Urinary Incontinence
What is urinary incontinence (UI)?
UI is also known as ‘loss of bladder control’ or ‘urinary leakage.’ UI is when urine leaks out before you can get to a bathroom. If you have UI, you are not alone. Millions of women have this problem, especially as they get older.Some women may lose a few drops of urine when they cough or laugh. Others may feel a sudden urge to urinate and cannot control it. Urine loss can also occur during sexual activity and can cause great emotional distress.What causes UI?
UI is usually caused by problems with muscles and nerves that help to hold or pass urine.Urine is stored in the bladder. It leaves the body through a tube that is connected to the bladder called the urethra. Look at the images below to see how this process works.
Muscles in the wall of the bladder contract to force urine out through the urethra. At the same time, sphincter (ss-FINK-ter) muscles around the urethra relax to let the urine pass out of the body.Incontinence happens if the bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine.UI is twice as common in women as in men. Pregnancy, childbirth, and menopause are major reasons why. But both women and men can become incontinent from brain injury, birth defects, stroke, diabetes, multiple sclerosis, and physical changes associated with aging.- Pregnancy — Unborn babies push down on the bladder, urethra (tube that you urinate from), and pelvic floor muscles. This pressure may weaken the pelvic floor support and lead to leaks or problems passing urine.
Fetus Pressing on Bladder
- Childbirth — Many women leak urine after giving birth. Labor and vaginal birth can weaken pelvic floor support and damage nerves that control the bladder. Most problems with bladder control during pregnancy and childbirth go away after the muscles have time to heal. Talk to your doctor if you still have bladder problems 6 weeks after childbirth.
- Menopause — Some women have bladder control problems after they stop having periods. After menopause, the body stops making the female hormone estrogen. Some experts think this loss of estrogen weakens the urethral tissue.
Other causes of UI that can affect women and men are:- Constipation — Problems with bladder control can happen to people with long-term (chronic) constipation.
- Medicines — UI may be a side effect of medicines such as diuretics (“water pills” used to treat heart failure, liver cirrhosis, hypertension, and certain kidney diseases). Hormone replacement has been shown to cause worsening UI.
- Caffeine and alcohol — Drinks with caffeine, such as coffee or soda, cause the bladder to fill quickly and sometimes leak.
- Infection — Infections of the urinary tract and bladder may cause incontinence for a short time. Bladder control returns when the illness goes away.
- Nerve damage — Damaged nerves may send signals to the bladder at the wrong time, or not at all. Trauma or diseases such as diabetes and multiple sclerosis can cause nerve damage. Nerves may also become damaged during childbirth.
- Excess weight — Being overweight is also known to put pressure on the bladder and make incontinence worse.
What are the types of UI?
- Stress incontinence — Leakage happens with coughing, sneezing, exercising, laughing, lifting heavy things, and other movements that put pressure on the bladder. This is the most common type of incontinence in women. It is often caused by physical changes from pregnancy, childbirth, and menopause. It can be treated and sometimes cured.
- Urge incontinence —This is sometimes called "overactive bladder." Leakage usually happens after a strong, sudden urge to urinate. This may occur when you don't expect it, such as during sleep, after drinking water, or when you hear or touch running water.
- Functional incontinence — People with this type of incontinence may have problems thinking, moving, or speaking that keep them from reaching a toilet. For example, a person with Alzheimer's disease may not plan a trip to the bathroom in time to urinate. A person in a wheelchair may be unable to get to a toilet in time.
- Overflow incontinence — Urine leakage happens because the bladder doesn't empty completely. Overflow incontinence is less common in women.
- Mixed incontinence —This is 2 or more types of incontinence together (usually stress and urge incontinence).
- Transient incontinence — Urine leakage happens for a short time due to an illness (such as a bladder infection or pregnancy). The leaking stops when the illness is treated.
How do I talk to my doctor about UI?
Many women do not want to talk to their doctor about such a personal topic. But UI is a common medical problem. Millions of women have the same problem. Many have been treated successfully. Your doctor has probably heard many stories like yours.Even if you feel shy, it is up to you to take the first step. Some doctors don't treat bladder control problems, so they may not think to ask about it. They might expect you to bring up the subject.Family practitioners and internists can treat bladder problems. If your doctor does not treat such problems, ask for help finding a doctor who does, such as a urologist, OB/GYN, or urogynecologist.Here are some questions to ask your doctor:- Could what I eat or drink cause bladder problems?
- Could my medicines (prescription and over-the-counter) cause bladder problems?
- Could other medical conditions cause loss of bladder control?
- What are the treatments to regain bladder control? Which one is best for me?
- What can I do about the odor and rash caused by urine?
It also helps to keep a bladder diary. This means you write down when you leak urine. Be sure to note what you were doing at the time, such as sneezing, coughing, laughing, stepping off a curb, or sleeping. Take this log with you when you visit your doctor.How do I find out if I have UI?
