Urinary problems in women. Taken seriously. Treated precisely.

The answer depends on the problem. Urologists are the right choice for: recurrent urinary tract infections (UTIs) not responding to antibiotics; blood in the urine (haematuria) at any age; bladder cancer investigation and treatment; overactive bladder (urgency, frequency, nocturia); urinary incontinence; kidney stones; and pelvic organ prolapse affecting the bladder or urethra. Gynaecologists manage: uterine or ovarian pathology; vaginal infections; menstrual problems; and pregnancy-related urinary symptoms. Many female urological conditions overlap between specialties - in those cases, a urogynae or a urologist with experience in female urology is the right choice. Dr. Nitin sees women with the full range of lower urinary tract conditions.

Recurrent UTI is defined as two or more episodes confirmed by urine culture in 6 months, or three or more in 12 months. If you have had repeated UTI courses, you should see a urologist rather than continuing to repeat antibiotic courses without investigation. A urologist will assess: whether the bacteria are changing (suggesting inadequate treatment), whether there is an anatomical reason (bladder not emptying fully, urethral narrowing, pelvic organ prolapse), whether there is a bladder stone or foreign body, and whether your antibiotic choices are appropriate given culture results. Recurrent UTI in post-menopausal women is particularly common and often responds well to vaginal oestrogen in combination with preventive strategies.

Urinary incontinence - leaking urine - has two main types. Stress incontinence is leaking on coughing, sneezing, laughing, or exercise, due to weak pelvic floor or urethral support. Urgency incontinence is leaking before reaching the toilet, due to overactive bladder. Mixed incontinence is a combination of both. Treatment is not always surgical. First-line treatment is pelvic floor physiotherapy, bladder training, and lifestyle changes - effective for most mild-to-moderate cases. Second-line includes medication (anticholinergics or beta-3 agonists) for urgency incontinence. Surgical options for stress incontinence include mid-urethral sling procedures (TVT/TOT), which are highly effective with short recovery. For urgency incontinence not responding to medication, Botox injection into the bladder is a very effective day-case procedure.

Overactive bladder (OAB) is caused by involuntary contractions of the detrusor (bladder) muscle, producing sudden urge, frequency (more than 8 times per day), and nocturia. In women, common contributing factors include: hormonal changes after menopause (reduced oestrogen affects bladder and urethral lining); pelvic floor weakness; bladder hypersensitivity; neurological conditions; caffeine and fluid habits; and medications. OAB can significantly affect quality of life - disrupting sleep, confidence, and daily activities. It is eminently treatable. Dr. Nitin manages the full OAB pathway: bladder diary assessment, lifestyle modification, pelvic floor referral, medication optimisation, and bladder Botox for cases not responding to tablets.

No - and this is an important distinction. Blood in the urine (haematuria) in a woman should not be attributed to a UTI without investigation, particularly if it is painless, if it persists after treatment, or if the woman is over 40 or a smoker. Haematuria can be caused by bladder cancer (the most important diagnosis to exclude), kidney stones, kidney tumours, glomerulonephritis, or anticoagulant medication. A urine cytology, flexible cystoscopy (camera into the bladder), and a CT urogram are the standard investigations for visible haematuria. These can be arranged quickly and are done as outpatient procedures. Dr. Nitin investigates haematuria thoroughly before reassurance is given.

Kidney stone pain (renal colic) presents similarly in men and women - severe flank or loin pain radiating to the groin, with nausea and blood in the urine. However, in women, kidney stone pain can sometimes be confused with gynaecological emergencies (ovarian cyst, ectopic pregnancy) because the pain patterns overlap. A non-contrast CT KUB (CT scan of the kidneys, ureters, and bladder without dye) is the gold-standard investigation and distinguishes stones from gynaecological causes quickly. Women with recurrent kidney stones also deserve a metabolic workup - a 24-hour urine collection and stone composition analysis - to identify preventable causes of recurrence.