Introduction
The female bladder stores and passes urine at the appropriate time and place. When there are problems with bladder function, the patient will need to visit the toilet often, unable to pass urine or even leak urine.
Urinary Frequency and Urgency
- Urinary frequency is the need to pass urine for more than seven times during the day or less than every 2 hourly.
- Urgency is a strong and sudden desire to void which, if not relieved immediately, may lead to urge incontinence.
- Urge Incontinence is an involuntary leakage of urine, usually preceded by urgency.
What are the common causes of frequency and urgency?
| Psychosocial |
Excessive drinking
Habit
Anxiety |
| Urological |
Urinary tract infection
Detrusor (bladder muscle) overactivity
Bladder tumour
Bladder stones |
| Gynaecological |
Pregnancy
Bladder prolapse
Pelvic mass, e.g. fibroids |
| Medical |
Diuretic therapy
Disease of the brain / spinal cord
Diabetes |
What to do if you have urinary frequency and urgency?
You should visit you family doctor. The doctor will then ask you a few questions on your medical history and urinary habits. After a physical examination, he/she may perform a few simple tests such as collecting your urine specimen for analysis to exclude urinary tract infection. Depending on the cause of your condition, the doctor may start you on medication or refer you to a specialist for further management.
Urinary Incontinence
Urinary incontinence refers to an involuntary loss of urine. Types of incontinence includes:
• Stress urinary incontinence — involuntary loss of urine associated with coughing, sneezing, carrying heavy things and even running or jumping.
• Urge incontinence — involuntary loss of urine preceded by a sudden strong desire to pass urine and voiding before the ability to reach the toilet.
• Overflow incontinence — involuntary loss of urine due to an inability to empty the bladder well.
What should you do if you have urinary incontinence?
Mild urinary incontinence may not be troublesome but moderate to severe urinary incontinence can affect the quality of life of the woman drastically. It can also cause social and hygiene problems.
These women should seek help from their doctor. Management depends on the type of incontinence and the severity of the condition.
Management of Urinary Incontinence
Regular pelvic floor exercises can be performed to improve the incontinence for mild cases. In severe cases of stress urinary incontinence, surgical correction by your gynecologist should be considered (Table 52.1).
Urinary Tract Infection (UTI)
 UTI is due to the presence of bacteria in the urine. UTI can be divided into either upper tract infection (kidney) or lower tract infection (bladder). Pyelonephritis is the acute bacterial infection of the kidneys. Patients have severe back pain and high fever. There may be presence of frequency and urgency of urine as well. Cystitis is the infection of the urinary bladder and patients complain of frequency, urgency and dysuria (pain on passing urine).
What should you do if you have a urinary tract infection (UTI)
General measures for simple cystitis include taking more fluids of more than two liters a day to encourage more urine formation to flush out the bacteria.
You would need to consult a doctor if the symptoms persist or if you have a fever. Oral antibiotics prescribed by the doctor would eradicate 90% of infection in a normal person. The doctor may order some investigations relevant to your condition if necessary. Patients having severe UTI associated with fever and kidney infection may require intravenous antibiotics and hospitalization.
" The New Art and Science of Pregnancy and Childbirth". A Pregnancy Book written by Dr. Tan Thiam Chye, Dr. Tan Kim Teng, Dr. Tan Heng Hao, Assoc Prof John Tee Chee Seng. KK Women's and Children's Hospital.
* Available at all major book stores and Pharmacy in KK Women's and Children's Hospital. |