Frequently Asked Questions About Urologic Health and Care
Questions about urinary symptoms, an abnormal test result or a new diagnosis can quickly lead to more questions. The answers below address common concerns and provide links to more detailed information about urologic conditions, evaluation and treatment options.
Urinary Symptoms and When to Seek Care
Changes in urination can have many possible causes, ranging from common benign conditions to problems that require further evaluation. Understanding what a symptom may mean—and when to discuss it with a physician—is an important first step.
Why am I having trouble urinating?
Difficulty urinating can include trouble starting, a weak or interrupted stream, straining to urinate or feeling that your bladder has not completely emptied. In men, an enlarged prostate (BPH) is one common cause, but urinary obstruction, bladder dysfunction, scar tissue and other conditions can produce similar symptoms. Because treatment depends on the underlying cause, persistent or worsening difficulty urinating should be evaluated rather than assumed to be a normal part of aging.
Learn more: Benign Prostatic Hyperplasia (BPH) | Urinary Obstruction | Voiding Dysfunction
Does blood in my urine mean I have cancer?
No. Blood in the urine, called hematuria, can have many possible causes and does not by itself mean that you have cancer. Causes can include urinary tract infections, kidney stones, an enlarged prostate and other urinary tract conditions. However, blood in the urine can also occur with cancers of the bladder, kidneys or upper urinary tract, so visible blood or persistent microscopic blood should not simply be ignored.
Learn more: Bladder Cancer | Kidney Cancer | Kidney Stones | Upper Tract Urothelial Cancer
Why do I feel like I need to urinate so often?
Frequent urination can result from increased urine production or from changes affecting the bladder, prostate or urinary tract. BPH, overactive bladder, urinary tract infections and other conditions can cause frequency or urgency, and some people experience more than one contributing problem. A urologic evaluation can help distinguish between problems involving urine storage, urinary flow and bladder emptying.
Learn more: Benign Prostatic Hyperplasia (BPH) | Voiding Dysfunction
When should recurrent urinary tract infections be evaluated by a urologist?
Urinary tract infections are common, but infections that repeatedly return may warrant further evaluation to determine whether another condition is contributing to them. Problems with bladder emptying, urinary obstruction, kidney stones or abnormalities within the urinary tract can sometimes make infections more likely to recur. Evaluation is individualized according to symptoms, medical history and the pattern of infections.
Learn more: Kidney Stones | Urinary Obstruction | Voiding Dysfunction
PSA, Prostate Health and Prostate Cancer
PSA testing can provide useful information about prostate health, but the result is not a cancer diagnosis by itself. Understanding what PSA can—and cannot—tell you can make the next steps easier to understand.
Does an elevated PSA mean I have prostate cancer?
No. Prostate-specific antigen (PSA) can be elevated for reasons other than prostate cancer, including benign prostate enlargement and inflammation. A physician interprets PSA in the context of factors such as previous PSA results, age, prostate health, medical history and other clinical findings. An abnormal result may lead to additional evaluation, but the PSA level alone does not establish a diagnosis of prostate cancer.
Learn more: Prostate Cancer | Benign Prostatic Hyperplasia (BPH)
Is an enlarged prostate the same as prostate cancer?
No. Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate and is different from prostate cancer. BPH commonly affects urinary flow because the prostate surrounds part of the urethra, while prostate cancer develops when cells within the prostate become cancerous. A person can have BPH, prostate cancer or both, which is why urinary symptoms or abnormal prostate findings need to be evaluated in context.
Learn more: Benign Prostatic Hyperplasia (BPH) | Prostate Cancer
Does prostate cancer always need to be treated right away?
No. Some prostate cancers have characteristics that make careful monitoring an appropriate option rather than immediate surgery, radiation or another treatment. Active surveillance follows the cancer with structured monitoring so treatment can be considered if there are meaningful signs of progression. The decision depends on the characteristics of the cancer as well as the patient’s age, overall health, life expectancy and preferences.
Learn more: Active Surveillance & Watchful Waiting | Prostate Cancer
What is the difference between active surveillance and watchful waiting?
