Botox, the same medicine used to smooth wrinkles might also help relieve one type of incontinence overactive bladder.

Ask the doctor

What can I do about an anal fissure?

Q. I had pain and some bleeding during bowel movements. My doctor says it's an anal fissure. What is that, and what's the best way to treat it?

A. An anal fissure is a tear in the tissue that lines the anal canal, usually resulting from trauma, such as the passage of hard stool. It causes sharp, tearing pain while passing a bowel movement, often accompanied by a small amount of blood on the toilet tissue or surface of the stool. Anal fissures are common and can easily become chronic, because after the first tear, bowel movements reinjure the area. The sphincter muscle beneath the tear goes into spasm, pulling the edges of the tear apart. A cycle of spasm and pain further damages the tissue and prevents healing.

Departures from the familiar yellow are often harmless but should be discussed with a doctor.

Most of the time, urine is a pale-yellow color because it contains urochrome, one of the substances produced when hemoglobin gets broken down. Hemoglobin is the protein in red blood cells that sticks to oxygen so it can be ferried around the body.

Occasionally, though, urine turns a very different color. Men may notice the change as their urine enters the toilet bowl or urinal. Women may be more likely to observe it after wiping. Seeing red or orange instead of the usual yellow can be alarming, especially if there are also symptoms like a burning sensation or pain with urination. The alarm may be justified: an abnormal urine color can be an early sign of a serious medical condition. To be on the safe side, it should be discussed with a doctor or another clinician.

Up to 40% of postmenopausal women have overactive bladder — an urgent and frequent need to urinate, sometimes resulting in incontinence. The most common drug treatment is oxybutynin (Ditropan), which is an anticholinergic medication. That means it blocks the neurotransmitter acetylcholine, relaxing the bladder and decreasing the need to urinate. But anticholinergics can cause dry mouth and constipation, side effects that prompt many women with overactive bladder to stop taking the medication. Now, a study in Menopause: The Journal of the North American Menopause Society (September 2011) finds there's an equally effective alternative that lacks those side effects — an ultra-low-dose estradiol vaginal ring (Estring). Vaginal estrogen cream can help manage overactive bladder symptoms, but creams can be messy and must be reapplied several times a week. The ring is worn continuously and can stay in place for three months.

The study. The study included 59 postmenopausal women with overactive bladder, defined as urinating 10 or more times in 24 hours. Thirty-one were randomly assigned to take oxybutynin; 28 received the vaginal ring. The women recorded their urination times during two 72-hour periods, once at the start of the 12-week study and again at the end. They also filled out questionnaires on the distress caused by their symptoms and their overall quality of life.

Also called painful bladder syndrome, this frustrating disorder disproportionately affects women.

Interstitial cystitis is a chronic bladder condition that causes recurring bouts of pain and pressure in the bladder and pelvic area, often accompanied by an urgent and frequent need to urinate — sometimes as often as 40, 50, or 60 times a day, around the clock. Discomfort associated with interstitial cystitis can be so excruciating that, according to surveys, only about half of people with the disorder work full-time. Because symptoms are so variable, experts today describe interstitial cystitis as a member of a group of disorders collectively referred to as interstitial cystitis/painful bladder syndrome. (In this article, we'll call it interstitial cystitis, or IC.)

Among the one to two million Americans with IC, women outnumber men by as much as eight to one, and most are diagnosed in their early 40s. Several other disorders are associated with IC, including allergies, migraine, irritable bowel syndrome, fibromyalgia (a condition causing muscle pain), chronic fatigue syndrome, and vulvodynia (pain or burning in the vulvar area that isn't caused by infection or skin disease).

Genitourinary malignancies are a worry for men. In adolescents and young adults, testicular cancer is the main concern. One of the unappreciated benefits of growing older is that cancer of the testicles becomes rare — but as men outgrow that risk, they face the problem of prostate cancer. With these well-publicized diseases to head their worry list, it's easy for men to overlook bladder cancer — but that would be a mistake. In fact, about 53,000 American men will be diagnosed with the disease this year alone, and over 10,000 will die from it.

Bladder cancer is the fourth most common internal malignancy in American men; it is also one of the 10 deadliest cancers, and it saps our strapped economy of almost $3 billion a year. But there's good news, too. Early diagnosis can nip the disease in the bud, and new treatments are improving the outlook for patients with advanced disease. And when it comes to good news, you'll also be glad to know that you can take simple steps to reduce your risk of getting bladder cancer.

This common colon condition usually produces no symptoms, but it can result in bleeding, pain, and serious infection.

Diverticular disease is a range of conditions caused by small balloon-like pouches, called diverticula (the singular is diverticulum), in the walls of the large intestine, or colon. Most people with diverticula in the colon — a condition called diverticulosis — don't have symptoms. In fact, the pouches are often discovered by chance during a colonoscopy or sigmoidoscopy performed for other reasons. Some people with diverticulosis experience abdominal cramping and bloating, often precipitated by eating (although the cause isn't always clear — irritable bowel syndrome has similar symptoms).

Pelvic floor strengthening exercises, also known as Kegel exercises, are known to be effective for stress urinary incontinence in women, with cure rates of up to 80%. Now, in the largest trial of its kind, Norwegian researchers have found that pelvic floor strengthening can also improve pelvic organ prolapse and alleviate its symptoms. This condition develops when supporting structures of the pelvic area become lax and allow one or more pelvic organs (bladder, urethra, rectum, or uterus) to protrude into the vagina.

Surgery is the only definitive treatment, but pelvic floor exercises are often recommended to women who have mild symptoms or want to avoid surgery. The Norwegian study concludes that pelvic floor muscle training (PFMT) under the supervision of a physical therapist can not only help prevent the condition from worsening but also correct some of the underlying defects. Results were published in the American Journal of Obstetrics and Gynecology (August 2010).

Diverticular disease develops due to a lack of dietary fiber, and is most common in the elderly, but many people never realize they have it because there are few symptoms.

I have been taking a stool softener daily for two months. It's helped with my constipation. Are there any risks to taking a stool softener on a long-term basis?