January 21, 2022 by John Fernandez
From Annoying to Disruptive: These Bladder Health Issues Can Be Diagnosed, Treated
Bladder issues can range from urinary tract infection and incontinence to life-disrupting frequent urination and pain — and all can be treated either medically or with lifestyle changes, or a combination. But don’t delay an appointment with your primary care physician who may refer you to an urologist.
Many individuals consider talking about bladder issues somewhat embarrassing, explains Lunan Ji, M.D., urologist at Baptist Health South Florida. There is no reason to be ashamed of bladder problems, many of which can affect daily activities, he said. (November is National Bladder Health Month)
“I find a lot of patients can be embarrassed to talk to their healthcare providers about some of these issues, particularly involving incontinence,” said Dr. Ji. “There is absolutely no shame in these very common problems, and there are good treatments out there. It is important to get over that stigma. We’re here to help you do that here at Baptist Health.”
The bladder is a hollow organ in your lower abdomen that stores urine. Many conditions can affect your bladder. Some common ones are cystitis, or inflammation of the bladder, often from an infection; and urinary incontinence, or a loss of bladder control.
Doctors diagnose bladder diseases using different tests, including urinalysis, X-rays, and an examination of the bladder wall with a scope called a cystoscope. Treatment depends on the cause of the problem. It may include behavioral changes, medicines and, in some cases, surgery.
Here’s more about bladder health from Dr. Ji, with excerpts from a Baptist HealthTalk podcast hosted by Jonathan Fialkow, M.D., deputy medical director and chief of cardiology at Miami Cardiac & Vascular Institute.
How does the bladder function?
“The bladder is an organ for the storage of urine and helps our body get rid of excess fluid and toxins. It doesn’t work on its own, like many of our organs, it doesn’t work in isolation. The bladder is connected to the kidneys, so if you have disease of the kidneys, that can affect your bladder and vice versa. Many people are also not aware of how our brain and our nervous system connects to our bladder. So, when there is an imbalance between the two that can lead to a dysfunction of the bladder.
What are the more common symptoms that one might experience that would be signs of a bladder problem?
“Some common symptoms that may suggest a disorder of the bladder are pain or burning with urination, foul-smelling or discolored urine, needing to rush to the bathroom, and leakage of urine. And if you’re waking in the middle of the night to urinate, and you’re doing that more than once or twice per night, that is also abnormal. It can seriously disrupt your sleep.
“Of course, if you see blood in the urine, that’s a pretty serious concern. You need to see a urologist fairly quickly, if you do see that. Particularly for our female audience, if you feel like your bladder’s dropping down, or feel a bulge in the vaginal area, that could be a sign of what’s called vaginal prolapse.”
How would you advise a patient who has an overactive bladder, or is going to the bathroom too many times?
“There are a number of treatments for it. It could be as simple as changing your behavior. For instance, there are certain bladder irritants and this may not be the same for different patients. We have to individualize that as well. It could be common things like coffee, alcohol, and spicy food. It could be as simple as avoiding some of these or monitoring your fluid intake. That might be enough for some patients, but there are also medications that reduce urinary urgency. Then for patients that don’t respond well to that, other treatments, such as injecting Botox into the bladder or neuromodulation are available.”
What might predispose someone to stress incontinence and similarly, what are the ways you would address it to offer the patient relief?
Dr. Lunan Ji:
“Stress incontinence is urinary leakage when someone stands up, when they cough, during exercise or walking, or even something as simple as laughing. It is more common in women. About one in three women suffer from stress incontinence during their lifetime. It can occur in men as well, but usually with men it’s more common after treatment for prostate cancer. Again, there could be much stigma associated with this. Some patients may need to use multiple pads a day to manage this. Fortunately, there are actually very effective treatment options available for stress incontinence.”
Are you seeing in your practice any shifts in the number of patients coming in — or the kinds of problems you’re seeing — as a result of lifestyle changes impacted by the COVID-19 pandemic?
Dr. Lunan Ji:
“We have people who used to go into work and had a regular routine, that’s really being disrupted during the pandemic. You may have someone who’s now at home and at their desk drinking five cups of coffee a day, that’s completely changing up their routine. Many of us are also under increased stress during the pandemic. It may sound a little like a cliche, but it’s true. When we have increased stress, increased anxiety. And because our bladder is controlled by our nervous system, that can potentially lead to a lot of irritative urinary symptoms, such as overactivity. The good news: For many of our patients, we might be able to help them identify behavior changes that can improve these symptoms.”