While any individual can develop urologic disease like kidney stones, incontinence, or urinary tract infection, certain people are more susceptible than others, with age, gender, and lifestyle all playing a role.
Urologic conditions can be broadly classified into three categories—developmental abnormalities, functional disorders, and cancers—and each is accompanied by its own risk factors.
Developmental Abnormalities of the Urinary System
Many of these conditions are heritable and affect young children, but others develop spontaneously with little warning or explanation. Developmental abnormalities of the urinary system include:
- Renal dysplasia (when fluid-filled cysts develop instead of normal kidney tissue)
- Polycystic renal diseases (a genetic condition in which multiple cysts grow inside the kidneys)
- Posterior urethral valves (when urethral valves narrow and reverse the flow of urine)
- Ureteropelvic junction obstruction (a blockage where the ureter and renal pelvis meet)
Congenital abnormalities are present at birth. These can caused by spontaneous genetic mutations that affect fetal development, by maternal exposure to toxins that interfere with development, or by poor maternal nutrition and infections during pregnancy. Sometimes these conditions, such as ureteropelvic junction obstruction or abnormal kidney development, can even be detected before a baby is born.
Functional Disorders of the Urinary System
Functional disorders are caused by disease or injury to a previously healthy urinary system. These may include enlarged prostate, kidney or ureter stones, incontinence, and urinary tract infections. A person's susceptibility to these disorders depends on sex, age, and lifestyle.
- Women are more likely to develop functional disorders such as urinary tract infections (UTIs) and incontinence.
- Men frequently develop an enlarged prostate. This condition, known as benign prostatic hyperplasia, is more common with age.
- Age increases risk in both men and women. As men age, changes in hormone levels can cause the prostate to swell, leading to the development of benign prostatic hyperplasia (BPH). In post-menopausal women, declining estrogen levels can weaken the vaginal walls and contribute to the onset of incontinence.
- Lifestyle factors, such as poor diet and inactivity, can cause obesity and--along with it--an increase in calcium, uric acid, and other mineral concentrations. This, in turn, increases the risk of kidney and ureter stones.
Cancers of the Male Reproductive and Urinary Systems
Some of the most common types of urologic cancers are bladder cancer, prostate cancer, and testicular cancer. Like the other types of urologic disease, several different factors can increase an individual's risk of urinary and male reproductive cancers. These include:
- Age: As humans age, our DNA replicates less and less faithfully, leading to an increase in potentially cancer-causing mutations.
- Medications: Certain medications, such as diuretics, have been associated with higher risk of cancer. A meta-analysis examining diuretic use and the development of renal cell carcinoma showed that patients taking diuretics had double the risk of kidney cancer. So far the correlation has not been linked to a cause and researchers don't know what the mechanism of such a connection might be.
- Lifestyle Factors: Overweight, poor diet, and smoking all increase risk of urinary and reproductive cancers.
- Heritability: Individuals with a family history of cancers are more likely to develop malignancies over time.
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