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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

Antibiotics are medicines that fight bacterial infections in people and animals. They work by killing the bacteria or by making it hard for the bacteria to grow and multiply.

Antibiotics can be taken in different ways:

• Orally (by mouth). This could be pills, capsules, or liquids.
• Topically. This might be a cream, spray, or ointment that you put on your skin. It could also be eye ointment, eye drops, or ear drops.
• Through an injection or intravenously (IV). This is usually for more serious infections.

Antibiotics only treat certain bacterial infections, such as strep throat, urinary tract infections, and E. coli.

You may not need to take antibiotics for some bacterial infections. For example, you might not need them for many sinus infections or some ear infections. Taking antibiotics when they're not needed won't help you, and they can have side effects. Your health care provider can decide the best treatment for you when you're sick. Don't ask your provider to prescribe an antibiotic for you.

Antibiotics do not work on viral infections. For example, you shouldn't take antibiotics for:

• Colds and runny noses, even if the mucus is thick, yellow, or green
• Most sore throats (except strep throat)
• Flu
• Most cases of bronchitis

The side effects of antibiotics range from minor to very severe. Some of the common side effects include:

• Rash
• Nausea
• Diarrhea
• Yeast infections

More serious side effects can include:

• C. diff infections, which cause diarrhea that can lead to severe colon damage and sometimes even death
• Severe and life-threatening allergic reactions
• Antibiotic resistance infections

Call your health care provider if you develop any side effects while taking your antibiotic.

You should only take antibiotics when they are needed because they can cause side effects and can contribute to antibiotic resistance. Antibiotic resistance happens when the bacteria change and become able to resist the effects of an antibiotic. This means that the bacteria continue to grow.

When you take antibiotics, it is important that you take them responsibly:

• Always follow the directions carefully. Finish your medicine even if you feel better. If you stop taking them too soon, some bacteria may survive and re-infect you.
• Don't save your antibiotics for later.
• Don't share your antibiotic with others.
• Don't take antibiotics prescribed for someone else. This may delay the best treatment for you, make you even sicker, or cause side effects.

Centers for Disease Control and Prevention

Circumcision is a surgical procedure to remove the foreskin from the penis. The foreskin is the loose skin that covers the tip of the penis. In the United States, circumcision is often done before a new baby leaves the hospital.

As parents, it is your decision whether to have your baby circumcised. When making your decision, you should consider your own religious, cultural, and personal preferences, as well as the medical benefits and risks. You can discuss these with your baby's health care provider before you make a decision.

The possible medical benefits of circumcision include:

• A lower risk of HIV and some other sexually transmitted infections (STIs).
• A slightly lower risk of urinary tract infections (UTIs) during the first year of life and penile cancer later in life. However, these conditions are rare in all males (circumcised or not).
• Prevention of certain penile problems, such as foreskin infections and phimosis, a condition in which the foreskin can't be retracted (pulled back).
• Easier hygiene.

The risks of circumcision include:

• A low risk of bleeding, infection, or scarring.
• A very low risk of having too much or not enough skin cut off.
• Pain. You can ask the health care provider to put a numbing medicine on your baby's penis to lessen the pain.

These risks are higher when circumcision is performed on older babies, boys, and men.

Premature babies and babies born with health problems should not be circumcised until they are healthy.

If have your baby circumcised, ask their provider how to care for the penis as it heals.

If your baby does not get circumcised, their provider can teach you how to keep your baby's penis clean. It's important to know that a newborn's foreskin may not retract completely. Over time, it retracts on its own.

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

Menopause is the time in your life when you stop having your period and can no longer get pregnant. You have reached menopause when you have not had a period for 12 months.

The time leading up to menopause is called the menopausal transition, or perimenopause. This transition usually begins in when you are in your 40s, but sometimes it can start earlier. It can last for several years. The most common age for reaching menopause is between 45 and 55 years old.

Early, or premature menopause happens when your ovaries stop making hormones and periods stop before age 40. This can happen on its own (with no known cause). It can also happen because of surgery to remove the ovaries or uterus. Medical treatments such as chemotherapy or hormone therapy to treat breast cancer may also cause early menopause.

A condition called primary ovarian insufficiency (POI) happens when your ovaries stop working normally before you are age 40. But this condition is different from early menopause. If you have POI, you may still have periods, even though they might not come regularly. And you might still be able to get pregnant.

