Bladder HealthBladder HealthPromotionPromotion

Community Awareness Presentation endorsed by the

Society of Urologic Nurses (SUNA) National Association for Continence( NAFC)

Simon Foundation for Continence

This presentation will review common bladder This presentation will review common bladder health concerns, their treatments and ways to health concerns, their treatments and ways to prevent them. prevent them.

These concerns include: These concerns include:

Urinary Tract InfectionsUrinary Tract Infections

Urinary IncontinenceUrinary Incontinence

Bladder CancerBladder Cancer

Urinary SystemUrinary SystemUrine: is formed in the kidneys and moves down the 2 ureters to the bladder.

Bladder: stores and eliminates urine

Detrusor: muscle of the bladder contracts and pushes the urine out during urination.

Urethra: tube from the bladder that carries urine out of the body.

Pelvic floor muscles: a sling of muscles that surround and press on the urethra to maintain urine in the bladder.

Bladder FunctionBladder FunctionWhen you are ready to When you are ready to urinate, the brain relays a urinate, the brain relays a signal to the sphincter to signal to the sphincter to relax and open and a signal relax and open and a signal to the bladder to contract.to the bladder to contract.

After you urinate, the After you urinate, the sphincter closes sphincter closes tightlytightly and and the bladder relaxes and the the bladder relaxes and the refilling can resume.refilling can resume.

Urinary Tract InfectionsUrinary Tract Infections

Urinary Tract Infections (UTI)Urinary Tract Infections (UTI)A UTI is an infection anywhere in the urinary tract. Your urinary tract includes the organs that collect and store urine and release it from your body. They are the

•kidneys •ureters •bladder •urethra

Urinary Tract Infections (Urinary Tract Infections (UTIUTI’’ss))

•• Painful urinationPainful urination

•• Cloudy, foul smelling Cloudy, foul smelling

urineurine

•• IrritativeIrritative symptoms symptoms

(frequency, urgency (frequency, urgency

&/or bladder pressure)&/or bladder pressure)

Signs and Symptoms may include any or all of the Signs and Symptoms may include any or all of the following:following:

•• Urine leakageUrine leakage

•• Blood in the urineBlood in the urine

•• FeverFever

•• Feeling tired and achy Feeling tired and achy

•• Confusion in elderlyConfusion in elderly

Risks Factors for Risks Factors for UTIUTI’’ss

●● Pregnancy and Childbirth Pregnancy and Childbirth

●● GenderGender

●● Sexual ActivitySexual Activity

●● Enlarged prostate or prostate infectionEnlarged prostate or prostate infection

●● Physical abnormalities, Physical abnormalities, ieie., strictures, ., strictures,

birth defects birth defects

●● Weakened immune systemsWeakened immune systems

Prevention of Prevention of UTIUTI’’ss

●● Maintain proper fluid intake. If you Maintain proper fluid intake. If you suspect suspect an infectionan infection--increase fluid intake, especially increase fluid intake, especially waterwater

●● Women should wipe from front to back after Women should wipe from front to back after passing urine to avoid contamination passing urine to avoid contamination

●● Wear cotton undergarments Wear cotton undergarments

●● Shower regularly, gently dry completelyShower regularly, gently dry completely

Treatment of UTI’s●● Contact your healthcare provider for evaluation and possibly medication

●● Treatment may include antibiotics and pain relievers

●● Common over the counter pain relievers can decrease aches and fever

●● Increase fluid intake especially water

Bladder Control :

Urinary Incontinence

Urinary IncontinenceUrinary Incontinence

Definition:Definition:

Any uncontrolled loss of Any uncontrolled loss of

urine of any amounturine of any amount

Urgency and frequency of urination are not Urgency and frequency of urination are not considered incontinence unless there is loss of considered incontinence unless there is loss of bladder control, even a few drops of urine.bladder control, even a few drops of urine.

