Hesperian Health Guides
Other Problems of the Urine System
Blood in the urine
If your urine has blood in it, and if there are no other signs of a bladder or kidney infection, you may have bladder or kidney stones (see below). Or you may have one of these diseases, if they are common in your community:
- Bilharzia (blood flukes, schistosomiasis) can cause permanent damage to the urine system if it is not treated early enough. See a health worker trained in problems of the urine system for treatment, and to learn how to prevent bilharzia from happening again. For more information about bilharzia, see Where There Is No Doctor or another general medical book.
- Tuberculosis (TB) can damage the bladder and kidneys.
Kidney or Bladder Stones
These are small hard stones that start to grow in the kidney, and then move through the urine system.
- Sudden, very bad pain: in the back where the kidneys are, or in the side near the kidneys, or lower down in the urine tubes or bladder.
Other signs are:
- Blood in the urine. This can happen if the stones scratch the inside of the urine system.
- Difficulty passing urine. This can happen if a stone blocks the tubes.
- Drink large amounts of liquid (at least 1 or 2 cups every 30 minutes). This will help wash the stone out of the kidney and down the urine tube.
- Take a pain medicine. If the pain is very bad, get medical help.
Sometimes the blocked urine tubes become infected. Treat this problem the same way you would treat a kidney infection.
Need to pass urine often
This may happen because:
- the muscles around your bladder and womb have become weak. The ‘squeezing exercise’ may help strengthen these muscles.
- a growth (like a fibroid) in your abdomen is pushing against the bladder so it cannot hold much urine.
- you have a bladder infection.
- you have diabetes.
Poor control of urine (incontinence)
This is caused by weak or damaged muscles around the bladder. It happens mainly to older women or to women after childbirth. The urine leaks out when a woman puts pressure on the weak muscles in her lower belly during sex, or by laughing, coughing, sneezing, or lifting. The ‘squeezing exercise’ may help.
Urine leaking from the vagina (fistula)
When a woman leaks urine all the time from the vagina, she may have a hole between her vagina and bladder. (Sometimes the hole is between the rectum and the vagina, and stool leaks out.)
This serious problem happens as a result of an obstructed childbirth, when the baby has difficulty getting out. It can happen to women of all ages. The baby’s head presses on the skin between the bladder and the vagina (or the rectum and vagina). This causes an opening (fistula) to form between the bladder and the vagina (or the rectum and vagina). The baby is almost always born dead.
After the birth, the fistula does not heal on its own and urine or stool leaks out through the vagina all the time. The girl or woman has to clean herself continuously, and if she has extra cloth or a pad, she can wear this to stay dry. If she cannot get help, fistulas can cause serious problems for a girl or woman in her daily life. Her husband, family, and friends may avoid her because she smells of urine all the time. It may be difficult for her to earn money if she no longer can work, and she may feel extremely embarrassed and ashamed.
Some girls and women get “traumatic fistula” because of rape or other violent sexual actions such as a weapon being pushed into a vagina. This can cause tears inside the woman that also cause her to leak urine or stool. Girls and women with traumatic fistula will need support and counseling about the sexual violence, as well as surgery to repair the fistula and other damage to their genitals.
If you have leaking urine or stool after giving birth, seek medical help right away.
After the birth, if you are leaking urine or stool, talk with a health worker as soon as possible to find out if she or he knows of a hospital where the fistula can be repaired. You should go to the hospital as soon as possible. If you are leaking urine and cannot get to the hospital quickly, the health worker may know how to put in a plastic or rubber tube (catheter) through the urine hole into the bladder. This tube will drain the urine and may help the fistula heal. But you must still go to the hospital. When you get there, the doctor will examine you to see if you need an operation to repair the fistula. Do not despair. The problem can often be made better.
- Avoid marriage and pregnancy until a girl is 18 years old.
- All women should deliver their babies with a trained midwife or health worker.
- Women with extra risks should give birth at a hospital.
- Do not have babies too close together, so that your muscles can get strong again in between births.