micturition

Your kidneys make urine by filtering wastes and extra water from your blood. The waste is called urea. Your blood carries it to the kidneys. From the kidneys, urine travels down two thin tubes called ureters to the bladder. The bladder stores urine until you are ready to urinate. It swells into a round shape when it is full and gets smaller when empty. If your urinary system is healthy, your bladder can hold up to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours.

You may have problems with urination if you have:

• Kidney failure
• Urinary tract infections
• An enlarged prostate
• Bladder control problems like incontinence, overactive bladder, or interstitial cystitis
• A blockage that prevents you from emptying your bladder

Some conditions may also cause you to have blood or protein in your urine. If you have a urinary problem, see your health care provider. Urinalysis and other urine tests can help to diagnose the problem. Treatment depends on the cause.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

The bladder is a hollow organ in your lower abdomen that stores urine. Many conditions can affect your bladder. Some common ones are:

• Cystitis - inflammation of the bladder, often from an infection
• Urinary incontinence - loss of bladder control
• Overactive bladder - a condition in which the bladder squeezes urine out at the wrong time
• Interstitial cystitis - a chronic problem that causes bladder pain and frequent, urgent urination
• Bladder cancer

Doctors diagnose bladder diseases using different tests. These include urine tests, x-rays, and an examination of the bladder wall with a scope called a cystoscope. Treatment depends on the cause of the problem. It may include medicines and, in severe cases, surgery.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

An enlarged prostate is when your prostate gland becomes larger than normal. It's also called benign prostatic hyperplasia or BPH for short. Benign means not cancer. And hyperplasia means too much cell growth. BPH isn't cancer and it doesn't increase your risk of getting prostate cancer.

Usually, the prostate gland continues to grow during adult life. That's why BPH is the most common prostate condition in people over age 50. As the prostate gets bigger, it may press against the bladder and pinch the urethra. This can slow or block the flow of urine out of your bladder.

Over time, the bladder muscle may become weak from trying to pass urine through a narrow urethra. When this happens, your bladder may not empty completely when you urinate. A narrowed urethra and weak bladder cause many of the urinary problems you may have with BPH.

Researchers aren't sure why the prostate keeps growing. Some researchers think changes in hormones with aging may cause the prostate to get bigger.

You're more likely to develop BPH if you:

• Are age 40 or older. The chance of getting BPH increases as you get older.
• Have family members who have had BPH.
• Have certain health conditions such as:
  • Obesity.
  • Heart disease and problems with blood circulation.
  • Type 2 diabetes.
  • Erectile dysfunction.
• Don't get enough physical activity.

Symptoms of BPH include:

• Having a frequent or urgent need to urinate
• Waking up many times to urinate
• Having problems with urine flow, such as:
  • Trouble starting to urinate
  • A stream that's weak, slow, or stops and starts
  • Dribbling after urination
  • Urinary incontinence
  • Feeling that you can't completely empty your bladder
• Pain after ejaculation or during urination
• Urine with an unusual color or smell

It's important to see your health care provider if you have any of these symptoms because they could be from a more serious health problem.

You should get medical help right away if you:

• Can't urinate at all
• Have fever and chills with urination that's painful, frequent, and urgent
• Have blood in your urine
• Have pain in your lower abdomen (belly) and urinary tract

For most people, BPH doesn't cause other problems. But BPH increases your chance of developing serious conditions, including:

• Acute urinary retention. With this condition, you suddenly can't urinate at all. This a medical emergency. Acute urinary retention is common in older males and the chance of having it increases with age. It may be triggered by:
  • Taking certain over-the-counter cold or allergy medicines
  • Drinking alcohol
  • Cold temperatures
  • Not moving enough over a long period of time
• Urinary tract infections (UTIs)
• Bladder damage and bladder stones
• Kidney damage

To find out if you have BPH, your provider will:

• Ask about your medical history. Be sure to tell your provider about all the medicines you take, because certain medicines can make BPH symptoms worse.
• Ask about your family health history.
• Examine you. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to check if your prostate is large, tender, or irregular in any other way.
• Order medical tests, if needed, such as:
  • Urine tests.
  • A PSA blood test (prostate-specific antigen test).
  • Urodynamic testing to see how well you can hold and release urine.
  • Cystoscopy to look inside your urethra and bladder.
  • Ultrasound pictures of your prostate and urinary tract.
  • A prostate biopsy to diagnose or rule out prostate cancer.