During the menopausal transition, your ovaries start to make less of the estrogen and progesterone hormones. The changes in these hormones cause the symptoms of menopause, which can include:

• A change in your periods; they may be:
  • Irregular, with more or less time in between periods.
  • Shorter or longer.
  • Lighter or heavier.
• Hot flashes, a sudden warm feeling in your face, neck, and chest. They may cause you to sweat. If they happen at night and cause sweating, they are called night sweats.
• Trouble sleeping, such as trouble falling asleep or getting back to sleep when you wake up. Over time, a lack of sleep can lead to fatigue and memory problems.
• Vaginal dryness, which may cause pain or discomfort during sexual intercourse.
• Mood changes, which can make you feel moody, anxious, or more irritable.
• Bladder issues, such as urinary incontinence (loss of bladder control) and urinary tract infections (UTIs).

You may also have other physical changes which could put you at risk for certain diseases. For example, the loss of estrogen can:

• Cause you to lose bone density. This can lead to osteoporosis, a condition that causes bones to become weak and break easily.
• Raise your cholesterol levels and increase your risk of heart disease and stroke.

You may not need treatment for the symptoms of menopause. But if you do, there are several different types of treatments:

You may find that you can manage your symptoms with lifestyle changes. Here are some changes that might make you feel better:

• If you have hot flashes, dress in layers that can be removed at the start of a hot flash. You may want to carry a portable fan to use when you get a hot flash.
• Avoid alcohol, spicy foods, and caffeine. They can make your menopause symptoms worse.
• If you smoke, try to quit, not only for hot flashes, but for your overall health.
• Try to maintain a healthy weight. Being overweight or having obesity can make hot flashes worse.
• Have good sleep habits. Keep your bedroom dark, quiet, and cool.
• Get regular exercise. It can help you sleep better, improve your mood, and help lower your risk for many age-related diseases.
• Lower stress, for example by using relaxation techniques such as meditation, deep breathing, and muscle relaxation exercises.

If lifestyle changes are not enough to improve your symptoms, you may want to contact your health care provider. They will talk to you about your symptoms, family and medical history, and preferences. They also can explain the risks and benefits of the treatments.

There are various non-hormone treatments for menopause symptoms, such as:

• Medicines for hot flashes, including certain antidepressants, a medicine just for hot flashes, an antiseizure medicine, and a blood pressure medicine. Some of these medicines may also help with sleep problems.
• Medicines for urinary incontinence.
• Medicines to treat or help prevent osteoporosis.
• Low-dose birth control pills for very heavy bleeding or periods that are close together.
• Water-based lubricants to treat vaginal dryness.
• Medicines for painful intercourse that is caused by vaginal changes from menopause.
• Cognitive behavioral therapy (CBT), a type of talk therapy, for trouble sleeping.

Like all medicines, MHT has benefits and risks. Talk with your provider about whether it is safe for you. If you decide to take MHT, your provider may recommend taking the lowest dose that works for the shortest time needed.

There are various products that are marketed for menopause symptoms. They include supplements, herbs, and over-the-counter "natural" hormone creams. There has been research on many of these products. So far, none of them has clearly been shown to be helpful. Also, there is little information on the long-term safety of these products. Some supplements can have harmful side effects or interact with medicines. Check with your provider before you take use any of them.

Urinary incontinence (UI) is the loss of bladder control, or being unable to control urination. It is a common condition. It can range from being a minor problem to something that greatly affects your daily life. In any case, it can get better with proper treatment.

There are several different types of UI. Each type has different symptoms and causes:

• Stress incontinence happens when stress or pressure on your bladder causes you to leak urine. This could be due to coughing, sneezing, laughing, lifting something heavy, or physical activity. Causes include weak pelvic floor muscles and the bladder being out of its normal position.
• Urge, or urgency, incontinence happens when you have a strong urge (need) to urinate, and some urine leaks out before you can make it to the toilet. It is often related to an overactive bladder. Urge incontinence is most common in older people. It can sometimes be a sign of a urinary tract infection (UTI). It can also happen in some neurological conditions, such as multiple sclerosis and spinal cord injuries.
• Overflow incontinence happens when your bladder doesn't empty all the way. This causes too much urine to stay in your bladder. Your bladder gets too full, and you leak urine. This form of UI is most common in men. Some of the causes include tumors, kidney stones, diabetes, and certain medicines.
• Functional incontinence happens when a physical or mental disability, trouble speaking, or some other problem keeps you from getting to the toilet in time. For example, someone with arthritis may have trouble unbuttoning his or her pants, or a person with Alzheimer's disease may not realize they need to plan to use the toilet.
• Mixed incontinence means that you have more than one type of incontinence. It's usually a combination of stress and urge incontinence.
• Transient incontinence is urine leakage that is caused by a temporary (transient) situation such as an infection or new medicine. Once the cause is removed, the incontinence goes away.
• Bedwetting refers to urine leakage during sleep. This is most common in children, but adults can also have it.
  • Bedwetting is normal for many children. It is more common in boys. Bedwetting is often not considered a health problem, especially when it runs in the family. But if it still happens often at age 5 and older, it may be because of a bladder control problem. This problem could be caused by slow physical development, an illness, making too much urine at night, or another problem. Sometimes there is more than one cause.
  • In adults, the causes include some medicines, caffeine, and alcohol. It can also be caused by certain health problems, such as diabetes insipidus, a urinary tract infection (UTI), kidney stones, enlarged prostate (BPH), and sleep apnea.

