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Urology and Prevention: 5 Key Exams Not to Miss After Age 50 to Maintain Urinary Health in Colmar

Urology and Prevention: 5 Key Exams Not to Miss After Age 50 to Maintain Urinary Health in Colmar

Urology and Prevention: 5 Key Exams Not to Miss After Age 50 to Maintain Urinary Health in Colmar

Why Urological Prevention is Vital

The urinary tract and the male genital system are complex and essential to our well-being. With advancing age, particularly after 50, the risk of developing certain pathologies (benign prostatic hyperplasia, cancers, chronic infections) increases significantly. However, many of these disorders, when detected early, are treated very effectively. The secret lies in prevention and regular screening.

The Centre d’Urologie de Colmar (39 Avenue de la Liberté, 68000 COLMAR) encourages all its patients to have a regular urological check-up. We present here the five key examinations recommended by urologists to monitor and maintain your urinary and genital health.

Expert Reminder: “A preventive consultation with the urologist, even in the absence of symptoms, is a direct investment in your future quality of life. Don’t wait for an emergency.”

Summary

1. The Prostate-Specific Antigen (PSA) Test

What is PSA?

PSA (Prostate-Specific Antigen) is a protein produced specifically by the cells of the prostate. A simple blood test measures its level.

Role in Screening

An elevated PSA level can be a warning sign for potential prostate cancer. It is the most commonly used biochemical tool in the context of prostate cancer screening in Colmar

Caution: An elevated level is not synonymous with cancer. PSA can also increase in cases of infection (prostatitis) or a simple benign enlargement (Benign Prostatic Hyperplasia, BPH). This is why the test must always be interpreted by your urologist.

When to Get It Done?

The debate on the optimal age is ongoing. Generally, it is recommended to discuss PSA testing with your primary care physician or urologist from age 50, or from age 45 if you have a family history of prostate cancer .

Source : Société Française d’Urologie (AFU) – Recommandations sur le dépistage [1].

The Clinical Examination: The Digital Rectal Exam (DRE)

A Quick and Essential Procedure

Despite some misconceptions, the Digital Rectal Exam (DRE) remains an essential pillar of the urological examination, particularly in the evaluation of the prostate.

What the Urologist Evaluates

 

The urologist, after taking all necessary precautions, evaluates:

  • The volume and shape of the prostate: Useful for diagnosing BPH.
  • The consistency: The presence of hard, irregular, or abnormal areas can signal the possibility of cancer.

An abnormal DRE combined with an elevated PSA level often constitutes the main indication for performing a prostate biopsy to establish an accurate diagnosis .

Source : Ameli.fr (Assurance Maladie) – Dépistage du cancer de la prostate [2].

 

3. The Urine Analysis (Urine Cytobacteriological Examination - ECBU)

Urinary Tract Assessment

The Urine Cytobacteriological Examination (ECBU) is a simple yet powerful test, often requested by your urologist in Colmar during a preventive check-up.

What ECBU Reveals

 

  • Urinary Tract Infections: It detects the presence of bacteria (cystitis, pyelonephritis) or other infectious agents. Urinary tract infections in men, especially after 50, can be a sign of an underlying problem (BPH, stones).
  • Microscopic Hematuria: It reveals the presence of blood in the urine, even in very small amounts (invisible to the naked eye). Hematuria, even microscopic, should always be investigated by a urologist, as it can be a sign of kidney stones, or, more rarely, bladder or kidney tumors.

This examination is crucial to rule out any inflammation or infection before interpreting other tests such as PSA .

Source : Haute Autorité de Santé (HAS) – Guide des analyses urinaires [3].

4. Kidney and Bladder Ultrasound

Imaging of Urinary Organs

Ultrasound is a non-invasive and painless medical imaging exam. It uses ultrasound waves to visualize the organs.

