How to avoid seeing a urologist? Urinary problems are widespread in the general population; by the time someone reaches the age of 60 then most likely they will be visiting the toilet at least once during the night, which can be bothersome for some people, but a lot of symptoms aren’t inevitable with age and can be altered by diet and lifestyle choices. Here we have a look at some of the easily available options for managing symptoms without having to see the doctor. There are some symptoms which absolutely necessitate seeing the doctor quickly such as blood in the urine or testicular swelling, urinary symptoms with back pain or ongoing symptoms. Urinary infections. Some people are prone to infections, sometimes it is not clear why. Infections become more common in men as they age if they are not emptying their bladder fully because of some degree of obstruction from the prostate. The urinary passage travels through the prostate in men. In older men who have completed their families, prostates do not have much function as it serves to produce some of the fluid that makes up semen. To reduce the risk of urinary infections, increase fluid intake to about 2-3 litres per day, avoid constipation, pass urine before and after intercourse. There are some over the counter medications may help. The evidence for them is not very great but they might reduce the reliance on antibiotics which do have downsides. Examples of these are cranberry tablets and D-Mannose which stop bacteria sticking to the bladder, vitamin C and lactobacillus probiotics. In women after the menopause, taking oestrogen cream and applying to the urinary opening can be helpful provided there is no history of breast or womb cancer. Urinary Symptoms. Urinary symptoms can mean going to the toilet often or having to get there quickly, leakage of urine or difficulty passing urine. Getting to the toilet quickly or leakage of urine are usually the two most bothersome symptoms for patients. These symptoms can be altered by diet. Some foods can irritate the bladder and cause increased need to urinate quickly. These include caffeine (tea coffee,), fizzy drinks, artificial sweeteners, spicy foods, very acidic foods like citrus fruits e.g., oranges and lemons. Reducing these may help. Not drinking too much or too little helps. Drinking too much gives the bladder more work to do but drinking to little means that the urine is very concentrated with toxins the body is trying to get rid of which can irritate the bladder, which tries to empty more often. Going to the toilet often can sometimes be a behaviour that is learned, and it can sometimes be-unlearned. Using distraction to take the mind of the bladder can gradually increase the capacity of the bladder over time. The other option is to use the clock to set time intervals that are easily managed and gradually increasing these. It is about the bladder listening to you rather than you listening to the bladder. The brain and the bladder are constantly chatting to each other and sometimes the bladder talks too loudly or too often. Carrying out pelvic floor exercises can help to control leakage if it is due to weakness, particularly in women after childbirth. Carrying out 30 squeezes a day can lead to a big improvement in half of patients over 3 months. Pelvic Pain. Pelvic pain can be difficult to manage. It can be due to the bladder or prostate i.e., prostatitis in some men but can also be difficult to locate as could be due to host of other structures in the pelvis. Avoiding the foods which cause irritation already mentioned in the previous section may help. Increasing fluid intake to dilute the urine may help. Sometimes pain can be due to chronic low-grade infection and antibiotics can help, but for some patients with chronic pain, antibiotics cease to become helpful. There’s is some evidence that probiotics can be helpful for pelvic pain. There also seems to be an association with stress and lifestyles, relating to sitting down too much and over contraction of the pelvic floor, so relaxation techniques and exercise which involved controlled relaxation of the pelvic floor, such as yoga swimming and Pilates may be helpful. Kidney stones. Kidney stones may be genetically caused but diet can be a predisposing factor. The two main things that are proven are to increase fluid intake and reducing salt in the diet. Studies have examined reducing dietary Calcium. Calcium is present in 80% of kidney stones, however reducing calcium had the opposite effect to what was anticipated, resulting in the development of more kidney stones, so maintaining dairy products such as cheese and milk can be helpful though they aren’t the healthiest foods. Reducing red meat which is associated with uric acid stones can be helpful. Reducing oxalate in the diet may help to reduce the incidence of stones on some people. Oxalate is present in tea, coffee, nuts chocolate, rhubarb, kale, tomatoes, strawberries, and raspberries. Also keeping on top of urinary infections may be helpful for some. Erectile Dysfunction. All the things which reduces heart disease are good for erectile function so avoiding smoking, managing diabetes, cholesterol, high blood pressure and controlling weight are helpful. Aerobic exercise is very helpful and has been to be shown to be as effective as Viagra in improving erectile dysfunction. Taking anabolic steroids is not a good idea, aside form the risks to the heart, taking testosterone will shut down the testicles and reduce fertility. In the long run the main hormonal control centre in the body, the pituitary gland reduces signalling for the testes to work and men will then require supplementation from a doctor to prevent their testosterone from going too low Malignancy. Reducing the risk of cancer means avoiding smoking, obesity high blood pressure, and reducing infections If the above is unhelpful then you need to see a urologist.