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Genito-Urinary - Other

Dr Jules Eden, dive medicine specialist and founder of e-med, answers divers' questions - as published in Sport Diver magazine:
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Q - Hi. I'm relatively new to diving and I'm going on my first liveaboard soon. My worry is this: I suffer with frequent bladder infections, and often need antibiotics to clear them up. Am I likely to get more of these due to diving, and can I dive if I'm taking antibiotics? I don't want to sit on the boat with my legs crossed all week!

A - Along with leg shaving, ďmonthliesĒ and wolf-whistling brickies, another curse of being female is the diminutive urethra. The simple reason that women get cystitis and men (by and large) donít is that the tube that leads from the bladder to the outside world (the urethra) is much shorter in a female. The bugs that cause the infection therefore donít have far to travel to set up shop and multiply. Salt water baths are often recommended as preventitive treatment, so in this sense diving might be helpful. Peeing lots helps clear the bacteria more often, so keep well hydrated (especially on a liveaboard). Other tips include wiping from front to back, urinating after sexual intercourse (to flush out any invaders introduced this way) and indulging in cranberry juice or tablets (the theory is that this makes it more difficult for bacteria to adhere to the bladder wall). Itís a good idea to take a stock of antibiotics with you on the boat as if all the above fails to alleviate the symptoms youíll need to start something before reaching dry land, but most are compatible with safe diving.

Q - I have been diving for ten years now, all warm water diving, and have a problem which seems to have got worse the more I dive and I was wondering if I am the only one with this problem.

Basically I have to urinate in my wet suit on each dive, sometimes twice and on the odd occasion three times. I try to hold it back but it becomes so painful and uncomfortable that it ruins the dive if I don't go. I go to the toilet just before the dive but it makes no difference.

I drink lots of water as most of my diving is in tropical climates and I know diving dehydrates the body. My current technique for flushing out the urine is to flood my wet suit first then urinate, this dilutes the urine before it soaks into the suit. However it is hardly hygienic and not pleasant and still smells.

I have not kept any data about: do I urinate when I dive below certain depths or dive over certain times, there have been times when I need to go after ten minutes in the water and there are other times, very few and far between when I didn't go at all during the dive.

I have got to the stage where I am seriously considering having a zip or velcro flap fitted to my wet suit or getting one specially made so I can urinate underwater without going in my wetsuit.

I am very passionate about diving and don't want to stop because of this embarrassing problem. Is it just me or are there others like me with a similar problem and is the zip in the wet suit the only solution.

I have been told that the pressure on your kidneys makes you want to urinate more and we have all seen divers rushing to get their gear off to get to the toilet at the end of a dive.

I hope you can help. If you want to use this letter in Sport Diver magazine feel free.

A - Got me here. I can't say I've come across this a lot. Sure, some people need to pee maybe once underwater, but 3 times is overdoing it a bit.

And if it's happening every time you dive then I can see your problems with a smelly wetsuit after a few days.

Hydration is important when diving, less fluid in you means less blood to take away the nitrogen. So I always recommend drinking enough to make your pee pale straw yellow before you dive. If its clear urine then I think you are over-hydrating. Likewise tea, coke and coffee will make you want to urinate more often, so avoid those drinks before a dive. Just stick to water.

I would be an idea to get a quick check for both diabetes. Mellitus and Insipidus, as their early symptoms are urinary frequency. See your GP for this.

But my hunchy bits here say that it's probably just one of those things, and you're going to have to live with it.

I thing the Velcro flap is a good idea. Just don't wave your old boy around too much. Little pink "fish" are at the bottom of the food chain.

(other dive medical questions)



   


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