Archive | Bladder Health

Healthy Bladder-Friendly Foods

Millions of Americans suffer from bladder infections, inflammation, and general bladder discomfort today.  But did you know that eating certain foods can actually help prevent such problems from ever starting?  For years physicians and dieticians have been recommending healthy foods, and now urologists have jumped in.  Try including these five foods to your diet and keep them a part of your regular daily meals for a healthy bladder:  cranberries, pears, whole grains, water, and yogurt.

Cranberries—These red berries have been used to prevent urinary tract infections for years.  They contain healthy doses of Vitamin C, dietary fiber, manganese, and Vitamin K.  Studies on the effects of cranberries indicate that about 16 ounces (2 cups) of pure cranberry juice daily treat and prevent urinary tract infections.  Cranberries do this by acidifying the urine, which breaks down the UTI-causing bacteria.  Further, they contain an antibacterial agent called hippuric acid and other compounds that reduce the ability of E. coli bacteria to adhere to the walls of the urinary tract.

Pears—Many patients with interstitial cystitis love pears as they are one of the few fruits that do not produce the feared symptom flare-up.  Due to their low acidity, the fruit makes for an easy snack for IC sufferers.  Pears are also a good source of dietary fiber and Vitamin C.  Pears are a high-alkaline (basic) food, so eating more of them helps balance an overly acidic system, which, in turn, keeps bladder issues under control.

Whole Grains—Constipation increases pressure on your bladder, making bladder problems even worse.  Whole grains provide significant amounts of dietary fiber, which aides in maintaining a healthy colon and allows for easy digestion, thereby decreasing defecation issues.  Examples of whole grain-rich foods include oatmeal, spelt, bulgur, brown rice, quinoa, wild rice, popcorn, and barley.  The recommended daily dosage of fiber for a healthy system is 25 grams a day.

Water—A properly hydrated body functions correctly.  But over-hydration puts too much pressure on the bladder.  Drinking eight to ten glasses of water a day is adequate to maintain a flushed and clean system without bogging your bladder down with unnecessary work.

Yogurt—According to a study conducted by the Division of Nutritional Epidemiology, National Institute of Environmental Medicine, Karolinska Institute, and the Department of Urology and Center for Assessment of Medical Technology, Orebro University Hospital, in Sweden, daily consumption of yogurt reduces the risk of bladder cancer.  The study focused on the association between the intake of cultured milk and other dairy foods and the incidence of bladder cancer.  Although the total dairy intake was not significantly associated with a decrease risk in bladder cancer, a significant association was observed for the intake of cultured milk (yogurt).  In other words, a high intake of yogurt (about two servings per day) may lower the risk of developing bladder cancer.

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Menopause and an Overactive Bladder

Do you have to plan out your day in accordance with the proximity of a bathroom?  Are you constantly delaying consumption of liquids in order to avoid a situation where you are dashing for the restroom?  And are you between the ages of 40 and 55?  Then you may be one of the many women who have an overactive bladder (OAB) associated with menopause and age.

More than 17 percent of women in the United States have an overactive bladder.  The difficulty determining just how many women have OAB is due to the fact that the problem remains under-reported.  Although some women do not feel comfortable talking to their doctors about the symptoms, help is available and urologists are always ready to listen.

An overactive bladder associated with age has a very specific relationship with menopause.  During perimenopause, the period leading up to menopause, and menopause itself, the level of estrogen begins to drop significantly.  Pre-menopause amounts of estrogen are used to keep the tissues of your bladder and urethra healthy, so if these necessary amounts begin to decline, then the bladder is at a higher risk of developing problems.  If you have begun to notice dryness and sensitivity during sex, it’s likely you’re at risk for bladder problems as well.  Just as tissues of the vaginal wall begin to thin and dry out, so does the tissue that lines the bladder, leading to a more sensitive bladder susceptible to “hair-trigger” releases.

Further, the lack of estrogen may lead to the pelvic muscles to weaken.  Strong, functioning pelvic muscles are necessary for maintaining bladder control.

Several treatment options exist for an overactive bladder associated with menopause.  The first is to avoid foods in your diet that may irritate the bladder.  These foods include coffee and black tea, citrus fruits and juices, chocolate, regular and diet sodas, alcohol, spicy foods, tomatoes and tomato-based foods and sauces, artificial sweeteners, and vinegar and vinegar-based salad dressings.

