What causes a urinary tract infection?
Most urinary tract infections are caused by common bacteria. These are often referred to as gram negative bacteria, the commonest one being E.coli. Normally we should be able to fight these infections off with our own defences. Sometimes though we are unable to do so due to factors within us such as a poorly emptying bladder, foreign bodies being present (such as catheters), the presence of kidney or bladder stones or our ability to fight of the infection being compromised (such as in diabetics or those on certain medications). As a rule any woman who has more than 2 infections in six months or any man who has one infection should be screened to look at the above factors.
Can cranberry juice really prevent it?
There is some evidence that drinking cranberry or taking cranberry tablets can reduce the frequency of recurrent urinary tract infections in women. The evidence is not so good for the elderly or men, and shows no help for those who have ‘neuropathic bladder related problems.’ This latter term includes those who have bladder problems secondary to having had a stroke, a spinal injury or a permanent indwelling catheter.
Unfortunately the studies that have been published to date do not agree on a concentration or amount that should be drunk or eaten. Also most studies have a high drop out rate reflecting that a lot of people find it difficult to continue taking the cranberry juice/tablets.
Therefore overall there is no harm in taking it, and it will probably do you some good but this may not work for everyone.
How often is it normal to urinate?
There is no standard as to how often we go to pass urine. Anywhere between three and eight times a day is probably normal.
As we get older getting up to pass urine up to twice during the night for men is probably normal.
Patients normally notice if they are going excessively, a lot more than their friends or there is a change in the number of times they go to the toilet. This can be due to many reasons such as, being diabetic, being on water tablets, having an infection or something else that is irritating the bladder.
Therefore if patients experience increased frequency of urination it is important to have somebody review your medication, exclude infections and assess your bladder. Simple treatments such as cutting down on caffeine containing products may help. Beyond that tablet treatment can help or even Botox injections into the bladder.
Should I be concerned about bloody urine?
Unfortunately having blood in the urine needs investigating. Broadly it is divided into being able to see the blood and only being able to detect it on testing the urine.
There can be many reasons such as infections (either in the kidneys or in the bladder), having stones (in the kidneys or bladder), or unfortunately having bladder or kidney cancer. For all these reasons patients with blood in their urine should be seen and investigated by a urologist.
What can I do about my stress incontinence?
Stress incontinence refers to leaking urine whilst raising the pressure within the pelvis/lower abdomen. This can be caused by coughing, sneezing, exercising or lifting. The underlying cause is usually weakness of the pelvic floor, risk factors for this include previous pregnancies and subsequent child birth, having many children, smoking, being overweight, having bronchitis and previous pelvic surgery (such as a hysterectomy).
Good evidence demonstrates that women who embark upon properly taught pelvic floor exercises (carrying them out at least three times a day, at each time doing at least 8 repetitions) will notice an improvement. Where these fail then surgical options include colposuspensions, fascial slings, or the newer treatments of TVT, TVT/O, TOT or Bulkamid injections.
Are bladder infections and UTIs the same?
‘Bladder infections’ refers only to those infections that affect the bladder. Typically patients complain of pain or a burning on passing urine, increased frequency of passing urine, passing blood and sometimes feeling unwell.
UTI’s are urinary tract infections. These are infections that occur anywhere within the urinary tract. This includes the bladder as well as the kidneys and the prostate and epididymis in men.
How does bacteria get into the urinary tract?
Bacteria that gain access to the urinary tract often do so by climbing up the urethra (water passage). Women are therefore more prone to getting infections due to the fact that the female urethra is 3-4cm long and the male one is typically 15-20cm.
Bacteria however can be found in association with abnormalities of the urinary tract such as indwelling foreign bodies (like a catheter), stones or even cancer. This is why it is important to be reviewed if you are a woman having recurrent infections or a man who has any infections.
Are female urology problems different from men?
Whilst both men and women have kidneys and bladders, due to the differences in anatomy they more often have very different problems. Examples include the frequency of infections women get in comparison to men and the fact that stress incontinence is predominantly a female problem. On the other hand women do not suffer with all the problems men do with regards their prostates.
Does menopause cause increased UTIs?
The menopause can cause an increase in UTI’s. Other causes need to be excluded (see answers to UTI questions), and the application of oestrogen to the genital area can often bring about a dramatic improvement in symptoms for women who have been through the menopause.
I wake up in the night having to urinate - is that a problem?
Unfortunately as we all get older getting up in the night becomes more common. It is probably normal to get up at least once. Beyond that treatment may help. Often it is not the number of times but the change in the number of times we get up. It is important to note that people who are poor sleepers are awake and therefore go to the toilet hoping that will help them get back to sleep. Management should therefore be aimed at helping these people sleep better.