Urinary tract infections
Urinary tract infection (UTI) is a bacterial infection that affects any part of the urinary tract.Symptoms include frequent feeling or need to urinate, pain during urination, and cloudy urine, chills, fever, night sweats.
The most common type of UTI is acute cystitis often referred to as a bladder infection. An infection of the upper urinary tract or kidney is known as pyelonephritis. Although they cause discomfort, urinary tract infections can usually be easily treated with a short course of antibiotics. To find out what specific organism is the cause of the inflammatory process, a urologist sends patient’s urine for subsequent laboratory analysis. Women often are at higher risk for UTIs because of the female anatomy, the urethra in females is much closer to the anus than in males. Other risk factors include diabetes, prostate enlargements, or other anatomical malformations. Recurrent infections may indicate presence of stones in the urinary tract or other disorders of the excretory system.
Incontinence means involuntary loss of urine. This conditions may be presented as a separate disease or be a symptom of another illness. According to statistics, about 38% of women in America suffer from this condition. Frequency of the disease is increasing with age. Many women are embarrassed to admit to their providers or family members that they have incontinence.
There are two main types of disease: Stress and Urge incontinence. Stress incontinence is involuntary loss of urine during sudden physical exertion, heavy lifting, coughing, strong laugh, sneeze. In this case the woman does not feel the need to empty the bladder. Stress incontinence is usually caused by weakening of pelvic muscles, anatomical pathology, or abnormalities of the connective tissue. Other causes include pregnancy, childbirth, perineal trauma, obesity, pelvic surgeries. Urge incontinence is the strong, sudden need to urinate due to bladder spasms or contractions. Often these contractions occur regardless of the amount of urine that is in the bladder. Urge incontinence may result from: urinary tract infection (cystitis), bladder tumors, bladder stones, menopause, and various nervous disorders. Since urinary incontinence in women may present as a symptom of some other urological diseases, effective treatment requires careful diagnosis. Careful history and physical examination is a key for finding out the right cause of the incontinence. Woman is asked to fill out a voiding diary as well. Urine is always sent to the laboratory to rule out infections. In some cases patient may need an ultrasound or CT of the abdomen and pelvis. Cystoscopy sometimes is needed for inspection of the bladder.
When choosing a method of treatment, our doctors take consideration the type and degree of incontinence, individual characteristics of the patient, and presence of concomitant diseases. Medications are applicable to all the types of incontinence, but mostly effective when urge component is present . Preference is given to anticholinergic. They help relax the muscles of the bladder, increase its capacity and reduce frequency of urination. Successful method of treatment is also a physical therapy including acupuncture, which gives no side effects and leads to a rather favorable results. During the acupuncture, tibal nerve is stimulated. Unlike most other types of acupuncture, this type of paid by most insurances. Other therapies include: use of pessaries (special vaginal rings), electrical stimulation of pelvic floor muscles, Kegel exercises, also called as pelvic muscle training exercises, and biofeedback. This allows a woman to learn how to control the frequency and force of contraction of the muscles of the perineum, which prevents episodes of involuntary urination in 50% of patients.
Surgical correction of incontinence is used when conservative methods are failed and has the best and most lasting effect. The essence of this method is to create support for the urethra using artificial and natural materials.
A lot of times women can prevent urinary incontinence by strengthening their pelvic floor muscles with Kegel exercises. Women should also minimize factors that may increase the risk of incontinence such as: smoking, alcohol consumption and unbalanced diet leading to obesity.