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Urinary Incontinence

WHAT IS OVERACTIVE BLADDER?

The overactive bladder is a syndrome that is quite common in some patients, especially in women and in the elderly. It is characterized by a sudden appearance of the irresistible need to urinate.

The overactive bladder affects the physical, social, vitality and emotional state of the patients who suffer from it, says the urologist in Delhi.

The International Continence Society defines the overactive bladder as a syndrome consisting of urinary urgency, in which urinary incontinence may also (or may not) occur, usually with the need to urinate 8 or more times during a period 24 hours (urinary frequency) and nocturia. This syndrome should be presented in the absence of any urinary tract infection or some other pathological condition and suggests an increase in detrusor muscle activity (muscle that allows us to urinate).

What are the symptoms of overactive bladder?

There are various signs and symptoms of the overactive bladder, among which, according to the best urologist in Pitampura, the ones that occur most frequently are the following:

  • Urinary urgency (distinctive symptom): It presents as the sudden and compulsive desire to urinate, a sensation which is difficult to postpone and is the hallmark of the overactive bladder.
  • Urinary incontinence: It is the inability to resist the urge to urinate and therefore there is an involuntary leakage of urine. It is one of the most common symptoms and occurs most frequently in women, says the urologist in Pitampura.
  • Nocturia: It is defined as the need to go to urinate many times during the night, that is, the patient may be sleeping and the need to urinate wakes him on one or several occasions throughout the night.
  • Urinary frequency: It is when the patient will urinate 8 or more times in a 24-hour period.

What are the causes that can cause an overactive bladder?

The overactive bladder is primarily a neuromuscular problem, in which the detrusor muscle contracts inappropriately during bladder filling. These contractions occur frequently, regardless of the amount of urine in the bladder, explains urologist in Rohini.

The overactive bladder can be caused by both nerve injuries and injuries that do not involve nerves. A spinal cord injury can cause this syndrome.

Some neurological diseases such as multiple sclerosis, dementia, Parkinson’s disease, and diabetic neuropathy can cause overactive bladder.

Increased detrusor muscle activity can occur in the absence of nerve injury. The contractions can be induced by the rapid filling of the bladder, changes in the posture of the body, walking or even coughing because these causes are not due to some nerve injury, the need to urinate can be contained for a few minutes, says the best urologist in Rohini.

There are many risk factors that can precipitate this syndrome, such as:

  • Arthritis.
  • High body mass index (overweight or obesity).
  • Age over 75 years.
  • Hormone replacement therapy
  • Having had several children.
  • Present urinary infections frequently.

The diagnosis of overactive bladder can be made by having some data such as patient history (parity, previous illnesses, among others), physical examination and some laboratory studies (general urine test).

Hyperactive bladder treatment

The purpose of the treatment used in patients with an overactive bladder is to reduce the symptoms they present in order to lead a better quality of life, says urologist in Delhi.

There are both treatments with medications and with various physical exercises and changes in the lifestyle and habits of the patient.

Within the treatment with medications, anticholinergic agents can be used because they reduce the ability to contract the detrusor muscle, so it is intended to reduce the number of times it is necessary to go to urinate, although this type of medication can have dry mouth and constipation.

Within the changes in the lifestyle and habits of the patient, modifications to the diet must be made, as well as establishing fixed schedules to go to urinate and perform exercises on the floor of the pelvis, suggests urologist in Pitampura.

6 CAUSES OF PAIN TO URINATE IN MEN

What is dysuria?

Pain to urinate, also known as dysuria, is one of the most common symptoms in patients with urinary tract inflammation/infection, states urologist in Delhi.

We consider dysuria any discomfort that arises at the time of urination, be it pain, burning, heaviness, burning or stinging.

In women, the main cause of dysuria is urinary tract infection, more specifically cystitis, which is the name we give to bladder infection.

In men, however, the story is different, at least for those between the ages of 15 and 50, since in this group cystitis is not a common situation. In men, urethritis (inflammation of the urethra) caused by sexually transmitted diseases is a much more frequent cause of urination pain than urinary tract infection.

In this article, the best urologist in Uttam Nagar will talk about the main causes of discomfort or pain during urination among men.

Main causes of dysuria in men

Dysuria usually arises when there is inflammation, whether infectious or not, somewhere in the lower genitourinary tract, which in men is composed of the prostate, bladder, testis, and urethra, explains urologist in Uttam Nagar.

