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Urinary Problems


Urinary problems include infections of the urinary tract and cystitis. The urinary system consists of the kidneys, bladder and urethra. Infections occur when bacteria spreads and moves through the urethra causing infection in the urinary tract. If this spreads to the bladder it can cause cystitis. If the infection continues into the kidneys it can cause pyelonephritis.
Urinary Problems

In This Article
Causes of urinary problems Symptoms of urinary problems
Diagnosis of urinary problems Related terms

There are a number of problems that can affect the function of the urinary system from infections to incontinence. The most common problem is a urinary tract infection (UTI) which affects both men and women.

UTIs are caused by bacteria entering and infecting the urinary tract. The common bacteria that causes UTIs is Escherichia coli which lives in the colon. The bacteria can enter through the urethra opening and multiply in the bladder.

This infection is usually spread when wiping the anus after using the toilet when the paper comes into contact with the genitals. As the bacteria works its way through the urinary tract, it infects the bladder (a condition known as cystitis) and can continue toward the kidneys (a condition called pyelonephritis).

Another common urinary problem is urinary incontinence. This is the unintentional passing of urine and affects around three million people in the UK. Although common in elderly people, the condition can affect anyone but women are more susceptible than men.

There are a number of causes of incontinence:
  • Stress incontinence – this occurs to a weakening of the pelvic floor muscles which prevents the urethra from closing properly. Pressure on the bladder (e.g. from laughing or coughing) causes urine to leak out. Pregnancy, the menopause, obesity, age or a hysterectomy can cause this type of incontinence.
  •  Urge incontinence – this causes the bladder to contract too early, usually before it is even full and without enough time to reach a toilet. Possible causes include: urinary infections, MS, stroke, Parkinson's disease, enlarged prostate gland.
  • Overflow incontinence – if the bladder has a blockage or obstruction it may not be able to empty fully. Pressure then builds causing frequent leaks. Causes include: enlarged prostate gland, urinary stones, constipation.
  • Total incontinence – this is caused by a bladder that is incapable of storing urine and requires someone to constantly pass large amounts of urine or pass urine with frequent leaks. Causes of this problem include: bladder defect from birth, spinal cord injury or a bladder fistula (a tunnel which can develop between the bladder and area such as the vagina).

Other causes of urinary incontinence include:
  • Medications (particularly muscle relaxants)
  • Caffeine and alcohol (which act as diuretics)
  • Fruit juices which contain sweeteners (which irritate the bladder)


Symptoms of a lower urinary tract infection (in the bladder) include:
  • Pain or burning when urinating
  • Frequent need to urinate
  • Feeling unable to fully pass urine
  • Cloudy or foul-smelling urine
  • Blood in the urine
  • Lower abdomen pain
  • Mild fever
Symptoms of an upper urinary tract infection (in the kidney) include:
  • Same symptoms as with a lower UTI but including:
  • High fever
  • Nausea
  • Vomiting
  • Shivers
  • Lower back pain or pain on one side
The main symptom of urinary incontinence is a loss of bladder control but this will vary depending on the type of incontinence you have.

Stress incontinence

Small or large amounts of urine leak out when:
  • Coughing
  • Sneezing
  • Laughing
  • Lifting heavy objects
  • Running or physical exercise
Urge incontinence
  • An intense need to pass urine
  • Needing to urinate after changing position
  • A need to urinate after sex
  • Frequently needing to urinate at night
Overflow incontinence
  • Passing small amounts of urine often
  • A feeling that the bladder is never properly emptied
Total incontinence
  • Passing large amounts of urine
  • Leaking small amounts in between


A UTI will require a diagnosis by your GP. An upper UTI will require a urine test but the typical symptoms of cystitis (infection of the bladder) will usually not require further testing.

If you are experiencing urinary incontinence then in the first instance visit your GP. The GP will attempt to establish the type of incontinence you have and there are a few tests to determine this.

First, your GP will perform a physical examination to assess your urinary system. For women, this may involve examination of the vagina to check the pelvic floor muscle strength. Men may require a check of the rectum to see if the prostate gland is enlarged.

If the GP suspects that the problem is being caused by an infection, they will test your urine for bacteria. If you're unable to fully empty your bladder, you may be referred for an ultrasound to show how much urine is left in the bladder after going to toilet. During this process, a small flexible tube is inserted into your urethra and fed into the bladder.

If the ultrasound fails to show how much urine is remaining in the bladder, a catheter (small hollow tube) will be fed through the urethra into the bladder to drain and measure the amount of remaining urine.


Urine
Wee
Kidney pain
Kidney stones
Urology
Uric acid


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