Urinary Conditions

Your urinary tract is the system that makes urine and carries it out of your body. It includes your bladder and kidneys and the tubes that connect them. A normal human being goes to pee around 8 times a day.
Most urinary tract infections are bladder infections. A bladder infection usually is not serious if it is treated right away. If you do not take care of a bladder infection, it can spread to your kidneys. A kidney infection is much more serious and can sometime cause permanent damage.
Usually, germs get into your system through your urethra, the tube that carries urine from your bladder to the outside of your body. The germs that usually cause these infections live in your large intestine and are found in your stool. The most common germ is E.coli. If these germs get inside your urethra, they can travel up into your bladder and kidneys and cause an infection.
Women tend to get more bladder infections than men. This is probably because women have shorter urethras that are closer to the rectum, so it is easier for the germs to move up to their bladders. Having sex can make it easier for germs to get into a woman’s urethra. The rate of infection is higher for sexually active women – between 16 and 35 years old – than for men.
For reasons that are not well understood, some women get bladder infections again and again. A woman who has had more than three UTIs is more likely to keep getting these infections.
5 to 9% of women with UTIs show no symptoms. Typical symptoms are:
✓ strong, constant urge to urinate
✓ small amounts of urine with a sensation the bladder is not empty
✓ burning sensation when urinating felt inside vagina or felt as pain deep inside
✓ cloudy urine
✓ urine that appears red, bright pink or brownish
✓ strong-smelling urine
✓ pelvic pain
Visit the ER Department of any hospital if you think you have an infection and:
✓ You have a fever, nausea and vomiting, or pain in one side of your back under your ribs.
✓ You have diabetes, kidney problems, or a weak immune system.
✓ You are older than 65.
✓ You are pregnant.

Gout is a kind of arthritis. It can cause an attack of sudden burning pain, stiffness, and swelling in a joint, usually a big toe. These attacks can happen over and over unless gout is treated. Over time, they can harm your joints, tendons, and other tissues. Gout is most common in men, affecting them usually in the fifth decade of their lives.
Gout is caused by too much uric acid in the blood. The uric acid is the final breakdown product of purine, which are natural substances found in your body’s cells. Most of the time, having too much uric acid isn’t harmful. Many people with high levels in their blood never get gout. But when uric acid levels in your blood are too high, the uric acid may form hard crystals in your joints.
Your chances of getting gout are higher if you are overweight, drink too much alcohol, or eat too much meat and fish that are high in chemicals called purines. Some medicines, such as water pills (diuretics), can also bring on gout.
The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and sharp pain in your big toe. You can also get gout attacks in your foot, ankle, or knees, or other joints. The attacks can last a few days or many weeks before the pain goes away. Another attack may not happen for months or years.
A number of dietary and lifestyle modification are helpful for treating hyperuricemia and for prevention of acute attack of gout.

Kidney stones are made of salts and minerals in the urine that stick together to form small “pebbles.” They can be as small as grains of salt or as large as golf balls. Although there are many types of stones, the most common are calcium oxalate stones and these are the most amendable to nutritional interventions.
The stones may stay lodged in your kidneys or travel out of your body through the urinary tract. The urinary tract is the system that makes urine and carries it out of your body. It is made up of the kidneys, the tubes that connect the kidneys to the bladder (the ureters), the bladder, and the tube that leads from the bladder out of the body (the urethra).
When a stone travels through a ureter it usually causes (severe) pain and other symptoms.
Kidney stones form when a change occurs in the normal balance of water, salts, minerals, and other things found in urine. The most common cause of kidney stones is not drinking enough water. Try to drink enough water, enough so that your urine is light yellow or clear like water. Some people are more likely to get kidney stones because of a medical condition, such as gout, also discussed in this chapter.
Kidney stones may also be an inherited disease, meaning they can run in families. If other people in your family have had kidney stones, you may have them too.
Kidney stones often cause no pain while they are in the kidneys. But they can cause sudden, severe, sharp pain as they travel from the kidneys to the bladder.
The most common treatment with the medical establishment is extracorporeal shock wave lithotripsy  (ESWL). ESWL uses shock waves to break a kidney stone into small pieces, so that the bits can pass out of your body in your urine. Other times, a doctor will need to remove the stone by surgery or place a small flexible plastic tube (called a stent) in the ureter to keep it open while stones pass.

