Urinary Disorders

Urine produced by the kidneys is stored in our bladder from there due to an increase in bladder size, as water is passed into it, it eventually stimulates nerve endings this in turn produces the feeling that tells us we need to pee (pass water).

The muscle that surrounds the neck of the bladder is called the sphincter and under normal health conditions keeps the bladder closed until the feeling to pee is felt. The muscle would then be consciously relaxed to allow the urine to pass into the urethra which channels the urine for expelling from the body.

There are a number of disorders that affect the normal function of the bladder. The most common one that most people are aware of is called cystitis which affects the bladder, while urethritis affects the urethra tube which is attached to the bladder and carries the urine out of the body.

Other disorders are urinary incontinence which is a loss of control over urination, and urinary retention which is an inability to expel urine and is not as common a problem as cystitis. Various drugs can be used to treat these problems, such as: Analgesics, antibacterial drugs, drugs to increase the acidity of the urine and drugs that act on the nerve control over the bladder and the sphincter which holds the neck of the bladder closed.

Medication for Urinary Infection

There are a number of drugs that can be used to treat urinary infections which are caused by bacteria. symptoms include a continual urge to pee (urinate), although often nothing is passed, there is also pain when urinating and lower abdominal pain.

There are a number of drugs that could be used to treat a urinary infection. Among the most widely used because of their effectiveness would be trimethoprim and amoxycillin and antibacterial drugs.

There are times when there would be a need to increase the acidity of the urine making it hostile to bacteria. The same effect can also be created by using ascorbic acid (vitamin C) and acid fruit juices would also increase acidity. To help in the relief of cystitis making the urine less acidic with potassium or sodium citrate would help to relieve the discomfort from this common complaint. To get the maximum benefit from drugs used to treat urinary infections it would be advised to increase your fluid intake, this would help flush the urinary system.

Medication for Incontinence

There are a number of reason why incontinence occurs and it is important to realise that not all require drug intervention. Stress incontinence is one such disorder, here all that would be required is exercise to strengthen the pelvic floor muscle, failing this surgery to tighten up stretched ligaments may be effective. Stress incontinence is commonly found in women who have had children. Having children can often cause a weakening of the sphincter muscle (the neck of the bladder) which allows small amounts of urine to pass involuntary when sneezing, coughing or physical exertion increases abdominal pressure.

Urinary urgency (a sudden urge to pee) is another incontinence problem and often occurs as a result of irritation and/or inflammation of the bladder wall known as the urothelium*.
This disorder stems from the over-sensitivity of the bladder muscle. Small amounts of urine trigger the need to pee frequently. It is possible for this complaint to be helped by using anticholinergic and antispasmodic drugs. These type of drugs work by reducing the nerve signals from the muscles in the bladder this in turn allows for a greater volume of urine to build up, without stimulating the need to pee as often.

*The urothelium is the tissue layer that lines much of the urinary tract, including the renal pelvis, the ureters, the bladder, and parts of the urethra.

Multiple sclerosis (neurological disorder) can also cause incontinence this is due to a loss of nerve control which is a feature of this disorder and would be unlikely to be help with drug control. A term known as nocturnal enuresis (bed-wetting in children) is also considered an incontinence disorder. Tricyclic antidepressants such as imipramine have anticholinergic effects and has been used to treat enuresis (bed-wetting at night) in children. Another medication used to treat nocturnal enuresis (night time bed-wetting) is desmopressin.

Medication for retention

The inability to empty the bladder is known as urinary retention (also known as ischuria) this is caused when the bladder muscle fails to contract sufficiently allowing for the expelling of accumulated urine. possible causes could be prostate problems (enlarged prostate gland) a tumour or maybe a long-standing neurological disorder, it is also known that some antidepressants, COX-2 inhibitors, amphetamines and opiates as well as Various pharmaceuticals can cause this problem. Acute retention caused by complete anuria* is a medical emergency, as the bladder may distend (stretch) to enormous sizes and possibly tear if not dealt with quickly.

*Anuria is often caused by failure in the function of kidneys. It may also occur because of some severe obstruction like kidney stones or tumours and chronic kidney disease. (and others)

In the vast majority of cases a tube (catheter) needs to be inserted into the urethra which drains the urine from the bladder without relying on bladder muscle control. There may also be a need for surgery to stop the recurrence of the problem. Drug treatment to relax the sphincter or to stimulate bladder contraction for urinary retention is rare. Types of drug are used for long-term treatment of prostate enlargement, finasteride which prevents the production of male hormones and alpha blockers such as terazosin, prazosin and indoramin. These drugs relax the prostate and urethral smooth muscle which makes for improved urine flow and release. Long trem drug treatment for this complaint can relieve the symptoms and delay the need for surgery.

Common Drugs Used To Treat Urinary Disorders

Anticholinergics

• Flavoxate
• Imipramine
• Oxybutynin
• Propiverine
• tolterodine
• Trodpium

Parasympathomimetic

• distigmine

Alpha Blockers

• Alfuzsin
• Indoramin
• Prazosin
• Tamsulosin
• Terazosin

Other Drugs Used

• Desmopressin
• Finasteride
• Potassium citrate
• Vitamin C
• Dimethyl Sulphoxide