Active surveillance is a structured approach used to monitor selected prostate cancers while preserving the possibility of curative treatment if the cancer shows meaningful progression. Watchful waiting generally involves less intensive cancer monitoring and places greater emphasis on managing symptoms and quality of life if problems develop. Although the terms have sometimes been used interchangeably, they represent different approaches to care.
Learn more: Active Surveillance & Watchful Waiting for Prostate Cancer
Understanding a Urologic Cancer Diagnosis
A diagnosis is only the beginning of determining what a cancer means for an individual patient. Cancer type, location, stage, grade and other findings help physicians understand the disease and determine which options deserve consideration.
What happens after a urologic cancer is diagnosed?
The next step is to determine the characteristics and extent of the cancer and how those findings affect treatment decisions. Depending on the type of cancer, this may involve review of pathology, imaging, laboratory testing and other diagnostic information. Your overall health, previous treatment and personal priorities also become part of the discussion when determining whether surveillance, surgery, radiation therapy, systemic treatment or another approach may be appropriate.
Learn more: Urologic Conditions | Urologic Treatment Options
How do doctors determine whether cancer has spread?
Staging evaluates the extent of a cancer, including whether it remains confined to its original location or has reached nearby tissues, lymph nodes or more distant parts of the body. The information used for staging varies by cancer and may include imaging, examination, biopsy or surgical pathology and laboratory testing. Accurate staging helps determine which treatments are appropriate and whether more than one type of treatment should be considered.
Learn more: Urologic Conditions
Does finding cancer mean I will need surgery?
No. Surgery is an important treatment for many urologic cancers, but it is not appropriate or necessary for every patient. Depending on the cancer and its characteristics, options may include active surveillance, radiation therapy, focal treatment, systemic therapy, surgery or combinations of treatment. The purpose of discussing these choices is to determine which approach fits the disease and the individual patient rather than simply selecting the most aggressive treatment.
Learn more: Surgery for Urologic Cancers | Radiation Therapy for Urologic Cancers | Urologic Treatment Options
Choosing and Understanding Treatment
Patients may have more than one reasonable treatment option, and the differences between them are not always obvious from the name of a procedure. Understanding the purpose of treatment, its potential effects and what happens afterward can help make those conversations more productive.
How do doctors decide which urologic treatment is right for me?
Treatment recommendations consider the diagnosis, extent and characteristics of the disease along with your anatomy, overall health, previous treatments and personal priorities. Physicians also consider how different options may affect urinary, sexual, reproductive or kidney function and quality of life. When more than one approach is medically appropriate, understanding these tradeoffs becomes an important part of shared decision-making.
Learn more: Urologic Treatment Options
How do surgery and radiation therapy differ for urologic cancers?
Surgery physically removes a tumor, affected tissue or sometimes an organ, while radiation therapy uses targeted radiation to damage cancer cells. Either approach may be used as a primary treatment for certain cancers, and radiation can also have a role before or after surgery or in treating advanced disease. The choice is specific to the cancer and patient; neither approach is automatically the better treatment in every situation.
Learn more: Surgery for Urologic Cancers | Radiation Therapy for Urologic Cancers
What does robotic surgery actually do?
Robotic-assisted surgery is a way for the surgeon to perform certain minimally invasive operations; the robot does not independently perform or decide the surgery. The system provides magnified three-dimensional visualization and articulated instruments that can help the surgeon work within confined areas and perform detailed dissection, suturing and reconstruction. The surgeon remains in control of the procedure and determines how the technology is used.
Learn more: Robotic Prostate Cancer Surgery | Robotic Urologic Reconstruction
What happens if I need additional treatment after surgery?
Additional treatment after cancer surgery does not necessarily mean the operation was unsuccessful. Surgical pathology and follow-up testing can provide new information about the cancer and the risk that microscopic disease remains or may return. Depending on the cancer and those findings, your care team may recommend surveillance, radiation therapy, systemic treatment or another approach as the next part of the treatment plan.
Learn more: Surgery for Urologic Cancers | Radiation Therapy for Urologic Cancers
Do you have a question?
At Providence Saint John’s Health Center, our goal is to give patients a clear understanding of their diagnosis and access to personalized urologic care—from evaluation and surveillance to advanced medical, minimally invasive and surgical treatment.
If you have questions about a diagnosis, symptoms or which type of urologic care may be appropriate, our team can help you determine the next step.