Types of IncontinenceTypes of Incontinence

●● Stress Stress –– leakage of urine due to an increase in leakage of urine due to an increase in abdominal pressure with sneezing, laughing, lifting abdominal pressure with sneezing, laughing, lifting or changing positionor changing position

●● Urge Urge –– leakage of urine with a strong urge to urinate leakage of urine with a strong urge to urinate usually on the way to the bathroomusually on the way to the bathroom

●● Mixed Mixed –– a combination of Stress and Urge a combination of Stress and Urge incontinence incontinence

Types of Incontinence Cont.Types of Incontinence Cont.●● Overflow incontinence (a flaccid or Overflow incontinence (a flaccid or

enlarged bladder) occurs when the enlarged bladder) occurs when the bladder canbladder can’’t fully emptyt fully empty

This can occur from an enlarged prostate This can occur from an enlarged prostate in men, diabetes, stroke, multiple in men, diabetes, stroke, multiple sclerosis, spinal cord injury &/or other sclerosis, spinal cord injury &/or other neurologicneurologic diseases as well as side effects diseases as well as side effects of medicationsof medications

Signs and Symptoms of UI Signs and Symptoms of UI ●● Stress-leakage of urine with physical activities,

exercise, coughing, laughing or sneezing

●● Urge- strong urge to urinate followed by uncontrollable leakage

●● MixedMixed-- leakage of urine with both an urge to leakage of urine with both an urge to urinate and activities as listed aboveurinate and activities as listed above

●● Overflow-leakage of urine with a full bladderor a need to strain when passing urine

Risk FactorsRisk Factors for Incontinencefor Incontinence●● Congenital defectsCongenital defects

●● Limited mobility Limited mobility

ex. inability to get ex. inability to get

to the bathroom)to the bathroom)

●● PregnancyPregnancy

●● MenopauseMenopause

●● Enlarged prostateEnlarged prostate

●● ObesityObesity

●● ConstipationConstipation

●● Medications (ex. diuretics Medications (ex. diuretics and sedatives)and sedatives)

●● Cigarette smoking Cigarette smoking

●● Diet (caffeine, alcohol, poor Diet (caffeine, alcohol, poor fluid fluid intake)intake)

●● Surgery (ex. Prostatectomy)Surgery (ex. Prostatectomy)

●● Disease (ex. ParkinsonDisease (ex. Parkinson’’s, MS,s, MS,diabetes, spinal injuries diabetes, spinal injuries

●● Urethral stricturesUrethral strictures

Prevention of Incontinence Prevention of Incontinence ●● Work with urology healthcare professionals to Work with urology healthcare professionals to

determine an appropriate voiding scheduledetermine an appropriate voiding schedule

●● Take time to empty your bladder completelyTake time to empty your bladder completely

●● Be aware of how certain medications effect your Be aware of how certain medications effect your

bladder control bladder control

●● Attend lectures, seminars and health fairs toAttend lectures, seminars and health fairs to

learnlearn more about the treatment options for more about the treatment options for

maintaining controlmaintaining control

Treatments for Stress IncontinenceTreatments for Stress Incontinence

●● Lifestyle changes: weight loss, reducing dietary irritants, smoking cessation

●● Pelvic floor muscle exercise

●● In women, pessary placement

●● Injection of bulking agent such as collagen

●● Surgical treatments include: artificial urinary sphincter, bladder neck suspension, and urethral sling

Treatments for Urge IncontinenceTreatments for Urge Incontinence●● FluidFluid management (time and amount of fluid, management (time and amount of fluid,

limiting alcoholic and caffeine beverages)limiting alcoholic and caffeine beverages)

●● Dietary management and weight reduction Dietary management and weight reduction

●● Pelvic floor muscle exercisePelvic floor muscle exercise

●● Bladder retrainingBladder retraining

●● Medications Medications

●● Surgical : Sacral nerve stimulators and Surgical : Sacral nerve stimulators and dennervationdennervation surgerysurgery

Treatment for Treatment for Overflow IncontinenceOverflow Incontinence

●● Surgical repair of urethral strictures

●● Remove or reduce obstruction

●● Scheduled timed voiding

●● Clean intermittent catheterization

Bladder CancerBladder Cancer

Bladder CancerBladder CancerBladder Cancer occurs when cells grow out Bladder Cancer occurs when cells grow out

of control forming a growth or tumor in the of control forming a growth or tumor in the lining layer of the bladder.lining layer of the bladder.