Chronic kidney disease is also called chronic renal failure or chronic renal insufficiency.
The prevalence of chronic kidney disease during the period 2007–2009 was 12.5%, representing about 3 million Canadian adults.
The task of your kidneys is to filter your blood. They remove waste products and extra fluid and flush them from your body as urine. When your kidneys don’t work right, wastes build up in your blood and make you sick, from skin problems, muscle dysfunctions, tiredness to cognitive impairment.
One way to measure how well your kidneys are working is to figure out your glomerular filtration rate (GFR). The GFR is usually calculated using results from your blood creatinine test. Then the stage of kidney disease is figured out using the GFR. There are five stages of kidney disease, each stage representing a worsening of kidneys function, from kidney damage with normal GFR to kidney failure.
Each of your kidneys has about a million tiny filters, called nephrons, the physiological and functional unit of kidneys. If nephrons are damaged, they stop working. For a while, healthy nephrons can take on the extra work, called compensatory action. But if the damage continues, more and more nephrons shut down. After a certain point, after the Glomerular Filtration Rate (GFR) drops by more than 50%, the nephrons that are left cannot filter your blood well enough to keep you healthy, so plasma levels of urea and creatinine will be marked increase.
The most common causes of the damage to the kidneys are:
✓ Uncontrolled high blood pressure (Hypertension) over many years.
✓ High blood sugar over many years. This happens in uncontrolled type 1 or type 2 diabetes.
Other things that can lead to chronic kidney disease include:
✓ Kidney diseases and infections, such as polycystic kidney disease, pyelonephritis, and glomerulonephritis, or a kidney problem you were born with.
✓ A narrowed or blocked renal artery. A renal artery carries blood to the kidneys.
✓ Long-term use of medicines that can damage the kidneys. Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), such as celecoxib (Celebrex) and ibuprofen (Advil).

Urinary incontinence is the accidental release of urine. It can happen when you cough, laugh, sneeze, or jog. Or you may have a sudden need to go to the bathroom but can’t get there in time. Bladder control problems are very common, especially among older adults. They usually don’t cause major health problems, but they can be embarrassing and cause emotional distress. It can happened to both men and women, but the prevalence is higher in women.
Incontinence can also be a short-term problem caused by a urinary tract infection, a medicine, or constipation. It gets better when you treat the problem that is causing it. But this topic focuses on ongoing urinary incontinence.
There are two main kinds of urinary incontinence. Some women – especially older women – have them both.
✓ Stress incontinence occurs when you sneeze, cough, laugh, jog, or do other things that put pressure on your bladder. It is the most common type of bladder control problem in women.
Stress incontinence can be caused by childbirth, weight gain, or other conditions that stretch the pelvic floor muscles.
✓ Urge incontinence happens when you have a strong need to urinate but can’t reach the toilet in time. This can happen even when your bladder is holding only a small amount of urine. Some women may have no warning before they accidentally leak urine. Other women may leak urine when they drink water or when they hear or touch running water. Overactive bladder is a kind of urge incontinence. But not everyone with overactive bladder leaks urine.
It may be caused by irritation of the bladder, emotional stress, or brain conditions such as Parkinson’s disease or stroke.
In men, incontinence is often related to prostate problems or medical treatments.

Interstitial cystitis is an inflammatory condition of the bladder that occurs primarily in women. It is also called painful bladder syndrome. It is tough to diagnose (there is no test) and it is primarily a diagnosis of exclusion (other possible causes of the presented symptoms need to be ruled out first).
Common symptoms of this condition are:
✓ Bladder pressure and pain that gets worse as your bladder fills up with urine.
✓ Pain in your lower abdomen, lower back, pelvis, or urethra (the tube that carries pee from your bladder out of your body).
✓ For women, pain in the vulva, vagina, or the area behind the vagina.
✓ For men, pain in the scrotum, testicles, penis, or the area behind the scrotum or pain after sex.
✓ The need to pee often (more than the normal 7-8 times daily).
✓ The feeling you need to pee right now, even right after you go.
✓ For women, pain during sex.
Certain things might make symptoms worse:
✓ Some foods or drinks
✓ Mental or physical stress
✓ Your period
It’s not clear what causes Interstitial cystitis, but here are some ideas that were suggested in scientific circles:
✓ A problem with bladder tissue lets things in your pee irritate your bladder.
✓ Inflammation causes your body to release chemicals that cause symptoms.
✓ Something in your urine damages your bladder.
✓ A nerve problem makes your bladder feel pain from things that usually don’t hurt.
✓ Your immune system attacks the bladder.
✓ Another condition that causes inflammation is also targeting the bladder.
Women start having this problems in their 40s. The risk of getting it goes up as you get older. In Canada it is estimated that around 100,000 people live with this nasty disease. Spontaneous remission occurs in about 50% of the patients.

