WHAT IS A URINARY PROBLEM?
The urinary tract consists of the kidneys, ureters, bladder, and urethra. Your kidneys filter your blood, creating urine, which travels through the ureters to the bladder, where it is stored. When the appropriate time comes, the muscles of your bladder contract and urine exits your body through your urethra. Urinary disorders include any diseases, disorders, or conditions that affect your kidneys, ureters, bladder or urethra, or that affect their function.
Examples of urinary disorders include cancers of the urinary tract, incontinence (inability to control urine flow), interstitial cystitis, kidney stones, kidney failure, and urinary tract infections. Common symptoms of urinary disorders include abdominal, pelvic, or lower back pain or discomfort; blood in the urine; changes in the urine; difficulty producing urine; fever and chills; frequent urination; leaking of urine; and urgent need to urinate. Some urinary disorders, such as infections, may develop quickly, while others, such as cancer, develop more slowly.
What Can Cause Difficulty Urinating?
Difficulty passing urine is a common problem. It can be caused by conditions that affect the kidneys, bladder, or prostate gland (in men). Urinary tract infections, prostate problems, and kidney stones are common triggers for this problem to develop. In some people, more than one condition is present. Anyone who experiences difficulty passing urine for more than 24 to 48 hours should see a doctor.
Difficulty urinating can be a result of anatomical abnormalities within the genitourinary tract. In men, enlargement of the prostate gland, due most commonly to benign prostatic hyperplasia and less commonly to prostate cancer, can cause difficulty in urinating. In both men and women, difficulty urinating can result from neurological or muscular conditions that affect the function of the bladder. When it becomes difficult to urinate, other symptoms such as dribbling (leaking or mild incontinence) and a weak urine stream may also be present. Certain medications can also cause problems with urination. Scar tissue from surgery or trauma can also cause problems with the flow of urine. Infections of the urinary tract or the nervous system can also cause retention of urine.
Some issues that cause difficulty while urinating:
Urinary retention can be caused by a problem with the nerves that control your bladder. This can happen as a result of diabetes, stroke, multiple sclerosis, brain or spinal cord infections or injuries, or pelvic injury. If you’ve recently had surgery with anesthesia and IV fluids, it’s normal to have temporary issues with urinating, as they can impair your nerves. Normal urination should return as soon as the anesthesia wears off.
Many medications may interfere with bladder function, including antihistamines, antidepressants, and medications used to treat muscle spasms.
Weakened bladder muscles
Both men and women may experience a loss of bladder muscle strength with age. Regular Kegel exercises can help strengthen the bladder muscles and resolve bladder issues.
Urinary tract stones
Urinary tract Infections (UTI)
UTIs can make you feel an urgent need to urinate frequently, only to go a little. Other symptoms include a burning feeling and pain, during urination, and blood in your urine.
As men age, their prostates continue to grow, which can cause a condition known as benign prostatic hypertrophy (BPH). When a man has BPH, it can put pressure on his urethra. As a result, he may experience an inability to urinate, even when he feels the need to go, and he may try to go for several minutes before actually urinating, or may produce only a weak stream of urination. Other conditions that may prevent a man from urinating, when he feels the need, are bladder stones, prostate cancer, and scarring of the urethra.
A woman may have trouble urinating, because of a condition called cystocele, which is a bulging of the bladder into the vagina. This happens when muscles and supportive tissues in the vagina and surrounding area weaken and stretch, most commonly after pregnancy and childbirth. A woman also may experience trouble urinating, when her rectum bulges into her vagina, in a condition called a rectocele. Both conditions can be treated with pelvic muscle exercises, a vaginal pessary (a support device that fits into your vagina), or surgery.
What Are Some Health Problems that Cause Difficulty with Urination?
Several health conditions can make it hard for you to pee or to keep from peeing.
- Stress incontinence: This happens when the muscles that keep urine, are becoming weak. You may leak when you exercise, walk, bend, sneeze, cough, or lift something heavy.
- Overactive bladder: Your brain tells your bladder to empty even when it doesn’t need to. This causes you to feel like you suddenly have to pee and it makes you go more often.
- Overflow incontinence: This happens when your body makes more urine than your bladder can hold. It can also happen because your bladder isn’t able to empty properly, so it gets full and causes you to leak.
Urinary incontinence happens in both men and women. Reasons it may occur in men include an enlarged prostate or prostate cancer.
In women, UI may occur because of pregnancy, childbirth, menopause, and hysterectomy (surgical removal of the uterus).
For both men and women, UI becomes more common as you age. Over time, your bladder muscle loses its ability to hold urine as well as it used to. Obesity can also lead to UI. Extra weight puts pressure on your bladder. This can make you feel like you have to pee before your bladder is full.
