Cystoscopy :: Digital Rectal Exam ::  Pathology :: PSA :: Radiology :: Urodynamics :: TRUS

Pathology

Following your first or subsequent visit to the urologist, you may be asked for a blood or urine test, below are a few common tests prescribed the urologist.

Urinanalysis :: Blood tests

Some of the more common blood tests are...

FBC. Full Blood Count The haemoglobin level is checked and the different blood cells are looked at in detail under the microscope. Various forms of anaemia are picked up as are viral infections like glandular fever. People on some medications require regular FBE's.

UEC's. Urea Electrolytes and Creatinine. This test is a measure of kidney function. We see an elevated serum urea or creatinine with dehydration or if the kidney function is impaired. The electrolytes are the various salts in the bloodstream... things like sodium, potassium, chloride and bicarbonate. The potassium level is of particular importance in people on diuretics or fluid tablets. Frequently the level falls in these patients and oral potassium supplements are required. Calcium in blood may be assessed to determine the

LFT's. Liver function tests. The levels of several liver enzymes rise markedly when the liver is damaged by infections like hepatitis, or by toxins like alcohol and certain drugs. Likewise, in a jaundiced patient where bile secretion from the liver is blocked, an elevated bilirubin level is seen. We also measure the protein and albumin levels; with chronic illnesses the albumin tends to gradually fall to quite low levels.

Cholesterol, triglyceride and other blood lipid levels. There is now no doubt at all that a high blood cholesterol level is an important risk factor for coronary artery disease. HDL-cholesterol seems to be protective and we like to see a higher level of this lipid. LDL-cholesterol appears a major factor in the development of coronary artery disease and we like to see a low level. Various ratios of HDL, LDL and total cholesterol are also used and may be more accurate predictors of coronary artery disease. Recent research suggests that an elevated triglyceride level is also significant and has to be taken into account.

Blood tests to check the levels of certain hormones might be prescribed to determine the cause of

• Impotence
• Recurrent urinary stones
• Uro-gynaecological cases?
  

PSA

stands for prostate specific antigen . It is a substance produced almost exclusively in the prostate and plays a role in fertility. The vast majority is actually released into the ejaculate but tiny amounts are released into the blood stream and can be detected by a simple blood test.

PSA is increased by cellular abnormalities within the prostate and abnormally high levels of PSA can be an indication of disease of the prostate.

As men get older the prostate gland grows and so the PSA is likely to rise. A high PSA may indicate some type of prostate disease. Common reasons for a high PSA level in the blood stream may include prostate cancer, large prostates, and age related inflammation of the prostate or infection of the prostate. Obviously the first concern is to exclude prostate cancer.

PSA is a useful tool for diagnosing and monitoring prostate diseases, but further tests are required to confirm which condition is present.

Urinanalysis

A urinalysis is an analysis of the urine. A doctor does a series of physical, microscopic, and chemical tests on a sample of urine. The tests can screen for kidney disease and infections of the urinary tract. It can also help diagnose diseases that produce abnormal breakdown products called metabolites that are passed from the body in the urine.

Urine culture

Urine culture help identify organisms that cause infection that may be present in urine.

The culture may be ordered

• When symptoms indicate the possibility of a urinary tract infection, such as pain and burning when urinating and frequent urge to urinate
  
  
• Patients who have a catheter inserted for an extended period of time, even if they do not show overt symptoms of an infection, since there is a risk of bacteria being introduced via the catheter.
  
  
• Pregnant women without any symptoms may be screened for bacteria in their urine, which could harm the baby

If you have Urinary Tract Infection (UTI), antibiotic susceptibility testing is usually done to determine the resistance of bacteria (germs).

A clean catch or mid stream sample of urine should be used for urinanalysis.