Schedule a visit with your doctor. Your doctor will ask you about your symptoms and take a medical history, including:- How often you empty your bladder
- How and when you leak urine
- How much urine you leak
Your doctor will do a physical exam to look for signs of health problems that can cause incontinence. Your doctor also will do a test to figure out how well your bladder works and how much it can hold. For this test, you will drink water and urinate into a measuring pan. The doctor will then measure any urine still in the bladder. Your doctor also may order other tests such as:- Bladder stress test — During this test, you will cough or bear down as the doctor watches for loss of urine.
- Urinalysis — A urinalysis tests your urine for signs of infection or other causes of incontinence.
- Ultrasound — Sound waves are used to take a picture of the kidneys, bladder, and urethra.
- Cystoscopy — A doctor places a thin tube connected to a tiny camera in the urethra to look at the inside of the urethra and bladder.
- Urodynamics — A doctor places a thin tube into your bladder and your bladder is filled with water. The doctor then measures the pressure in the bladder.
Your doctor may ask you to write down when you empty your bladder and how much urine you produce for a day or a week.How is UI treated?
There are many ways to treat UI. Your doctor will work with you to find the best treatment for you.Types of treatments include:- Behavioral treatments
- Medicines for bladder control
- Devices
- Nerve stimulation
- Biofeedback
- Surgery
- Catheterization
Behavioral treatmentsBy changing some basic behaviors, you may be able to improve your UI. Behavioral treatments include:Exercising your pelvic floor muscles regularly can help reduce or cure stress leakage. A doctor or nurse can teach you the right way to do the exercises if needed. A pelvic floor physical therapist may be available in your area to help teach you how to strengthen these muscles or help you with other treatments. To do Kegel exercises:
- First, try practicing these exercises while lying down.
- Squeeze the muscles in your genital area as if you were trying to stop the flow of urine or trying to stop from passing gas. Try not to squeeze the muscles in your belly or legs at the same time. Try to squeeze only the pelvic muscles. Be extra careful not to tighten your stomach, legs, or buttocks.
- Relax. Squeeze the muscles again and hold for 3 seconds. Then relax for 3 seconds. Work up to 3 sets of 10 repeats.
- When your muscles get stronger, try doing your exercises while sitting or standing. You can do these exercises any time, while sitting at your desk, in the car, waiting in line, doing the dishes, etc.
See your doctor, nurse, or physical therapist to learn how to do these exercises correctly. Kegel exercises are most effective when the patient has received proper instruction from a health care professional. Simply trying to stop your urine flow or trying to do the exercises hundreds of times a day without instruction from a health professional will not help.Bladder retrainingYou may regain bladder control by going to the bathroom at set times, before you get the urge to urinate. You can slowly increase the time between set bathroom trips as you gain control.Weight lossExtra weight puts more pressure on your bladder and nearby muscles. This can cause bladder control problems. Work with your doctor to plan a diet and exercise program if you are overweight.Dietary changesSome foods and beverages are thought to contribute to bladder leakage. While doctors do not know if these foods really do cause UI, it is reasonable to see if stopping one or all of these items is helpful:- Alcoholic beverages
- Carbonated beverages (with or without caffeine)
- Coffee or tea (with or without caffeine)
Other changes include drinking fewer fluids after dinner and eating enough fiber to avoid constipation. Also, avoid drinking too much. Six 8-ounce glasses of fluid a day is enough for most people.Quitting smokingResearchers are still looking at the link between incontinence and cigarette smoking. Studies show that smokers have more frequent and severe urine leaks.Medicines for bladder controlMedications can reduce some types of leakage. Some medicines, for example, help relax the bladder muscles and prevent bladder spasms. Talk to your doctor to see if medication is right for you.It is always important to take your medicine exactly as your doctor tells you to. Also, all drugs have side effects and may affect people differently. Always tell your doctor about any over-the-counter medicines you are taking.DevicesA pessary (PESS-uh-ree) is the most common device used to treat stress incontinence. It is a stiff ring that a doctor or nurse inserts into the vagina. The device pushes up against the wall of the vagina and the urethra. This helps reposition the urethra to reduce stress leakage. See your doctor regularly if you use a pessary.Nerve stimulationSome people with urge incontinence may not respond to behavioral treatments or medicine. In this case, electrical stimulation of the nerves that control the bladder may help.You will be tested to see if this treatment, called neuromodulation (ner-roh-mod-yoo-LAY-shun), can work for you. The doctor will first place a device outside your body to deliver a pulse. If it works well, a surgeon will implant the device.BiofeedbackBiofeedback helps you learn how your body works. A therapist puts an electrical patch over your bladder and urethral muscles. A wire connected to the patch is linked to a TV screen. You and your therapist watch the screen to see when these muscles contract, so you can learn to control these muscles.Biofeedback can be used with pelvic muscle exercises and electrical stimulation to help control stress incontinence and urge incontinence.SurgerySurgery is most effective for people with stress UI who have not been helped by other treatments. Talk to your doctor about whether surgery would help you, and what type of surgery is best for you.CatheterizationThe doctor may suggest a catheter if you are incontinent because your bladder never empties completely (overflow incontinence). This is also an option if your bladder cannot empty because of poor muscle tone, past surgery, or a spinal cord injury. A catheter is a thin tube that is placed in the bladder by a doctor or by you. It drains the bladder into a bag that you can attach to your leg.
