Kidney tumours and the urinary tract and their effect on driving
Kidney tumours and the upper urinary tract.
Tumours of the renal parenchyma and the upper urinary tract can be benign and they only cause clinical symptoms characterized by pain and haematuria with colic pain when they reach a certain size.
The invasion of neighbouring organs, thrombosis of the renal veins, fever, anaemia, weight loss, varicocele, etc, are more characteristic of malignancy.
The treatment is surgical and is associated with coadjuvant oncological treatment in cases when it is required.
Advice on Kidney tumours and the upper urinary tract
- During the symptomatic period the patient will be unable to drive until the specialist reports that he has recovered without sequelae after the treatment, and can once again drive.
- Surgical resolution of the problem will be followed by a recuperation period that will continue until scarring is complete and there are no sequelae, which will allow the patient to drive completely safely once more once a specialist has issued a report confirming this.
Vesicle tumours
These produce haematuria, pollakiuria, pain urinating, tenesm, dysuria.
The treatment is local resection via tran urethral in benign cases and vesicle resection in malign cases.
Radiotherapy and intravesicle instillation with chemotherapy are other alternatives.
Advice on Vesicle tumours
- The patient must not drive with symptoms.
- After the treatment indicated to eradicate the tumour, the doctor will report when the patient can once again drive without any increased risk.
- Surgical resolution of the problem will be followed by a recuperation period that will continue until scarring is complete and there are no sequelae, which will allow the patient to drive completely safely once more once a specialist has issued a report confirming this.
Benign hyperplasia of the prostate
This produces variable degrees of obstruction at the exit of the bladder, producing symptoms that interfere with daily life, including driving and sleeping.
The most habitual symptoms are progressive pollakiuria, an urge to urinate, sensation of complete emptying and nocturia. Complete urinary retention can appear at any moment.
In some cases the bladder become very distended, leading to incontinence because of bladder overflow.
Increased vesicle pressure, due to prolonged urinary retention, is transmitted towards the ureters and the kidneys producing hydronephrosis and progressive, progressive posterior parenchymal renal lesion.
Stinging while urinating, shivering and fever, indicate urinary infection.
On occasions, episodes of acute urinary retention resulting from prolonged attempts to retain urine, environmental cold, immobilization, anticholinergenic and sympathicomimetic medications, and consumption of alcoholic drinks.
When the obstruction at the exit of the bladder is accompanied by urinary infection or kidney failure, treatment with antibiotics is recommended, as well as stabilizing renal function and drainage using a bladder catheter.
Anticongestant medications for the prostate are indicated to decrease the symptoms, and can occasionally cause headaches, dizziness and nausea, and sleep disturbances.
Terazosin causes sleepiness and the patient should be warned to drive carefully.
Alfuzosin can produce vertigo, dizziness, gastrointestinal problems and asthenia, especially at the beginning of treatment, and the patient should be warned of this. If it is prescribed in combination with antihypertensives, this can lead to orthostatic hypertension.
Tamsulosin can cause dizziness.
The definitive treatment is surgical treatment by transurethral resection of the prostate whenever possible, as this leads to better recuperation.
In certain cases open prostate surgery will be required.
Advice on Benign hyperplasia of the prostate
- Drivers with prostatic symptoms should only drive short distances in their vehicles, which will allow them not to force urinary retention.
- It is not advisable to use air conditioning inside the car.
- The patient should not drink alcohol, particularly beer, which can lead to an acute episode of urinary retention and the patient should also be reminded that driving is not permitted after consuming alcohol.
- As immobilization can cause urinary retention, we recommend that drivers make frequent stops and take the opportunity to empty the bladder.
- We should warn the patient of the side effects of some medications, advising him to drive carefully, and in case of the slightest symptom he should park the vehicle in an accident free zone and ask for help.
- When a patient with prostatic symptoms are prescribed anticholinergenic and sympathicomimetic medications, we should advise them that they could make the symptoms worse and even lead to acute urinary retention.
- This situation will make driving even more complicated, so if there is even the merest suspicion of problems, the doctor should be notified.
- Surgical resolution of the problem will be followed by a recuperation period that will continue until scarring is complete and there are no sequelae, which will allow the patient to drive completely safely once more once a specialist has issued a report confirming this.