• March Newsletter

    March Newsletter

    Welcome to the March Newsletter

    Thank you to everyone who has attended our two open meetings in the practice. They were very informative and enjoyable and we are hoping to run a series of meetings over the coming year and are open to suggestions on topics of interest to you.
    Please leave any suggestions with Anne your practice manager, we would be delighted to hear from you.
    This month we would like to focus on Bladder Health.
    What is your Bladder ?
    bladder

    Your bladder is part of your urinary tract. This consists of two kidneys, which filter waste from your blood and produce urine. Urine travels through a tube leading from each kidney to the bladder called a ureter. Your bladder is a balloon shaped pouch made of a thin layer of muscle with a smooth lining. It sits behind your pubic bone. Urine collects here until you are ready to urinate. You usually start to get an urge to urinate when your bladder is half full. A muscle called the sphincter contracts to prevent urine from passing until you decide to do so. When you decide to pass urine the sphincter relaxes and the bladder muscle contracts. Then urine leaves the body through a tube called the urethra. In men the prostate gland surrounds the urethra.

    pic bladder

    Urinary tract infections (UTI’s)
    Normally the bladder is free from germs but the skin just outside the bladder has plenty of germs and bacteria that normally live there called commensals and these can sometimes travel into the bladder and cause infection, this happens more commonly in women because the urethra is shorter and at certain times when the urethra is more relaxed e.g. during pregnancy.
    UTI in men or children is uncommon and may need further investigation. Symptoms of infection in the bladder or cystitis may include: passing urine more frequently, pain or burning sensation when passing urine, infection can occasionally cause blood in the
    Urine but if this happens you must see your doctor as soon as possible.
    If you have fever, chills or shaking called rigors the infection may be higher up in the urinary tract or the kidneys.
    Infection is usually treated with a course of antibiotics; your doctor may decide further tests are necessary if you have recurrent infections.
    1 in 3 women and 1 in 10 men will have at least one UTI in their lifetime.
    Urinary Incontinence
    Incontinence is more common than you may think, in Ireland it affects men and women equally about 16% of all men and 16.9% of all women in Ireland suffer from incontinence. Contrary to popular belief it is not a normal part of aging but is more common with age.
    There are two types of incontinence
    Stress Incontinence and Urge Incontinence
    Many people are embarrassed to say that they have incontinence and delay seeking help, many people wait years before they mention the problem to their doctor. Incontinence can affect your social life, your mood and / or your relationships, but there are treatment options and if you do have symptoms please discuss ways to help with your doctor.
    Stress Incontinence
    This occurs when there is extra effort exerted on the pelvic muscles, and if the pelvic muscles are weak the sphincter muscle is overcome and some leaking occurs.
    This can happen during coughing, sneezing, jumping, jogging, straining, lifting and getting up from sitting position.
    The major risk factor for women is childbirth or later in life prolapsed uterus and for men it is prostate surgery that can sometimes damage the sphincter muscles.
    Urge Incontinence
    This is usually due to a condition called over active bladder. This is due to muscles of the bladder contracting before you want them to and this overcomes the sphincter muscle and leaking occurs before the toilet is reached.
    This can occur due to irritation of the lining of the bladder due to recurrent infections, nerve damage to the nerves that control the bladder or frequent ingestion of irritants such as caffeine or acidic fruit juices.

    Mixed Incontinence – Is when both conditions occur together.
    Overflow Incontinence
    Is when the bladder is blocked from emptying fully e.g. with an enlarged prostate and can result in a constant dribbling of urine. If this is happening for you contact your doctor for treatment options.
    Other causes of incontinence include spinal injury or neurological disorders like Parkinson’s disease or MS.
    Haematuria
    This is blood in the urine. You must see your doctor if this happens, as it could be a sign of bladder cancer.
    If bladder cancer is detected early it is usually curable, you will usually be referred to a Urologist for a camera test into the bladder called a cystoscopy and you may need to have an ultrasound scan of your kidneys.
    Usually the cancer is adherent to the wall of the bladder and can be completely removed if detected early.
    Risk factors for bladder cancer include smoking, almost 50% of those with bladder cancer smoke
    Other risk factors include working in a dyeing industry and contact with other
    Chemicals / pesticides.
    Interstitial cystitis
    This is a chronic inflammatory condition in the wall of the bladder that can cause pain when passing urine or mucus production. There is usually frequency or urination but no infection when you doctor tests the urine.
    Women may experience pain during sexual intercourse and both men and women may experience groin pain.
    This condition is more common in those with diabetes.
    Treatments available

     

    • Diet and bladder irritant review
    •  Lifestyle advice e.g. if you get up in the night to urinate don’t drink a glass of water before bedtime
    •  Medication in tablet or patch form
    •  Post Tibial nerve stimulation for overactive bladder
    •  There are surgical treatment options for prolapse
    •  Ring pessary may be helpful
    •  Better diabetic control
    • Referral to the continence care clinic
    •  Referral to physiotherapist for pelvic floor exercises
    • Referral to urologist or gynaecologist may be helpful

    What can I do to maintain a healthy bladder?

     

    •  Over 40? check your urine annually
    •  If you see blood in your urine, see your doctor
    • Don’t smoke, smokers are 2-3 times more likely to develop bladder cancer
    •  Avoid constipation; eat a diet high in vegetables
    •  Drink 4-6 glasses of water per day
    •  When toileting wipe from front to back
    •  When urinating don’t rush, take your time and void completely
    •  Urinate as soon as convenient after sexual intercourse

    If you have any questions about anything you have read be sure to ask your doctor.
    We are having an information evening on Women’s Health on Wednesday 26th March at 7pm and we hope you will attend for further information. We will also be having an information evening on men’s health in the near future.
    We have a new calling system in the practice and feedback has been very positive so thank you for all your comments.
    We have also streamlined the appointment system for the blood clinic and have received positive comments about this also, many thanks.
    Patients are being called in sequence by their given appointment time. We would ask you not to arrive too early before your appointment time to avoid delays.
    As always when booking appointments for any procedure or smear test it is important to let us know so that we can allocate the proper time for your appointment.
    The evenings are getting longer and spring is in the air!
    Have a Happy Healthy March.
    From Dr Steele and everyone at Buncrana Medical Centre

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