What is urinary incontinence (UI)?
UI is also known as ‘loss of bladder control’ or ‘urinary leakage.’ UI is when urine leaks out before you can get to a bathroom. If you have UI, you are not alone. Millions of women have this problem, especially as they get older.
Some women may lose a few drops of urine when they cough or laugh. Others may feel a sudden urge to urinate and cannot control it. Urine loss can also occur during sexual activity and can cause great emotional distress.
What causes UI?
UI is usually caused by problems with muscles and nerves that help to hold or pass urine.
Urine is stored in the bladder. It leaves the body through a tube that is connected to the bladder called the urethra. Look at the images below to see how this process works.
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Muscles in the wall of the bladder contract to force urine out through the urethra. At the same time, sphincter (ss-FINK-ter) muscles around the urethra relax to let the urine pass out of the body.
Incontinence happens if the bladder muscles suddenly contract or the sphincter muscles are not strong enough to hold back urine.
UI is twice as common in women as in men. Pregnancy, childbirth, and menopause are major reasons why. But both women and men can become incontinent from brain injury, birth defects, stroke, diabetes, multiple sclerosis, and physical changes associated with aging.
- Pregnancy — Unborn babies push down on the bladder, urethra (tube that you urinate from), and pelvic floor muscles. This pressure may weaken the pelvic floor support and lead to leaks or problems passing urine.
Fetus Pressing on Bladder
- Childbirth — Many women leak urine after giving birth. Labor and vaginal birth can weaken pelvic floor support and damage nerves that control the bladder. Most problems with bladder control during pregnancy and childbirth go away after the muscles have time to heal. Talk to your doctor if you still have bladder problems 6 weeks after childbirth.
- Menopause — Some women have bladder control problems after they stop having periods. After menopause, the body stops making the female hormone estrogen. Some experts think this loss of estrogen weakens the urethral tissue.
Other causes of UI that can affect women and men are:
- Constipation — Problems with bladder control can happen to people with long-term (chronic) constipation.
- Medicines — UI may be a side effect of medicines such as diuretics (“water pills” used to treat heart failure, liver cirrhosis, hypertension, and certain kidney diseases). Hormone replacement has been shown to cause worsening UI.
- Caffeine and alcohol — Drinks with caffeine, such as coffee or soda, cause the bladder to fill quickly and sometimes leak.
- Infection — Infections of the urinary tract and bladder may cause incontinence for a short time. Bladder control returns when the illness goes away.
- Nerve damage — Damaged nerves may send signals to the bladder at the wrong time, or not at all. Trauma or diseases such as diabetes and multiple sclerosis can cause nerve damage. Nerves may also become damaged during childbirth.
- Excess weight — Being overweight is also known to put pressure on the bladder and make incontinence worse.
What are the types of UI?
- Stress incontinence — Leakage happens with coughing, sneezing, exercising, laughing, lifting heavy things, and other movements that put pressure on the bladder. This is the most common type of incontinence in women. It is often caused by physical changes from pregnancy, childbirth, and menopause. It can be treated and sometimes cured.
- Urge incontinence —This is sometimes called "overactive bladder." Leakage usually happens after a strong, sudden urge to urinate. This may occur when you don't expect it, such as during sleep, after drinking water, or when you hear or touch running water.
- Functional incontinence — People with this type of incontinence may have problems thinking, moving, or speaking that keep them from reaching a toilet. For example, a person with Alzheimer's disease may not plan a trip to the bathroom in time to urinate. A person in a wheelchair may be unable to get to a toilet in time.
- Overflow incontinence — Urine leakage happens because the bladder doesn't empty completely. Overflow incontinence is less common in women.
- Mixed incontinence —This is 2 or more types of incontinence together (usually stress and urge incontinence).
- Transient incontinence — Urine leakage happens for a short time due to an illness (such as a bladder infection or pregnancy). The leaking stops when the illness is treated.
How do I talk to my doctor about UI?
Many women do not want to talk to their doctor about such a personal topic. But UI is a common medical problem. Millions of women have the same problem. Many have been treated successfully. Your doctor has probably heard many stories like yours.
