Bladder Problems
Urination seems as if it should be an easy task to perform and the majority of the time it causes no problems. Many people have urination problems varying from frequency, blood in the urine to infection they need accurate diagnosis and prompt treatment. Urinary infection and (pelvic) bladder pain can cause on going bladder problems if not dealt with, this article outlines many bladder conditions but is not a substitute for accurate medical diagnosis.
Urine – sterile liquid produced by the kidneys. Also referred to as, wee, pee
The kidneys produce the urine after filtering and extracting the waste products from the blood. It is an on-going process the waste products and water are transferred along the ureters to the bladder where it is stored until enough has filled the bladder. A message is sent to the brain which indicates that the bladder needs to be emptied. Under normal circumstances this all happens without you thinking about it, it only comes to our attention when we have smelly urine or see cloudy urine, or we have pain when urinating.When you think you have a urine infection it is necessary to decide if it is an upper urinary tract infection or a lower urinary tract infection.
The Bladder
The bladder is located in your pelvis and is where urine is stored prior to being expelled from the body. The bladder is like a small balloon which can expand and contract depending on the amount of urine being stored. Bladder capacity is usually up to 500mls, however when you are experiencing bladder problems this can diminish to 50mls. When you experience bladder infection symptoms they can vary depending on where the infection is located, the symptoms will need to be diagnosed by your General practitioner. You may be experiencing an upper or lower urinary tract infection
What is the normal colour of urine?
When you have been drinking sufficiently and are not dehydrated the colour of urine should be the colour of light straw. It should not smell, and shouldn’t be cloudy and shouldn’t have “bits” floating in it. If your urine is dark in colour it is an indication you are not drinking sufficiently. The average recommended daily intake of fluids should be at least 2 litres a day
What is a Urine infection?
A urine infection does not originate from the urine; it originates from the bacteria which have been introduced to the normally sterile liquid which is urine. The bacteria cause infection; the infection can be from, the tube you pass urine from (urethritis), a bladder infection (cystitis) the tubes which carry the urine from the kidneys (ureteritis), or the kidneys themselves (pyelonephritis) where the urine is created
Upper Urinary Tract Infection Symptoms include:-
Pain in your side, back or groin area
A temperature of 38 degrees
Uncontrolled shivering
Feeling like vomiting
Diarrhoea
discomfort when urinating
Lower Urinary Tract Infection Symptoms can include:-
Feeling generally unwell
Frequent urination during the night
Urgency – needing to urinate unable to hold on
Pelvic pain or discomfort
Back Pain
Blood in your urine
Cloudy Urine
Pain when passing urine
Smelly Urine
What is a Urinary Tract Infection?
A urinary tract infection is where bacteria from your anus have been transferred to your bladder via the urethra. This can happen when you have your bowels open and the paper used to wipe yourself has come into contact with your genital area or your hands have become contaminated; The bacteria will then track back to the bladder itself where you may experience a bladder infection (cystitis). Women tend to be more prone to cystitis due to the short urethra and the close proximity to the anus. It is more difficult for men’s urethra to be contaminated .
Bacteria / Infection in the urethra (the tube you pass urine from) an infection here is called urethritis.
Bacteria / Infection in the bladder (where you store urine) is called cystitis.
Bacteria /Infection in the ureters (the tubes from the kidneys to the bladder) is called ureteritis.
The final destination for these bacteria is the Kidneys where an infection here is known as pyelonephritis.
What does blood in urine mean?
Blood in urine is also known as haematuria this may mean that you have an infection or irritation of the bladder. It may also mean that you may have some either obstruction in your ureters (the tubes which transfer the urine from your kidneys to your bladder) due to a kidney stone or kidney infection. Blood isn’t always clearly visible and can be detected with a urine dipstick.Your doctor or practice nurse can test your urine when you attend your heatlh centre.
What does having cloudy urine mean?