In adults, you are at higher risk of developing UI if you:

• Are female, especially after going through pregnancy, childbirth, and/or menopause
• Are older. As you age, your urinary tract muscles weaken, making it harder to hold in urine.
• Are a man with prostate problems
• Have certain health problems, such as diabetes, obesity, or long-lasting constipation
• Are a smoker
• Have a birth defect that affects the structure of your urinary tract

In children, bedwetting is more common in younger children, boys, and those whose parents wet the bed when they were children.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms. Your provider may ask you to keep a bladder diary for a few days before your appointment. The bladder diary includes how much and when you drink liquids, when and how much you urinate, and whether you leak urine.
• A physical exam, which can include a rectal exam. Women may also get a pelvic exam.
• Urine and/or blood tests
• Bladder function tests
• Imaging tests

Treatment depends on the type and cause of your UI. You may need a combination of treatments. Your provider may first suggest self-care treatments, including:

• Lifestyle changes to reduce leaks:
  • Drinking the right amount of liquid at the right time
  • Being physically active
  • Staying at a healthy weigh
  • Avoiding constipation
  • Not smoking
• Bladder training. This involves urinating according to a schedule. Your provider makes a schedule from you, based on information from your bladder diary. After you adjust to the schedule, you gradually wait a little longer between trips to the bathroom. This can help stretch your bladder so it can hold more urine.
• Doing exercises to strengthen your pelvic floor muscles. Strong pelvic floor muscles hold in urine better than weak muscles. The strengthening exercises are called Kegel exercises. They involve tightening and relaxing the muscles that control urine flow.

If these treatments do not work, your provider may suggest other options such as:

• Medicines, which can be used to
  • Relax the bladder muscles, to help prevent bladder spasms
  • Block nerve signals that cause urinary frequency and urgency
  • In men, shrink the prostate and improve urine flow
• Medical devices, including
  • A catheter, which is a tube to carry urine out of the body. You might use one a few times a day or all the time.
  • For women, a ring or a tampon-like device inserted into the vagina. The devices pushes up against your urethra to help decrease leaks.
• Bulking agents, which are injected into the bladder neck and urethra tissues to thicken them. This helps close your bladder opening so you have less leaking.
• Electrical nerve stimulation, which involves changing your bladder's reflexes using pulses of electricity
• Surgery to support the bladder in its normal position. This may be done with a sling that is attached to the pubic bone.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Delirium is a mental state in which you are confused, disoriented, and not able to think or remember clearly. It usually starts suddenly. It is often temporary and treatable.

There are three types of delirium:

• Hypoactive, when you are not active and seem sleepy, tired, or depressed
• Hyperactive, when you are restless or agitated
• Mixed, when you change back and forth between being hypoactive and hyperactive

There are many different problems that can cause delirium. Some of the more common causes include:

• Advanced cancer.
• Alcohol or drugs, either from intoxication or withdrawal. This includes a serious type of alcohol withdrawal syndrome called delirium tremens. It usually happens to people who stop drinking after years of alcohol use disorder (AUD).
• Dehydration and electrolyte imbalances.
• Dementia.
• Hospitalization, especially in intensive care.
• Infections, such as urinary tract infections, pneumonia, and the flu.
• Medicines. This could be a side effect of a medicine, such as sedatives or opioids. Or it could be from withdrawal after stopping a medicine.
• Metabolic disorders.
• Organ failure, such as kidney or liver failure.
• Poisoning.
• Serious illnesses.
• Severe pain.
• Sleep deprivation.
• Surgeries, including reactions to anesthesia.