Even if you feel shy, it is up to you to take the first step. Some doctors don't treat bladder control problems, so they may not think to ask about it. They might expect you to bring up the subject.
Family practitioners and internists can treat bladder problems. If your doctor does not treat such problems, ask for help finding a doctor who does, such as a urologist, OB/GYN, or urogynecologist.
Here are some questions to ask your doctor:
- Could what I eat or drink cause bladder problems?
- Could my medicines (prescription and over-the-counter) cause bladder problems?
- Could other medical conditions cause loss of bladder control?
- What are the treatments to regain bladder control? Which one is best for me?
- What can I do about the odor and rash caused by urine?
How do I find out if I have UI?
Schedule a visit with your doctor. Your doctor will ask you about your symptoms and take a medical history, including:
- How often you empty your bladder
- How and when you leak urine
- How much urine you leak
Your doctor will do a physical exam to look for signs of health problems that can cause incontinence. Your doctor also will do a test to figure out how well your bladder works and how much it can hold. For this test, you will drink water and urinate into a measuring pan. The doctor will then measure any urine still in the bladder. Your doctor also may order other tests such as:
- Bladder stress test — During this test, you will cough or bear down as the doctor watches for loss of urine.
- Urinalysis — A urinalysis tests your urine for signs of infection or other causes of incontinence.
- Ultrasound — Sound waves are used to take a picture of the kidneys, bladder, and urethra.
- Cystoscopy — A doctor places a thin tube connected to a tiny camera in the urethra to look at the inside of the urethra and bladder.
- Urodynamics — A doctor places a thin tube into your bladder and your bladder is filled with water. The doctor then measures the pressure in the bladder.
Your doctor may ask you to write down when you empty your bladder and how much urine you produce for a day or a week.
How is UI treated?
There are many ways to treat UI. Your doctor will work with you to find the best treatment for you.
Types of treatments include:
- Behavioral treatments
- Medicines for bladder control
- Devices
- Nerve stimulation
- Biofeedback
- Surgery
- Catheterization
Behavioral treatments
By changing some basic behaviors, you may be able to improve your UI. Behavioral treatments include:
Exercising your pelvic floor muscles regularly can help reduce or cure stress leakage. A doctor or nurse can teach you the right way to do the exercises if needed. A pelvic floor physical therapist may be available in your area to help teach you how to strengthen these muscles or help you with other treatments. To do Kegel exercises:
- First, try practicing these exercises while lying down.
- Squeeze the muscles in your genital area as if you were trying to stop the flow of urine or trying to stop from passing gas. Try not to squeeze the muscles in your belly or legs at the same time. Try to squeeze only the pelvic muscles. Be extra careful not to tighten your stomach, legs, or buttocks.
- Relax. Squeeze the muscles again and hold for 3 seconds. Then relax for 3 seconds. Work up to 3 sets of 10 repeats.
- When your muscles get stronger, try doing your exercises while sitting or standing. You can do these exercises any time, while sitting at your desk, in the car, waiting in line, doing the dishes, etc.
See your doctor, nurse, or physical therapist to learn how to do these exercises correctly. Kegel exercises are most effective when the patient has received proper instruction from a health care professional. Simply trying to stop your urine flow or trying to do the exercises hundreds of times a day without instruction from a health professional will not help.
Bladder retraining
You may regain bladder control by going to the bathroom at set times, before you get the urge to urinate. You can slowly increase the time between set bathroom trips as you gain control.
Weight loss
Extra weight puts more pressure on your bladder and nearby muscles. This can cause bladder control problems. Work with your doctor to plan a diet and exercise program if you are overweight.
Dietary changes
Some foods and beverages are thought to contribute to bladder leakage. While doctors do not know if these foods really do cause UI, it is reasonable to see if stopping one or all of these items is helpful:
- Alcoholic beverages
- Carbonated beverages (with or without caffeine)
- Coffee or tea (with or without caffeine)
Other changes include drinking fewer fluids after dinner and eating enough fiber to avoid constipation. Also, avoid drinking too much. Six 8-ounce glasses of fluid a day is enough for most people.
Quitting smoking
Researchers are still looking at the link between incontinence and cigarette smoking. Studies show that smokers have more frequent and severe urine leaks.
Medicines for bladder control
Medications can reduce some types of leakage. Some medicines, for example, help relax the bladder muscles and prevent bladder spasms. Talk to your doctor to see if medication is right for you.
It is always important to take your medicine exactly as your doctor tells you to. Also, all drugs have side effects and may affect people differently. Always tell your doctor about any over-the-counter medicines you are taking.
Devices
A pessary (PESS-uh-ree) is the most common device used to treat stress incontinence. It is a stiff ring that a doctor or nurse inserts into the vagina. The device pushes up against the wall of the vagina and the urethra. This helps reposition the urethra to reduce stress leakage. See your doctor regularly if you use a pessary.
