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Gotta Go?

Are Bladder Issues Holding You Back?

Fifty-six-year-old Colorado Springs resident Cathy had just finished dinner at a downtown café with a couple of friends. Following a nice meal and great conversation, the trio decided to stroll Tejon, ducking into a new store they’d been wanting to check out. All was well until Cathy felt the familiar, instant and pressing urge to go to the bathroom. Gazing around the new store, she knew there would be no public restroom. She didn’t have much time, literally seconds, and with a quick, “I’ll be right back,” she darted out of the store and down the street in search of a restroom.

It’s so embarrassing,” says Cathy. “I’ll be going along just fine and then it’s a ridiculous race to try and reach a bathroom before I leak. Whenever I go out anywhere, one of the first things I do is look for the restrooms, in case of a sudden leak or possible accident.”

Let’s face it, bladder issues are no fun. They can disrupt our daily routines and can be painful, embarrassing and frustrating.

Gary Bong, MD, a urologist with Pikes Peak Urology, says, “Incontinence can be very severe, patients often become less social, leave their homes less and become almost reclusive as a result.”

Right now, at least 25 million Americans are dealing with a bladder issue of some kind, many having to do with incontinence. And studies show that half of all people with symptoms don’t consult a doctor. Women wait, on average, six years before seeking help.

Dr. Bong says the most common visits to his Colorado Springs urology office with regard to bladder health are incontinence, BPH (benign prostate overgrowth in men), overactive bladder (OAB) and recurrent urinary tract infections (UTIs).

“The most bothersome urinary symptoms that patients experience,” he says, “are urinary frequency, urgency—rushing off to the bathroom, and nocturia—getting up at night to void. Some patients get up five or six times per night to void, which clearly disrupts normal sleep patterns.”

Strictly speaking, incontinence is defined as the involuntary loss of urine, while OAB is urgency, with or without incontinence, usually with frequency and nocturia issues. According to the US Department of Health and Human Services, one in four adults will suffer from bladder problems during his/her life.

“Bladder problems tend to be more prevalent as we age,” says Dr. Bong. “Stress incontinence is more prevalent after vaginal childbirth, especially with larger babies. In women, risk of incontinence, prolapse and urinary infections all increase after menopause as estrogen is essential to vaginal health.”

Most bladder problems are more common in women than in men, says Dr. Bong. “Overactive bladder is twice as common in women than in men, but most men have OAB symptoms from urinary obstruction caused by an enlarging prostate gland. In many cases, men have significant improvements in OAB symptoms when the prostate is treated medically or surgically. Urinary tract infections are 50 times more common in women, primarily due to the differences in anatomy.”

So what’s a person to do, and not do?

Let’s begin with To Dos. Kegel exercises, of course, to strengthen the pelvic floor. And fluids, for starters. Dr. Bong says moderate fluid intake is by far the best way for men and women to improve bladder health.

“Concentrated urine is irritating to the lining of the bladder,” he says. “Most UTIs, when symptoms are experienced early, are cleared by drinking excessive fluids and do not require antibiotics. Cranberry juice has been shown to be effective in early UTIs as well. Cranberry juice contains two compounds that prevent bacteria from adhering to the bladder wall. Cranberry tablets contain concentrated forms of these compounds.”

Not to do? “There are known foods and drinks that irritate the bladder,” says Bong, “whether the patient has OAB, an infection or Interstitial Cystitis - such as caffeine, spicy foods and tomato sauces.”

An exciting treatment on the horizon for overactive bladder is, interestingly enough, BoTox. When injected into the bladder, BoTox relaxes the bladder muscle and has been very effective in patients with severe overactive bladder and incontinence. “If approved by the FDA,” says Bong, “BoTox will give thousands of local patients with OAB an additional option if they do not respond to current medications.” BoTox is already approved for those with OAB secondary to neurologic disease.

The key takeaway here is if you are currently dealing with bladder issues, there’s plenty of help to be had. It might be time to visit a urology doc.