WATERWORKS PROBLEMS
WOMEN
The urinary system in women suffers from two aspects of the female anatomy. Firstly the water pipe (urethra) from the bladder to the outside world is very short (much shorter than in men) and this allows germs (usually from the bowel) easy entry to the bladder and secondly it is very close to the vagina so that damage to the muscles around the vagina whilst giving birth can affect continence. Even vigourous sexual intercourse may traumatise the urethral opening and cause a "cystitis".
Simple urine infections in adult women often respond to increasing fluid intake and perhaps something to render the urine alkaline like barley water or a proprietary treatment from the chemist. Antibiotics (with the consequent risk of thrush) can often be avoided. Further investigation is not usually required unless the infection is difficult to shift or keeps recurring. The presence of back pain and/or fever is a different matter and suggests that the infection may have spread to the kidneys, in which case antibiotic treatment will be required.
Incontinence. After vaginal delivery the muscles of the pelvic floor are stretched and may become slack.Regular pelvic floor exercises (squeezing the buttocks and sphincters tight as when holding on to go to the loo) after delivery helps to reverse any damage to the pelvic floor muscles which can lead to continence problems - particularly "stress incontinence" which means that coughing, sneezing etc. leads to an involuntary voiding of some urine. In fact, practising regular pelvic floor exercises throughout life does no harm at all and may cure stress incontinence if it is not severe. However, if this fails to work an examination is necessary to assess whether more active intervention is required. This may include surgery to repair the damaged muscles. Another type of incontinence is urge incontinence (in which a sudden urge to pass urine is followed quickly by the passage of some urine if it is not satisfied) is due to irritability of the bladder and the nerves controlling it. There are a number of potential causes including infection and pregnancy - it needs explanation unless very transient. Of course stress and urge incontinence can occur together.
Blood in the Urine (haematuria) Go to page5.