Women tend to have more problems with the urinary tract than men for several reasons. The uterus puts pressure on the bladder during pregnancy and may lead to later problems, and the shorter female urethra makes infection more likely, while the drop in hormones in menopause affects the integrity of muscles that keep the bladder in place. Problems of the female urinary tract can cause significant discomfort and distress.
Urinary Tract Infection
Urinary tract infections, or UTIs, are common bacterial infections. Women are much more prone to UTIs than men because the path from the bladder to the end of the urethra, the tube that carries urine from the bladder, is shorter in women than it is in men: 1.5 inches compared to 8 inches. The proximity of the anus and vagina also allows easy movement of bacteria to the bladder. Menopausal changes make UTIs most common in post menopausal women. In premenopausal women, 80 percent of UTIs occur within 24 hours of a sexual encounter.
The symptoms of UTI are pain, bladder spasms, frequent urination, blood in the urine, urgency, and lower abdominal discomfort. URIs are treated with antibiotics. Culturing the urine before starting antibiotics helps ensure that the correct antibiotic will be used; E coli, a common bacteria found in the bowel, is the most common cause of UTI.
Incontinence
There are several types of incontinence: stress incontinence, urge incontinence and overflow incontinence. Incontinence is not just a female problem, but it occurs in women twice as often as in men, according to the National Kidney and Urologic Diseases Information Clearinghouse. Stress incontinence is involuntary leaking of urine when coughing sneezing, laughing or just walking. Urge incontinence occurs when a woman feels the urge to urinate, but can't get to the bathroom in time. Overflow incontinence is the constant dripping of urine.
Diseases such as diabetes and stroke, bladder damage from childbirth or aging changes related to hormone loss all contribute to incontinence. Medications to relax the bladder, electrical stimulation therapy to help the nerves perform properly plus Kegel exercises to strengthen the pelvic floor and surgery are used to treat incontinence.
Cystocele
Cystocele is the medical term for prolapsed or fallen bladder, where the weakened wall between the bladder and vagina allows the bladder to sag into the vagina. Cystocele can lead to urinary incontinence. There are three grades of cystocele, with grade 1 being the least serious and grade 3 the most serious. In grade 3, the bladder bulges out of the vagina, according to the University of Maryland.
Childbirth, heavy lifting or straining and hormonal changes in menopause that weaken the muscles around the bladder and vagina all contribute to cystoceles. Cystocele may be treated surgically; temporary structures to hold the bladder in place called pessaries may also be helpful. Hormone replacement therapy may also help strengthen the muscles that hold the bladder in place.
