A urinary tract infection (UTI) is a common condition where bacteria cause inflammation in the urinary tract. This can lead to symptoms such as pain when urinating and needing to urinate more frequently. Although a bladder infection is usually treatable, it is important to take symptoms seriously and consult your GP if necessary.
What is a urinary tract infection?
The urinary tract consists of the kidneys, ureters, bladder, and urethra. When bacteria enter through the urethra, they can cause inflammation.
The most common form is a bladder infection, where the infection is located in the bladder. Sometimes an infection can ascend further to the kidneys. This is then called pyelonephritis, a more serious condition that is often accompanied by fever and feeling unwell.
Women are more likely to get bladder infections than men because women have a shorter urethra, which allows bacteria to reach the bladder more easily.
POSSIBLE COMPLAINTS
Complaints that may be indicative of a urinary tract infection include:
Please contact your GP immediately if you experience these symptoms.
POSSIBLE CAUSES
Most urinary tract infections are caused by bacteria from the gut that reach the bladder via the urethra. Factors that can increase the risk include:
What can you do yourself for mild complaints?
When experiencing the first signs of a bladder infection, it can help to:
To determine if there is a urinary tract infection, it may be necessary for urine to be examined.
You can collect a sterile urine sample pot from the practice for this. It is important that the urine is collected correctly so that the test is reliable.
HOW TO COLLECT URINE CORRECTLY (MIDSTREAM URINE)
SUBMITTING URINE
TREATMENT
The treatment depends on the severity of the symptoms and the results of the urine test. Sometimes advice is sufficient. When there is a clear bacterial infection, the GP can prescribe antibiotics.
In case of recurring complaints, fever, or suspicion of a kidney infection, the GP will advise further investigation or a different treatment.
Sexually transmitted infections (STIs) are infections that are transmitted through sexual contact. This can occur during vaginal, anal, or oral sex. STIs are caused by bacteria, viruses, or parasites and can be transmitted through bodily fluids or by direct contact with mucous membranes.
Not everyone with an STI experiences symptoms. This means someone can have an infection and unknowingly pass it on to a partner. That's why it's important to get tested if you've been at risk.
When is it sensible to get an STI test?
Consider a test when, for example:
POSSIBLE COMPLAINTS
Complaints that can occur with an STI include:
It’s important to know that many STIs don’t cause clear symptoms.
Common STIs
Chlamydia
Chlamydia is the most common bacterial STI. Many people have no symptoms. Possible symptoms include pain when urinating, discharge from the penis or vagina, and lower abdominal pain. Untreated chlamydia can lead to pelvic inflammatory disease and reduced fertility in women.
The treatment consists of antibiotics.
Gonorrhoea
Gonorrhoea (also known as “the drip”) is a bacterial infection that can cause symptoms such as pain when urinating, yellowish-green discharge from the penis or vagina, and lower abdominal pain. The infection can also occur in the throat or anus.
The treatment usually consists of antibiotics according to the current guidelines.
Syphilis
Syphilis is a bacterial infection that progresses through different stages. Initially, a painless sore may develop at the site of infection. Later, skin lesions, fever, or other symptoms may occur.
Syphilis is treated with antibiotics (usually penicillin). Early treatment prevents complications.
Genital herpes
Genital herpes is caused by a virus. It can cause painful blisters or sores around the genitals. The virus remains in the body after infection and can sometimes cause symptoms again.
Medicines can reduce the duration and severity of symptoms, but do not cure the infection.
HUMAN PAPILLOMAVIRUS (HPV)
HPV is a common virus. Some types cause genital warts, other types can cause cervical cancer or other forms of cancer in the long term.
Genital warts can be treated. In the Netherlands, young people are also vaccinated against HPV.
HEPATITIS B
Hepatitis B is a virus that infects the liver. Transmission can occur through sexual contact or via blood. Some people experience symptoms such as fatigue, nausea, or jaundice, but often the infection occurs without symptoms.