Urinary Tract Infection (UTI)
You can develop a UTI when bacteria get into any part of your urinary tract (bladder, urethra, and kidneys). When you have a UTI, it may burn when you pee. You might feel like you have to go more often. Also, the urge to pee may come on suddenly, but only a little urine comes out.
The prostate is a gland that’s part of a man’s reproductive system. It’s located just below the bladder. It surrounds the urethra, which is the tube urine travels through from the bladder to the outside of the body. Certain conditions that affect the prostate can lead to peeing problems. These include:
- Enlarged prostate: This is also known as “benign prostatic hyperplasia” (BPH). With this condition, you have to pee often, including during the night. You may leak urine, have a hard time starting to pee, and have a weak stream when you go.
- Prostatitis: This is inflammation in or around the prostate. Prostatitis can cause pain during or after peeing. You may also feel the need to go more often and have a hard time holding it.
People with type 2 diabetes may have to pee often. When you have diabetes, sugar builds up in your bloodstream. Your kidneys have to work harder to remove the excess sugar. When they can’t keep up, the sugar goes into your urine and brings fluids from your body along with it. And, the more you pee, the thirstier you feel. As a result, you drink more fluids. That, in turn, makes you have to pee even more.
Sexually Transmitted Infections (STIs)
Certain STIs, such as chlamydia, gonorrhea, and trichomoniasis, can cause pain when you pee.
Kidney stones are small, hard objects made up of minerals that form inside your kidney. When a kidney stone travels through your ureter (the tube that carries urine from your kidney to your bladder) it can cause urinary problems like:
- Severe pain in the sides or back
- Pain when peeing
- Pink, red, or brown-colored urine
- Cloudy urine
- Foul-smelling urine
- Frequent need to urinate
- Passing small amounts of urine
Many different conditions can cause a blockage in your ureter and make it hard to pee. A blockage can also cause blood in your urine. It can form for any of the following reasons:
- A stone anywhere in the kidney, ureter, or urethra
- Congenital problems (issues you’re born with) that affect how your urinary system is set up
- Severe constipation
- Endometriosis — a condition in women that causes the tissue that lines the uterus to grow in other places inside the body
- Tumors (cancerous or noncancerous)
How Do You Fix Urine Problems?
To beat stress incontinence
Your first move is to do pelvic floor exercises (aka Kegels), which firm up the hammock of muscles supporting your pelvic organs. Surgery is an option, too. Laser and radiotherapy treatments are also being touted as effective for stress incontinence, but the technology is new and needs further study.
To beat an overactive bladder
Start by cutting back on food and drinks that can irritate the bladder; common culprits include coffee, tea, alcohol, carbonated drinks, artificial sweeteners, citrus, and spicy foods. Mastering Kegels (on your own or with a pelvic floor physical therapist) can also make a difference. “Squeezing and relaxing your pelvic floor muscles can help ease urgency problems at the moment—or just give you more time to get to the bathroom,” says Jeannine Marie Miranne, MD, a urogynecologist at Brigham and Women’s Hospital in Boston. Another strategy: emptying your bladder on a schedule, starting with smaller intervals, like on the hour, then working up to every two to three hours. The next step is medication, including anticholinergics, which helps prevent bladder spasms, and Myrbetriq, a drug that works by relaxing the bladder muscle. Botulinum toxin (Botox) is a third-line option. It’s injected into the bladder muscle, which may help prevent the muscle from contracting excessively. Another procedure involves stimulating one of the nerves in the leg, which affects the nerves going to the bladder.
To beat interstitial cystitis
Pelvic floor physical therapy helps, as does stress reduction: “IC tends to flare up under stress,” says Dr. Miranne. Low-dose tricyclic antidepressants can help block pain; the Rx medication Elmiron may protect the bladder lining against irritation. Numbing medications delivered to the bladder via a catheter can offer relief as well. Some people find temporary improvement after a procedure called cystoscopy with bladder distention, in which doctors fill the bladder to capacity with water.
To beat a urinary tract infection
One word: antibiotics. Lower your risk of UTIs by avoiding tight undies, drinking plenty of water, not holding in your pee, peeing after sex, and using a vaginal estrogen cream after menopause to help keep tissues healthier and less prone to infection.
Urinary problems can be related to several causes. However, detection of the cause, proper treatment, and maintaining a healthy lifestyle will help. Hopefully, this article gave you some insight into urinary problems.
MEDELINE ZECH RUIZ in the book I MARRIED A DICK DOCTOR, talks in detail about the various reasons for difficulty in urination. We suggest picking up this book to read an engaging and informative narration.