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Champion HHC Health Information Library

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Ureteral Disorders

Your kidneys make urine by filtering wastes and extra water from your blood. The urine travels from the kidneys to the bladder in two thin tubes called ureters.

The ureters are about 8 to 10 inches long. Muscles in the ureter walls tighten and relax to force urine down and away from the kidneys. Small amounts of urine flow from the ureters into the bladder about every 10 to 15 seconds.

Sometimes the ureters can become blocked or injured. This can block the flow of urine to the bladder. If urine stands still or backs up the ureter, you may get a urinary tract infections.

Doctors diagnose problems with the ureters using different tests. These include urine tests, x-rays, and examination of the ureter 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

Urethral Disorders

The urethra is the tube that allows urine to pass out of the body. In men, it's a long tube that runs through the penis. It also carries semen in men. In women, it's short and is just above the vagina. Urethral problems may happen due to aging, illness, or injury. They include

  • Urethral cancer - a rare cancer that happens more often in men
  • Urethral stricture - a narrowing of the opening of the urethra
  • Urethritis - inflammation of the urethra, sometimes caused by infection

Urethral problems may cause pain or difficulty passing urine. You may also have bleeding or discharge from the urethra.

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

Urinary Incontinence

What is urinary incontinence (UI)?

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.

What are the types of urinary incontinence (UI)?

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.
Who is at risk for urinary incontinence (UI)?

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.

How is urinary incontinence (UI) diagnosed?

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
What are the treatments for urinary incontinence (UI)?

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

Urine and Urination

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

Usher Syndrome

Usher syndrome is an inherited disease that causes serious hearing loss and retinitis pigmentosa, an eye disorder that causes your vision to get worse over time. It is the most common condition that affects both hearing and vision.

There are three types of Usher syndrome:

  • People with type I are deaf from birth and have severe balance problems from a young age. Vision problems usually start by age 10 and lead to blindness.
  • People with type II have moderate to severe hearing loss and normal balance. Vision problems start in the early teens and get worse more slowly than in type I.
  • People with type III are born with normal hearing and near-normal balance but develop vision problems and then hearing loss.

There is no cure. Tools such as hearing aids or cochlear implants can help some people. Training such as Braille instruction, low-vision services, or auditory training can also help.

NIH: National Institute on Deafness and Other Communication Disorders