You may also try to include several specific foods in your diet in order to protect your bladder from irritation and urges.  These foods include eight glasses of water spaced throughout the day, milk (cow, almond, or soy), and probiotic supplements (which help control yeast growth and promote a healthy bladder).

Kegel exercises are often recommended for those women with OAB.  These exercises are used to control the bladder’s ability to hold in urine by strengthening the pelvic floor muscles.  To perform the exercise, squeeze and hold the pelvic muscles and then relax them.  A nurse or physical therapist who specializes in pelvic floor strengthening can also help with exercises.

Bladder retraining may also be necessary.  If you have OAB, your bladder muscles have been conditioned over time to influence the sudden need to urinate.  You may retrain your bladder by timing visits to the bathroom according to a strict schedule, gradually extending the intervals between bathroom visits.  A therapist may also teach you ways to distract yourself between bathroom visits.  Results from retraining usually take at least six to eight weeks to emerge.

Estrogen therapy is a possibility for some.  If the bladder symptoms first appeared during perimenopause or if you’re experiencing other menopause-related symptoms, your OB/GYN may help you control the symptoms with hormone therapy.  A ring or cream application containing vaginal estrogen has been found to be extremely effective in treating OAB.  Vaginal estrogen application is different from and should not be confused with systemic hormone therapy, which uses oral hormones and has more risks than the vaginal creams.

If you believe you have menopause-related OAB, talk to your doctor.  Many other treatments do exist, including weight loss, biofeedback, sacral nerve stimulation surgery, and/or other medications.  Your doctor will be able to determine the best treatment option for you.

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Weight Loss Eases Urinary Incontinence in Heavy Women

Leslee L. Subak, MD, of the University of California, San Francisco, and colleagues, reported in a January issue of the New England Journal of Medicine that weight loss may significantly improve urinary incontinence for overweight and obese women.  A loss of about 17 pounds in an extensive six-moth diet and exercise program reduced the average number of weekly incontinence episodes by 47% compared with 28% for the control group.

Losing weight was particularly effective against stress incontinence in the randomized trial, and was as effective overall as behavioral treatments, such as pelvic muscle exercises.  Dr. Subak reports that these findings may help motivate incontinent patients to overcome the common fear of episodes occurring during exercise.  The researchers’ Program to Reduce Incontinence by Diet and Exercise (PRIDE) study included 338 overweight and obese women with at least 10 urinary incontinence episodes per week, with an average of 24 episodes per week.  Participants were randomized to an intensive six-month weight-loss program of reduced-calorie diet, exercise, and behavior modification (226 participants) or to four group classes on the benefits of exercise, a healthy diet, and weight loss (112 participants). By the end of the program, the average weight loss from baseline was 8.0, compared with 1.6% among controls.

More women in the weight-loss group had a clinically relevant reduction of at least 70% in total weekly incontinence episodes, stress-incontinence episodes per week, and urge-incontinence episodes per week.  The primary effect of weight loss was on stress incontinence, which dropped by 57.6% compared with 32.7% among controls.

Urge incontinence, which was more common in both groups at baseline, tended to also decrease with weight loss, but the effect was not significant compared with other controls.

Limitations of the study include the fact that it relied on self-reports, the lack of blinding, and the fact that participants were selected by potential for adhering to behavioral modification, which might limit generalizability.

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One-Third of Women Experience Stress Urinary Incontinence

About one in three women experience stress urinary incontinence (SUI), an involuntary loss of urine due to forces on the bladder caused by physical movement of the body.  Even though SUI can interfere with quality of life, it often goes untreated because of the personal nature of the symptoms.  Any women feel embarrassed about their bodies and are reluctant to discuss or report urinary leakage.

For these reasons, the American Urological Association (AUA) Foundation issued a new Monograph, titled “Stress Urinary Incontinence: Monograph from the AUA Foundation,” a few months ago to encourage women and their healthcare providers to openly discuss SUI and to empower women to make lifestyle changes to decrease their risk of this condition and understand that they are not alone if they experience SUI.  The monograph provides information about SUI, including symptoms, risk factors, prevalence and common myths associated with the condition.  It highlights the fact that overweight and obese women are more prone to SUI, and evidence shows that weight loss may improve urinary incontinence in obese women.  The monograph also provides ways to prevent or control the symptoms of SUI, including lifestyle changes, urinary control devices or surgery.  Women can manage SUI by using mini pads, sanitary pads, or incontinence pads.