It is very important to know the main causes of dysuria so as not to fall into the trap of thinking that every pain when urinating is caused by a urinary tract infection. In women, this reasoning may even lead you to make the diagnosis right in most cases, but in young men it is completely wrong.

Next, let’s briefly talk about the 6 most common situations that can cause pain during urination. They are:

  • Urethritis.
  • Prostatitis.
  • Cystitis.
  • Urinary calculus.
  • Epididymitis.
  • Benign Prostate Hyperplasia

Urethritis

We call urethritis the inflammation of the urethra, which is the channel that goes inside the penis and drains the bladder urine.

Urethritis is the most common cause of dysuria in young and sexually active men. The main causes of urethritis are gonorrhea and chlamydia, two sexually transmitted bacterial infections.

In both infections, in addition to dysuria, the patient also usually has a purulent urethral discharge, which may arise spontaneously or only when the patient “milks” the penis.

This symptom is the key point that helps differentiate urethritis from urinary tract infection, as cystitis patients do not usually have urethral discharge.

In addition to gonorrhea and chlamydia, urethritis can also be caused by other germs such as Mycoplasma genitalium, Ureaplasma urealyticum, adenovirus and herpes simplex virus.

Inflammation of the urethra may also have non-infectious origin, as in cases of trauma, such as when passing a bladder tube, or irritation by chemicals such as antiseptics or spermicides.

Excessive masturbation may also cause trauma to the urethra and temporary dysuria.

Prostatitis

Prostatitis, which is inflammation of the prostate gland, is another common cause of dysuria in men.

Unlike benign prostate hyperplasia and prostate cancer, which are two complications that occur almost exclusively in the elderly, prostatitis can appear in young adults.

Prostatitis can be acute or chronic.

Acute prostatitis is a condition that is usually caused by a bacterium, such as Escherichia coli, Proteus or Klebsiella.

The most common symptoms of acute prostatitis are pain to urinate, fever, chills, urge to urinate all the time, difficulty urinating, pelvic pain, weakness and general malaise.

Conical prostatitis, which is also called chronic pelvic pain syndrome, is a condition of unknown cause that can last for months.

In addition to dysuria, chronic prostatitis can also cause testicular pain, ejaculating pain, difficulty urinating and blood in the sperm.

Urinary infection

As noted earlier in the text, urinary tract infection is the leading cause of dysuria in women, but is uncommon in young men.

Urinary tract infection in men usually only occurs in those who have an abnormality of the urinary system, such as urethral stricture, vesicoureteral reflux, or prostate abnormalities that cause urinary flow obstruction.

Therefore, in healthy young men complaining of pain to urinate, cystitis should not be the first or second hypothesis to be considered.

On the other hand, if the patient is already over 50 years old and has a history of benign prostate hyperplasia, the urinary tract infection may be home to dysuria.

Urinary Calculus

The passage of a urinary stone through the urethra can cause injury to the urethra, leading to the onset of dysuria.

Depending on the size of the stone, it can be impacted on the urethra, also causing symptoms such as blood in the urine, difficulty urinating, weak urinary jet and pain in the penis region.

Often the patient can see the moment when the stone passes through the urethra as it comes out in the urine and falls into the toilet. If the stone passage has been very traumatic, the pain to urinate may persist for a few more days.

Epididymitis

The epididymis is a structure that is located above the testicles and its function is to store the sperm produced.

Epididymitis is a condition of inflammation of the epididymis, usually caused by infection with the bacterium Chlamydia trachomatis.

Epididymitis may cause pain when urinating, but its most common symptoms are testicular pain and scrotum swelling.

Benign Prostate Hyperplasia

As men get older, their prostate tends to swell, a condition called benign prostate hyperplasia (BPH). About half of patients over 50 have BPH. Already in the age group above 80 years, the rate is greater than 80%.

As the urethra passes inside the prostate, it may become compressed in cases of benign prostate hyperplasia. This compression makes it difficult to pass urine, causing obstruction of urinary flow.

Obstruction can cause pain when urinating because of the patient’s own difficulty passing urine through the urethra, but also because it favors the proliferation of bacteria in the urine, which increases the risk of urinary infection.

In addition to dysuria, the most common symptoms of BPH are weak urinary jet, difficulty initiating urination, urge to urinate all the time, even with low urine volume, urge to urinate, and frequent urination at night., during sleep.