Nerve stimulation
Some people with urge incontinence may not respond to behavioral treatments or medicine. In this case, electrical stimulation of the nerves that control the bladder may help.
You will be tested to see if this treatment, called neuromodulation (ner-roh-mod-yoo-LAY-shun), can work for you. The doctor will first place a device outside your body to deliver a pulse. If it works well, a surgeon will implant the device.
Biofeedback
Biofeedback helps you learn how your body works. A therapist puts an electrical patch over your bladder and urethral muscles. A wire connected to the patch is linked to a TV screen. You and your therapist watch the screen to see when these muscles contract, so you can learn to control these muscles.
Biofeedback can be used with pelvic muscle exercises and electrical stimulation to help control stress incontinence and urge incontinence.
Surgery
Surgery is most effective for people with stress UI who have not been helped by other treatments. Talk to your doctor about whether surgery would help you, and what type of surgery is best for you.
Catheterization
The doctor may suggest a catheter if you are incontinent because your bladder never empties completely (overflow incontinence). This is also an option if your bladder cannot empty because of poor muscle tone, past surgery, or a spinal cord injury. A catheter is a thin tube that is placed in the bladder by a doctor or by you. It drains the bladder into a bag that you can attach to your leg.
Urinary Tract Infection (UTI)
What is a Urinary (YOOR-uh-nair-ee) Tract Infection (UTI)?
A UTI is an infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract include:- Kidneys—collect waste from blood to make urine
- Ureters (YOOR-uh-turz)—carry the urine from the kidneys to the bladder
- Bladder—stores urine until it is full
- Urethra (yoo-REE-thruh)—a short tube that carries urine from the bladder out of your body when you pass urine
What causes Urinary Tract Infections (UTIs)?
Bacteria (bak-TIHR-ee-uh), a type of germ that gets into your urinary tract, cause a UTI. This can happen in many ways:- Wiping from back to front after a bowel movement (BM). Germs can get into your urethra, which has its opening in front of the vagina (vuh-JEYE-nuh).
- Having sexual intercourse. Germs in the vagina can be pushed into the urethra.
- Waiting too long to pass urine. When urine stays in the bladder for a long time, more germs are made, and the worse a UTI can become.
- Using a diaphragm (DEYE-uh-fram) for birth control, or spermicides (creams that kill sperm) with a diaphragm or on a condom. To read more about diaphragms, go tohttp://www.plannedparenthood.org/health-topics/birth-control/diaphragm-4244.htm.
- Anything that makes it hard to completely empty your bladder, like a kidney stone.
- Having diabetes, which makes it harder for your body to fight other health problems.
- Loss of estrogen (ESS-truh-juhn) (a hormone) and changes in the vagina after menopause. Menopause is when you stop getting your period.
- Having had a catheter (KATH-uh-tur) in place. A catheter is a thin tube put through the urethra into the bladder. It’s used to drain urine during a medical test and for people who cannot pass urine on their own.
What are the signs of a Urinary Tract Infection (UTI)?
If you have an infection, you may have some or all of these signs:- Pain or stinging when you pass urine.
- An urge to pass urine a lot, but not much comes out when you go.
- Pressure in your lower belly.
- Urine that smells bad or looks milky, cloudy, or reddish in color. If you see blood in your urine, tell a doctor right away.
- Feeling tired or shaky or having a fever.
How does a doctor find out if I have a Urinary Tract Infection (UTI)?
To find out if you have a UTI, your doctor will need to test a clean sample of your urine. The doctor or nurse will give you a clean plastic cup and a special wipe. Wash your hands before opening the cup. When you open the cup, don’t touch the inside of the lid or inside of the cup. Put the cup in easy reach. Separate the labia, the outer lips of the vagina, with one hand. With your other hand, clean the genital area with the wipe. Wipe from front to back. Do not touch or wipe the anus. While still holding the labia open, pass a little bit of urine into the toilet. Then, catch the rest in the cup. This is called a “clean-catch” sample. Let the rest of the urine fall into the toilet.If you are prone to UTIs, your doctor may want to take pictures of your urinary tract with an x-ray or ultrasound. These pictures can show swelling, stones, or blockage. Your doctor also may want to look inside your bladder using a cystoscope (SISS-tuh-skohp). It is a small tube that's put into the urethra to see inside of the urethra and bladder.How is a Urinary Tract Infection (UTI) treated?
UTIs are treated with antibiotics (an-tuh-beye-OT-iks), medicines that kill the bacteria that cause the infection. Your doctor will tell you how long you need to take the medicine. Make sure you take all of your medicine, even if you feel better! Many women feel better in one or two days.If you don't take medicine for a UTI, the UTI can hurt other parts of your body. Also, if you're pregnant and have signs of a UTI, see your doctor right away. A UTI could cause problems in your pregnancy, such as having your baby too early or getting high blood pressure. Also, UTIs in pregnant women are more likely to travel to the kidneys.Will a UTI hurt my kidneys?
