Bladder problems can range from urinary tract infection and incontinence to frequent urination and life-disrupting pain – and all can be treated either medically, with lifestyle changes, or with a combination. But don’t delay an appointment with your primary care doctor who might refer you to a urologist.
Many people find it somewhat embarrassing to talk about bladder problems, says Lunan Ji, MD, a 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 that a lot of patients can be embarrassed to talk to their health care providers about some of these issues, especially incontinence,” said Dr. Ji. “There is absolutely no shame in having these very common problems, and there are good treatments available. It is important to overcome this stigma. We’re here to help you do that here at Baptist Health.
The bladder is a hollow organ in the lower abdomen that stores urine. There are many conditions that can affect your bladder. Some common are cystitis or inflammation of the bladder, often due to infection; and urinary incontinence, or loss of bladder control.
Doctors diagnose bladder disease using a variety of tests, including a urinalysis, x-rays, and examining the bladder wall with a telescope called a cystoscope. Treatment depends on the cause of the problem. This can include behavioral changes, medication, and in some cases, surgery.
Here’s more on Dr. Ji’s bladder health, with excerpts from a Baptist HealthTalk podcast hosted by Jonathan Fialkow, MD, assistant medical director and chief of cardiology at the Miami Cardiac & Vascular Institute.
How does the bladder work?
“The bladder is an organ for storing urine and helps our body get rid of excess fluid and toxins. It does not work on its own, like many of our organs, it does not work in isolation. The bladder is connected to the kidneys, so if you have kidney disease it can affect your bladder and vice versa. Many people also don’t know how our brain and nervous system connect to our bladder. So when there is an imbalance between the two it can lead to bladder dysfunction.
What are the most common symptoms one might experience that would be signs of a bladder problem?
“Some common symptoms that may suggest a bladder disorder are pain or burning when urinating, foul-smelling or discolored urine, the need to rush to the toilet, and urine leakage. And if you wake up in the middle of the night to urinate, and you do it more than once or twice a night, that’s also abnormal. It can seriously disrupt your sleep.
“Of course, if you see blood in your urine, that’s a pretty serious concern. You need to see a urologist pretty soon, if you see this. Especially for our female audience, if you have the impression that your bladder is sagging or if you feel a bulge in the vaginal area, it could be a sign of something called vaginal prolapse.
What advice would you give to a patient who has an overactive bladder or who goes to the bathroom too often?
“There are several treatments for this. It can be as easy as changing your behavior. For example, there are certain bladder irritants and it may not be the same for different patients. We also have to individualize that. These can be common things like coffee, alcohol, and spicy food. It can be as simple as avoiding some of them or monitoring your fluid intake. This may be sufficient for some patients, but there are also drugs that reduce urinary urgency. Then, for patients who do not respond well to this, other treatments, such as injecting Botox into the bladder or neuromodulation are available.
What could predispose someone to stress incontinence and, similarly, how would you address it to provide relief to the patient?
Dr Lunan Ji:
“Stress incontinence is urine leakage when someone stands up, when they cough, while exercising or walking, or even something as simple as laughing. It is more common in women. About one in three women will experience stress incontinence in her lifetime. It can also occur in men, but generally in men it is more common after treatment for prostate cancer. Again, there could be a lot of stigma associated with this. Some patients may need to use multiple electrodes per day to manage this. Fortunately, there are actually some very effective treatment options for stress incontinence. “
Are you seeing changes in your practice in the number of patients arriving – or the types of issues you are having – as a result of lifestyle changes impacted by the COVID-19 pandemic?
Dr Lunan Ji:
“We have people who went to work and had a regular routine, which is really disrupted during the pandemic. You can have someone who is now at home and at their office drinking five cups of coffee a day, it changes their routine completely. Many of us are also under increased stress during the pandemic. It might sound a bit cliché, but it’s true. When we have increased stress, increased anxiety. And because our bladder is controlled by our nervous system, it can potentially lead to many irritating urinary symptoms, such as overactivity. The good news: For many of our patients, we may be able to help them identify behavior changes that may improve these symptoms.