Urinary Tract Infections and Flying

General aviation is great. You can jump in your airplane (after appropriate and exhaustive pre-flight planning, of course), point her in any direction you please and buzz along for as long as winds, weather, avgas and ATC allow.

What's not so great is that very few of our aircraft have rest rooms. I have yet to see a C-172 with a loo. I know you can buy nifty little plastic bags filled with super absorbent gunk from Sporty's.

Of course there is always the old milk bottle. I have yet to convince my dear wife that either of these options is appropriate for a civilized human being. Since most of us would rather not try the mid-flight milk bottle trick, those four or five hour flight legs can get pretty uncomfortable. Let's hope we don't have to go missed!

In addition to being darn uncomfortable, holding it can be associated with another threat to your well-being...something that's called "infrequent voiding syndrome" or more colorfully, "lazy bladder syndrome." It occurs in folks who, for one reason or another, usually work related, can't go to the bathroom as often as necessary. They get in the habit of holding urine in the bladder far longer than that useful organ is designed to wait.

As a result the bladder enlarges. As it gets stretched out of shape the muscularity of the wall deteriorates and it becomes harder and harder to expel all your urine when you finally get a chance to go. It also gets harder to hold urine back when coughing or laughing. These "little accidents" can be distressing.

Lower abdominal aches and pains are common. Even worse is the increased tendency to develop a urinary tract infection (UTI). That residual urine left after each voiding is prime real estate for a bacterium to set up shop, multiply and create a UTI. Once you get one, you'll experience pain and burning on urination. You'll have to go frequently. Often the urine is cloudy even red. Aching pain in the lower abdomen is common.

If you start to get chills, fever or pain in the flank, watch out! This suggests that the infection is moving up the urinary tract into the kidney. If this isn't properly treated you can end up with permanent kidney damage.

Fortunately most urinary tract infections respond well to one of the commonly used antibiotics. This assumes that you go in and get it treated rather than "toughing it out."

Luckily for the occasional GA cross-country flyer it usually takes a few years of forced urinary retention to create a "lazy bladder." So unless you're making the nightly red-eye run from International Falls to Hartsfield in your light twin with tip tanks, it shouldn't be too much of a risk.

But what about the airman who isn't making regular bladder-busting flights who comes down with a UTI? Should you be worried? It depends.

About 75% of UTIs are sporadic. In 25% of cases they are recurrent. UTIs are common in sexually active females owing to their shorter urethra-the passage from the outside up to the bladder. It's pretty unusual for a young man with his longer urethra to have a UTI unless he has an infection of the prostate.

In contrast, UTIs are common in the elderly. A lot of things can predispose to recurrent UTIs with the risk of kidney damage. An enlarged prostate or prostate cancer, previous sexually transmitted disease, foreign bodies, kidney stones, and anatomical malformations of the urinary tract are high on the list. Pregnancy is commonly complicated by UTI.

A UTI is not disqualifying as far as the FAA is concerned, although, if you have one, it's a really good idea to postpone flying until it's under control.

If you have some of the things that predispose to them, like kidney stones or a prostate cancer, you'll have to provide more information to the FAA to get your medical. So if you think you have a UTI, get to your doc and have it checked out. If they keep coming back, a trip to your friendly urologist would be a good idea. Then, hopefully you'll be able to give your milk bottle a rest!

Fly wisely. See you next month.

As always, comments, questions and suggestions are welcome:

jdlakin@mnallergyclinic.com.