American Medical Association Family Medical Guide - American Medical Association [595]
Treatment
You can probably control urge incontinence with a few lifestyle changes if you don’t also have stress incontinence or a pelvic support problem. Limit your intake of caffeine-containing drinks such as coffee or cola, which increase fluid loss from the body by increasing the need to urinate. Urinate before leaving the house, and make sure you know where the bathrooms are in malls, restaurants, and other destinations.
If these measures are not effective, your doctor may prescribe a drug that relaxes the contractions of your bladder muscles or reduces the activity of the nerves that control the muscle contractions that affect urination. Another treatment involves inserting an electrode the size of a tampon into the vagina to stimulate the pelvic floor muscles that support the bladder, making the muscles stronger.
Chronic Urethritis
Chronic urethritis is the term used to describe recurring inflammation of the urethra. The symptoms are similar to those of cystitis (see previous page), except that they last for only 1 or 2 days. Infection is the usual cause—often a sexually transmitted disease such as chlamydia (see page 477)—although the microorganism that is responsible cannot always be easily identified. The urethra can also become inflamed during intercourse or from exposure to some spermicides, bath oils, or other chemical irritants.
Symptoms and Diagnosis
Chronic urethritis causes burning and stinging during urination, frequent urination, and a sudden urge to urinate.
If you have symptoms of urethritis, the doctor will ask you for a sample of urine for analysis to find out if an infection is causing the problem. He or she may also take a sample of vaginal discharge to determine if you have a sexually transmitted disease. If these tests do not show signs of infection, the doctor may perform a cystoscopy, in which he or she uses a viewing instrument to examine the inside of your urethra.
Treatment
If the underlying cause of the inflammation is an infection, it can usually be treated successfully with antibiotics or antibacterial drugs. If no infecting organism is found, the doctor will recommend that you empty your bladder completely after each time you have intercourse or after you engage in any other activities that could irritate your urethra, such as riding a bicycle vigorously or for a long time. Keep your genitals clean by washing them before and after having intercourse. Ask your partner to wash his genitals before intercourse.
Disorders of the Vagina and Vulva
The vulva is the outer area that surrounds the opening to the female urinary and reproductive systems. It consists of two outer folds of tissue called the outer labia, which lie on each side of the openings of the urethra and the vagina. The vulva also includes the inner labia, folds of tissue that enclose several lubricating glands and the clitoris (a small, sensitive organ that swells in response to sexual stimulation). The vagina is the passage that connects the vulva with the uterus. The tissues of the vulva are susceptible to skin problems such as warts or severe itching. The lining of the vagina and glands in the vulva produce fluid that cleanses the vagina, lubricates it during intercourse, and makes it easier for sperm to pass up to the uterus.
The vulva
Bacterial Vaginosis
Bacterial vaginosis (often referred to as BV) is the most common vaginal infection. It results from an overgrowth of one or more types of bacteria (usually gardnerella bacteria) that are normally present in the vagina in smaller amounts. When these bacteria overgrow, they prevent the protective bacteria from maintaining a healthy balance of microorganisms in the vagina. The infection can affect the vagina, urethra, bladder,