AUA Foundation Executive Director Sandra Vassos, MPH, reported that the prevalence of SUI costs society an estimated $8 billion annually.  Symptoms of SUI vary widely from light to heavy leakage, which may occur during rigorous activity or natural reflexes, such as playing sports or coughing.  In more severe cases, leakage may occur due to low impact movements, such as standing up, walking or bending over. Because these symptoms often lead to feelings of isolation, they may interfere with women’s day-to-day activities, impact their relationships, and prevent them from opening up about their condition. For these reasons, many women with SUI may miss important opportunities to learn more about SUI and manage its symptoms.

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Cesarean Section May Not Prevent Incontinence

Vaginal delivery has been thought to cause urinary incontinence through physical trauma and damage to nerves as such there is a suggestion that women who choose c-section over vaginal delivery might be protecting themselves against urinary or fecal incontinence down the road.

This might not be necessarily true according to the findings of a recent study.  Dr. Cathryn Glazener of the University of Aberdeen in the UK and her colleagues tracked almost 4,000 women who gave birth in the UK and New Zealand for 12 years after their delivery.

The researchers recorded how the first babies were delivered and kept in touch with the women through questionnaires to find out if they had more children and whether those children were born through c- sections or vaginal deliveries.  They also asked the participants if they had symptoms of urinary or fecal incontinence and if so, how often.

In women who had given birth only through vaginal delivery, 55% reported experiencing urinary incontinence compared to 59% of women who had at least one baby through vaginal delivery and one baby through c-section. In women who only had c-section, 40% reported experiencing urinary incontinence.

Regardless of how they delivered their children, women who were heavier, had given birth more times, and were older at their first delivery reported higher rates of incontinence.

Recent evidence shows that the rate of C-sections performed in the U.S. has been rising, from one in five births in 1996 to almost one in three births in 2007, according to the Centers for Disease Control and Prevention. Many doctors see this trend as risky because C-sections have been linked to a higher chance of breathing problems in babies and future pregnancy complications in moms.

Glazner and her colleagues concluded that, “Unless women are resolved to have all their deliveries by the abdominal (c-section) route (and their medical advisors agree), cesarean section does not protect from subsequent” urinary incontinence.

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No Relationship Found Between Weight Changes and LUTS

Even though obesity has been related to lower urinary tract symptoms (LUTS) in aging men, new findings from researchers at the Mayo Clinic College of Medicine in Rochester, Minnesota suggest that modest weight loss may not prevent the onset or progression of LUTS among these men.  Also, no relationship was found between weight gain and the development or progression of LUTS.

The research team analyzed data from 1,674 white men participating in the Olmstead County Study (OCS) of Urinary Symptoms and Health Status among Men, funded by Merck Research Laboratories, and 168 black men participating in the Flint Men’s Health Study.  Researchers separated the participants into three categories based on differences between their baseline weight and weight during four year of follow-up: no weight loss, less than 5% of baseline weight loss, and more than 5% of baseline weight loss.

Jennifer L. St. Sauver, Ph.D., the lead author of the study, reported at the American Urological Association annual meeting that participants in both studies and in all weight categories experienced no statistically significant change in LUTS.  Her research team found that in the OCS cohort, weight loss was not related to receipt of treatment for benign prostatic hyperplasia.  Dr. St. Sauver concludes that although weight loss can help prevent a number of diseases such as diabetes, modest weight loss may not prevent development of LUTS.  A report of the study will be published in Urology. Data collection for this study was additionally funded by grants from the National Institutes of Health.

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Sleep Problems Associated with Incontinence

According to the results of a new study, sleep problems are associated with urologic conditions such as incontinence, lower urinary tract symptoms (LUTS) and nocturia – the need to get up during the night to urinate.

For five years, researchers at New England Research Institutes, Inc. in Watertown Massachusetts followed 1,610 men and 2,535 women assessing sleep disturbances and the development of urologic symptoms.

The investigators found that short sleep duration among men and restless sleep in both men and women was strongly associated with the incidence of lower urinary tract symptoms – 8% among men and 13% among women. Incidences of urinary incontinence and nocturia were associated with restless sleep among women but not in men.

The study is scheduled to be presented to the media during a special press conference at the American Urological Association’s (AUA) annual meeting in Washington, D.C. along with another study that examined the relationship between obstructive sleep apnea (OSA) and erectile dysfunction.

