The urinary incontinence

The urinary incontinence (IU) consists of the involuntary loss of urine.  The it affected has a sudden and imperious need of urinates but is incapable to retain the urine.  The escapes can be produced al to sneeze, to laugh, to carry out some effort or physical exercise.  It supposes a psychic, social, and sanitary problem, since influences in the routine activity of the sick one and reduces its quality of life.  The incontinence is not an illness in itself, but the consequence of an alteration in the phase of filled vesical that is presented in numerous illnesses.  It can be declared to any age and in both sexes.  Nevertheless, is more frequent in the women that in the men.

People that suffer it

Any abnormality that cause an obstruction of the flow of urine (stones in the kidney, anomalous structures. ..) can induce to a urinary infection.  A dilated prostate can also brake the flow of urine, for which increases the risk of infection.

The people submitted to exams by means of pipes or catheters or that need you probe can develop more easily infections originating in said instruments.

The greater they are seen affected by this type of infections with greater frequency, as well as the ones that suffer a decrease of the nervous system, that impedes to control the bladder to will.

On the other hand, any disorder that produce a suppression in the immune system increases the risk to suffer a urinary infection, since this system is the responsible for maintaining to line the pathogenic microorganisms responsible for the infections.

Also they are given in born babies with some deformation of the urinary tract, that often they should be corrected by means of surgery.

Symptoms

- Frequent and urgent Need of urinates.

- Stinging feeling or quemazón in the urethra al urinates.

- Reddening of it return and vaginal itch (in the women).

- Pain al urinates and in the sexual relations.

- Milky, murky Color (thick) or abnormal of the urine.

- Apparition of blood in the urine.

- Fever and chills (the fever can signify that the infection has reached the kidneys).

- Vomitings and queasiness.

- Pain in the side or back (indicates infection in the kidneys).

- Often, the women feel a light pressure above the bone púbico and many men feel an enlargement of the straight one.

- To Be more irritable of the normal thing.

The childlike symptoms, in turn, they can be confused with other inconveniences; besides, they are found before the difficulty of know not to express what passes them.  Nevertheless, if a boy presents a urinary infection he can declare the following indications:  – To Be more irritable of the normal thing.

- Not to eat as does it normally.

- To Have fever for no apparent reason that besides does not have just disappeared.

- Not to be able to be endured the urine.

- To Suffer alterations in its development.

Diagnostic

The tests and analysis that will have to be carried out a patient they will depend on the zone where is presumed that situates the infection and of the symptoms that this suffer.  Some of the most general tests are the following:  – Physical Exam:  The doctor palpates the pelvic and abdominal zone of the patient to detect the places in pain or with reddening.

- Analysis of urine:  With a sample of urine of the patient is examined if this contains some infectious agent (harmful germ).

- Cultivations of urine, vaginal or liquid liquid uretral:  A drop is sown of some of these liquids in a plate with nutrients for bacteria and, after elapsed several hours so that these grow, what type of bacteria is determined is the cause of the infection and what antibiotics can result troops (antibiograma).

- Citoscopia:  It consists of introducing for the urethra a pipe provided of lenses and light to observe directly the state of the urethra and the urinary bladder.

- Abdominal Ultrasound:  It is a painless study of the abdomen that is carried out by means of ultrasonidos that form an image in a monitor.

- Urografía:  It is a x-ray of the kidney, for which one must inject previously a substance that will create a contrast and the kidney will be able to be observed with facility.

Processing

The infections of the urinary apparatus treat with antibiotics, if they are caused by bacteria, or with antiviral (as the aciclovir) if they are caused by virus.  To administer efficiently one and another type of medicine, the medical specialist has the possibility to carry out a test of sensibility or antibiograma, that helps to elect the most effective one against the type of microorganism that is producing the infection.

The most they used antibiotics are the trimetoprim, the amoxicilina and the ampicilina.  Also a class of called medicines quinolonas have been approved in recent years for the processing of the infections of the urinary tract, like they are the ofloxacina, ciprofloxacina and trovafloxina.