This can be indicative of having a urine infection or UTI – Urinary Tract Infection as there is bacteria in the urine and cells which have sloughed off from the bladder walls.
What is urine analysis?
This can be performed in two ways the first is where you can go to your doctor with a specimen of urine and the doctor or nurse will test the urine with a urine dipstick. The dipstick will change colour and will show if you have protein in your urine, glucose, blood or ketones amongst others present. The levels and colours of these are an indicator as to whether further investigations are required. A Urine sample may be sent to the local hospital laboratory for more in-depth examination.
What does smelly urine mean?
Offensive smelling urine can be an indication of infection or it can be due to diet- asparagus can make urine smell very strong. Make sure you are drinking enough fluids as concentrated urine smells. If this is something which persists and is combined with other symptoms above you should get this investigated
Cystitis
Cystitis is usually an Inflammation of the bladder caused by bacteria causing a bladder infection, this is known as bacterial cystitis.It can also be caused by irritation or damage caused by frequent sexual intercourse,it used to be referred to as honeymooners infection and is commonly referred to in the medical profession as a UTI – urinary tract infection.
It is a condition which is more prevalent in women due to the location and length of the urethra, and unfortunately is more common in Plus Fifties who are post-menopausal. It is not unknown in men and can be more serious as it may be as a result of prostatitis, an enlarged prostate, a tumour or stone.
Bladder Infection symptoms
An urge to urinate
Passing only small amounts of urine at a time, but feeling like you really need to go
Frequent urination
Bladder pain
Pain or stinging when urinating
Smelly dark urine
Blood in urine
Feeling generally unwell
Treatment for Cystitis
Symptoms of cystitis usually will clear up on their own within 4- 8 days; you can take regular pain relief if necessary and increase your fluid intake to between 6-8 large glasses of water a day. You can also help sooth your bladder by taking a 5ml teaspoon of bicarbonate of soda dissolved in half a glass of water twice a day however DO NOTtake this home remedy for cystitis if you suffer from either high blood pressure or any Heart conditions. Always consult your pharmacist or doctor if you are taking any other forms of medication.If you are a man suffering from cystitis you should visit your GP to ensure there is not an underlying cause.If it is your first experience of cystitis as a women you should also visit your GP however if you have had it before you should be reassured your body’s own defences should resolve the problem within 4-8 days. If this is not the case you may need to see your GP for a short course of antibiotics.If you have more that three attacks during the course of a year you should consult your doctor
Preventative measures for Cystitis
To reduce your chances of contracting bacterial cystitis you can try
•Taking showers rather than baths
• Washing your genital region daily with mild soap and water dry well, to prevent soreness
• Do not use perfumed bubble bath or talcum powder
• Not using spermicides or feminine hygiene sprays as these can irritate
• After having your bowels open make sure you wipe from front to the back to prevent the bacteria entering the urethra.
• Drinking plenty of fluids is good as dehydration is one of the main problems of people with cystitis. The Food Standards Agency advise that the average adult should take in 1.5-2 litres of water in a typical day, this would equate to 6-8 (250ml) glasses or 4 x 500ml sports water bottles per day. This also depends on your age weight and the weather conditions; if it is hot you will need to drink more.
• Do not drink caffeinated drinks, alcohol, carbonated or acidic drinks
• Not waiting or hanging on before going to the toilet to empty your bladder
• Use a unperfumed water based lubricant during sexual intercourse to reduce friction
• Once you have had sexual intercourse try and empty your bladder to flush out any bacteria which may have entered the urethra.
Recurrent Cystitis
This is when you suffer repeated bouts of cystitis up to six times a year, caused by a bacterial urinary tract infection, which is responsive to antibiotics. However this is an aggravating condition which requires further investigation as it is very uncomfortable and disparaging condition.
