URINARY PROBLEMS

By their very nature, urinary problems are liable to be distressing and often embarrassing for the adult male and female. Any infection of the bladder and urinary tract will lead to discomfort and the need for frequent, painful urination. In men, enlargement of the prostate can also cause frequent urination, with difficulty in starting, and dribbling. In women, leakage of urine (incontinence) is a common urinary problem, with a variety of causes and 'triggers'.

The process of urination begins when waste fluids flow out of the kidneys into two long tubes called ureters. The ureters empty into the bladder, which rests on top of the pelvic floor, a muscular structure similar to a sling running between the pubic bone and the base of the spine. As the bladder fills to its capacity of 8 to 16 oz of fluid, its nerves send signals of fullness to the spinal cord and the brain. The brain regulates the muscles in the urinary tract partly by means of a pathway of nerve cells and neurotransmitters (chemical messengers) called the cholinergic and adrenergic systems. While the bladder is filling, the brain signals the bladder to relax. As the bladder swells, the sensation becomes conscious and a person voluntarily contracts the muscles to prevent urination.

When the person wants to urinate, the spinal cord initiates the voiding reflex, an automatic process in which the muscles surrounding the bladder, called the detrusor muscles, contract and the internal sphincter, a strong muscle encircling the bladder neck, relaxes. Urine flows out of the bladder into the urethra. These muscles are involuntary; that is, they require no conscious effort for contraction or relaxation. Once the urine enters the urethra, the lowest part of the urinary tract, a person consciously relaxes a voluntary muscle called the external sphincter and allows urination.

Urinary incontinence is the inability to control urination. It may be temporary or permanent and can result from a variety of problems in the urinary tract. Urinary incontinence is generally divided into four groups, according to the malfunction involved: stress, urge, overflow, and functional incontinence. Often, more than one type of incontinence is present; approximately 40% of incontinence cases fall into more than one of the four categories.
Six out of every 7 cases of adult incontinence occur in women, and between 15% and 30% of women experience incontinence during their lifetimes. In older men, prostate problems and their treatments affect the urinary tract and increase their risk for incontinence to the extent that the incontinence rates in men and women tend to even out. All older adults, however, are susceptible to incontinence. About half of the elderly who are house-bound or in nursing homes are incontinent, and between 25% to 30% of older adults experience incontinence after hospitalization from a serious illness.Other common urinary disorders include urinary infections and benign prostatic hyperplasia (BPH) in men.

Urinary tract infections (UTIs) are caused by bacteria and are 10 times more common among women than men. About 30% of UTIs go away and do not recur. When they do recur, it is often because the treatments used to suppress bacteria seem to work at first, but do not produce a lasting cure. UTIs can also recur when a woman is infected again by a different kind of bacterium. Antibiotics get rid of the bacteria that are cause the infection. They also stop the infection from reaching the kidneys - a potentially serious complication, as pyelitis and ascending nephritis are more painful and more difficult to control.


Why do women have urinary tract infections more often than men?

Women tend to have urinary tract infections more often than men because bacteria can reach the bladder more easily in women. The urethra is shorter in women than in men, so bacteria have a shorter distance to travel.The urethra is also located near the rectum in women. Bacteria from the rectum can easily travel up the urethra and cause infections.Having sex may also cause urinary tract infections in women because bacteria can be pushed into the urethra. Using a diaphragm can lead to infections because diaphragms push against the urethra and make it harder to completely empty the bladder. The urine that stays in the bladder is more likely to grow bacteria and cause infections.


Tips on preventing urinary tract infections

1.Drink plenty of water to flush out bacteria. Drinking cranberry juice may also help prevent urinary tract infections. However, if you're taking warfarin (brand name: Coumadin), check with your doctor before using cranberry juice to prevent urinary tract infections. Your doctor may need to adjust your warfarin dose or you may need to have more frequent blood tests.

2.Don't hold your urine. Urinate when you feel like you need to.

3.Wipe from front to back after bowel movements.

4.Urinate after having sex to help wash away bacteria.

5.Use enough lubrication during sex. Try using a small amount of lubricant (such as K-Y Jelly) before sex if you're a little dry.

6.If you get urinary tract infections often, you may want to avoid using the diaphragm. Ask your doctor about other birth control choices