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Time to seek immediate help when urologic emergencies occur.

Emergency Conditions

Kidney stones can be one of several emergency conditions.

Most individuals are unaware that they have kidney stones until they move. Once they start to move, they can cause excruciating pain, nausea, and vomiting. When stones move suddenly, they can be one of several urologic emergency conditions that require immediate attention. A urologist will want to determine how the kidney stone(s) should be removed. They will also want to assess if the patient will benefit from medications to ease their pain and discomfort.

Sometimes, kidney stones are incidentally detected by the presence of microscopic hematuria (blood in the urine). If a stone is suspected, imaging will be performed to confirm the diagnosis. These stones can be treated or watched depending on their size and location.

Visible blood in the urine – gross hematuria

Gross hematuria is among the urologic emergency conditions that should be assessed immediately. It is characterized by blood in the urine that is clearly seen by the naked eye. Blood can range in color from bright red to brown, and is symptomatic of an underlying medical condition. Individuals with gross hematuria many also be experiencing pain. As a medical standard, persons who detect blood in their urine should seek immediate help.

There are several medical ailments associated with gross hematuria. These can include:

  • Urinary tract infection
  • Kidney infection
  • Infection or inflammation of the prostate
  • Enlarged prostate – Benign Prostatic Hyperplasia (BPH)
  • Bladder or kidney stones
  • Blood disorders such as Sickle Cell Anemia or Hemophilia
  • Urologic cancers including bladder, kidney, or prostate cancer

Gross hematuria may also be the result of an injury, certain medications or strenuous exercise.

Gross hematuria differs from what is known as microscopic hematuria. With this condition, blood is also present in the urine, however, it can only be detected under a microscope. Oftentimes, it is an incidental finding during a urinalysis or other lab test. There are many common reasons to have microscopic blood in the urine. These can include sexual intercourse, menstruation, or exercise. Regardless, when blood is present in the urine, it should always be diagnosed and treated.

Urinary retention

An individual is in urinary retention when their bladder fills with urine, but they are unable to urinate. Instead, the bladder continues to stretch and enlarge to accommodate more urine. This condition is very painful, and can ultimately cause damage to the bladder or kidneys. Severe retention may also lead to kidney failure. Emergency conditions such as urinary retention requires swift treatment in order to drain the urine and relieve pressure off the urinary organs.

Retention is routinely relieved by catheterization or medications, depending on the severity. This should be performed by a medical provider; self-catheterization is not recommended

Sudden, acute urinary retention is different than milder forms of retention that indicate as a weak, slow or intermittent stream of urine.

Generally, urinary retention is caused by a blockage that prohibits urine from draining properly. Blockages can occur from:

  • Bladder stones
  • Kidney stones
  • Enlarged prostate (BPH)
  • Prolapsed bladder
  • Tumors
  • Urethral stricture (narrowing of the urethra)

Retention may also be triggered by medications, nerve damage, or injury, among others.

Long-term erection (priapism)

Many individuals associate Priapism – a long-term sustained erection – with the use of erectile dysfunction medications. While this can occur, priapism may also be indicative of a serious underlying medical condition.

Priapism is diagnosed when an erection will not decrease after sexual stimulation or ejaculation. This occurs when the engorgement of blood remains in the penis rather than circulating properly. The longer the erection is sustained, the more painful it can become. Also, the likelihood of permanent penial damage increases. This may include erectile dysfunction or deformity. It’s important to seek qualified medical help if an erection has been maintained for more than four hours. Treatment is critical within the first 24 hours in order to minimize damage.

Priapism can be caused by the following:

  • Medications – prescription or recreational (cocaine)
  • Blood disorders such as Sickle Cell Anemia
  • Idiopathic – unknown causes

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