In the association’s news release, Dr. Kevin T McVary, AUA spokesman said “We know that proper amounts of sleep and quality of sleep can impact a wide range of health conditions, these data may help us better assess how helping patients modify their sleep patterns may help improve their health and overall quality of life.”

The data and conclusions of these studies should be viewed as preliminary until published in a peer-reviewed journal because these studies were presented during a medical meeting.

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Drinking Less to Avoid Incontinence

A study which pulled data from more than 65,000 health and lifestyle surveys of female nurses looked at women who had not yet developed incontinence, to see whether fewer beverages each day could prevent the onset of incontinence later. The survey tracked nurses for 2-4 years, asking how much they drank each day and seeing who later developed incontinence.  The researchers tallied all beverages, including alcohol, coffee, milk, water and juice.  The survey did not ask how many beverages each day the women had, but rather the total amount of fluids they drank.

Drinking ranged from a little more than a liter – about three 12 ounce cans of soda – to nearly three liters each day. The researchers grouped the women into five categories, from the smallest amount of fluid intake to the largest.

“The rate of developing incontinence was the same” said Fran Grodstein, the lead researcher of the study. About 30 percent of the women later came to have at least one leaking episode per month which is consistent with other estimates of incontinence among women.

Incontinence can be caused by poor control over a full bladder or forced leaks from sneezing or laughing.  People who experience it frequently limit how much they drink to manage the problem and reduce leaks.

“Adequate hydration especially for older women is important and they shouldn’t be restricting fluids for fear of causing incontinence” Grodstein added.

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Susceptibility to Urinary Incontinence Linked to Genetic Factors

University of Gothenburg in collaboration with the Swedish Twin Registry at Karolinska Institutet in Stockholm, Sweden studied just over 25,000 Swedish twins aged 20 to 46. Information about urinary incontinence, overactive bladder and other lower urinary tract symptoms were analysed using a statistical method which measures how much of the difference between people is due to genetic variation. By comparing the prevalence of these symptoms in identical twins, who have identical genes, and non-identical twins, who share half of their genetic material, the researchers were able to draw conclusions about the relative significance of genetic and environmental factors.

Gynecologist Anna Lena Wennberg, one of the researchers behind the study said “incontinence is caused by a combination of factors and we already knew that there are hereditary factors, but now we’ve been able to show for the first time how important the genetic component is for various types of urinary tract disorder”.

In urinary incontinence, half of the variation (51%) can be explained by genetic factors. This means that around 50% of people’s susceptibility to urinary incontinence can be explained by their genes.

In nocturia – the need to get up in the night to urinate, 34% of the variation has a genetic explanation.

Wennberg does not believe that there is a single incontinence gene, rather that a number of different genes play a role. These genes combine with various environmental factors or cause disorders which, in turn, increase the risk of urinary incontinence.

“Urinary incontinence is a multifactorial condition, and while we now know that much of the variation between people is down to their genes, treatment will continue to focus on environmental factors which are easier to influence, such as smoking and excess weight.”

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Dietary Supplements No Impact on Bladder Cancer

A large U.S. study shows that at this time taking any supplements to prevent bladder cancer cannot be recommended.

This new results are based from a study of more than 77,000 older men and women in Washington State, who had filled out a detailed questionnaire about their health, diet and supplement intake at the outset of the study.  Over the following six years, 330 people developed bladder cancer.  Whether or not they reported taking dietary supplements had no impact on their risk, after accounting for age, smoking, fruit and vegetable intake and other factors.

Dr. James Hotaling of the University Of Washington School Of Medicine in Seattle and his colleagues who worked on the study and looked at a wide range of substances, including multivitamins, several B vitamins, vitamin C, D, and E, calcium, magnesium, zinc, glucosamine, ginkgo biloba, fish oil and garlic.

Hotaling said “the number of patients who take these supplements is extremely high and supplements have become a million-dollar industry but there is not a lot of data to show that these supplements make a difference”.

“If eating extra vitamins actually protected against the disease it would not only save lives but also a lot of money”, he added.  Patients with bladder cancer require repeated checkups to ensure the cancer doesn’t return after they’ve had surgery.

According to the American Cancer Society (ACS), about one in 26 American men and one in 84 women get bladder cancer.

ACS does not recommend using supplements to prevent cancer.

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