Dear doctor;

For the last six months when I run I feel like I want to go to the toilet, and usually wet myself slightly. I go to the gym and nearly every time I go on the tread mill I wet myself. It is embarrassing. Please help.

Ken, 37, Musanze.

Dear Ken,

It seems that in all probability you are  suffering from cystitis, that is, infection of the urinary bladder. Cystitis can occur due to infection of the genital parts which are sexually acquired. Due to close proximity of the bladder to the genitals microbes pass easily from one part to another. In women, cystitis can occur due to poor menstrual hygiene, trauma or infection of bladder during child birth and sexually acquired infections. Normally, women are more  prone to develop infections of urinary tract due to short length of urethra (tube connecting bladder to exterior for voiding urine). Cystitis can cause burning pain, frequency of urination    and even slight leaking of urine. 

Apart from this, urinary incontinence can occur in young men and women if they hold back a full bladder for a long time. Stricture of the urethra in men which can be post traumatic or post infections like gonococcal urethritis can cause difficulty in passing urine and even slight incontinence. Neurological problems can also cause incontinence, but in those cases the symptoms will be overshadowed by other features like paralysis of legs. 

Drinking lot of water helps to keep the urinary system clear of germs. Always empty bladder to prevent weakening of the urinary sphincter. 

Testing of the first morning mid stream sample will help to confirm presence of infection. If positive it is curable by antibiotics. If there is any difficulty in passing urine, minor surgical procedures can correct it.