11 September 2017
Mr Stephen Brown, Consultant Urologist
Bladder problems in women are commonly ignored, being put down to the fact of being a woman, the inevitable consequence of child birth or just of growing old. And yet the majority of the conditions can be treated successfully if appropriately diagnosed and managed.
Frequent and painful urination are the typical symptoms of a lower urinary tract infection or ‘cystitis’ which is common from late teenage years onwards. If frequent and troublesome, your urologist will be asked to investigate to ensure there are no underlying problems and advise on appropriate treatment.
One of the commonest symptoms that women experience in later years and particularly after childbirth is leakage of urine on coughing, sneezing or exercise, known as stress incontinence. This results from a weakness of the pelvic floor. After a careful assessment to exclude other conditions, first line treatment is usually in the form of lifestyle advice and pelvic floor exercise supervised by a physiotherapist. If not sufficiently helpful, your urologist will arrange for further investigation and may then suggest a number of surgical options as appropriate and give you detailed information regarding the benefits and side effects of each type of treatment.
In the absence of infection, frequency and urgency to pass urine are common symptoms and can be the first sign of an overactive bladder. This can be quite disabling and occasionally severe enough to be associated with urinary leakage, the condition known as urge incontinence. Treatment in its simplest form may be just avoiding caffeinated drinks and bladder training. Medication is available from the GP if required to help reduce the frequency of passing urine and reduce the intensity of the urgency experienced. If not proving effective your urologist will be able to investigate the problem further and advise on additional treatment. Where symptoms are failing to respond to medication, other treatments are available including the injection of Botox into the bladder and nerve stimulation techniques.
Occasionally chronic symptoms of frequency and urgency are associated with pain as the bladder fills. If these symptoms persist and do not respond to the usual treatment for cystitis, patients are investigated to check for chronic inflammation of the bladder, a condition known as Painful Bladder Syndrome / Interstitial Cystitis. The cause is not fully understood, but can be helped with a variety of oral medications and instillations into the bladder.
No women should suffer in silence.
The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.