Ask the Doctor: What’s going on with my bladder?

I’m a 33-year-old single woman. About two weeks ago, I went to the bathroom to urinate and I felt pain in my abdomen. The strangest part is that the urine seemed quite little yet by the time I went to let it out, I felt like it was full. There is also some slight pain when the urine is coming out. I kept on peeing every 10 minutes, very little and painful. It went on for two days then stopped. Last weekend, it happened again. Am I infected with something? It’s really worrying me. Belinda, Nyamirambo Dear Belinda, It seems you are suffering from infection of the urinary bladder, known as cystitis. Women are more vulnerable to cystitis due to multiple risk factors. Short length of the urethra (tube connecting the bladder to the exterior for passage of urine), makes it easy for microbes to ascend up and enter the bladder, multiply and cause infection. Blood loss during menstruation also increases susceptibility to cystitis because blood provides rich medium for bacteria to grow. The risk is increased due to dampness prevailing during the days of menstrual cycles. Cystitis can also be the consequence of sexually transmitted disease, where microbes can enter the bladder from the vagina or other pelvic parts. Stones in the urinary bladder can also cause pain and infection leading to all clinical features of cystitits. Cystitis manifests as frequency of micturition i.e. one has to go to pass urine many times. Apart from this, the desire to void becomes very urgent, where holding the bladder seems very difficult. These symptoms are associated with a sense of incomplete evacuation of the bladder, thus compelling one to go to the toilet repeatedly, pain in the lower abdomen, with or without fever. The infection may subside in intensity and relapse again as germs multiply again on finding favourable circumstances. One may get repeated infections due to poor pelvic hygiene, particularly during menses and or unprotected intercourse with an infected partner. Inadequate intake of water further aggravates the problem as urine and hence the infectious germs get concentrated. Cystitis is diagnosed by typical features. Microscopic examination of the first morning sample of urine confirms the diagnosis. The causative germs can be identified precisely by inoculating a sample of the urine in suitable culture medium which helps germs to grow. This is an absolutely curable condition. But if treatment is delayed, or occurs repeatedly, there is a risk of infection affecting the kidneys causing damage to them. One needs to take a complete course of a suitable antibiotic to clear the infection. Drinking lots of water (8-10 glasses daily), is useful both in preventing and curing the infection. This occurs because more water produces more urine which helps to flush out infectious germs, toxins as well as small stones from the bladder. It is also important to maintain good pelvic hygiene during menses and sex to prevent access to microbes causing infection of the private parts as well as bladder. During menses, one should also make efforts to always keep dry. Thus prevention and treatment of cystitis is not difficult, the only thing needed is to be aware of it. Dr. Rachna Pande is a Specialist in Internal Medicine at Ruhengeri Hospital