There is an effective vaccination against hepatitis B.
HIV
HIV is a virus that affects the immune system. Without treatment, this can eventually lead to AIDS. With modern medication, HIV can nowadays be well suppressed, allowing people to lead a normal life and the virus is no longer transmissible with effective treatment.
Mycoplasma genitalium
Mycoplasma genitalium is a bacterium that can be sexually transmitted and can cause symptoms such as:
According to current guidelines, routine testing for Mycoplasma genitalium is not carried out in asymptomatic individuals. This is because the bacterium is often present without causing symptoms, and treatment can contribute to antibiotic resistance.
Therefore, the following principles apply:
RESEARCH AND TESTING
Depending on your symptoms and risk, investigations may include:
Your GP or assistant will discuss with you which tests are necessary in your situation. The examination is always carried out in confidence and discreetly.
Preventing STIs
You can reduce the risk of an STI by:
GET IN TOUCH
Do you have symptoms that could indicate an STI, or would you like to be tested after a risky contact? Please contact the practice. We will discuss your situation confidentially and determine together what investigation or treatment is needed.
It is quite normal to feel down, tense, or anxious from time to time. Everyone experiences these feelings occasionally. This can occur, for example, after stressful events, loss, relationship problems, or pressure at work or school. Often, these feelings disappear on their own, but when low mood or anxiety persists for a long time or interferes with daily functioning, it can be important to discuss this with your GP.
Depressieve en angstige klachten kunnen zich op verschillende manieren uiten. **Depressieve klachten** kunnen onder andere zijn: * **Moeite met het ervaren van plezier:** Dingen die je normaal leuk vond, geven geen voldoening meer. * **Piekeren en somberheid:** Continue negatieve gedachten en een algemeen gevoel van neerslachtigheid. * **Verlies van energie of juist rusteloosheid:** Je voelt je uitgeput of juist heel onrustig en gespannen. * **Slaapproblemen:** Moeite met in slaap vallen, doorslapen of juist veel te veel slapen. * **Veranderingen in eetlust:** Minder of juist meer honger, met gewichtsverlies of -toename tot gevolg. * **Concentratieproblemen:** Moeite met focussen, beslissingen nemen of dingen onthouden. * **Gevoelens van waardeloosheid of schuld:** Jezelf bekritiseren en een negatief zelfbeeld hebben. * **Gedachten aan de dood of zelfmoord:** Dit kan variëren van vluchtige gedachten tot concrete plannen. **Angstklachten** kunnen onder andere zijn: * **Overmatige zorgen en spanning:** Constant piekeren over mogelijk gevaar, ook al is er geen duidelijke reden. * **Lichamelijke klachten:** Hartkloppingen, zweten, trillen, ademhalingsproblemen, misselijkheid, duizeligheid of spierspanning. * **Voortdurende onrust en nervositeit:** Een ongemakkelijk gevoel en moeite met ontspannen. * **Vermijdingsgedrag:** Situaties, plaatsen of activiteiten vermijden die angst oproepen. * **Paneelvallings (paniekaanvallen):** Plotselinge, intense periodes van angst met extreme lichamelijke symptomen, het gevoel de controle te verliezen of zelfs te sterven. * **Irritatie en prikkelbaarheid:** Sneller boos worden of geërgerd zijn. * **Gevoel van 'op je hoede' zijn:** Altijd alert en gespannen zijn, alsof er gevaar dreigt. Het is belangrijk op te merken dat iedereen wel eens last kan hebben van stemmingen of angsten. Van een depressieve of angststoornis is sprake wanneer deze klachten langdurig aanhouden, een grote impact hebben op het dagelijks leven en veel leed veroorzaken. Als je je zorgen maakt over je eigen klachten of die van iemand anders, is het raadzaam professionele hulp te zoeken.
When experiencing depressive symptoms, various signs can occur:
With anxiety symptoms can occur such as:
If these symptoms persist for longer than two weeks and affect daily functioning, it may indicate a depressive or anxiety disorder.
