The most common urinary tract problem that urologists see in their offices are women with frequency of urination and the severe urge to urinate, a non-ending feeling of a fullness of the bladder. Many of these women tell horror stories about having to go to the bathroom every 15 minutes, 30 minutes or an hour. Everyday. And many women say they do not even make it to the bathroom, causing not only embarrassing social moments, but psychological pain as well.
Many women have had multiple tests, x-rays, drugs, urethral stretching (dilatation) and still continue with this major annoyance. While most cases are not serious, and not life-threatening they are life-style threatening. It is often embarrassing, uncomfortable, a major nuisance, and affects activities of daily living. The first stop is a health care professional.
In order to treat the problem you have to know what the problem is, and therefor lets talk about causes. This urgency and frequency syndrome, which I coined, is medically referred to as urethral syndrome, or unstable bladder, and is probably called such because they don't know what the problem really is and how to handle it. Just about anything irritating the bladder or the urethra (the urine tube) can give you the urgency/frequency symptoms.
Many are associated with an abnormal urinalysis and other associated urinary symptoms such as burning on urination, blood in the urine as well as cloudy urine with pus in it. However, most of the problems that have abnormal urinalyses and other symptoms can be diagnosed, treated with antibiotics, or after simple diagnostic tests treated by stretching the urethra. The remainder are the problem patients, the ones with this urethral syndrome the question is how to make a specific diagnosis and be able to treat this complex, not easily treatable disorder?
We have to think about certain entities that can give you this problem and are hard to diagnose without some special tests. The first entity is interstitial cystitis, a bladder inflammation involving mostly the muscle layers of the bladder. The cause is unknown, but is probably due to a lack of a normal substance being produced by the lining of the bladder allowing urine to enter the muscle of the bladder causing irritation and possibly stimulating some kind of autoimmune mechanism where the body becomes allergic to its own bladder muscle.
This problem is treatable with a specific medication called DMSO, which is instilled in the bladder at regular intervals, and a new oral drug called Elmiron which is taken three times a day. With these treatments 90+% of usually women with this problem can get resolution which is a far cry from the old days when two-thirds of the patients worsened and frequently became incapacitated from this disease.
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