Health Issue Detective Series 2
"Silent hematuria" - Why is it a fuze for tumors?
"Doctor, I remember that I was clearly visiting the heart, why did I ask so many questions about urination?" Maybe it was curious, maybe it was because the doctor asked about urination repeatedly that made him very puzzled. Mr. X couldn't help but ask this question to his "health management full-time doctor".
"Of course it's related," said the full-time health management doctor, pointing to Mr. X's exclusive customized health file on the table. "There is the key to diagnosing your condition."
...
"Not just the heart"
40 Mr. X, who is over 40, has occasionally had symptoms of palpitations and discomfort since June, so in October, he came to the Sheshan Campus of Zhongshan Hospital Affiliated to Fudan University to focus on checking heart problems. Mr. X was a "full-time doctor in health management". Mr. X had never heard of such a "doctor" before coming here. After thoroughly inquiring about Mr. X's physical condition and condition, the full-time doctor established an exclusive health record for Mr. X.
The full-time doctor first asked about Mr. X's heart disease manifestations, but during the consultation, Mr. X inadvertently mentioned that the number of urinations in recent times has been more frequent than before, but he himself felt that it may be related to drinking more tea recently. The doctor immediately became vigilant. Drinking more tea simply will not lead to a significant increase in the number of urination over a period of time. Therefore, while considering whether it is pathological frequent urination, the doctor additionally asked Mr. X if he had urination pain, urgency or redness in urine recently...
Although Mr. X felt that it seemed that urination frequency urination had nothing to do with the heart, out of full trust in the hospital, Mr. X listened to the advice of the full-time doctor, in addition to checking the heart, he also carefully checked the urinary system.
"Silent Lead"
During the physical examination, the color ultrasound doctor found multiple physical spaces on the back wall of Mr. X's bladder , which means that there may be foreign objects or something in Mr. X's bladder. After observing the abnormality, the color ultrasound doctor immediately notified the full-time doctor: "Discover clues and check them quickly!" The full-time doctor immediately found Mr. X to ask after receiving the examination report. This time, he asked about the bladder-related medical history in more detail. After continuous guidance and questioning, Mr. X recalled that he reminded him that " red blood cells can be seen" two years ago during a routine urine test.
"'Visible red blood cells', you are hematuria ! Why didn't there be any further examination or treatment?" said the full-time doctor in confusion. It turned out that Mr. X had a routine urine review at that time, but the indicators had returned to normal. In addition, there was no urgency, pain, etc., and no redness in urine, so he didn't care about this. "Doctor, my urine has not turned red, why did it be determined to be hematuria?" Mr. X was puzzled.
Therefore, it is not necessary to turn red in urine to be judged as hematuria, and simply turn red in urine cannot be judged as hematuria. After examination, it is necessary to find that the red blood cell excretion in the urine exceeds the standard before it can be determined to be hematuria. Since Mr. X stated that he did not have any urinary pain or urgency during the examination, it can be inferred that Mr. X had painless hematuria.
can cause painless hematuria, but once painless hematuria occurs, you should be highly vigilant. The causes of painless hematuria are as follows (among them, malignant tumors in the urinary system are the most common causes):
(1) Inflammation of the urinary tract: cystitis , urethritis , prostatitis , pyelonephritis , etc.;
(2) Stones in the urinary system: kidney stones , urethritis , etc.;
(3) Trauma and prostate hypertrophy;
(4) renal cancer , bladder cancer , and prostate cancer , etc.
It can be said that painless hematuria is like a silent lead. If it is not cleared in time, it will cause a huge health crisis.
"Scary Bomb"
It was not until Mr. X saw the inspection results that he believed in his eyes. "After the enhanced CT examination just now, CT prompted multiple parenchymal placeholding in the posterior bladder wall.Given that intermittent painless hematuria is more correlated with urinary tract tumors, we initially diagnose you with the possibility of bladder cancer. "Then the full-time doctor explained to Mr. X the crisis behind "painless hematuria":
chemical carcinogens (contact of aromatic amines, etc.), smoking, dietary factors, the abuse of painkillers with similar chemical structures and aniline dyes, artificial sweeteners, chronic infections, pelvic radiotherapy, cyclophosphamide intake, etc., will increase the risk of bladder cancer. Painless hematuria is an important clinical manifestation of bladder cancer patients. Symptoms of bladder stimulation, dysuria or urinary retention and upper urinary obstruction symptoms are all basis for judgment.
"Bomb Disposal Expert"
originally thought it was just an ordinary physical examination, but because the "full-time doctor of health management" of Zhongshan Hospital conducted sufficient and detailed inquiries during the physical examination process, he keenly discovered this "tumor fuse". Mr. X felt deeply admired and actively cooperated with the subsequent medical arrangements. The full-time doctor also immediately contacted the urology surgeon and arranged for Mr. X to go to the International Department of Zhongshan Hospital the next day for treatment and was admitted to the hospital for further examination and treatment.
Regarding how to prevent bladder cancer, the "full-time doctor of health management" gave the following suggestions:
1. Quit smoking and prohibit excessive drinking, maintain a healthy lifestyle;
2. Staff who often deal with chemicals that may cause bladder cancer should take protective measures during their work and often contact them. People with pigments, hair dyes and other substances also need to take good protection and reduce exposure;
3. Drink water frequently, and the rinsing effect of urine will reduce the residence time of harmful substances in the bladder, thereby reducing the risk of cancer.
Sheshan Campus of Zhongshan Hospital Affiliated to Fudan University is a new era innovation that has been experienced by Zhongshan Hospital. It is the first batch of international medical tourism pilot units of public hospitals. Relying on the strong medical, education and research strength of Zhongshan Hospital, it promotes "high-quality health management". Sheshan Campus provides a full-life cycle health management service integrating prevention, screening, disease prediction, diagnosis, treatment and rehabilitation, focusing on the main issues affecting people's health, and providing professional, efficient and high-quality health management services to the general public.
Author: Zou Jian, Fu Yue, Jiang Sunfang