Not everyone needs treatment for BPH. Treatment options depend on how much your symptoms bother you, your health, age, and the size of your prostate:

• Lifestyle changes may improve mild symptoms. They include:

  • Drinking less before bedtime or going out
  • Avoiding or cutting back on beverages with caffeine and alcohol
  • Bladder training and exercising the muscles that control urine flow
  • Preventing or treating constipation

• Medicines can help mild to moderate symptoms by:

  • Stopping the prostate from growing
  • Shrinking the prostate
  • Relaxing muscles to improve urine flow

  Sometimes combining 2 types of medicine helps more than taking just one type of medicine.

• Medical procedures can help improve moderate to severe BPH symptoms when medicines don't help enough. There are several different types of procedures. They all use an instrument inserted into the urethra to either:

  • Widen the urethra
  • Destroy part of the prostate with heat

• Surgery may be helpful when symptoms are severe, other treatments haven't helped, or you have another problem, such as bladder damage. Different types of surgery are used to:

  • Remove part or all of the prostate
  • Make cuts in the prostate to take pressure off the urethra

  Most BPH surgery is done with tools inserted into the urethra.

Your provider can explain the possible benefits and side effects of your treatment options so you can decide what's best for you.

Researchers haven't found ways to prevent BPH. You can take care of your prostate health by:

• Talking with your provider about your risk for developing an enlarged prostate
• Getting regular checkups
• Paying attention to your symptoms so you can get treatment early if you see signs of BPH

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

The prostate is a gland in the male reproductive system. It lies just below the bladder. It makes fluid that is part of semen.

There are many types of prostate diseases:

• Prostatitis is inflammation (swelling and pain) in the prostate gland. It's the most common type of prostate problem in people under than age 50. There are different types:
  • Chronic prostatitis is also called chronic pelvic pain syndrome. It's the most common type of prostatitis.
  • Acute bacterial prostatitis starts suddenly from a bacterial infection and is treated with antibiotics. It is not common.
  • Chronic bacterial prostatitis happens when a bacterial infection keeps coming back. The symptoms usually start slowly. It may take longer to treat than acute bacterial prostatitis.
  • Asymptomatic prostatitis has no symptoms and usually doesn't need treatment. You may learn you have it after having tests for other health problems.
• Enlarged prostate is also called benign prostatic hyperplasia (BPH). The prostate gland tends to grow larger with age. That's why enlarged prostate is very common in older people and rare in those who are under age 40. When the prostate grows larger, it may press on your urethra and cause problems with urination.
• Prostate cancer happens when cancer cells form in the prostate gland. Prostate cancer is a common type of cancer in those aged 50 and older. Most prostate cancers grow slowly and may never cause health problems. But certain prostate cancers are serious.

Anyone with a prostate can develop prostate problems. But some people are at higher risk.

You may be more likely to develop prostatitis if you have:

• A lower urinary tract infection, also called a UTI. An infection in your lower urinary tract (bladder and urethra) may lead to acute or chronic bacterial prostatitis.
• Nerve damage in your lower urinary tract from surgery or an injury. This may lead to chronic prostatitis.
• Emotional stress, which can lead to chronic prostatitis.

You may be more likely to develop an enlarged prostate (BPH) if you:

• Are age 40 or older.
• Have family members who have had BPH.
• Have certain health conditions such as:
  • Obesity.
  • Heart disease and problems with blood circulation.
  • Type 2 diabetes.
• Don't get enough physical activity.

You may be more likely to develop prostate cancer if you:

• Are older than age 50.
• Have a parent, sibling, or child who has or had prostate cancer.
• Are African American.

The symptoms of prostate problems include:

• Needing to urinate a lot.
• Needing to rush to the bathroom, but not being able to urinate or only going a little.
• Leaking or dribbling urine.
• Having a weak urine stream.

Other symptoms depend on the type of prostate problem you have and may include:

• Not being able to urinate at all. This is a medical emergency.
• Any problems, starting or controlling urine flow.
• Waking up often to urinate.
• Blood in your urine or urine that has an unusual smell or color.
• Fever, chills, or body aches.
• Great discomfort or pain:
  • While urinating or after ejaculation.
  • In your abdomen (belly), between your scrotum and anus, or in your scrotum or penis.