Why Ultrasound is Essential

The urologist may request an ultrasound to:

  • The Kidneys: Search for the presence of kidney stones (calculi), cysts, signs of hydronephrosis (kidney dilation due to an obstruction), or kidney tumors.
  • The Bladder: Evaluate the thickness of the wall (a sign of overactive bladder or straining against an obstruction) and the post-void residual urine volume (the volume of urine remaining after urination). A significant post-void residual is often associated with BPH
  • The Prostate: Obtain a more precise estimate of the prostatic volume.

Source : Ameli.fr (Assurance Maladie) – L’échographie [4].

5. Uroflowmetry

Functional Assessment

Uroflowmetry is a simple test used to evaluate the quality of micturition (the act of urinating).

How the Test is Performed

The patient urinates into a funnel connected to a device that records the urinary flow rate (the volume of urine evacuated per second).

What Uroflowmetry Reveals

  • Obstruction: A low maximum flow rate and a plateau curve may indicate an obstruction at the bladder outlet, often due to Benign Prostatic Hyperplasia (BPH) in men.
  • Jet Strength: The test evaluates the strength and speed of the urinary stream.

This test is essential for objectifying the severity of lower urinary tract symptoms (LUTS) reported by the patient and guiding therapeutic choices .

Source : MSD Manuals – Évaluation des symptômes des voies urinaires inférieures [5].

Book Your Urological Check-up in Colmar

Don’t let urinary disorders impact your daily life or undiagnosed risks threaten your health. Prevention is your best ally.

The team of urologists at the Centre d’Urologie de Colmar is available to perform a complete and personalized urological check-up, using modern equipment for precise and rapid diagnoses.

Whether you are 45, 60, or presenting with recent symptoms, don’t hesitate to take the first step.

Contact the Centre d’Urologie de Colmar to schedule your check-up:

I will schedule an appointment.

Official Medical Sources

  • [1] Association Française d’Urologie (AFU). (2024). Recommandations concernant le dépistage du cancer de la prostate.
  • [2] Ameli.fr (Assurance Maladie). (2023). Le dépistage du cancer de la prostate.
  • [3] Haute Autorité de Santé (HAS). (2022). Infection urinaire : place de l’ECBU.
  • [4] Ameli.fr (Assurance Maladie). (2023). L’échographie : déroulement et résultats.
  • [5] MSD Manuals. (2023). Évaluation des symptômes des voies urinaires inférieures.
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When can erectile nerves be preserved during robotic prostatectomy?

When can erectile nerves be preserved during robotic prostatectomy?

Before discovering the signs of complications, find out what symptoms to look out for in our guide:: What are the symptoms of prostate cancer?

Robotic-assisted radical prostatectomy is a commonly performed surgical procedure for the treatment of localized prostate cancer. However, this procedure can have an impact on quality of life, particularly on erectile function. Erectile nerve preservation, also known as nerve conservation, is a technique that can reduce these side effects, but is not always possible. Here’s a comprehensive guide to when this approach might be considered.

Contents

What is nerve preservation?

The erectile nerves are located in neurovascular bundles that run along each side of the pprostate. They are not visible to the naked eye.
During a prostatectomy, the surgeon may attempt to preserve them, provided this does not compromise the removal of the cancer. This is a delicate technique, as the bundles are very close to the prostate and sometimes in direct contact with the cancer cells.

Criteria for nerve preservation

Tumor location and extension

Tumor location is a key factor. If the tumor is located at a distance from the neurovascular bundles, it is possible to preserve them. However, if the tumor is close to or invades these areas, complete nerve preservation may increase the risk of cancer recurrence.

How does the surgeon assess this location?

Pre-operative imaging, such as multiparametric MRI, enables visualization of the tumor and its relationship with the neurovascular bundles. This assessment is essential for deciding on the surgical strategy.

Gleason score and cancer aggressiveness

What is the Gleason score?