If treated right away, a UTI is not likely to damage your kidneys or urinary tract. But UTIs that are not treated can cause serious problems in your kidneys and the rest of your body.How can I keep from getting Urinary Tract Infections (UTI)?
These are steps you can take to try to prevent a UTI. But you may follow these steps and still get a UTI. If you have symptoms of a UTI, call your doctor.- Urinate when you need to. Don't hold it. Pass urine before and after sex. After you pass urine or have a bowel movement (BM), wipe from front to back.
- Drink water every day and after sex. Try for 6 to 8 glasses a day.
- Clean the outer lips of your vagina and anus each day. The anus is the place where a bowel movement leaves your body, located between the buttocks.
- Don't use douches or feminine hygiene sprays.
- If you get a lot of UTIs and use spermicides, or creams that kill sperm, talk to your doctor about using other forms of birth control.
- Wear underpants with a cotton crotch. Don’t wear tight-fitting pants, which can trap in moisture.
- Take showers instead of tub baths.
I get UTIs a lot. Can my doctor do something to help?
About one in five women who get UTIs will get another one. Some women get three or more UTIs a year. If you are prone to UTIs, ask your doctor about your treatment options. Your doctor may ask you to take a small dose of medicine every day to prevent infection. Or, your doctor might give you a supply of antibiotics to take after sex or at the first sign of infection. “Dipsticks” can help test for UTIs at home. They are useful for some women with repeat UTIs. Ask your doctor if you should use dipsticks at home to test for UTI. Your doctor may also want to do special tests to see what is causing repeat infections. Ask about them.
What is a Urinary (YOOR-uh-nair-ee) Tract Infection (UTI)?
A UTI is an infection anywhere in the urinary tract. The urinary tract makes and stores urine and removes it from the body. Parts of the urinary tract include:
- Kidneys—collect waste from blood to make urine
- Ureters (YOOR-uh-turz)—carry the urine from the kidneys to the bladder
- Bladder—stores urine until it is full
- Urethra (yoo-REE-thruh)—a short tube that carries urine from the bladder out of your body when you pass urine
What causes Urinary Tract Infections (UTIs)?
Bacteria (bak-TIHR-ee-uh), a type of germ that gets into your urinary tract, cause a UTI. This can happen in many ways:
- Wiping from back to front after a bowel movement (BM). Germs can get into your urethra, which has its opening in front of the vagina (vuh-JEYE-nuh).
- Having sexual intercourse. Germs in the vagina can be pushed into the urethra.
- Waiting too long to pass urine. When urine stays in the bladder for a long time, more germs are made, and the worse a UTI can become.
- Using a diaphragm (DEYE-uh-fram) for birth control, or spermicides (creams that kill sperm) with a diaphragm or on a condom. To read more about diaphragms, go tohttp://www.plannedparenthood.org/health-topics/birth-control/diaphragm-4244.htm.
- Anything that makes it hard to completely empty your bladder, like a kidney stone.
- Having diabetes, which makes it harder for your body to fight other health problems.
- Loss of estrogen (ESS-truh-juhn) (a hormone) and changes in the vagina after menopause. Menopause is when you stop getting your period.
- Having had a catheter (KATH-uh-tur) in place. A catheter is a thin tube put through the urethra into the bladder. It’s used to drain urine during a medical test and for people who cannot pass urine on their own.
What are the signs of a Urinary Tract Infection (UTI)?
If you have an infection, you may have some or all of these signs:
- Pain or stinging when you pass urine.
- An urge to pass urine a lot, but not much comes out when you go.
- Pressure in your lower belly.
- Urine that smells bad or looks milky, cloudy, or reddish in color. If you see blood in your urine, tell a doctor right away.
- Feeling tired or shaky or having a fever.
How does a doctor find out if I have a Urinary Tract Infection (UTI)?
To find out if you have a UTI, your doctor will need to test a clean sample of your urine. The doctor or nurse will give you a clean plastic cup and a special wipe. Wash your hands before opening the cup. When you open the cup, don’t touch the inside of the lid or inside of the cup. Put the cup in easy reach. Separate the labia, the outer lips of the vagina, with one hand. With your other hand, clean the genital area with the wipe. Wipe from front to back. Do not touch or wipe the anus. While still holding the labia open, pass a little bit of urine into the toilet. Then, catch the rest in the cup. This is called a “clean-catch” sample. Let the rest of the urine fall into the toilet.