Contact your provider if you have any of these symptoms.

To find out if you have a prostate problem, your provider will:

• Ask about your medical history and symptoms.
• Ask about your family health history.
• Do a physical exam. The exam may include a digital rectal exam (DRE) of your prostate. In a DRE, your provider inserts a gloved finger into your rectum to feel the general size and condition of your prostate.
• Order tests, if needed. Tests may include:
  • Blood and urine tests to look for infection.
  • Urodynamic testing to see how well you can hold and release urine.
  • Cystoscopy to look inside your urethra and bladder.
  • Ultrasound pictures of your prostate and urinary tract.
  • A PSA blood test (prostate-specific antigen test).
  • Prostate biopsy to diagnose or rule out cancer.

Treatment depends on what prostate disease you have and which symptoms bother you most.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Fainting is a temporary loss of consciousness. If you're about to faint, you'll feel dizzy, lightheaded, or nauseous. Your field of vision may "white out" or "black out." Your skin may be cold and clammy. You lose muscle control at the same time, and may fall down.

Fainting usually happens when your blood pressure drops suddenly, causing a decrease in blood flow to your brain. It is more common in older people. Some causes of fainting include:

• Heat or dehydration
• Emotional distress
• Standing up too quickly
• Certain medicines
• Drop in blood sugar
• Heart problems

When someone faints, make sure that the airway is clear and check for breathing. The person should stay lying down for 10-15 minutes. Most people recover completely. Fainting is usually nothing to worry about, but it can sometimes be a sign of a serious problem. If you faint, it's important to see your health care provider and find out why it happened.

Sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are infections that are passed from one person to another through sexual contact. They are usually spread during vaginal, oral, or anal sex. But sometimes they can spread through other sexual contact involving the penis, vagina, mouth, or anus. This is because some STDs, like herpes and HPV, are spread by skin-to-skin contact.

Some STDs can be passed from a pregnant person to the baby, either during pregnancy or when giving birth. Other ways that STDs may be spread include during breastfeeding, through blood transfusions, or by sharing needles.

There are more than 20 types of STDs, including:

• Chlamydia
• Genital herpes
• Gonorrhea
• HIV
• HPV
• Pubic lice
• Syphilis
• Trichomoniasis

STDs can be caused by bacteria, viruses, and parasites.

Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women.If an STD is passed to a baby, it can cause serious health problems.

STDs don't always cause symptoms or may only cause mild symptoms. So it is possible to have an infection and not know it. And even without symptoms, STDs can still be harmful and may be passed on during sex.

If there are symptoms, they could include:

• Unusual discharge from the penis or vagina
• Sores or warts on the genital area
• Painful or frequent urination (peeing)
• Itching and redness in the genital area
• Blisters or sores in or around the mouth
• Abnormal vaginal odor
• Anal itching, soreness, or bleeding
• Abdominal painn
• Fever

If you are sexually active, you should talk to your health care provider about your risk for STDs and whether you need to be tested. This is especially important since many STDs do not usually cause symptoms.

Some STDs may be diagnosed during a physical exam or through microscopic examination of a sore or fluid swabbed from the vagina, penis, or anus. Blood tests can diagnose other types of STDs.

Antibiotics can treat STDs caused by bacteria or parasites. There is no cure for STDs caused by viruses, but medicines can often help with the symptoms and lower your risk of spreading the infection.

Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading STDs. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.

There are vaccines to prevent HPV and hepatitis B.

Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading STDs. If your or your partner is allergic to latex, you can use polyurethane condoms. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.

There are vaccines to prevent HPV and hepatitis B.

Centers for Disease Control and Prevention

Trichomoniasis is a sexually transmitted disease caused by a parasite. It spreads from person to person during sex. Many people do not have any symptoms. If you do get symptoms, they usually happen within 5 to 28 days after being infected.

It can cause vaginitis in women. Symptoms include:

• Yellow-green or gray discharge from the vagina
• Discomfort during sex
• Vaginal odor
• Painful urination
• Itching burning, and soreness of the vagina and vulva

Most men do not have symptoms. If they do, they may have:

• Itching or irritation inside the penis
• Burning after urination or ejaculation
• Discharge from the penis

Trichomoniasis can increase the risk of getting or spreading other sexually transmitted diseases. Pregnant women with trichomoniasis are more likely to give birth too early, and their babies are more likely have a low birth weight.

