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Key Signs and Symptoms of Urological Disease and Injury

Key Signs and Symptoms of Urological Disease and Injury

Urological diseases and injuries have different signs and symptoms. This paper describes signs and symptoms related to the urinary tract in men and women and to the male reproductive organs. See what your medical symptoms could mean, and learn about possible conditions.

It is important to realize that this information is general. It does not consider your individual medical situation. If you have questions or concerns about your health, please contact your doctor.

Bladder pain: Bladder pain syndrome (interstitial cystitis)
Painful urination: Painful urination, also known as dysuria, suggests a urinary tract infection. This is the most common cause in women. An infection in the urethra (urethritis) or prostate problems are more common causes in men. Pain, burning, and discomfort can also be associated with blood in the urine (hematuria). Sometimes this pain can be a sign of bladder cancer.

A number of conditions can cause dysuria:

  • Medications that irritate the bladder
  • Sexually transmitted diseases
  • Kidney or bladder stones
  • Infection of the kidney, urethra, prostate or vagina
  • Yeast infection
  • Personal care products that contain soaps or perfumes

If you experience dysuria or bladder pain, you should consult your doctor.

Flank pain: The flank is the lower back and side between the ribs and the hips. Flank pain can be constant or can come and go. It can be sudden and severe. It can be a sign of a urinary stone or a urinary tract infection. Contact your doctor soon if you feel strong flank pain or immediately if pain is severe and/or includes fever.

Flank pain can also be a sign of a kidney injury. Injury can be caused by a car or bicycle accident, a fall, or a direct blow to the flank or abdomen during sports activities. Kidney injuries can also be associated with skin injures or bruises (hematomas) in the flank area. In case of flank pain after an accident, see a doctor immediately.

Hematospermia: Blood in the sperm might occur for harmless reasons. Often no cause can be found. It will usually go away on its own. If it does not or if it comes back, see your urologist for further evaluation.

Infection can cause hematospermia, especially in younger men, but usually has other symptoms too. Prostate surgery or biopsy can cause blood in the sperm for several weeks. Hematospermia might be caused by something as simple as a broken blood vessel.

If there is a lot of blood in the sperm or blood keeps coming back, more thorough tests might be needed. This could be a warning sign for cancer, but the risk is low.

Other causes include:

  • Surgery of the penis, testicles, or prostate
  • Infection in the lower urinary tract
  • Sexually transmitted disease
  • Excessive or interrupted sexual activity or prolonged abstinence
Hematuria: Blood occurs in the urine when part of the urinary tract has allowed blood cells to leak in. It can occur with or without pain or dysuria. If you see blood in your urine or if hematuria is related to an accident, contact your doctor immediately.

Blood in urine can be a sign of urological disease or result from another problem. Painful hematuria suggests a urinary tract infection such as cystitis (inflamed bladder). Hematuria can also indicate a kidney or bladder stone. Blood in the urine as a sign of advanced cancer in the urinary tract is more rare.

An enlarged prostate or an infection of the prostate can cause hematuria. It can also be a sign of infection of the bladder or the kidney, although a kidney infection can also cause fever and flank pain. Some inherited disorders such as sickle cell anemia can cause blood to be in the urine.

Glomerulonephritis, a type of kidney disease, inflames the kidneys’ filtering system, which often causes hematuria. This inflammation has a number of causes. Diabetes can cause glomerulonephritis, as can viral or bacterial infections. It can also result from vascular disease or immune problems. Sometimes it occurs on its own.

Kidney injury or even strenuous exercise can allow blood to leak into the urine. A blow to the kidney from physical contact or an accident can injure the kidney. Some athletes, particularly runners, may experience hematuria after a particularly intense workout.

Finally, medications such as chemotherapy, penicillin, and blood thinners can cause bleeding in urine.

If you have blood in your urine, consult your doctor for examination.

Penis pain: Pain in the penis or urethra can be a sign of urinary tract infection. Pain can occur in an erect penis with penile curvature. If you experience pain while urinating (dysuria) or bladder pain, you should consult your doctor.

If you feel pain caused by trauma to your erect penis, you might have a penile fracture. Penile fracture is associated with a sudden cracking or popping sound, pain, and immediate loss of erection. Swelling of the penile shaft develops quickly. Bleeding may occur at the urethral opening. You may also have bruising (hematoma) or wounds (lesions) in the urethra. In such a case, you should see a doctor immediately.

Priapism: Priapism is an erection that lasts longer than 4 hours without sexual arousal. This might be painful and can damage to the erectile tissue. Priapism is rare overall but is more likely to occur with certain diseases (for example, sickle cell anemia) or medications (such as those for erectile dysfunction). Damage of the erectile tissue can cause problems getting or keeping an erection. If you have priapism, seek treatment immediately.
Scrotal pain: Scrotal pain can be a sign of inflammation of the testicle or the surrounding tissue like an epididymitis. It is usually associated with scrotal swelling and sometimes dysuria or fever. In such cases you should consult your doctor for further diagnosis.

Sudden (acute) and severe scrotal pain, especially in children or teens and often after physical activity, can be a sign that blood supply to the testicles has been cut off (testicular torsion). This can be accompanied by nausea and vomiting. A prompt treatment of testicular torsion is required, since irreparable damage to the testicle might occur after only few hours. If your child reports scrotal pain or you experience sudden or severe scrotal pain, you should consult a doctor immediately.

Scrotal pain can also occur after accidents or injuries such as a kick or hit to the scrotum. Such blunt trauma to the scrotum can cause injuries to the testicle and/or scrotal bruising (hematoma). You should consult a doctor immediately.

Blood at the urethral opening can be a sign of urinary tract infection. It can also be a sign of injury to the urethra if associated with an accident, especially when accompanied by a sudden inability to urinate. Blood in the urine and pain when urinating may be present. Swelling of the scrotum or penis is possible. If you have had an accident, you should see a doctor immediately. Otherwise, you should consult your doctor for further diagnosis


This information was produced by the European Association of Urology (EAU) Patient Information Working Group.
Dr. P. Honeck – Bernsheim, Germany
Dr. J.P. Jessen – Sindelfingen, Germany