What can you do yourself?
With mild symptoms, the following measures can help:
Relaxation exercises
Wanneer contact opnemen met de huisarts?
Please contact us when:
Your GP can assess with you what support is most suitable and discuss whether treatment is necessary.
SUPPORT WITHIN OUR PRACTICE
Our practice has a mental health practitioner (POH-GGZ), Ms E. Ewalts, with extensive experience in supporting individuals experiencing low mood, anxiety, stress, and overexertion.
The POH-GGZ can, among other things:
CONFIDENTIAL CONVERSATION
Mental health issues such as low mood and anxiety are common and treatable. You don't have to carry them alone. Get in touch with the practice so we can look together at what support would be best for you.
Excess weight is a common problem in our society and can have a significant impact on your daily life. It also increases the risk of various health problems, such as cardiovascular diseases, type 2 diabetes, high blood pressure, joint complaints, and pregnancy problems. Addressing excess weight is often difficult, and many people require guidance. You can visit our GP practice for this.
What do we mean by overweight?
Overweight means your body weight is too high in relation to your height, often due to an excess of body fat. Two commonly used methods to assess this are.
BMI (Body Mass Index) A calculation of your weight and height. A BMI over 25 indicates overweight, over 30 indicates obesity. You can calculate this yourself using online BMI calculators or have it measured at our practice.
Waist circumference: In women, a waist circumference over 80 cm and in men over 94 cm is considered to be an increased risk.
Why is being overweight a cause for concern?
Being overweight doesn't just affect your fitness and energy levels, it can also impact your long-term health. It can lead to:
Therefore, it is important to take action in good time to address your weight and lifestyle.
SUSTAINABLE APPROACH: LIFESTYLE AS THE CORE
The most effective way to reduce excess weight is a sustainable change in lifestyle, focusing on diet, exercise, and behaviour. Quick fixes are often temporary and rarely lead to lasting results. In our practice, we support you with:
MEDICATION SUPPORT:
Sometimes medication, such as GLP-1 agonists (e.g. Ozempic or Wegovy), can be considered as a supplement to lifestyle guidance. These agents stimulate the feeling of fullness and can lead to weight loss. Important points are:
We emphasise that sustainable behavioural change always remains the foundation. Medication can be supportive, but it does not replace a healthy lifestyle or behavioural change.
Make an appointment
Would you like guidance on losing weight responsibly? Or would you like to know if medication support is suitable for you? Make an appointment at our practice. Together, we will assess what is most effective and achievable for you, so that you can lose weight in a healthy and sustainable way.
Breast cancer is the most common form of cancer in women in the Netherlands. Approximately 1 in 8 women will develop breast cancer during their lifetime. Thanks to improved diagnostics and treatments, a large proportion of women now survive breast cancer well, especially when the disease is detected early.
POINTS TO NOTE
Not all changes in the breast mean that there is cancer. Common, usually benign changes include cysts or hormonal lumps. Nevertheless, it is important to pay attention to the following:
If you notice any of these changes and they persist, it is advisable to discuss them with your GP.
BREAST CANCER SCREENING SURVEY (BCSS)
In the Netherlands, women between the ages of 50 and 75 are invited every two years for the national breast cancer screening programme (BVO). This screening consists of a mammogram (an X-ray of the breast) and aims to detect breast cancer at an early stage, before any symptoms are present.
The screening programme contributes to a reduction in breast cancer mortality, as tumours are detected at an earlier stage than if people only waited for symptoms to appear.
The screening programme is aimed at women aged between 50 and 75 because the risk of breast cancer increases significantly from this age and because there is currently the most evidence for effectiveness in this group.
SCREENING OUTSIDE OF THE POPULATION SURVEY
Some women have an increased risk of breast cancer, for example due to a strong family history or certain inherited mutations (such as BRCA1 or BRCA2). For these women, screening outside the regular programme can be offered, for instance by starting imaging (such as mammography or MRI) earlier, in consultation with a specialised centre.