Lab tests can tell if you have the infection. Treatment is with antibiotics. If you are infected, you and your partner must be treated.

Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading trichomoniasis. If your or your partner is allergic to latex, you can use polyurethane condoms. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.

Centers for Disease Control and Prevention

The urinary system is the body's drainage system for removing wastes and extra water. It includes two kidneys, two ureters, a bladder, and a urethra. Urinary tract infections (UTIs) are the second most common type of infection in the body.

You may have a UTI if you notice:

• Pain or burning when you urinate
• Fever, tiredness, or shakiness
• An urge to urinate often
• Pressure in your lower belly
• Urine that smells bad or looks cloudy or reddish
• Pain in your back or side below the ribs

People of any age or sex can get UTIs. But about four times as many women get UTIs as men. You're also at higher risk if you have diabetes, need a tube to drain your bladder, or have a spinal cord injury.

If you think you have a UTI it is important to see your doctor. Your doctor can tell if you have a UTI with a urine test. Treatment is with antibiotics.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Dehydration is a condition caused by the loss of too much fluid from the body. It happens when you are losing more fluids than you are taking in, and your body does not have enough fluids to work properly.

You can become dehydrated because of:

• Diarrhea
• Vomiting
• Sweating too much
• Urinating too much, which can happen because of certain medicines and illnesses
• Fever
• Not drinking enough water or other fluids

Certain people are more likely to develop dehydration:

• Older adults. Some people lose their sense of thirst as they age, so they don't drink enough fluids.
• Infants and young children, who are more likely to have diarrhea or vomiting
• People with chronic illnesses that cause them to urinate or sweat more often, such as diabetes, cystic fibrosis, or kidney problems
• People who take medicines that cause them to urinate or sweat more
• People who exercise or work outdoors during hot weather

In adults, the symptoms of dehydration include:

• Feeling very thirsty
• Dry mouth
• Urinating and sweating less than usual
• Dark-colored urine
• Dry skin
• Feeling tired
• Dizziness

In infants and young children, the symptoms of dehydration include:

• Dry mouth and tongue
• Crying without tears
• No wet diapers for 3 hours or more
• A high fever
• Being unusually sleepy or drowsy
• Irritability
• Eyes that look sunken

Dehydration can be mild, or it can be severe enough to be life-threatening. Get medical help right away if the symptoms also include:

• Confusion
• Fainting
• Lack of urination
• Rapid heartbeat
• Rapid breathing
• Shock

To find out if you dehydration, your health care provider will:

• Do a physical exam
• Check your vital signs
• Ask about your symptoms

Your provider may also order tests, such as:

• Blood tests to check your electrolyte levels, especially potassium and sodium. Electrolytes are minerals in your body that have an electric charge. They have many important jobs, including helping to keep a balance of fluids in your body.
• Blood tests to check your kidney function.
• Urine tests to check for dehydration and its cause.

The treatment for dehydration is to replace the fluids and electrolytes that you have lost. For mild cases, you may just need to drink lots of water. If you lost electrolytes, sports drinks may help. There are also oral rehydration solutions for children. You can buy those without a prescription.

Severe cases may be treated with intravenous (IV) fluids with salt in a hospital.

The key to preventing dehydration is making sure that you get enough fluids:

• Drink enough water every day. Each person's needs can be different, so ask your health care provider how much you should be drinking each day.
• Avoid drinks that have sugar and caffeine.
• Drink extra fluids when the weather is hot, especially if you are exercising or working outside. If you are losing a lot of minerals in sweat, sports drinks can help you. But some sports drinks have lots of sugar, so be careful not to drink too much of them.
• Get extra fluids when you are sick. If you are having trouble keeping liquids down, you can try taking small sips of water or sucking on ice chips.

Diabetes insipidus (DI) causes frequent urination. You become extremely thirsty, so you drink. Then you urinate. This cycle can keep you from sleeping or even make you wet the bed. Your body produces lots of urine that is almost all water.

DI is different from diabetes mellitus (DM), which involves insulin problems and high blood sugar. The symptoms can be similar. However, DI is related to how your kidneys handle fluids. It's much less common than DM. Urine and blood tests can show which one you have.

Usually, DI is caused by a problem with your pituitary gland or your kidneys. Treatment depends on the cause of the problem. Medicines can often help.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases