Bladder Problems - Overview

Bladder and urinary problems are sure to be distressing and often embarrassing for the adult man and woman. An infection of the bladder and urinary tract often leads 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 leakage. In women, escape of urine (incontinence) is a common urinary problem, which possesses a variety of causes.

Frequent symptoms of a bladder or urinary problem include:

Burning with urination - the most common symptom of a urinary tract infection.
Frequent urge to urinate without the ability to pass a desired amount of urine (frequency).
Urgent need to urinate (urgency).
Feeling of incompletely emptying of your bladder.
Blood in the urine (hematuria). Your urine may look red, brown, or pink. Blood in the urine may occur after exercise, such as running or bicycling.
Leaking urine (incontinence)

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Urinary Tract Infection

Urinary Tract Infections usually occur when bacteria enter the urinary tract through the urethra and multiply in the bladder. Infection-fighting assets are found in the urinary system and help inhibit the growth of bacteria. Unfortunately, certain factors boost the chances that bacteria will enter the urinary tract and develop into an infection.

Most cases of cystitis are caused by E. coli, a type of bacteria usually found in the gastrointestinal tract. When men suffer from a UTI it is typically acquired from sexual contact. Some sexually transmitted diseases, like herpes or chlamydia, also are possible causes.

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Frequent Urination

Symptoms of frequent urination in men can point to more serious conditions such as diabetes, urinary tract infection, benign prostatic hyperplasia (BPH) or other prostate problems. Waking up in the middle of the night to urinate is known as nocturia. Individuals suffering from severe nocturia may need to get up five or six times in the night.

This urinary problem can be a characteristic sign of a urinary tract infection. Because irritation and swelling reduces the bladder's ability to hold urine, even small amounts of urine cause discomfort. Pregnancy, diabetes and prostate problems are other common causes of frequency.

Other possible causes include:

Interstitial cystitis, described as a constant irritation of the bladder that is more common in women than men and typically hard to diagnose and treat.
Diuretics and many other medications
Radiation therapy
Dysfunction of the bladder
Bladder cancer

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Urgency

This condition can occur due to a variety of different causes. There are certain to be other possible sources of urinary urgency, so talk with your doctor about symptoms you experience. Possible causes of urgency include:

Alcohol, caffeine and artificial sweeteners
Bladder conditions and stones
Bladder irritation
Interstitial cystitis
Urge incontinence
Urinary tract infection
Blocked urine flow
Urinary Retention
Hematuria
Urinary Incontinence

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Urinary Retention

This problem may happen unexpectedly (acute), causing discomfort or pain, or may take place long term (chronic). As with most urinary problems there are many possible causes, including:

Blockages in the urinary system due to urinary tract stones or birth defects
Narrowing of the urethra due to scarring from injury or infection
Benign enlargement of the prostate gland
Nerve or bladder muscle problems
Prostate cancer or kidney stones
Side effects from some medications, such as antihistamines

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Hematuria

From Hemat = blood and uria = of urine

Hematuria simply means blood in the urine. Microscopic hematuria means that the blood is only seen when the urine is examined under a microscope. Gross hematuria, on the other hand, means that there is enough blood in the urine so that the change can be appreciated with the naked eye. Obviously, gross hematuria has more blood in the urine than microscopic hematuria, but the types of diagnoses that can cause the problem are the same and the work-up or evaluation that is needed is identical.

The number of causes of hematuria is great -- perhaps 20 or 25 different groups of causes.

Some are much more serious than others and require diagnosis sooner that later. These groups include cancers or malignancies, stones, infections, and blockages or obstructions to flow.

In the case of cancers, one must be concerned with every organ in the urinary tract, thus the reason to look at the entire urinary tract. Of the other groups, many are less important and most require no treatment. These may include viral infections, non-specific inflammations of the kidney such as drug reactions (non-steroidal anti-inflammatory drugs, such as ibuprofen can cause non-specific inflammation, usually without harm). Many medications can cause blood in the urine, particularly medications which thin the blood's clotting ability, like coumadin or aspirin.

ANATOMY

To understand the needed evaluation for hematuria, one must know the anatomy of the urinary tract in The kidneys function to make urine by filtering the blood and discarding into the urine the waste products that are no longer needed. Water and salts accompany these waste products by necessity. The urine is then transported through two narrow tubes, called ureters, to the bladder, which is the reservoir for urine in between each void. The urine exits the bladder through a channel called the urethra that first passes through the prostate and then through the penis to the outside.

The blood in the urine must come from one of the above places: kidneys, ureters, bladder, prostate, or urethra. The evaluation requires that we look at the ENTIRE urinary tract in patients with hematuria.

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Incontinence

Urinary incontinence has recently gained considerable attention in the United States. It is estimated that approximately 10 to 20 million people (10-35% of the U.S. population) are suffering from urinary incontinence. Nearly 50 percent of the institutionalized elderly are incontinent.

The estimated cost of diagnosis and treatment of this group is $15 billion per year. Though these numbers are staggering, about half of incontinent patients do not alert their physician or family members of their problem. Unfortunately, most of these individuals assume nothing can be done for incontinence or feel that leakage is a normal part of aging.

Urinary incontinence is defined as the involuntary loss of urine from the bladder. It is important to remember that not all incontinence is the same. There are several types of incontinence:

Stress incontinence
Urge incontinence
Mixed incontinence
Overflow incontinence
Functional incontinence

Correct diagnosis of the type of incontinence is the first and most important step in developing an appropriate and effective treatment plan for incontinence.

This condition may occur due to a variety of different reasons, to include weak pelvic muscles or diabetes. Common causes include:

Diminished skin thickness or drying in the vagina or urethra, particularly after menopause in women
Inflamed prostate gland or prostate surgery in men
Some medications
Stool build-up of in the bowels
Immobility
Urinary tract infection
Elevated calcium levels

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