Problem twinkles

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There are many euphemisms for urinating (to use the ‘correct’ term).  It is amazing just how many words are used by the average Anglo-Saxon family to describe one of nature’s most basic and instinctual acts.  From pee-pee, to passing water, to Number Ones, to doing a “wet” – the list is endless.  When asking a young child about bladder habits I always speak to the parents first saying, “What do you call it in your house?”  One I really do love is having a twinkle!

Just this week, a gentleman of my acquaintance came to ask my advice on his urinary problems, which ranged from urgency to blockage and everything in between.  So here we go.

Urinary Tract Infections are otherwise known as UTI’s in the med bizz and are characterized by painful ‘twinkles’.  This is a condition which can result in Cystitis, which women get more frequently than men.  Did you know that women suffer from UTI’s 10 times more than men?  The reason for this is simply a poor layout and poorly designed plumbing!  It is another example of some fairly dubious design work at the initial stages, several millennia ago.  You see, it is said, and probably with some correctness too, that the female short Urethra (the tube from the bladder to the outside world) is the reason for this, while the male, with the longer Urethra does not have the problem.  One wonders if this was the start of the so-called “penis envy”?  The Urethra is also located near the rectum in women.  Bacteria from the rectum can easily travel up the urethra and cause infections.  In other words, with women, the exhaust is too close to the inlet.  A good hydrodynamics engineer would have designed it better.

So how do you know if you have a UTI?  Read through the following list and tick all the symptoms and signs you have had:

A burning sensation when you urinate,

Feeling like you need to urinate more often than usual,

Feeling the urge to urinate but not being able to,

When you eventually do go, it is a teaspoonful only,

Leaking a little urine,

Cloudy, dark, smelly or blood in the urine.

The most common symptoms of a UTI are burning and scalding and frequency (going to the toilet many times a day) but if the infection is coming down from the kidneys there can also be pain in the loin region and the patient can be quite ill, with fevers and rigors (uncontrollable shaking).

Diagnosis begins with the history and then examination of the urine, and the best way is what we call a Mid-Stream Urine (which we shorten to an MSU because we love acronyms).  If you are going to see the doctor you can save time by taking along your MSU.  The MSU is obtained by passing water into the toilet, then passing some into a clean bottle and then finishing in the toilet bowl again.

The doctor may elect to have the urine examined and cultured for the micro-organism involved, or it may be just a simple dipstick test, with the doctor quite sure of the diagnosis.

The end result is treatment which is generally some antibiotics and something to make the urine more alkaline if there is a lot of pain, but one of the cornerstones of all UTI treatments is for the patient to drink lots and lots and lots and lots of water.  Really flush the urinary tract through, taking the bugs away and out of the body.  I cannot emphasize enough the need to drink gallons (liters) of water, and I do realize that because it stings when you pee, the patient is reluctant to drink more – but it is necessary.

Of course, if the UTI’s are recurrent, then it will be necessary to investigate further and see why this is so.  Sometimes the Ureters (the tubes from the kidneys to the bladder) are malformed, or there can be stones in the kidney which may predispose the patient towards this condition.  Generally we would begin with an ultrasound and work on through from there – but the majority of UTI’s are a simple infection.  And bad plumbing.