Benign prostatic hyperplasia (BPH), also known as benign prostatic hypertrophy, is an enlarged prostate gland. The prostate gland, the size and shape of a walnut, surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate gets bigger, it may squeeze or partly block the urethra. This often causes problems with urinating.
What does prostate do? What is it good for?
The prostate gland has two functions. Because it surrounds the urethra, its muscle fibers squeeze the urethra slightly and helps control the flow of urine. These muscle also help expel semen during ejaculation. Its second function is the production of fluids that are added to the seminal fluid (semen) so that the semen is more viable. It is estimated that 80% of the fluid released during ejaculation comes from the prostate gland. So, we have to keep it, brothers.

BPH occurs in almost all men as they age. BPH is not cancer. An enlarged prostate can be a nuisance, but it is usually not a serious problem. About half of all men older than 60 have some symptoms. It is very common amongst men in Western countries.
Benign prostatic hyperplasia is probably a normal part of the aging process in men, caused by changes in hormone balance and in cell growth.
BPH causes urinary problems such as:
✓ Trouble getting a urine stream started and completely stopped (dribbling).
✓ Often feeling like you need to urinate. This feeling may even wake you up at night.
✓ A weak urine stream.
✓ A sense that your bladder is not completely empty after you urinate.
In a small number of cases, BPH may cause the bladder to be blocked, making it impossible or extremely hard to urinate. This problem may cause backed-up urine (urinary retention), leading to bladder infections or stones, or kidney damage.
BPH does not cause prostate cancer and does not affect a man’s ability to father children. It does not cause erection problems.

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Erectile dysfunction (ED)
There are a lot of reasons guys can get ED. It could be a problem with blood flow; for instance, you could have an artery problem between your heart and your penis.
Or it could be stress, depression, feeling anxious about how you perform if you have a new partner. Some conditions and medicines can cause it too, like diabetes, hypertension, sedentary lifestyle, neurological and hormonal disorders.
Your health care provider can help you figure out what’s going on and how to solve it.
Is it about my age?
The older a man gets, the more common it is. About 5% of 40-year-old men have ED. For 65-year-olds, it’s between 15% and 25%.
So is ED a normal part of aging?
No. While it is true that older men may need more stimulation (such as stroking and touching), they should still be able to get an erection and enjoy sex.
If it happens only occasionally, it’s not likely to be serious. All men have problems with erections at some time in their lives.
If it slowly but consistently gets worse over time, there’s probably a physical cause. This is generally what happens with chronic impotence.
If it happens suddenly but you’re still stiff early in the morning and can get an erection while masturbating, that suggests your mind is involved. There could be something going on physically, too.
Lifestyle Changes?
Your health care provider may tell you to make some day-to-day adjustments. Expect to hear things like:
✓ Stop any tobacco or illegal drug use.
✓ Cut back on alcohol.
✓ Lower stress (this is big here!
✓ Eat a healthy diet.
✓ Exercise regularly.
✓ Lose weight if you’re overweight or obese.
He may also ask you to change some of the medicines you take. Some medication may affect your interest in sex or your ability to be ready for it.

Prostatitis is an inflammation or infection of the prostate gland and it can affect men of all ages. Conventional treatment of bacterial prostatitis consists mainly of antibiotics.
The primary symptom of chronic infectious prostatitis is usually repeated bladder infections. Prostatitis is considered chronic if it lasts more than three months.
Types of prostatitis include:
✓ Acute bacterial prostatitis. A sudden bacterial infection marked by inflammation of the prostate. This is the least common form of prostatitis (5-10% of the cases), but the symptoms are usually severe. They often have fever, chills, nausea, vomiting, and burning when urinating. Acute bacterial prostatitis requires prompt treatment, as the condition can lead to bladder infections, abscesses in the prostate or, in extreme cases, completely blocked urine flow. Left untreated, the condition can cause confusion and low blood pressure, and may be fatal. The condition is usually treated in the hospital with intravenous antibiotics, pain relievers, and fluids.
✓ Chronic bacterial prostatitis. This condition is the result of recurrent urinary tract infections that have entered the prostate gland. It is thought to exist for several years in some men before producing symptoms. The symptoms are similar to acute bacterial prostatitis, but are less severe and can fluctuate in intensity.
✓ Chronic nonbacterial prostatitis/chronic pelvic pain syndrome. This is the most common form of the disease (90% of the cases). The condition is marked by urinary and genital pain for at least three of the past six months. Patients have no bacteria in their urine, but may have other signs of inflammation. The condition can be confused with interstitial cystitis (a chronic inflammation of the bladder).