While there’s no shortage of advertisements touting products for “leaky pipes,” many women hesitate to broach the topic of bladder problems with their doctors. Some may dismiss the issue, believing that it’s a normal part of aging.
Certainly, urologists can tackle some of the issues women face, but the proximity of a woman’s bladder and urinary tract to her reproductive organs can complicate issues. Urogynecologists — specially trained physicians with expertise in both gynecology and urology — may be best equipped to address issues unique to women’s bladder health.
We sat down to discuss bladder health issues specific to women with urogynecologist Gunhilde Buchsbaum, M.D., who is hosting a free educational event for women on Nov. 14, “Maintaining Your Bladder Health.” (Please click here for details.)
Scripts: When women think of the term “bladder health” they probably think mostly about incontinence. Are there other related issues they should be concerned about?
Buchsbaum: Besides the common concern of incontinence, many women experience urinary tract infections, problems with frequent urination, and even bedwetting. Other concerns include painful bladder syndrome, bacterial cystitis, and bladder cancer.
It’s important for women to be aware of these problems, and to know they aren’t alone in facing them. So many women suffer in silence, either embarrassed by the problem or believing nothing can be done for it. In reality, there are many tools for evaluating and treating bladder problems, as well as steps women can take on their own to improve bladder health.
Buchsbaum: There are many things women can look for, some of which they might write off as normal, but may be worth investigating. Take urine leakage. It’s a common complaint of women. If you have this problem, you should tell your doctor. Don’t assume it’s something you just have to live with; there are many things that can be done to address it. Frequent or painful urination is another fairly common symptom, which may be a sign of infection or urethral stricture.
Other signs include blood in urine, which can indicate infection, kidney or bladder stones, or, in some cases, even bladder cancer. Without exception, if you find blood in your urine, you should consult your doctor. While it doesn’t necessarily mean there is a serious problem, if there is one, catching it early can make a big difference in identifying and treating a problem.
Scripts: Issues with incontinence and that “gotta go” feeling seem so prevalent now. TV ads tout medications for it and women often crack jokes about it. Is it a normal part of a woman’s aging, especially if the woman has gone through childbirth? And is there really anything you can do to avoid it, or to treat it?
Buchsbaum: While it’s true that urinary incontinence becomes more common with age, it’s not a normal part of aging. There are steps women can take to help prevent it. These include doing pelvic floor exercises (think Kegel’s exercises); avoiding consumption of bladder irritants like caffeine, alcohol, and artificial sweeteners; and developing habits that will help with the urge to go to the bathroom.
When necessary, there are various treatment options depending on the type of incontinence and of the needs of the woman. For instance, stress incontinence – which occurs commonly with exercise, coughing, sneezing, or laughing – may be corrected with pelvic floor exercises, insertion of a device called a pessary to help control leakage, or surgical intervention. Urge incontinence – a sudden and/or strong urge to urinate – can be treated with behavioral changes and, in some cases, medication or nerve stimulation techniques. Overflow incontinence – also known as urinary retention, when bladder is unable to fully empty – is usually treated with self-catheterization or, in certain cases, surgical intervention.
The bottom line is that there are very effective treatment options. Just ask.
Scripts: What should women in their 20s know that might help them in their 30s, 40s and beyond? And if a woman is 50+, is it too late?
Buchsbaum: It is never too early and rarely too late for starting good bladder habits. Developing strong pelvic floor muscles (again, by performing Kegel’s excercises) is key for addressing stress and urge incontinence at all ages, but it’s best to start young, especially for women in childbearing years. Limiting caffeine in your diet is a smart habit at any age.
Also, it is helpful for women to recognize symptoms of urinary tract infections (bladder) infections. These may vary from person to person and become less obvious in elderly women. For example, a young woman usually has the classic symptoms: urgency, frequency, and pain with urinating. An older woman may notice fatigue, confusion, low backache, or perhaps an increase in urinary incontinence. Women of all ages should know that incontinence is not normal. Bladder leakage can get worse if not treated.
Scripts: What one thing do you recommend that a woman asks her doctor at her annual checkup with her primary care physician or gynecologist?
Gunhilde Buchsbaum is a professor Obstetrics and Gynecology, professor of Urology, and director of urogynecology at URMC. She founded and directs the Pelvic Health and Continence Specialties practice at URMC’s Women’s Health Pavilion.