November is Bladder Health Awareness Month
What is the bladder?
The bladder is a hollow, triangle-shaped organ which is bordered by the pubic bone at the front of the pelvis and the rectum at the back of the pelvis. The bladder is supported by ligaments and connects at the top of two ureters and the bottom to the urethra.
The bladder serves as a reservoir to hold the urine. With flexible walls that expand as it fills with urine, the bladder may extend up into the abdomen when it’s full. An average bladder can hold up to 2 cups of urine before it needs to be emptied every 3-5 hours. The bladder consists of the detrusor muscle which works in coordination with the pelvic floor muscles. When the detrusor muscle is relaxed the muscles of the pelvic floor contract to hold the urine inside the bladder and the pelvic floor relaxes, the detrusor muscle contracts to allow passage of the urine during urination.
A number of problems can arise with both bladder or urination. Not many pay attention to bladder health unless it is affected in one way or the other. Each year millions of men, women, and children get affected by bladder health issues.
Some of the common bladder health issues are:
- Incontinence: Voluntary leakage of urine is called incontinence. Consists of stress, urge, overflow, and functional incontinence.
a. Stress incontinence is the most prevalent and affects an estimate of 15 million adult females. There is the involuntary leakage of urine during physical activity or an increase in abdominal pressure like coughing, sneezing, jumping, running, lifting, etc. Treatment includes pelvic physical therapy, pessary or surgery
b. Urge : Estimated 12.2 million adults have urge incontinence, It’s a sudden urgent need to urinate , followed by accidental leakage. Treatment includes pelvic physical therapy, diet modification, medication.
c. Overflow: This happen when the bladder overflows due to excessive urine in the bladder than it can hold. Treatment includes bladder diary, behaviour modification
d. Functional: The person is fully aware of urination but is unable to reach the bathroom on time due to physical or mental reasons. Treatment includes Physical/ Occupation therapy, modified devices, treating the functional cause
e. Interstitial Cystitis: Also known as painful bladder syndrome affects an estimated 1-4 million men and 3-8 million women. It is characterized by pain and /or pressure in the bladder area and sometimes the pelvic floor, back, vaginal or anal region. Many feel an increase in urinary frequency and urgency. May increase with certain foods or drinks. Treatment includes relieving pain and inflammation.
2. Urinary Tract Infection: UTI is the infection of any part of your urinary system and is more prevalent in women. Symptoms include an increase in frequency, pain while urinating, cloudy strong-smelling urine with sometimes blood in the urine, and pelvic pain in women, especially around the pubic area. Treatment usually includes antibiotics
3. Nocturia: It is the urge to urinate that wakes you up more than twice a night. Can cause fatigue during the day as it interrupts the sleep cycle. Causes can be increased fluid intake or underlying medical conditions. Treatment includes lifestyle modification and treatment of the underlying medical condition
4. Enuresis: Is the loss of control of urine or bedwetting in children over the age of 5. Causes can be bladder irritants, overflow, neurological conditions, weak pelvic floor, decrease muscle co-ordination, psychological problems. Treatment includes lifestyle modification, pelvic physical therapy, medication, or counseling.
5. Bladder Cancer: The sixth most common cancer in the United States that begins in the cells of the bladder. More common in males than females. Symptoms include frequent urination, painful urination, blood in the urine, and low back pain. Risk factors include smoking, age, frequent urinary infections, etc. Treatment may include chemotherapy, surgery, medical procedure depending on the stage.
6. Prolapse: Also known as cystocele usually occurs when the pelvic floor muscles and tissues are stretched or become weak. This results in prolapse and the bladder will protrude at the tip of the vagina. Can be caused by heavy lifting, chronic coughing (or other lung problems), constipation, obesity, menopause (when estrogen levels start to drop), prior pelvic surgery, aging. Symptoms include frequent urination, feeling of heaviness or pressure in the vaginal area, painful sex, pain in the vagina, pelvis, groin, or lower abdomen/back. Treatment includes physical therapy, pessary or surgery.
Life style changes to improve bladder health:
- Reduce the intake of caffeine
- Drink adequate amount of water
- Limit acidic/spicy food
- Quit smoking
- Reduce body weight
- Make sure you are not constipated.
It is always advised to talk to your physician if you have any of the above symptoms. Pelvic floor rehabilitation can help with incontinence and constipation. Your therapist will evaluate the pelvic floor for weakness, tissue restrictions, spasm, pain, or altered sensation. The Physical Therapist will enable you to gain control over your incontinence, help you avoid special undergarments, help you strengthen the pelvic floor muscles. Book an appointment or consult by calling 925-587-3240 or email firstname.lastname@example.org
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