Bladder and Urinary Conditions

Why does diabetes and high blood pressure increase my risk for kidney disease?

DEAR DOCTOR K: I have high blood pressure and diabetes. I was surprised to learn that they increase my risk of kidney disease. How do they do that?

DEAR READER: Many people know that high blood pressure and diabetes increase the risk of getting heart disease. But less well known is the fact that they are also powerful risk factors for kidney disease. The kidneys filter toxins and wastes from the bloodstream, flushing them out of the body in urine. At the same time, they hold on to important proteins and other useful substances. This process helps control levels of fluid, salt and acid in the body. The kidneys also play an important role in regulating blood pressure.

I have pelvic organ prolapse. Are there any exercises I should avoid?

DEAR DOCTOR K: I have pelvic organ prolapse. Are there any exercises I should avoid?

DEAR READER: Pelvic organ prolapse is a condition in which the uterus, bladder, urethra or rectum drop down and press against the walls of the vagina. Normally your pelvic floor -- a sling of muscles and ligaments that stretches from your pubic bone to your tailbone -- holds your pelvic organs in place. Pelvic organ prolapse results from a weakened pelvic floor.

I found out I have a kidney infection from a UTI, why didn’t I have any other, earlier symptoms?

DEAR DOCTOR K: I am a woman in my 80s. I went to my doctor because I suddenly developed back pain. It turned out to be a urinary tract infection that had spread to my kidneys. Why didn't I have any other, earlier symptoms?

DEAR READER: If you had urinary tract infections (UTIs) when you were younger, you probably remember the burning, pain and intense urge to urinate frequently. But these symptoms don't always appear in older adults. UTIs commonly occur when bacteria from the rectum (such as E. coli) infect the skin around the opening of the urethra (the tube leading to the bladder).

How do I prevent another kidney stone?

DEAR DOCTOR K: I recently had a very painful kidney stone. What can I do to prevent another?

DEAR READER: First of all, my sympathies: Pain from passing a kidney stone can be as bad as any kind of pain. Kidney stones are hard, chemical deposits that form inside the kidney chambers where urine is collected. Urine passes from the kidney down a narrow tube (the ureter) and into the bladder. If a stone gets carried into the narrow ureter, it can get stuck. This can cause severe pain, bloody urine, nausea and vomiting. If you've had one kidney stone, you're at increased risk for another.

What helps relieve interstitial cystitis symptoms?

DEAR DOCTOR K: I have interstitial cystitis. Medications have helped, but not much. What else could help relieve my symptoms?

DEAR READER: Interstitial cystitis is a puzzling bladder condition in which the bladder wall becomes irritated or inflamed. We don't know what causes the condition. Some doctors speculate that an infection, most likely with viruses, is responsible. However, I'm not aware of any good evidence in support of that. The symptoms of interstitial cystitis are similar to those of a bacterial urinary tract infection.

How can my 4-year-old prevent another UTI?

DEAR DOCTOR K: I think my 4-year-old daughter may have a urinary tract infection. How will it be treated? And what can I do to make sure she doesn't get another one?

DEAR READER: A urinary tract infection (UTI) occurs when bacteria infect urine in the kidneys, bladder or urethra, a small tube that connects the bladder to the outside. In girls (and women), the urethra is located in front of the vagina. The opening of the urethra is also near the rectum. The large intestine (the colon and rectum) are filled with bacteria. During bowel movements, those bacteria start living on the skin around the rectum and near the urethra.

Do eating and bowel habits change as we age?

DEAR DOCTOR K: As I've entered my 70s, I've noticed that my eating and bowel habits have changed. Is this normal?

DEAR READER: Well, I could tell you what it says in the medical textbooks, or I could speak from personal experience. The answer would be the same: It sure is normal. Aging most definitely affects our eating and bowel habits. The human digestive system -- our gastrointestinal (GI) tract, or "gut" -- is a series of hollow organs linked to form a long, twisting tube. It begins at the mouth and winds down through the esophagus, stomach, small intestine and colon. These organs break down food into components that the body can absorb and use for energy. What's left is expelled by an efficient disposal system.

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.