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Your urine may be 95 percent water, but it can reveal whether you're pregnant, have diabetes, are taking painkillers, or even ate asparagus for lunch. It contains an awe-inspiring number of elements, including proteins, enzymes, minerals, hormones, electrolytes, and vitamins. Researchers say that someday urine may help doctors diagnose cancer.
The system of organs that manufactures your pee is equally remarkable -- until something goes wrong. More than half of all women suffer from incontinence, compared with a mere 14 percent of men, according to one large study. And you're also more likely to suffer infections and other pee-related problems than your guy (at least until middle age, when men's prostate problems start to swell). Adding insult to injury, you can't even pee standing up.
On history's stage, pee has had some pretty wacky roles. The Aztecs cleaned wounds with it and ancient Romans used it to whiten their teeth. Some World War I soldiers used pee-soaked cloths as gas masks, and more recently the U.S. military developed dried meals that can be rehydrated with urine. The practice of ingesting or applying the stuff, known as urine therapy, purportedly wards off disease, though peeing on a jellyfish sting probably won't stop the pain. Read our guide and you'll come away with a whole new appreciation for your urinary system.
Now or Never How do we know when it's time to go? Nerves in the bladder sense how full it is and send a message to the brain: toilet, now. Or, a little later, Toilet now! "Peeing is complicated," says ob-gyn Sandy Culbertson, MD, at the University of Chicago. "Three sets of muscles must work in coordination: The pelvic floor muscles and the urethra must relax, then the bladder must contract."
The answer is yes -- and no. If you're stranded or, say, shipwrecked, experts say drinking urine could extend your life by a day or two. There are famous examples of people who have done it, like Aron Ralston, who cut off his arm to save his life while trapped in a Utah canyon. But the chemicals in urine are toxic enough that even the military has advised soldiers not to drink it. There's a reason it's meant to be waste.
Women suffer more than men from urinary tract infections, overactive bladder, interstitial cystitis (now often referred to as bladder pain syndrome), and two kinds of incontinence, while men get more bladder cancer. Here are the facts.
Urinary Tract Infections
If you're having trouble peeing even though you feel you need to, that's a warning sign of a UTI. Burning or pain with urination are also symptoms, says Ziya Kirkali, MD, senior scientific adviser in the division of kidney, urology, and hematology at the NIH. Your doctor will do urinalysis to determine the source of the trouble. The most common culprit is E. coli, which causes up to 90 percent of UTIs. Unfortunately, for many women, having one means getting many more. No one knows why some women are more vulnerable, but several factors contribute. Bacteria stick to the lining of some people's bladders more easily, and they can't just pee it out. When your estrogen decreases after menopause, that makes the tissues of the urethra and bladder more fragile and a less effective barrier to infection. ?And for many women, having sex puts them at risk," Dr. Culbertson says, explaining that it's probably a matter of mechanics. Because women's urethras are short, bacteria from the vagina can get pushed up into the bladder by sex (hence the term "honeymoon cystitis").
Only antibiotics can cure the infection, but there are ways to ward off recurrences. You may not be drinking enough water, or you're waiting too long to pee. Dr. Culbertson recommends that you drink five to eight glasses of water a day and pee every two hours. If your tissues have thinned after menopause, a vaginal estrogen cream can help. Wendy Cohan, RN, author of The Better Bladder Book, points out another preventive measure: ?You need to wipe correctly, from front to back. Surprisingly, some people don't." While this one may sound a bit fussy, Cohan also recommends that you and your partner wash your hands and genitals before and after sex. Cranberry juice has also been heralded as prevention for UTIs, but research hasn't shown definitively that it works. It shouldn't replace antibiotics if you have an infection, but it couldn't hurt to try if you have recurrent episodes.
Doctors don't know what causes this chronic inflammation of the bladder wall. You feel pain as urine starts to fill the bladder and get relief once you pee. And when your bladder is inflamed, you feel the urge to go even more often. Up to 8 million women may have IC, according to the Interstitial Cystitis Association.
Sometimes just changing your diet can ease the symptoms. Try cutting out these five categories of foods and beverages, which can irritate the bladder:
Common treatments include physical therapy or biofeedback to relax the pelvic muscles, medications such as pain relievers, low-dose tricyclic antidepressants and antihistamines to help relieve frequency, a drug called Elmiron that coats the bladder (as Pepto-Bismol coats the stomach), anesthetic medicines administered through catheters, and sometimes even surgery.
Incontinence might make you think of adult diapers, but the problem is seldom that bad. If you release a tiny spurt of pee when you cough, sneeze, or laugh, that's stress incontinence. Not the end of the world, but it can be embarrassing. What causes it? Pregnancy, childbirth, and menopause all weaken the muscles that control peeing. And obesity literally weighs down your bladder. You might also have some leakage during intercourse if your pelvic muscle tone isn't good, says Dr. Kirkali.