Certain factors put you at risk for delirium, including:

• Being in a hospital or nursing home
• Having dementia
• Having a serious illness or more than one illness
• Having an infection
• Older age
• Having surgery
• Taking medicines that affect the mind or behavior
• Taking high doses of pain medicines, such as opioids

The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:

• Changes in alertness (usually more alert in the morning, less at night)
• Changing levels of consciousness
• Confusion
• Disorganized thinking, talking in a way that doesn't make sense
• Disrupted sleep patterns, sleepiness
• Emotional changes: anger, agitation, depression, irritability, overexcitement
• Hallucinations and delusions
• Memory problems, especially with short-term memory
• Trouble concentrating

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• Physical and neurological exams
• Mental status testing, which checks for problems with your thinking and alertness
• Lab and diagnostic imaging tests

Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:

• Delirium starts suddenly and can cause hallucinations. It is mainly a problem with attention and staying alert. The symptoms may get better or worse and can last for hours or weeks.
• Dementia develops slowly and does not cause hallucinations. It usually starts with memory loss. The symptoms don't change often, like they can with delirium. Dementia almost never gets better.

Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time - weeks or sometimes even months. In the meantime, there may be treatments to manage the symptoms, such as:

• Controlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members around
• Medicines, including those that control aggression or agitation and pain relievers if there is pain
• If needed, making sure that the person has a hearing aid, glasses, or other devices for communication

Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and making sure that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).

Every year, lives are lost because of the spread of infections in hospitals. Health care workers can take steps to prevent the spread of infectious diseases. These steps are part of infection control.

Proper hand washing is the most effective way to prevent the spread of infections in hospitals. If you are a patient, don't be afraid to remind friends, family and health care providers to wash their hands before getting close to you.

Other steps health care workers can take include:

• Covering coughs and sneezes
• Staying up to date with vaccinations
• Using gloves, masks and protective clothing
• Making tissues and hand cleaners available
• Following hospital guidelines when dealing with blood or contaminated items

During pregnancy, some common infections like the common cold or a skin infection do not usually cause serious problems. But other infections can be dangerous to you, your baby, or both. Some infections may lead to preterm birth and low birth weight babies. Others can cause serious illness, birth defects, and lifelong disabilities, such as hearing loss or learning problems.

Some of the infections that can be dangerous during pregnancy include:

• Bacterial vaginosis (BV)
• Group B strep (GBS)
• Hepatitis
• Sexually transmitted infections (STIs)
• Toxoplasmosis
• Urinary tract infections
• Yeast infections
• Zika virus

To try to prevent infections:

• Don't eat raw or undercooked meat.
• Don't share food or drinks with other people.
• Wash your hands frequently.
• Don't empty cat litter. Cats can transmit toxoplasmosis.
• Talk to your health care provider about vaccinations.
• If you have sex during pregnancy, use a condom every time.

If you do get an infection during pregnancy, contact your health care provider about how best to protect you and your baby. Only some medicines are safe during pregnancy.

Germs, or microbes, are found everywhere - in the air, soil, and water. There are also germs on your skin and in your body. Many of them are harmless, and some can even be helpful. But some of them can make you sick. Infectious diseases are diseases that are caused by germs.

There are four main types of germs:

• Bacteria are one-celled germs that multiply quickly. They may give off toxins, which are harmful chemicals that can make you sick. Strep throat and urinary tract infections are common bacterial infections.
• Viruses are tiny capsules that contain genetic material. They invade your cells so that they can multiply. This can kill, damage, or change the cells and make you sick. Viral infections include HIV and the common cold.
• Fungi are primitive plant-like organisms such as mushrooms, mold, mildew, and yeasts. Athlete's foot and yeast infections are common fungal infections.
• Parasites are animals or plants that survive by living on or in other living things. Malaria and head lice are infections that are caused by parasites.

There are many different ways that you can get an infectious disease, depending on the type of germ. They can include:

• Through direct contact with a person who is sick. This includes kissing, touching, sneezing, coughing, and sexual contact. If you are pregnant, you can pass some germs to your fetus.
• Through indirect contact, when you touch something that has germs on it. For example, you could get germs if someone who is sick touched a door handle, and then you touch it.
• Through insect or animal bites.
• Through contaminated food, water, soil, or plants.

Infectious diseases can cause many different symptoms. Some are so mild that you may not even notice any symptoms, while others can be life-threatening.

There are treatments for some infectious diseases, such as antibiotic, antiviral, antifungal and anti-parasitic medicines. But for other infections, such as some caused by viruses, you can only treat your symptoms while you wait for your immune system to fight off the germ.

You can take steps to help prevent many infectious diseases:

• Get vaccinated.
• Wash your hands often.
• Pay attention to food safety.
• Avoid contact with wild animals.
• Use a latex condom every time you have sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
• Don't share items such as toothbrushes, combs, and straws.