Bladder cancer begins as superficial (on the Bladder cancer begins as superficial (on the surface) and can be easily treated. surface) and can be easily treated.

If not treated, it will continue to grow directly into If not treated, it will continue to grow directly into the lining of the bladder wall making it harder the lining of the bladder wall making it harder to treat. to treat.

Signs and Symptoms of Signs and Symptoms of Bladder CancerBladder Cancer

Most common signs of bladder cancer:

●● Blood in the urine

●● Pain during urination

●● Urinate urgently or very often

These can also be signs of infection, benign tumors, bladder stones, or other problems.

See your healthcare professional to determine the cause of the symptoms.

Risks Factor for Bladder Cancer Risks Factor for Bladder Cancer

Chemicals pass through the bladder and can cause damage to the cells resulting in cancer.

Researchers are not exactly sure

why some people get bladder

cancer. Some occupations are at a

higher risk for bladder cancer due

to exposure to cancer causing

substances.

Risks Factors for Bladder CancerRisks Factors for Bladder Cancer

People that handle rubber,

chemicals, and leather, as

well as hairstylists,

machinists, metal workers,

printers, painters, textile

workers, and truck drivers

are at higher risk.

●● LLimiting exposure to cancerimiting exposure to cancercausing ccausing chemicals in the workplacehemicals in the workplace

can decrease the risk of bladder can decrease the risk of bladder

Prevention of Bladder CancerPrevention of Bladder Cancer

●● If you smoke: STOP!!!!! If you smoke: STOP!!!!! Smokers are 2Smokers are 2--33--times more likely times more likely to develop bladder cancer than to develop bladder cancer than nonsmokersnonsmokers

Treatment for Bladder Cancer Treatment for Bladder Cancer ●● A specialized doctor called a A specialized doctor called a

Urologist will discuss Urologist will discuss your treatment options.your treatment options.

●● Options may includeOptions may include-- Surgical removal of the tumorSurgical removal of the tumor-- Bladder instillations to Bladder instillations to

destroy cancer cells on the destroy cancer cells on the bladder lining surfacebladder lining surface

●● After surgery, treatment and monitoring to After surgery, treatment and monitoring to prevent recurrence will be discussedprevent recurrence will be discussed. .

Promoting Promoting Bladder HealthBladder Health

Promoting Bladder HealthPromoting Bladder Health●● Drink 6Drink 6--8 cups of fluid daily, preferably water8 cups of fluid daily, preferably water

●● Limit the use of alcohol, caffeine, artificial Limit the use of alcohol, caffeine, artificial

sweeteners, high sugar, sweeteners, high sugar, citric/spicy foodscitric/spicy foods

●● Maintain weight, good posture and hygieneMaintain weight, good posture and hygiene

●● Keeping other medical conditions under controlKeeping other medical conditions under control

●● Be aware of medications that may lead to Be aware of medications that may lead to

incontinence (e.g., diuretics and sedativesincontinence (e.g., diuretics and sedatives))

Promoting Bladder HealthPromoting Bladder Health●● Learn how to strengthen the pelvic floor muscles by Learn how to strengthen the pelvic floor muscles by

doing pelvic floor exercisesdoing pelvic floor exercises

●● Work with your health care provider on timed Work with your health care provider on timed scheduled voidingscheduled voiding

●● Avoid constipation by eating a high fiber dietAvoid constipation by eating a high fiber diet

●● Report changes in bladder habits, frequency, Report changes in bladder habits, frequency, urgency, pain or blood in the urine to your urgency, pain or blood in the urine to your healthcare professionalhealthcare professional

Promoting Bladder HealthPromoting Bladder Health●● Keep a cup for drinking near Keep a cup for drinking near

bathroom and kitchen bathroom and kitchen

sinks as reminders to drink sinks as reminders to drink

●● Reduce drinking fluids in the Reduce drinking fluids in the evening to decrease nighttime evening to decrease nighttime urinationurination

●● Drink enough fluid for urine to be clearDrink enough fluid for urine to be clear

●● Drink evenly throughout day, not all at onceDrink evenly throughout day, not all at once

Bladder Health Bladder Health Promotion is an Promotion is an

important concern important concern for everyonefor everyone

Thank you for your Thank you for your attentionattention