If you are prone to UTIs, your doctor may want to take pictures of your urinary tract with an x-ray or ultrasound. These pictures can show swelling, stones, or blockage. Your doctor also may want to look inside your bladder using a cystoscope (SISS-tuh-skohp). It is a small tube that's put into the urethra to see inside of the urethra and bladder.
How is a Urinary Tract Infection (UTI) treated?
UTIs are treated with antibiotics (an-tuh-beye-OT-iks), medicines that kill the bacteria that cause the infection. Your doctor will tell you how long you need to take the medicine. Make sure you take all of your medicine, even if you feel better! Many women feel better in one or two days.
If you don't take medicine for a UTI, the UTI can hurt other parts of your body. Also, if you're pregnant and have signs of a UTI, see your doctor right away. A UTI could cause problems in your pregnancy, such as having your baby too early or getting high blood pressure. Also, UTIs in pregnant women are more likely to travel to the kidneys.
Will a UTI hurt my kidneys?
If treated right away, a UTI is not likely to damage your kidneys or urinary tract. But UTIs that are not treated can cause serious problems in your kidneys and the rest of your body.
How can I keep from getting Urinary Tract Infections (UTI)?
These are steps you can take to try to prevent a UTI. But you may follow these steps and still get a UTI. If you have symptoms of a UTI, call your doctor.
- Urinate when you need to. Don't hold it. Pass urine before and after sex. After you pass urine or have a bowel movement (BM), wipe from front to back.
- Drink water every day and after sex. Try for 6 to 8 glasses a day.
- Clean the outer lips of your vagina and anus each day. The anus is the place where a bowel movement leaves your body, located between the buttocks.
- Don't use douches or feminine hygiene sprays.
- If you get a lot of UTIs and use spermicides, or creams that kill sperm, talk to your doctor about using other forms of birth control.
- Wear underpants with a cotton crotch. Don’t wear tight-fitting pants, which can trap in moisture.
- Take showers instead of tub baths.
I get UTIs a lot. Can my doctor do something to help?
About one in five women who get UTIs will get another one. Some women get three or more UTIs a year. If you are prone to UTIs, ask your doctor about your treatment options. Your doctor may ask you to take a small dose of medicine every day to prevent infection. Or, your doctor might give you a supply of antibiotics to take after sex or at the first sign of infection. “Dipsticks” can help test for UTIs at home. They are useful for some women with repeat UTIs. Ask your doctor if you should use dipsticks at home to test for UTI. Your doctor may also want to do special tests to see what is causing repeat infections. Ask about them.
Organ Donation and Transplantation
What is organ donation and transplantation?
Organ transplantation is the surgical removal of an organ or tissues from one person (the donor) and placing it in another person (the recipient). Organ donation is when you allow your organs or tissues to be removed and given to someone else. Most donated organs and tissues are from people who have died. But, a living person can donate some organs. Blood, stem cells, and platelets can also be donated.
What is the status of organ donation and transplantation in the United States?
The number of people needing a transplant continues to rise faster than the number of donors. About 4,100 transplant candidates are added to the national waiting list each month. Each day, about 77 people receive organ transplants. However, about 18 people die each day waiting for transplants that can't take place because of the shortage of donated organs.
There are now more than 105,000 people on the waiting list for solid organ transplants. Experts suggest that each of us could save or help as many as 50 people by being an organ and tissue donor.
Who can be an organ donor?
There are no age limits on who can be an organ donor. Newborns as well as senior citizens have been organ donors. If you are younger than 18, you must have a parent's or guardian's consent. If you are 18 years or older, you can show you want to be an organ and tissue donor by signing a donor card. You can download and print an organ donor card at ftp://ftp.hrsa.gov/organdonor/newdonorcard.pdf.
Carry the card in your wallet. In some states, you can state your intent to be an organ donor on your driver's license. To learn more about state organ and tissue donor registries, visithttp://organdonor.gov/donor/registry.shtm.
If you want to be an organ donor, make sure your family knows your wishes. Your family may be asked to sign a consent form in order for your donation to occur. You may also want to tell your family doctor, lawyer, and religious leader that you would like to be a donor.
Who cannot be an organ donor?
People with certain medical conditions cannot donate an organ. This includes people with:
- HIV
- Actively spreading brain cancer
- Certain severe, current infections
In some cases, if you have another disease or chronic medical condition, you can still donate your organs.
Will my religion allow me to donate my organs?
Talk with a leader in your church, synagogue, or religious organization before making a decision about whether to donate your organs. You may be interested to know that most religions support organ and tissue donation as a charitable act of love and giving.
What organs and tissues can I donate?
Organs of the body that can be transplanted include:
- Kidney
- Heart
- Liver
- Lung
- Pancreas
- Intestines
People who are living can donate a kidney or part of the:
- Lung
- Liver
- Intestine
- Pancreas
Tissues that can be donated include:
- Cornea (coating of the eyeball)
- Middle ear
- Skin
- Heart valves
- Bone
- Veins
- Cartilage
- Tendons
- Ligaments
Stem cells, blood, and blood platelets can also be donated.