The Gleason score is a scale that measures the aggressiveness of cancer cells. The higher the score, the more aggressive the cancer. For example, a score of 6 indicates a less aggressive cancer, while a score of 8 or more suggests an advanced cancer.

Impact on nerve preservation

For less aggressive cancers (score 6 or 7), nerve preservation is often possible. For higher scores, on the other hand, the chances diminish, as the priority is to completely eliminate the cancer.

Advanced techniques

Robotic-assisted techniques enable 3D visualization and precise movements, improving the chances of nerve preservation. The use of appropriate energies, such as bipolar forceps, also reduces collateral damage.

Patient factors

Age and general health

Younger (under 65), healthier patients are more likely to recover erectile function after surgery. Co-morbidities, such as diabetes or cardiovascular disease, can also influence recovery.

Importance of preoperative discussion

An open discussion between patient and surgeon is essential. The patient’s expectations in terms of sexual quality of life and cancer treatment priorities must be taken into account to define an appropriate strategy.
This makes it possible to stratify priorities, taking into account the disease, its stage, the patient’s history and, above all, his or her expectations.

Conclusion

Preservation of erectile nerves during prostatectomy for cancer is an important objective for improving patients’ quality of life. However, it is not always possible, and depends on many factors, including the location and aggressiveness of the cancer. Accurate assessment and personalized discussion help optimize the outcome for each patient.

Need a diagnosis or follow-up? Make an appointment at the Colmar Urology Center for personalized care.

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What are the first signs of complications associated with untreated, progressive prostate cancer?

What are the first signs of complications associated with untreated, progressive prostate cancer?

Before discovering the signs of complications, check out the symptoms to look out for in our guide : What are the symptoms of prostate cancer?

If prostate cancer is not detected or treated in time, it can progress and lead to serious complications. These complications can occur at an advanced stage of the disease, affecting not only the prostate but also other parts of the body. Recognising these early signs is crucial to acting quickly. Here’s everything you need to know.

Contents

Why do complications arise?

As prostate cancer progresses, it can invade neighbouring tissues or spread to other organs, leading to what are known as metastases. These complications are often caused by uncontrolled tumour growth or delayed treatment.

Signs of prostate cancer complications

Urinary complications

  • Acute urinary retention: A sudden inability to urinate, often accompanied by intense pain.
  • Blood in the urine (haematuria) : A sign that the tumour is affecting the urinary tract.
  • Common urinary tract infections: Resulting from partial or total blockage of the urethra.
  • Kidney failure: If the tumour blocks the flow of urine over a long period.

Bone pain

When cancer spreads to the bones (bone metastases), it can cause :

  • Intense pain in the back, hips or ribs.
  • Increased fragility of bones, leading to fractures.

Neurological disorders

  • Weakness or numbness in the legs: Possible indication of spinal cord compression.
  • Difficulty walking : Linked to pain or nerve complications.

Hormonal and sexual disorders

  • Severe erectile dysfunction: Caused by nerve or vascular damage due to the tumour.
  • Hot flushes or intense fatigue: Often linked to advanced hormone treatments.

Fatigue and unexplained weight loss

These signs may indicate that the cancer has spread or that the body as a whole has been affected.

Quand consulter en urgence ?

Some symptoms require immediate consultation :

  • Persistent or severe bone pain.
  • Sudden inability to urinate.
  • Weakness or paralysis of the lower limbs.
  • Blood in urine or semen.
  • Rapid weight loss associated with extreme fatigue.

Don’t ignore these signs: prompt treatment can prevent serious complications and improve quality of life.

What can be done to limit complications?

  • Early detection: The best way to avoid complications is to diagnose cancer in its early stages. Consult a urologist as soon as any unusual symptoms appear.
  • Rigorous medical follow-up: If you’ve already been diagnosed, stick to the recommended appointments and treatments.
  • Healthy lifestyle: A balanced diet and regular exercise can support your overall health.

