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Finding yourself leaking urine at the most inopportune of moments isn’t the best advertisement for graceful ageing.

HAVE you suddenly found yourself experiencing urinary incontinence, where you can’t control your urination? Or have you become prone to urinary tract infections?

As we grow older, it is not just grey hairs or a thinning hairline that we have to contend with. Our urinary system goes through changes as well. This is why urinary problems tend to become an issue for women later in life. These problems can be embarrassing and debilitating for many women, who find that they have to curtail their daily activities due to their frequent need to go to the toilet.

If you find yourself avoiding family and friends because of your condition, or suffering from discomfort or pain all the time, you should seek medical advice. Don’t keep it to yourself, as urinary problems can be easily treated.

The urinary system

Despite the fact that we all take it for granted, the urinary system in our body plays a vital role in keeping us well and healthy. Most of the excess water, chemicals, and waste products in our body are excreted by our urinary system. This complex job is carried out by a pair of kidneys, which produce urine; a pair of ureters, through which urine passes to the bladder; and the urethra, a tube that passes the urine from the bladder out of the body.

The kidneys act as a filtration system by eliminating waste materials from the blood in your body through the one million nephrons in the kidneys. The kidneys also regulate the water and chemical levels in the body. If you drink too much and there is too much water in your body, the kidneys will excrete a lot of urine. When you don’t drink enough and the water level in your body is too low, the kidneys will excrete less urine.

The urine produced from the kidneys then travel through the ureters, which are narrow tubes made of muscle. The ureters drain the urine into the bladder, which is a sac that holds the urine. When the sphincter of the bladder is released, urine flows into the urethra and is passed out of the body.

A kink in the system

Can you imagine if this intricate system were disrupted and you were not able to remove the wastes and water from your body in this routine manner? Urinary disorders increase with age because every part of the system can be affected by ageing. For instance, the number and size of nephrons in the kidneys reduce with age, affecting the filtration of waste products. Even the kidneys themselves become smaller, and become less adept at regulating the balance of salts and other chemicals. Incontinence is often a problem in older people because the sphincter on their bladders have become less flexible, and is less able to close tightly. This causes urine to leak out easily.

Older women also complain that they constantly feel the urge to urinate. This is due to the bladder becoming less flexible, so it cannot hold as much urine and cannot squeeze hard enough to get rid of all the urine – hence the frequent trips to the toilet. The urethra also becomes shorter and the lining becomes thinner. Most of these changes are inevitable with age, but it does not mean that you have to let it deteriorate to an unbearable point. Some problems are manageable, but when infections arise, you need to seek medical attention.

Age and UTIs

Urinary tract infections are common among older women, especially those who have undergone menopause. This is because the shortening of the urethra and thinning of its walls, as mentioned above, cause the organs to become less resistant to bacteria. It also makes it easier for bacteria to travel to the bladder. As the bladder has lost its elasticity, the urine that stays in the bladder creates a breeding ground for bacteria to grow. This is called a urinary tract infection (UTI), although if it occurs in the bladder specifically, it is called cystitis.

Women with UTIs will experience a frequent and urgent need to urinate, sometimes even right after they have just urinated. There may also be a painful, burning sensation when urinating, and the urine will be cloudy and foul-smelling. If a simple UTI or bladder infection is left untreated, the infection can spread to the kidneys. This form of infection is very dangerous, and can lead to blood poisoning, damaged kidneys, and even death.

You should suspect a kidney infection if the earlier UTI symptoms escalate into a fever, blood in the urine, nausea, diarrhoea, and pain in the back or side, near the waist area. UTIs should be treated early with a proper prescription of antibiotics by your doctor. You can also practise a few home remedies to prevent recurrent infections. The most important thing is to drink sufficient water (six to eight glasses a day) to ensure the waste in your body is eliminated.

Practise good personal hygiene in the genital area, especially after urination, bowel motions, and sex. After using the toilet, wipe from the front to the back. Use unscented toilet paper and absorbent sanitary pads, keeping in mind to change your pads and liners frequently. Avoid feminine hygiene sprays and douches, as these do more harm than good. When you feel the urge to urinate, go to the toilet immediately and don’t hold it in.

Be conscious of changes in your usual routine, such as changes in the colour or odour of the urine, quantity and frequency of urination, your ability to control urination, as well as pain or other sensations related to urination. Do not let urinary disorders ruin your life. Get them treated and you can enjoy life again.

The Star Newspaper, Sunday December 19, 2010
Dr Nor Ashikin Mokhtar

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