PROSTATITIS: TYPES, CAUSES, & TREATMENT

PROSTATITIS: TYPES, CAUSES, & TREATMENT

PROSTATITIS: TYPES, CAUSES, & TREATMENT

It is a non-contagious infection of the prostate. The bacteria that produce it can enter the prostate from infected urine. Both acute and chronic prostatitis can be treated with antibiotics, however, non-infectious prostatitis is not treated with antibiotics, but the treatment is performed with muscle relaxants, sitz baths, and prostate massages, explains urologist in Pitampura.

The prostate is a gland that only the man has and that is in front of the rectum (final part of the digestive tract) and just below the bladder (where urine is stored). The normal prostate is the size of a nut and its weight is 20 grams. The urethra passes through this gland (a tube that carries urine from the bladder to the tip of the penis).

The prostate is made up of glands and muscular stroma. Its function is to produce liquids that bind to semen (a fluid that carries sperm produced in the testis). During orgasm (final part of the sexual act) the muscular stroma contracts and expels sperm. Prostatitis is not contagious and is not considered a sexually transmitted disease. It is not known with certainty what is the cause for which prostatitis occurs. Bacteria can ascend from the outside through the walls of the urethra and infect the prostate tissue.

THERE ARE THREE TYPES OF PROSTATITIS:

Acute prostatitis

It is produced by bacteria and as its name indicates it appears sharply and manifests itself by fever, chills, difficulty, and pain when urinating. It is a severe condition that sometimes requires immediate admission to inject antibiotics directly into a vein.

Chronic prostatitis

It is also produced by bacteria but does not occur abruptly and the symptoms are less intense characterized by discomfort under the testicles or below the navel. It is associated with repeated urinary infections. The patient does not need to be admitted. It is treated with antibiotics by mouth.

Non-infectious prostatitis (prostatodynia)

These are caused by bacteria and their cause is unknown. Antibiotics are not effective.

There are certain conditions or procedures that increase the risk of getting prostatitis:

  1. Recently placed some instrument through the urethra (probe, cystoscope, etc.).
  2. Perform sexual intercourse.
  3. Have some abnormalities in the urinary tract.
  4. Having recently had a urine infection.
  5. Having a large prostate (benign prostatic hyperplasia).

According to the best urologist in Pitampura, the symptoms of prostatitis will depend on the type of illness you have. You may not feel anything or have symptoms so abrupt and severe that they force you to go to an emergency service. When there are symptoms, they can be any of the following: fever, chills (shivering), urinating very frequently during the day or night, difficulty urinating, burning when passing urine, pain between the testicles and anus (perineum), blood in the urine (hematuria) or pain during ejaculation.

The symptoms of prostatitis can simulate the symptoms presented by other prostate diseases such as benign prostatic hyperplasia or urethritis (inflammation and infection of the urethra).

DIAGNOSIS OF PROSTATITIS

To facilitate the diagnosis of prostatitis the doctor will perform a rectal examination (put a finger in the rectum to find out about the size of the prostate, the consistency, the presence of pain, hard nodules suspected of tumor, inflammation or accumulation of pus). If your doctor suspects that you have prostatitis, he will send you to a urologist to confirm the diagnosis.

When prostatitis is suspected, a prostate massage should be performed to collect fluid produced in the gland and study it with the microscope to find bacteria or leukocytes (an indirect sign of the presence of infection)

TREATMENT TO FOLLOW

The treatment is different depending on the type of prostatitis you present. If you have acute prostatitis, you will probably need to be admitted to administering antibiotics directly into a vein for 2 or 3 days and upon discharge, you should continue with antibiotics by mouth for 2-3 weeks.

Chronic prostatitis will need antibiotics for a longer period of time and ranges between 4 and 12 weeks, which results in the disappearance of the condition in approximately 60% of cases. For cases that do not respond to this treatment, low dose treatment will be needed for a longer time.

If you have a prostatodynia, you do not need to receive antibiotics and, depending on the symptoms you present, you will need other medications such as alpha-blockers (substances that relax the muscle in the prostate, which reduces the difficulty in urinating). Sitz baths and diet can help you improve your symptoms.

UROLOGICAL CONTROL

Although prostatitis does not favor the onset of cancer, remember that after 50 years of age you should be checked annually by a urologist to detect the early onset of prostate cancer. In case you have family members who have had prostate cancer (father, siblings, grandfather, uncles), the control should begin at 40 years of age as recommended by the American Cancer Society.