When to contact the GP
Contact your GP if:
Your GP can then assess what is needed, conduct a physical examination and/or refer you for further investigation such as a mammogram or ultrasound.
Through regular checks and timely consultation for changes or complaints, breast cancer can be detected and treated early. Older technologies are also continuously being improved to make detection even better.
Flu, also known as influenza, is a respiratory infection caused by the influenza virus. The virus primarily affects the mucous membranes of the nose, throat, and airways, often leading to sudden symptoms. Most people recover within a few days to two weeks, but in certain groups, flu can be more severe.
How do you recognise flu?
Typical flu symptoms include:
A common cold starts gradually and usually doesn't involve a fever.
Who runs an extra risk?
Complications can occur with:
It is important to contact these groups promptly if symptoms worsen.
PREVENTION – THE FLU JAB
The annual flu vaccination is the most effective way to prevent flu and serious complications. The vaccine is adapted each year to the expected circulating virus strains.
Who is the flu jab for?
Non-risk groups can register for the flu jab in good time; this way, we can take the required numbers into account when ordering vaccines annually.
Caution. A flu jab reduces the chance of illness and complications, but never rules out flu entirely.
Self-care measures
What to do with flu symptoms?
Wanneer contact opnemen met de huisarts?
Call if you belong to a risk group, the symptoms worsen, or you become short of breath.
If in doubt, in our practice, in collaboration with DVU, a CRP test can be performed via a finger prick. This rapid test helps us to distinguish between a bacterial or viral infection, allowing for a more targeted treatment.
In some cases, the GP may prescribe antiviral medication, such as oseltamivir, particularly in at-risk patients, if treatment is started within 48 hours of symptom onset.
IN SUMMARY
Flu is a contagious infection that usually resolves on its own. Prevention, such as the annual flu jab, and good self-care reduce the risk of illness and complications. If you have any doubts or your symptoms worsen, you can contact us; together we will determine if further investigation or treatment is necessary.
Osteoarthritis is a common joint condition where the cartilage in a joint slowly wears away. This leads to pain, stiffness, and sometimes limited movement. The knees, hips, hands, and spine are particularly often affected. Although osteoarthritis is more common in older adults, it can also occur in younger people, for example, after an injury, overuse, or due to a genetic predisposition.
What happens in osteoarthritis?
Cartilage acts as a shock absorber and allows the bones to move smoothly against each other. In osteoarthritis, this cartilage gradually wears away, causing:
Osteoarthritis develops slowly and its severity can vary from person to person.
SYMPTOMS OF ARTHRITIS
Treatment Options for Osteoarthritis
While arthritis cannot be completely cured, symptoms can be effectively managed with a combination of lifestyle changes, exercise therapy, medication, and modern treatments.
LIFESTYLE AND EXERCISE THERAPY
Weight loss Reduces pressure on the joints and can significantly lower pain.
Movement and exercise therapy Strengthens muscles around the joint, improves stability and reduces pain.
GLAD therapy (Good Life with osteoArthritis in Denmark): A scientifically developed programme for knee and hip osteoarthritis. It combines personalised exercise therapy with education on lifestyle and self-management, with proven improvement in pain and function.
MEDICATION AND INJECTIONS
Painkillers Paracetamol or anti-inflammatories can offer temporary relief.
Corticosteroid injections (e.g. Kenacort): Effective for acute inflammation and pain, usually limited to a few times per year.
PRP/ACP INJECTIONS:
PRP (Platelet-Rich Plasma) Injections of concentrated platelets from your own blood. These contain growth factors that can support cartilage repair and reduce pain.
ACP (Autologous Conditioned Plasma) An advanced form of PRP where the plasma is carefully prepared and injected into the joint under local anaesthetic. This can help reduce pain and improve function in mild to moderate osteoarthritis, particularly in the knee and shoulder.
