Bladder and Urinary Conditions

Is it ok that I’ve stopped ejaculating even when I orgasm?

DEAR DOCTOR K: For the past few months, I haven't been ejaculating, even when I have an orgasm. Why not? What's wrong?

DEAR READER: It sounds like retrograde ejaculation. To explain that, we need to talk about anatomy. There is one tube, the urethra, which leads from the bladder and through the center of the penis. The urethra carries urine out of the body. Two tubes, one on each side of the urethra, lead from the seminal vesicles and open into the urethra. The seminal vesicles are tiny glands that make semen. (The prostate gland helps make semen, too). Semen is a thick fluid that helps nourish sperm. Semen really has no other purpose: It is produced onlyto help sperm.

Is my urinary incontinence caused by giving birth vaginally?

DEAR DOCTOR K: I've had urinary incontinence ever since I gave birth last year. Why?

DEAR READER: Many women who give birth vaginally go on to develop loss of bladder control. This is called urinary incontinence. Childbirth can cause two types of incontinence. If urine leaks out when you jump, cough or laugh, or during any activity that puts pressure on your bladder, you have stress incontinence. You have urge incontinence (overactive bladder) if you feel a strong, overwhelming urge to urinate, even when your bladder isn't full. You probably also release some urine before you make it to the bathroom.

My urine is dark with a strong smell — should I be concerned?

DEAR DOCTOR K: I sometimes have dark, strong-smelling urine. Should I be concerned?

DEAR READER: Given that this happens only occasionally, it probably is not something to worry about. But before reassuring you, I would need answers to some questions: --By dark, do you mean dark yellow? Or is your urine brown or red? If your urine is just a dark yellow color at times, especially when you don't drink enough fluids, then you don't need to worry. Dark yellow urine is a sign of dehydration.

I’m a 52-year-old man — What causes a stinging sensation and dripping after I urinate?

DEAR DOCTOR K: I am a 52-year-old man. When I finish urinating, I drip much more then I used to. And I have a stinging sensation in my urethra. What could cause this?

DEAR READER: What you're experiencing is a very common complaint. As we age, several things happen. One is some enlargement of the prostate gland. This is called benign prostatic hyperplasia, or BPH. Your doctor can perform a digital rectal exam to assess the size and texture of your prostate gland.

I can’t sleep because I keep waking up to urinate– What can I do?

DEAR DOCTOR K: I'm an older woman in good health, but I can't get a good night's sleep because I keep waking up to go to the bathroom. What can I do?

DEAR READER: "Nocturia" is the medical term for the need to get up frequently to urinate during the night. It's a common cause of sleep loss, especially among older adults. In severe cases, a person may get up as many as five or six times during the night. This can lead to sleep deprivation and daytime fatigue.

How can an enlarged prostate cause troublesome urinary symptoms?

DEAR DOCTOR K: I have BPH. Can you explain how an enlarged prostate causes troublesome urinary symptoms?

DEAR READER: Around the time of a man's 25th birthday, his prostate gland begins to grow. This natural enlargement is called benign prostatic hyperplasia (BPH). It is the most common cause of prostate enlargement. If a man lives long enough, he will almost certainly experience some degree of BPH.

I’ve just learned that my urinary incontinence is due to pelvic organ prolapse– what does this mean?

DEAR DOCTOR K: I'm a post-menopausal woman who suffers from urinary incontinence. I've just learned that my incontinence is due to pelvic organ prolapse. What does this mean? What is the treatment?

DEAR READER: Pelvic organ prolapse is a condition in which tissue from the uterus, bladder, urethra or rectum drops down into the vagina. As many as one in three middle-aged women have some degree of pelvic organ prolapse.

How can I prevent another kidney stone from forming?

DEAR DOCTOR K: I recently passed a kidney stone -- and I would do anything to prevent another one from forming. Can kidney stones be prevented?

DEAR READER: I've never had a kidney stone myself, but I've had plenty of patients who suffered from them. So I know that they really hurt. Kidney stones are hard chemical deposits that form inside the kidneys. They are often as small as grains of sand and pass painlessly out of the body in urine.

My prostate-cancer treatments left me with urinary incontinence — what can I do to treat it?

DEAR DOCTOR K: I have urinary incontinence that started after I was treated for prostate cancer. What can I do?

DEAR READER: The involuntary leakage of urine, urinary incontinence, unfortunately is a common -- and aggravating -- side effect of prostate cancer treatment. In some cases, incontinence improves on its own. If it doesn't, there are several options for treating, or at least managing, the problem.

What can cause painful urination in women?

DEAR DOCTOR K: I'm a 45-year-old woman. Now and then, I suddenly feel pain every time I urinate. It lasts for a week or so and then goes away. My doctor said I don't have a urinary infection and didn't prescribe any treatment. What else might be causing my symptoms?

DEAR READER: Several different conditions can cause such symptoms, including a bladder infection, kidney infection, or vaginitis.