Taking Control of Your Bladder

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Most people take bladder control for granted until it interrupts your ability to carry on an ordinary social and work life.

In this article, we will discuss how to take control of your bladder.

Signs of a Bladder Problem

• Inability to hold urine or leaking urine (i.e.,  Urinary Incontinence)
• Needing to urinate eight or more times in one day.
• Waking up many times at night to urinate.
• Sudden and urgent need to urinate.
• Pain or burning before, during, or after urinating.
• Cloudy or bloody urine.

Here we will focus mainly on Benign Prostatic Hyperplasia (B.P.H.) and Urinary Incontinence.

Benign Prostatic Hyperplasia (B.P.H.)

B.P.H.is a nonmalignant growth of the prostate gland. As the prostate enlarges with age, it squeezes the urethra that passes through it and can disrupt normal urinary function.

The prostate is a walnut-shaped gland that produces the seminal fluid in a man’s ejaculate. The gland typically starts to enlarge in men’s 40s as smooth muscle and lining cells proliferate. As the gland gradually increases in size, nearly half of men develop moderate to severe symptoms of the lower urinary tract by their eighth decade of life.

Risk Factors

Common risk factors for developing B.P.H. include:

• Age
• Family history of the condition
• Obesity
• Metabolic syndrome
• Sedentary lifestyle and diabetes. 
• Ethnic Group
• There is a higher incidence among African-American men. 
• Diets
• Diets high in starches and meat have been linked to progression of BPH, while a vegetable-rich diet has been associated with less severe symptoms.

Alternatives to Surgery for B.P.H.)

The good news is there are now quite a number of ways to alleviate the symptoms of B.P.H. short of surgery to remove part or all of the prostate, which can cause other problems, including erectile dysfunction. According to guidelines published by the American Urological Association, recent treatments have focused on slowing the progression of the condition and preventing its complications.

Here are the list of alternatives to surgery for B.P.H.:

• Lifestyle changes
• Reducing overweight
• Minimizing liquid intake late in the day
• Getting regular physical activity
• Avoiding 
• smoking and consumption of alcohol, caffeine and highly seasoned foods
• Treating constipation
• Double-voiding
• After urinating normally, wait about 20 to 30 seconds and try again. Men are likely to have more success emptying their bladders by sitting on the toilet and leaning forward instead of standing.
• Taking Medication
• Alpha-blockers like Flomax
• 5ARIs like finesteride
• PDE5 inhibitors like tadalafil
• Notes
• There is also a combination drug of an alpha-blocker and a 5ARI that is said to work better than either one alone. 
• While the sexual side effects of surgery are usually permanent, if such effects are caused by a medication, they can be reversed by stopping the drug and perhaps switching to another one.

Urinary Incontinence

Often, the causes of urinary incontinence are out of a person's control. For example, in women, incontinence is a common side effect of childbirth. For men, it's most often a side effect of treatment for prostate problems.

Although it may not be possible to avoid incontinence, you can take steps to lower the chances that you will develop this distressing problem.

1. Watch your weight 
• Excess weight and incontinence can go hand in hand, particularly for women. 
• One theory is that extra abdominal fat can weaken the pelvic floor muscles and lead to stress incontinence (leaking when coughing, laughing, sneezing, etc.). In some cases, simply losing weight can improve incontinence.
2. Don't smoke
• Smoking threatens your health in many ways. It also doubles the likelihood that a woman will develop stress incontinence. Nicotine has also been linked to urge incontinence.
3. Stay active
• In the Nurses' Health Study, middle-aged women who were most physically active were least likely to develop incontinence.
4. Minimize bladder irritants
• Caffeine and alcohol have been linked to urge incontinence (the feeling you need to urinate even when the bladder isn't full). Carbonated drinks, the artificial sweetener aspartame (NutraSweet), spicy foods, and citrus fruits and juices cause urge incontinence in some people.
5. Don't strain with bowel movements
• This can weaken the pelvic floor muscles. If your stools are frequently hard or take considerable effort to pass, talk with your doctor. 
• In a study involving people ages 65 and older, treating constipation improved a variety of urinary symptoms, including frequency, urgency, and burning. 

Treatments for urinary incontinence are more effective and less invasive than ever. If you have problems with the unintentional loss of urine, don't suffer in silence. Talk with your doctor.

For more on treating bladder and bowel incontinence, buy Better Bladder and Bowel Control, a Special Health Report from Harvard Medical School.

References

1. Bladder control problems in women: Seek treatment
2. Alternatives to Surgery for an Enlarged Prostate