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THE
ELDERLY
WITH BLOOD
IN
THE
URINE
ln
general, blood
in
the urine
is
due
either to
tumours or
infections,
stones
of
the urinarytract. When
duetotumour,
the blood in the urine
can
usually
be
seen
by
the
naked eye. When blood
occurs
repeatedly, the chance of it be-
ing tumour is more likely. When due
to
infection,
usually
there
may
also
be
fever, pain and frequency. Stones usu-
ally cause
very
intense pain. Of all
the
tumours occurring
in
the
urinary tract,
bladder
cancers
are
more
common than
kidney cancers; investigations
includ-
ing radiology and a cystoscopy
to
look
at
the
inner surface of
the
bladder are
required for diagnosis.
With
increasing
age,
the
incidence
of
benign
(non-
cancerous) prostate
hypertrophy
(enlargement
of
the prostate gland situ-
ated
just
below
the
bladder due to
aging)
is
very common and must
be
dif-
ferentiated
from
prostate cancer which
is
gradually getting more common even
in
the Chinese. The
PSA blood test
may
be useful. With enlargement
of
the
prostate, palients would
have
frequency
(especially at night) and difficulties
in
passing urine. Disease presentation as
blood
in
the urine is
not
common,
un-
less
there
is
accompanying prostatitis
(infection
of
the prostate). Never ignore
any urinary symptoms
in
the
elderly!
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72
