Pain when urinating, changes in the appearance of the urine and the smell of urine
The presence of blood in the urine is the main symptom of bladder cancer. To make a diagnosis, several tests are necessary. They also make it possible to assess the degree of extension of the cancer.
Symptoms
The main symptom of bladder cancer is hematuria, i.e. the presence of blood in the urine. It is found in approximately 90% of patients.
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Bleeding often appears at the end of urination. The urine may be slightly pink, dark red or burgundy depending on the intensity of the bleeding. There is no link between the amount of bleeding and the severity of the cancer.
Hematuria are sometimes too small to be spotted with the naked eye. They may also stop for some time and be interspersed with normal-looking urine. It is therefore recommended to systematically consult a doctor as soon as the first haematuria is detected. This approach makes it possible to carry out the examinations necessary to make the diagnosis of bladder cancer or, on the contrary, to direct towards other diseases which can also cause hematuria (kidney stones, chronic infections, cancer or kidney disease, etc.) .
Other local symptoms may alert the patient: more frequent urination, burning or pain during urination, etc. Whether or not they are associated with hematuria and if they persist, these manifestations should encourage the patient to consult his attending physician.
Diagnostic tests
The symptoms of bladder cancer are not specific: other diseases can be evoked in the presence of hematuria or painful urination.
To confirm the diagnosis, several examinations are therefore necessary.
The clinical examination
During a first consultation, the doctor auscultates the patient's abdomen. He generally practices a rectal examination, associated with a vaginal examination in women. These gestures make it possible to look for a possible anomaly at the level of the bladder. If the results of these examinations are generally normal for people with a superficial tumor, an anomaly can be spotted in the case of an advanced form.
ECBU (Cytobacteriological examination of urine)
ECBU consists of analyzing a urine sample previously collected from the patient under a microscope. This examination can identify bacteria that could be responsible for a urinary tract infection and hematuria.
Urinary cytology
Like the skin, the urothelium (inner layer of the bladder wall) desquamates naturally: dead cells are then evacuated in the urine. Urinary cytology is an examination that makes it possible to study the normal or cancerous appearance of these cells, from a simple urine sample. While this examination can identify high-grade tumours, it is not always suitable for detecting low-grade tumours. These are in fact made up of cancerous cells quite similar to normal cells.
Ultrasound
An ultrasound can observe the urinary system - bladder, kidneys and ureters - and the functional abnormalities that may affect them. It is performed on a full bladder, which requires drinking about a liter of water, one hour before the examination. This takes about 20 minutes and is painless. It is performed in a lying position: the doctor applies the ultrasound probe next to the bladder after applying a cold gel to the skin.
Cytoscopy
Cystoscopy is a very effective examination for making a diagnosis. A fine and flexible optical system is introduced inside the bladder (via the urinary meatus then the urethra) to identify and observe any cancerous abnormalities. To avoid discomfort related to the examination, an anesthetic gel can be injected into the urethra at the start of the procedure. Sterile water is also injected to round the bladder and facilitate observation of the internal walls. The doctor then observes the number, location, size and appearance of the abnormality(ies). If the surgeon deems it necessary, tissue samples can be taken and analyzed by microscopy: it is the biopsy that confirms the diagnosis.
In some cases, the doctor may strongly suspect the cancerous nature of the abnormalities detected even before performing a cystoscopy. For these patients, the examination is done under general or locoregional anesthesia (spinal anesthesia); the objective is that the surgeon can immediately remove the tumor by transurethral resection (which passes through the urethra). The tumor is then analyzed to confirm the diagnosis. If it is indeed cancer, this resection is the first stage of treatment.
Why does it hurt to pee and my pee smells weird?
Changes in the smell of your urine may be the first sign of a urinary tract infection (UTI). Soon after, you may begin to experience pain when you urinate. The smell is caused by bacteria in your urine. The bacteria can grow and spread into other parts of your urinary tract, like your bladder or kidneys.
Does a UTI change the smell of your urine?
Urinary tract infection: Foul-smelling urine is a symptom of a urinary tract infection. Other symptoms are cloudy urine, an urgent need to urinate, or a burning sensation while urinating. The foul smell may be the only symptom of a urinary tract infection.
What does it mean if the smell of your urine changes?
Changes in urine odor can also be caused by diet, vitamins or medication. Asparagus is known to give urine more of an ammonia smell. B-6 supplements can also give urine a strong odor. You may also experience changes in urine odor if you are not drinking enough water.
How to tell the difference between a kidney infection and a UTI?
Your doctor can determine if you have a UTI or a kidney infection by reviewing your symptoms, analyzing a urine sample, and ordering certain blood tests. They may also order imaging studies or other tests to monitor your kidney function. UTIs and kidney infections are treated with antibiotics.
Should I be worried if my pee smells different?
Pee smells different when there's less water and/or more waste. Certain foods, medications, and dehydration can cause smelly pee. Less commonly, smelly pee might be due to a health condition, like a urinary tract infection or diabetes. Smelly pee is common and rarely a cause for concern.
Should I be worried if my pee smells weird?
Urine is mostly waste products and water and normally has a mild smell and a light yellow color. If you have more waste than water in your urine, it can smell more strongly. In most cases, a strong smell isn't a sign of disease. It's usually from your diet and medications, or it means you need to drink more water.
What does a UTI smell like?
2. Urinary tract infection (UTI) A UTI can cause bacteria from the infection to contaminate the urine, resulting in a distinct fishy smell.
Why does my urine smell like fish?
Trimethylaminuria (TMAU) is an uncommon condition that causes an unpleasant, fishy smell. It's also called "fish odour syndrome". Sometimes it's caused by faulty genes that a person inherits from their parents, but this isn't always the case. There's currently no cure, but there are things that can help.
Why does my urine smell chemically?
Urine may smell like ammonia when it becomes concentrated with waste products. A variety of conditions can cause waste products to build up in urine, such as bladder stones, dehydration, and urinary tract infections. In most cases, urine that smells like ammonia can be treated with fluids or antibiotic medications.
