Last Updated on January 26, 2024
Urinary problems are distressing and can be the cause of embarrassment too, both to men and women.
Various underlying conditions can give rise to different kinds of urinary symptoms which may have similar, overlapping or different symptoms.
For example, an infection can lead to frequent painful urination, an enlargement of the prostate can lead to frequent urination, urgency, hesitancy, and leakage.
Incontinence may be a problem in elderly females.
Various Symptoms of Urinary Problems
Frequent symptoms of a urinary problem include
- Frequency of urination
- Nocturia – Increase in nighttime frequency of urine
- Hesitancy – Difficulty in starting urination
- Anuria or absence of urine
- Polyuria – Increase in quantity of urine
- Burning urination
- Frequency – Frequent urge to urinate without the ability to pass a desired amount of urine
- Urgency – Need to urinate becomes urgent
- Retention of Urine – Feeling of incompletely emptying of your bladder.
- Hematuria – Blood in the urine
- Incontinence – Leakage of urine
Various conditions which give rise to these Symptoms
Increased Frequency of Micturition and Nocturia
- Interstitial cystitis
- Diuretics
- Radiation therapy
- Bladder dysfunction
- Bladder cancer
- Small contracted bladder
- Bladder or urethral tumors
- Vesicular calculus
- Cystocele
- Prostate enlargement
- Stricture of urethra
- Incompetent internal urethral sphincter
- Ectopic ureter
- Urethritis
- Balanitis
- Pinhole meatus
- Phimosis
- Psychogenic
- Pregnancy
- Surrounding mass lesion.
Urgency of Urine
- Cerebrovascular accidents
- cerebral tumors
- head injuries
- Enlarged prostate
- Bladder neck obstruction
- Alcohol, caffeine and artificial sweeteners
- Bladder conditions and stones
- Bladder irritation
- Interstitial cystitis
- Urge incontinence
- Urinary tract infection
- Blocked urine flow
- Urinary Retention
- Hematuria
- Urinary Incontinence
Anuria or Absence of Urine
- Glomerulonephritis
- Pyelonephritis
- Polycystic kidney
- Chronic renal failure
- Nephrotoxic drugs
- Autoimmune diseases like systemic lupus erythematosus.
- Diarrhea and vomiting
- Burns
- Blood loss
- Hypotension
- Septicemia
- Intravascular hemolysis
- Calculi in the kidney or urinary tract
- Blockage of ureters by malignancy or crystals
- Retroperitoneal fibrosis
- Accidental ligation of ureter during surgery
Retention of Urine
This problem may be acute or chronic
Blockages in the urinary system due to urinary tract stones or birth defects
- Narrowing of the urethra due to scarring from injury or infection
- Benign enlargement of the prostate gland
- Nerve or bladder muscle problems
- Prostate cancer or kidney stones
- Side effects from some medications, such as antihistamines
- Spinal cord diseases – Transverse and compression myelitis
- Cauda equina lesions
- Multiple sclerosis.
- Phimosis
- Posterior urethral valves
- Foreign body in the urethra
- Stones
- Stricture of urethra
- Rupture of urethra
- Spasm of the bladder sphincter
- Prostatic enlargement
- Bladder atony, tumor, stone, or compression by fibroids or retroverted uterus.
- Drugs: Sympathomimetic agents, salbutamol, terbutaline, anticholinergic drugs, etc.
- Functional
Hematuria
- Viral infections
- Cancers of the renal system
- Trauma
- Renal stones
- Urinary tract obstruction
- Medications that thin the
- Benign prostate enlargement.
Urinary Incontinence
- Drying of vagina or female urethra, particularly after menopause
- Inflamed prostate gland or prostate surgery in men
- Automatic bladder
- Spine injuries
- Prolonged immobilization
- Urinary tract infection
- Elevated calcium levels
Diagnosis of Urinary Problems
Diagnosis making in urinary problems requires a detailed history and physical examination.
History
- What is the presenting complaint
- Details of presenting complaint and timeline of its occurrence.
- Any exaggerating factors
- Daily void schedule including night time wake up frequency?
- Any of the following urinary symptoms
- Painful urination
- Urgency
- Incontinence
- Hematuria, discharge
- Lower abdominal pain with urination
- Any muscle weakness, numbness, or tingling
- Alcohol, tobacco or drug usage
- Exposure to the toxic substance for the last 25 or more years
- History of kidney stones
- Any injuries and infections
- Recent illness
- Urinary or voiding history
Examination
- Examination of external urinary organs – inspection, palpation
- Per rectal examination to assess the prostate gland in males
- Examination of abdomen and spine
Investigations
- Urine examination to look for pus cells, glucose, blood, and protein
- Culture and sensitivity test
- Xrays
- Ultrasound
- Special urological studies like pressure studies
- Blood investigations may be done for infection [CBC, ESR, CRP], renal function test and other parameters
Immediate Treatment Measures
This is required in case of acute urinary retention. A thin, flexible tube, known as a catheter, is placed through your urethra to your bladder to release the urine.
In some cases, such as urethral strictures or big prostate, it may not be possible to pass the catheter successfully. In such cases, a procedure called suprapubic catheterization is done. In this, a special catheter is placed per abdomen into the bladder under local anesthesia.
Treatment of Urinary Problems
The treatment of urinary problem depends on the diagnosis. For example in the case of urinary infection, antibiotics and hydration is the usual treatment. If there is benign enlargement of the prostate which is causing the symptom, the patient might benefit from drug therapy and in some cases prostate surgery.
The treatment would vary from disease to disease and person to person as the patient profile needs to be taken into account for the treatment
Some treatments are carried on an outpatient basis whereas others would require admission in the hospital.
Apart from medical and surgical treatment bladder and bowel training, special diet, Kegel exercises, medications, and treatment of muscle spasms may be required.