Interstitial Cystitis
Recurrent cystitis may be the forerunner of interstitial cystitis but without the bacterial element to treat. The irritation, pain frequency and urgency go together to form a miserable problem. Over time the bladder wall becomes scarred and inflexible with sensitised nerve endings you will be referred to a consultant urologist who specialises is genitourinary medicine after comprehensive bladder investigations they will make will make recommendations on how best to manage this condition.
Medical Investigations for Bladder problems
You may need to undergo other urinary investigations which may consist of:
• Urinalysis: This is the analysing of a specimen of urine in the laboratory to detect specific substances, to assist the doctor in the diagnosis.
• Urine Culture: This is done to grow and identify the bacteria present in the urine
• Urine Cytology: This is a test in a laboratory, which is done to detect cancer cells, which may indicate if you have a bladder, ureteral (the tubes which carry the urine from you kidneys to your bladder) or Kidney cancer.
• Urodynamics: This is a test which is done with a continence advisor to assess and measure the bladder’s ability to hold and release urine.
• A Cystoscopy: This is an examination which is carried out with a local anaesthetic or with a general anaesthetic a flexible cystoscope can be used with a local anaesthetic and a rigid cystoscope with a general anaesthetic.
Resources
http://www.hospitalhelp.co.uk
The Cystitis and Overactive Bladder Foundation
76 High Street,
Stony Stratford,
Buckinghamshire,
MK11 1AH
Tel: +44 (0)1908 569169
Fax : +44 (0)1908 565665
Web: http://www.cobfoundation.org
Urological Terminology
Frequency: refers to frequent urination – the need to empty your bladder many times during the day as well as at night.
Urgency: The immediate need to urinate sometimes accompanied by pain when urinating, spasm and heaviness. You may feel the need to go to the toilet and are unable to get there in time causing leakage.
Continence - the ability to retain and dispose of a bodily discharge voluntarily
Incontinence – the lack of ability due to a variety of reasons of being able to retain urine
Stress incontinence: Urine leaks out when pressure is exerted on the muscle group i.e. when laughing, lifting heavy objects, coughing or sneezing.
Overflow Incontinence: This is more common in people with disorders that affect the nerve supply originating in the upper portion of the spinal cord. It can cause constant dribbling of urine even after visiting the toilet.
Urologist A doctor who is a specialist in the study and treatment of disorders of the urinary tract.
Urology – This is the study of diseases and treatment specifically to do with the urinary tract.
Urinalysis: This is the analysing of a specimen of urine in the laboratory to detect specific substances; this will assist the doctor in the diagnosis.
Urine Culture: This is performed to identify the bacteria present in the urine. A sample of urine is taken and a culture of the bacteria is grown. This means the best antibiotic that it responds to will be given to you to cure your particular problem.
Urine Cytology: This is a test which is performed in a laboratory, to detect cancer cells, which may indicate if you have a bladder, ureteral (the tubes which carry the urine from you kidneys to your bladder) or Kidney cancer.
Urodynamics: This is a test which is done with a continence advisor to assess and measure the bladder’s ability to hold and release urine.
Bladder Diary
When you have taken the first step and have spoken to your GP they may suggest a referral to a Consultant Urologist you may also be referred to a continence advisor these will be either nurses or physiotherapists who have undertaken further extensive training in the treatment and understanding of continence. They will be very receptive to your continence needs and will treat you with sensitivity and understanding.
It is a good idea while you are waiting for your appointment to keep a bladder habit diary, for an average week period, which means you keep a record of:
How often you are visiting the toilet – both date and time.
You can also keep a record of how much urine your bladder is able to hold by emptying your bladder into a 500ml jug ( this must be kept solely for this purpose and washed out thoroughly after each measurement) after disposing of the urine down the toilet
You need to record of if you were able to get to the toilet in time or if there was leakage
You can keep an additional note if you had any leakage after sneezing, laughing or when lifting heavy objects.
Keep a record of how much fluid you have been drinking – cups of tea, water and other drinks volume i.e. a mug of tea = 250ml
You can record if you had to get up in the night to urinate and on how many occasions.