women, the anus and the urethra are very close. Most of the bacteria found in stool are also seen in urine. That’s why urinary infections are very common,’he said.
However, he also suggested that rushing to the toilet every few minutes as soon as one feels the urge to urinate is not necessary, and advised developing a habit of urinating at regular intervals.
Doctors state that if urinary infections are frequent, the problem cannot be solved by simply taking antibiotics. He said that if there is a condition where urine remains in the bladder due to prostate issues in men, it needs to be treated.
He said,‘If it’s due to the prostate, then the prostate needs treatment. If the prostate is normal, the urine stream is good, and not much urine remains after urination, then we treat it with simple medicines, antibiotics. That too, only after checking the culture, if there is culture sensitivity, and we give medication accordingly.’
He stated that appropriate treatment is also necessary in cases of kidney infection. In normal cases, suitable antibiotics are selected based on urine culture and sensitivity tests.
However, he explained that in severe conditions where the patient has a high fever, burning urination, and the situation is critical, doctors cannot wait 72 hours for a culture report, so they may start necessary antibiotics immediately. According to him, the medication will be changed according to the culture report once it arrives.
Urges Not to Conceal Urinary Problems
Dr. Katwal stated that if there are urinary problems, one should not avoid treatment due to shame or hesitation. He urged to consult a urologist in time if problems such as burning urination, blood in urine, frequent infections, weak urine stream, or incomplete urination appear.
He also mentioned that with increased access to health institutions and expanded testing facilities in Nepal recently, more urological problems are being identified than before.
‘If there is any problem with urination, blood in urine, or burning sensation during urination, one should not hesitate. One should visit a nearby urologist and get timely treatment and necessary tests,’Dr. Katwal urged.
