Patient guide

What to bring

• Earlier urine and blood results, especially PSA, with dates
• Reports and images of ultrasound, CT or MRI scans
• A list of all your medicines, including herbal and over-the-counter ones
• Reports of past operations and biopsies
• Your bladder diary, if you have kept one

Think about these before the visit

• When did the problem start, and has it got worse?
• How many times do you pass urine by day and by night?
• Have you had pain, burning or blood?
• What disturbs your daily life most?

What happens

The doctor asks about your symptoms and, depending on the problem, may examine your abdomen, genitals or pelvis. In men a prostate examination is sometimes needed too. If you feel uneasy about this, say so. You can have someone with you in the room.

It is best not to arrive with a completely empty bladder, in case a urine sample is needed. If a urine flow test is planned, ask beforehand whether to come with a full bladder.

For companions

If you are coming with an older patient, write down the medicines and questions, and note the answers so that nothing is forgotten after the visit.

Why it helps

It is hard to remember how many times you went yesterday. A diary shows how much you drink, how often and how much you pass urine, and when the problem is worst. With this information the doctor can think about the cause far more precisely.

How to fill it in

Record at least three days, ideally in a row. For each day, write down:

• The time, type and amount of every drink
• The time of each trip to the toilet
• The amount of urine, if you can measure it with a marked container
• Every leak or moment of urgency, and what you were doing
• When you went to sleep and woke up, and how many times you woke at night

A few tips

• Do not change your habits for the diary. The aim is to see a normal day.
• Use a sheet of paper or your phone, and write each entry down at the time.
• Bring the diary to your visit.

Urine test

Shows signs of infection or blood. Give the sample as the laboratory explains.

PSA test

This blood test checks the prostate. For 48 hours beforehand, do not ejaculate, do hard exercise or ride a bike. Eating and drinking are fine. If you have had a urine infection, the test should wait until 4 to 6 weeks after it has cleared.

Urine flow test

You pass urine into a special container or toilet and a machine records the flow rate as a curve. This simple test shows whether the flow is weak. You may be asked to come with a full bladder.

Residual urine

After you pass urine, ultrasound or a catheter measures how much is left in the bladder. This shows whether the bladder empties fully.

Urodynamic tests

These tests show how the bladder works while filling and emptying. A thin catheter is placed in the bladder. You may feel mild discomfort when passing urine for a few hours afterwards. If you get a fever, chills or pain, contact your doctor.

Cystoscopy

A thin tube with a camera looks inside the bladder. The flexible type is done with numbing gel and usually takes 10 to 15 minutes. For a few days afterwards you may see a little blood in your urine or feel some pain when passing it. If this continues, contact your doctor.

Imaging

Ultrasound, CT and MRI are requested depending on the problem. The patient support network can help you arrange them.

Ask before the day

• What exactly is this procedure for, and what other options do I have?
• What are the benefits and risks, and how likely are complications?
• What type of anaesthetic is it, and from what time should I fast?
• Which medicines should I continue and which should I stop?

Do not stop blood thinners on your own. Ask your doctor about them and any other medicines before the day.

Mention any urine infection

If you have signs of infection, let the team know before the day. They may take a urine sample, and if there is an infection the procedure may be moved to another date.

After an anaesthetic

If you have had a general or spinal anaesthetic, someone needs to take you home and stay with you for 24 hours. During that time do not drive, drink alcohol or use dangerous machinery.

The days after

A small amount of blood in the urine and pain when passing it are common after some procedures and usually settle within a few days. Your own doctor’s instructions come before this general text.

If you cannot pass urine, get a fever or shivers, or see more blood and clots, call the same day.

What is a catheter?

A catheter is a soft tube that drains urine from the bladder into a bag. It is usually needed when the bladder cannot empty by itself, for example because the way out is blocked, or before and after surgery. An intermittent catheter is removed once the bladder is empty, and an indwelling one stays in the bladder for days or weeks, held by a small balloon.

Daily life

The catheter and bag stay hidden under clothes, and most daily activities, including work and exercise, are possible. If you have a long-term catheter, you are told about supplies, care and warning signs before you leave hospital. Catheter changes at home are also listed on the patient support form.

What is normal?

• Some discomfort, especially in the first days
• Bladder spasms that feel like stomach cramps, because the bladder is trying to push out the balloon
• A little blood or small debris in the tube

When to call

• Pain low in your abdomen or around your groin
• Fever, feeling cold and shivery, or confusion
• Urine leaking around the catheter
• No urine reaching the bag, or you think the catheter is blocked
• Clots or large pieces of debris in the tube

A blocked catheter should not wait until tomorrow. Get help as soon as you can.

Go to the emergency department at once, or call 115

• You cannot pass urine at all, or have severe pain low in your abdomen
• Sudden severe testicle pain, testicle pain with nausea or tummy pain, or pain lasting more than an hour
• Severe pain in your side with fever and shivering
• Confusion, drowsiness or trouble speaking with signs of infection

Do not drive yourself. Bring your medicines with you.

Call a doctor the same day

• Blood in your urine, even a small amount or if you are not sure it is blood
• A urine infection with fever, shivering or pain in the side or back
• Burning when passing urine in men, pregnant women, people with diabetes or people with a catheter
• Severe stone pain that painkillers do not settle
• A blocked catheter, or one with clots

Come soon

• A lump or swelling in a testicle
• Back pain or unexplained weight loss with a urinary problem
• Symptoms that have not improved 48 hours after starting treatment for an infection

This list does not cover everything. If you feel unwell and are not sure, do not wait.