Kegel exercises strengthen your pelvic-floor muscles, and cutting out certain foods can help (see foods and drinks to avoid in the interstitial cystitis section). If you're overweight, drop some pounds. Other therapies include biofeedback, which alerts you to when your bladder muscles are contracting so you begin to control them, and collagen injections to thicken the tissues that surround the urethra. In severe cases, surgery can create a "sling" to support the bladder and reduce leakage. But do your research: Complications from some mesh slings have triggered an FDA report about safety concerns.
The nerves and muscles of your bladder work overtime, so the bladder contracts even when it isn't full. An overactive bladder can send you to the bathroom incessantly, whether you need to go or not.
As with stress incontinence, biofeedback and doing Kegels can put you back in command. Or retrain your bladder by peeing on a schedule, every two hours at first, then gradually increasing the time between pees. Meds called anticholinergics relax bladder muscles, calming that constant urge to go. In certain cases surgery to expand bladder capacity reduces symptoms. Nerve stimulation is another option.
Women have a lower risk (one in 86) on this one than men do (one in 26). Symptoms include blood in your urine, back or abdominal pain, and pain when you pee. Smoking is one of the biggest risk factors. Recent research suggests that not drinking enough liquids may also increase your risk.
If bladder cancer is detected early enough, 97 percent of patients live five years or longer. Treatment usually involves surgery to remove the tumor, possibly combined with radiation and chemotherapy or immunotherapy. In advanced cases, the entire bladder may be removed; afterward, you will pee into a bag or use a catheter.
The hue of your pee provides a spectrum of information. Many color changes are harmless, but see your doctor if they persist.
Urinalysis is a cheap and effective way to figure out how well your body is functioning. Your pee can reveal a lot about your habits and your health. "It's a great fluid to let us investigate diseases of various systems of the body, not just the urinary tract," says Dr. Kirkali. Here's what some of those indecipherable words on your lab report might mean.
pH Normal range is 4.6 to 8.0. Acidic urine could indicate diabetes, dehydration, or diarrhea, while alkaline urine might signal a UTI.
Specific Gravity Normal range is between 1.020 and 1.028. If it's too low it could be nephritis, inflammation of the nephrons caused by a reaction to a drug, long-term use of painkillers, or an autoimmune disease. If it's too high, it could be diabetes or a fever.
Protein Levels can rise temporarily after exercise, but persistent high levels can indicate kidney damage.
Glucose Excess glucose, or sugar, in your urine might mean diabetes.
Red Blood Cells Could indicate kidney stones, bladder stones, or other urinary disorders, including cancer.
White Blood Cells High levels of leukocytes, or white blood cells, usually indicate that your body is battling an infection.
Ketones High levels of ketones, created when your body breaks down fat, can indicate diabetes, or that you're on a high-protein diet.
Bilirubin This substance is created by the breakdown of red blood cells; high levels could indicate a liver disorder.
Yeast Too much can mean a urinary tract infection.
Bacteria Also indicates a urinary tract infection.
Crystals Can mean painful kidney stones.
Odor & Out Unlike poop, pee is sterile, until it picks up bacteria passing through the urethra. When it comes out of your body, healthy urine doesn't even smell. But leave it sitting for a while and it'll stink. That's because one of the main components, urea, breaks down when exposed to air, giving off an odor of ammonia.
Seems like giving a urine sample really couldn't be simpler: just pee into a cup. But doing it right takes a little finesse. Here's the Mayo Clinic's clean-catch technique.
"I'm always on my feet at work and have few chances to go to the restroom. If I cough, I pee. If I sneeze, I pee. I wear a pad 24/7 because I never know when or if I'm going to have an accident!"
-- Joanie, Park Rapids, Minnesota
"My bladder trouble got really bad after the birth of my first child. My doctor says I have a form of urge incontinence. The worst part is getting the panicky feeling when you are somewhere without a public restroom, or there is one but it's really hard to get to fast, like at the mall."
-- Kayla, Weatherford, Texas
"I get a urinary tract infection about every six months. In college I couldn't have sex without getting one, even though I'd pee right afterward. It got so bad that I was taking low-dose antibiotics daily just to prevent them. Having a UTI is such a pain. Really, it hurts!"
-- Fallon, Miami, Florida
Do Your Kegels
Kegels deliver a one-two punch: a more satisfying sex life, relief from urgency, and no more leaking when you cough, laugh, or sneeze. Here's the drill: While sitting or lying down, tighten your pelvic-floor muscles by pretending you're holding back pee. Do 10 times, holding each one for 10 seconds. Repeat three times a day. And be patient: It may take three to six weeks for the effects to kick in. Meanwhile, use a panty liner for occasional leaks.