How does ACP/PRP work?
Blood is drawn from your arm, the plasma is concentrated with growth factors and injected into the affected joint.
Working: Reduces inflammation, pain, and swelling; increases joint lubrication, making movement smoother.
EFFECT AND TREATMENT DURATION:
Improvement often occurs 6–8 weeks after the first injection.
Usually, 2–3 injections are given at intervals of 6–8 weeks.
The effect lasts between 6 months and a year on average; treatment can be repeated.
Costs and Reimbursement
ACP/PRP injections are not currently covered by basic insurance, as our practice does not have a contract for this treatment.
Costs €225 per injection, fully at the patient's expense.
CONSULTATION RECOMMENDATION
Prior to treatment, a consultation will always take place to assess whether ACP injections are suitable.
Other supportive therapies, such as GLAD therapy or Kenacort injections, are combined where appropriate.
SURGERY
In cases of severe osteoarthritis, where conservative measures are insufficient, joint replacement surgery (e.g., knee or hip prosthesis) can be considered.
What can you do yourself?
IN SUMMARY
Arthritis is a chronic condition of the joints, but a combination of exercise, lifestyle, education, medication and modern injection therapies can significantly reduce pain and stiffness.
GLAD therapy Scientifically based exercise and education therapy for knee and hip osteoarthritis.
Kenacort injections For temporary relief of acute flare-ups.
ACP/PRP injections Innovative, complementary treatments that can reduce pain and support joint function.
With a sustainable treatment plan, focused on preserving function and quality of life, patients with osteoarthritis can gain better control over their symptoms and maintain a higher quality of life.
As men get older, many experience prostate problems, including benign prostatic hyperplasia (BPH) and, in some cases, prostate cancer. The prostate can gradually increase in size in men from around the age of 30. When the prostate becomes too large, it can lead to urinary symptoms, such as a weaker stream or needing to urinate more frequently. These symptoms do not necessarily mean that there is prostate cancer; BPH is far more common than malignant conditions.
PROSTATE CANCER: FACTS AND FIGURES
Prostate cancer is a type of cancer in which malignant cells develop in the glandular tissues of the prostate. The disease usually develops slowly, meaning symptoms are often not apparent until a later stage. Prostate cancer can spread to surrounding lymph nodes or, in advanced cases, to bones.
In the Netherlands, approximately 12,000 men are diagnosed with prostate cancer annually. Over the course of their lives, about 1 in 10 men receive this diagnosis.
SYMPTOMS OF PROSTATE PROBLEMS
The symptoms of an enlarged prostate and prostate cancer often overlap. It's important to know that many urinary symptoms are more commonly caused by BPH than by cancer. Possible symptoms include:
Having one or more of these complaints does not automatically mean that you have prostate cancer.
PREVENTIVE EXAMINATION AND PSA TESTING
Prostate cancer can be detected early through a prostate-specific antigen (PSA) blood test. However, the application of PSA screening remains controversial:
Advantages: Early stage prostate cancer can be detected, allowing for timely treatment.
Disadvantages: Met deze methode is er een risico op overdiagnose van langzaam groeiende tumoren die nooit klachten hadden veroorzaakt. Onnodige biopten en behandelingen kunnen leiden tot complicaties, zoals incontinentie of erectiestoornissen.
Current guidelines advise a personalised approach: a PSA test can be considered for men between 50-70 years of age (or from 45 years for high-risk groups, such as men with a family history of prostate cancer), following a well-informed discussion about the pros and cons. Routine screening for all men is not routinely recommended.
WHEN TO CONTACT YOUR GP?
Contact us if you are experiencing urinary problems that are affecting your daily life, or if you have concerns about your prostate health. Your GP can:
Discussing symptoms promptly allows for appropriate treatment to be initiated, ranging from lifestyle and medicinal options for BPH to specialist treatment for confirmed prostate cancer.
