American Medical Association Family Medical Guide - American Medical Association [593]
Cervical polyps
Cervical polyps are small, bulbous growths on stalks that protrude into the cervix from the lining of the uterus. Usually they are benign.
Disorders of the Bladder and Urethra
Located in the lower part of your abdomen, the bladder holds urine until you release it from your body during urination. The bladder lies in front of the uterus, just above the pubic bone. Urine drains slowly from your kidneys down two thin tubes called ureters into your bladder, where the urine is stored until you eliminate it through a short passage called the urethra.
Disorders of the bladder and urethra that affect both men and women are discussed in the chapter on disorders of the urinary tract (see page 801). The disorders included here either affect women exclusively or affect women differently than men.
Bladder and urethra
Cystitis in Women
Cystitis is inflammation of the bladder caused by a bacterial infection. The bacteria first infect the urethra and then travel up to infect the bladder. Most women have an episode of cystitis at some time in their life. It is especially common during times of increased sexual activity, such as on a honeymoon. Left untreated, the infection can spread to the kidneys, causing a kidney infection called acute pyelonephritis (see page 804).
To help prevent bladder infections, always wipe from front to back after bowel movements, drink lots of water, keep your genitals clean, wash your genital area before and after intercourse, and empty your bladder after intercourse. Ask your partner to wash his genitals before intercourse.
Symptoms
If you have cystitis, you will feel a frequent, painful urge to urinate, but when you try to urinate, you are able to release only a small amount of urine. The urine may have a strong smell, may contain blood, and you will feel burning or stinging when you urinate. The urge to urinate may be so strong that you cannot control it. You may also have a fever. Other urinary tract problems, such as urethritis (see next page), can produce similar symptoms.
Diagnosis
If you have symptoms of cystitis, your doctor will ask you for a midstream urine specimen in which you collect the urine sample in a sterile container after you have started to urinate. The doctor will test the sample in the office for pus, which indicates an infection, and then send the sample to a laboratory to identify the organism that is causing the infection.
If you have more than two or three episodes of cystitis within 6 to 12 months, your doctor may refer you to a urologist (a doctor who specializes in urinary tract disorders), who can determine whether you have a urinary tract abnormality that is making you susceptible to bladder infections. The urologist will examine you and may ask for additional midstream specimens of urine. Sometimes an ultrasound is performed to detect an abnormality. You may also have a procedure called an intravenous pyelogram (IVP), which is an X-ray of the kidneys and bladder, and an examination of the bladder called a cystoscopy, in which the doctor uses a viewing instrument to see inside your urethra and bladder.
Treatment
If your symptoms are very mild and you do not have a fever, try to flush your urinary tract by drinking lots of fluids—at least eight large glasses a day—to relieve your symptoms. Drinking cranberry juice may help flush out bacteria. If the symptoms persist longer than 24 hours or are severe, see your doctor. He or she will prescribe antibiotics or other drugs to treat the condition.
If you have recurring infections and if diagnostic tests find an abnormality in your urinary tract, the urologist will treat it. If no abnormality is found, the urologist may prescribe low-dose antibiotics or antibacterial drugs for you to take for a month or more, or only around the times you have intercourse.