Before being initiated the processing with antibiotics, the doctor determines if the patient suffers some inconvenience that can aggravate the infection, like an alteration of the nervous activity, a diabetes or a decrease of the defenses of the agency that can reduce the capacity of this last of fighting the infection.

In patients that suffer infections by Chlamydia or Micoplasma necessary a more long processing is done with tetraciclina or a combination of trimetoprim and sulfametoxazol.  A subsequent analysis helps to confirm that the urinary tract is free of germs.  The patients with infections of serious kidney have to be hospitalized until they can take fluids and medicines by their account.

The doctors think that to drink large aid water quantities to clean the urinary tract of bacteria and that is better to stop smoking (the tobacco is the main cause of the cancer of bladder) and to drink coffee, alcohol and foods with spices while the infection be maintained.

If the infection themselves due to a physical obstruction of the urine (to a stone, for example), can be necessary the surgery to eliminate that that produces the obstruction or to correct a possible physical anomaly as they could be a uterus and a bladder fallen.

The litotricia extracorpórea can disintegrate the stone by means of shock waves produced by means of a called apparatus litotritor.  Also it can be eliminated a stone of the kidney by means of the nefrolitotomía percutánea, that consists of a small incision in the back to create a direct tunnel al kidney by where is introduced a called instrument nefroscopio, that serves for locate and to extract the calculation.

To alleviate the symptoms that produce the infections of the urinary tract (urinary urgency, pain al urinates, spasms. ..) are utilized different types of medicines as the atropina and the fenazopiridina.
Prevention

As first preventive measure, is advisable to drink a large quantity of liquids.  In many cases of urinary infection antibiotic processing can be dispenses with only with taking this precaution.

The infections of sexual broadcast are easily avoidable; the use of condoms is used to being sufficient to impede them.

In turn, the vaccine against the urinary infection has an effect estimulador of the production of antibodies, that accumulate to be defended immediately against the microorganisms, in the event that the infection came to be produced.

In the case of the men, a correct and daily personal hygiene is an important measure to avoid the infections of urinary ways.

For the women, the sprays sanitary and deodorants are normally unnecessary; at times, even they turn out to be damaging.  If a spray for the vaginal hygiene is utilized, not one must direct it never toward the interior of the vagina, since can irritate the vaginal weaving.  If, at any rate, the skin of it return begins to be reddened or to be irritated, one must leave to use it because due to an allergic reaction to some component of the product.

The hygiene of the genital zone should be carried out employing water and a smooth soap once al day, to prevent, among others things, the apparition of urinary infections.  The vagina themselves clean by itself: its walls produce a fluid that drags the dead cells and other microorganisms al exterior.

The vaginal showers are generally little advisable, because they drag the “plug” of mucus that protects the entrance of the cervix of infectious microorganisms.  In spite of this, the doctor at times recommends them.  In that case, the recommendable thing is to maintain somewhat far away the mango of the shower to reduce the pressure of the spurt of entrance; otherwise, the vaginal agencies are dragged toward the uterus (headquarters), where they would be able to cause an infection.

The bacteria and germs that cause the vaginal infection tend to be developed in conditions of heat and humidity.  By this reason is recommendable to utilize knickers of adjusted little cotton (those of naylon cause humidity and heat in the genital area).

Finally, the anal hygiene should be done always toward atrá

Infection of urine in the Pregnancy

The changes that occur in the woman by the embarrassment to level of the urinary system, they favor the development of the urinary infection, complication that puts in risk to the mother and al fetus because relates to the threat of premature birth and other risks as a high arterial pressure.

The pregnant woman should perform in her first control prenatal a general exam of obligatory urine, to detect of early form any data of infection and to give adequate processing.

Urinary infections of repetition

When the picture of the infection persists and is repeated in several occasions, the processing for the woman one must undertake it since a triple focus:  – The adequate processing of the first episode is fundamental to avoid the repetition of the urinary infection.

- One must correct the alterations anatomical or functional capable to perpetuate or to favor the bacteriuria as well as the flattering dietary and sanitary habits of this.

- To Present a preventive processing in function of the urinary infections episodes number of repetition.