Who pays for the cost of organ donation?
The transplant recipient's health insurance policy, Medicare, or Medicaid usually covers the cost of a transplant. The donor's family neither pays for, nor receives payment for, organ and tissue donation.
Some people who get transplants have a hard time affording the cost of the transplant or related expenses, such as travel and lodging. There are many local, regional, and national organizations that provide help through grants or services. To learn more about financial issues that transplant candidates and recipients face, as well as available resources, go to http://www.transplantliving.org.
If I am a donor, will that affect the quality of my medical care?
No. Many people think that if they agree to donate their organs, the doctor or the emergency room staff won't work as hard to save their life. This is not true.
The transplant team is completely separate from the medical staff working to save your life. The transplant team does not become involved with you until doctors have determined that all possible efforts to save your life have failed.
Does organ donation disfigure your body?
No. Donation does not change the appearance of the body. Organs are removed surgically in a routine operation. It does not interfere with having a funeral, including open casket services.
Can I be an organ or tissue donor and also donate my body to medical science?
No. You can donate your whole body to medical science. But, you can’t donate your whole body and be an organ or tissue donor. If you wish to donate your whole body, you should contact the facility of your choice to make arrangements. Medical schools, research facilities, and other agencies need to study bodies to gain greater understanding of diseases in humans. This research is vital to saving and improving lives.
Can non-resident aliens donate and receive organs?
Non-resident aliens can both donate and receive organs in the United States. Also, people from other countries can travel to the United States to receive transplants.
Why should minorities be concerned about organ donation?
The need for transplants is high among minorities, particularly African-Americans.
- Some diseases of the kidney, heart, lung, pancreas, and liver that can lead to organ failure are found more often in minority women.
- The rate of organ donation from minority women does not keep pace with the number needing transplants.
- The organ donor and recipient need to be genetically similar. In most cases, people are more similar to people of their own race than to people of other races.
- Minority women may have to wait longer for matched organs. This may mean they are sicker at the time of transplant or die waiting. With more donated organs from this group, finding a match will be quicker, the waiting time will be cut, and more lives will be saved.
Who manages the distribution of organs?
The United Network for Organ Sharing (UNOS) maintains the Organ Procurement and Transplantation Network (OPTN). Through the UNOS Computer System, organ donors are matched to waiting recipients 24 hours a day, 365 days a year.
What is the process for receiving an organ for transplantation?
- If you need an organ transplant, your doctor will help you get on the national waiting list.
- To get on the list, you need to visit a transplant hospital. Every transplant hospital in the United States is a member of OPTN. You can use the directory at www.unos.org/members/search.asp to find a transplant hospital.
- Transplant doctors will examine you and decide if you meet the criteria to be put on the list. You can get on the waiting list at more than one transplant hospital. Each hospital has its own criteria for listing patients. If you meet their criteria, they will add you to the list.
- Your name will become part of a pool of names. When a donor organ becomes available, all the patients in the pool are compared to the donor. Factors considered to decide who gets the organ include:
- Blood and tissue type
- Size of the organ
- Medical urgency of the patient's illness
- Time already spent on the waiting list
- Distance between donor and recipient
What can I expect after an organ transplant?
After you receive an organ transplant, you should get to know your pharmacist and take steps to stay healthy.
Most people who have a transplant need to take a lot of medications. You may need to take some medicines several times a day while others are only taken on certain days. The doctors who did your transplant may have to change your mediations or adjust the dosages every few days or weeks. It’s important to find a good pharmacist who can help you understand your medications and manage your medication schedule. He or she can help explain how the medicine works, what the side effects may be, and how to keep track of your medications.
Your doctors will continue to monitor your health for many years after surgery. You will have a lot of lab tests, and you should try to understand the purposes of the tests to make sure the results are accurate. You will also take medication that stops your body from rejecting the transplanted organ, called immunosuppressants (IHM-yuh-noh-suh-PRESS-uhnts). This may make you more likely to get infections, and it may be harder for you to recover from some infections and illnesses.
Healthy lifestyle options are good choices for organ recipients as they are for everyone. Your transplant center can help you develop a plan for healthy eating and appropriate physical activity.
Can I contact the family of the person whose organ I received?
Sometimes organ recipients want to thank the family of the donor. Sometimes donor families want to check on the health and well-being of the organ recipient. But, transplant centers are required by law to protect the confidentiality of donors and recipients. However, they can arrange for contact between families when both sides agree. Usually, the process begins with a letter from the recipient to the donor family sent in care of the transplant center. Guidelines vary by center. To learn more about the process, visithttp://www.transplantliving.org/community/publications/newfactsheets.aspx?fact=contact.
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