Conclusion

Complications associated with prostate cancer are often the result of uncontrolled disease progression. Recognizing early signs, such as bone pain, urinary problems or unexplained fatigue, is key to acting quickly. If you notice any of these symptoms, consult a specialist immediately.

Need a diagnosis or follow-up? Make an appointment at the Colmar Urology Center for personalized care.

Make an appointment
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How is prostate cancer diagnosed?

How is prostate cancer diagnosed?

Before diving into the diagnostic stages, find out what symptoms to look out for in our guide : What are the symptoms of prostate cancer?

Prostate cancer is one of the most common cancers in men, particularly after the age of 50. If you are experiencing symptoms such as urinary problems, or simply wish to undergo preventive screening, it is essential to understand the key steps involved in making an accurate diagnosis. Here’s a complete guide to the prostate cancer diagnosis process.

An abnormal psa level should lead to a consultation with a urologist.

Contents

The importance of early diagnosis

Prostate cancer is often asymptomatic in its early stages. Early diagnosis enables :

  • Rapid care.
  • Reduced risk of complications.
  • A wider choice of effective treatments.

If you experience symptoms such as difficulty in urinating, frequent urination at night or pelvic pain, it is vital to consult a specialist.

Steps in diagnosing prostate cancer

Initial consultation with a urologist

  • Analysis of symptoms: The urologist will ask questions about your family history, your lifestyle and your symptoms.
  • Assessment of risk factors: Age, heredity, ethnic origin and pre-existing medical conditions.

Clinical examination: rectal examination

  • This quick, painless examination allows the doctor to palpate the prostate via the rectum to detect any abnormalities (induration), enlargement).
  • Although uncomfortable for some, it remains a key screening tool.

Biological tests: PSA assay

  • PSA (Prostate Specific Antigen) is a protein produced by the prostate gland.
  • A high level may indicate a problem: inflammation, benign hypertrophy or cancer.
  • This test is often used in addition to the digital rectal examination (DRE).

Medical imaging to confirm anomalies

  • Multiparametric MRI:
    • Advanced imaging to visualise the prostate and identify suspicious areas.
    • It is particularly useful for guiding biopsies.
  • Transrectal ultrasound :
    • Used to measure the size of the prostate and detect abnormalities.

Prostate biopsy: the definitive examination

  • If any abnormalities are detected, a biopsy is performed.
  • This involves taking samples of prostate tissue for laboratory analysis.
  • The results confirm the presence of cancer and determine its aggressiveness (Gleason score).

What to do after a diagnosis

Once the diagnosis has been made, several stages follow :

  • Determine the stage of the cancer (localised or metastatic).
  • Discuss treatment options tailored to your situation (surgery, radiotherapy, hormone therapy, etc.).

When should you go for screening?

  • From the age of 50: annual consultation for men with no risk factors.
  • From the age of 40-45: If you have a family history of prostate cancer or if you belong to a high-risk population (men of African origin, for example).
  • If you experience unusual urinary symptoms, even if you are younger.

Conclusion

Prostate cancer may be silent in its early stages, but signs such as urinary problems, pain or blood in the urine should be taken seriously. Early detection is essential to improve the chances of treatment and cure.

To find out more, or to consult a specialist, book an appointment at the Colmar Urology Center. We’re here to support you at every stage of your healthcare journey.

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"My duty is to inform my patient"

"My duty is to inform my patient"

Article 35 of the Code of medical ethics defines the terms of the information that the doctor must give the patient ‘…honest, clear and appropriate to the patient’s condition, and to the investigations and treatment the physician offers…’.

Information, which is always oral, is essential. In addition to this information, a written document may be given to the patient to allow him to refer to it in order to give free and informed consent.

Information, which is mainly oral, is essential

A practical sheet on the information before and after each surgical intervention is available on the website of the French Association of Urology on the following link:

https://www.urofrance.org/lurologie-grandpublic/fiches-patient/fiches-traitements.html

 

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