Bladder & Bowel Archive

This treatment approach may help provide relief for many women with chronic pelvic pain and urinary symptoms.

The exact cause of pelvic pain for many women can be elusive, despite lots of tests and scans. In some cases, the symptoms are related to a problem that is often overlooked, says Dr. Eman Elkadry, an instructor in obstetrics, gynecology, and reproductive biology at Harvard Medical School. Pelvic pain may stem from a pelvic floor muscle problem that can be helped by a specialized form of physical therapy known as pelvic physical therapy.

"Although pelvic physical therapy may not work for everyone, it can be quite effective for certain individuals," says Dr. Hye-Chun Hur, director of the Division of Minimally Invasive Gynecologic Surgery at Harvard-affiliated Beth Israel Deaconess Medical Center and associate faculty editor of Harvard Women's Health Watch. She stresses that pelvic physical therapy is normally undertaken by a trained female practitioner.

Research we're watching

While cesarean delivery may mean longer recovery time after your baby is born, it may make it less likely that someday you'll need to cross your legs when you cough or sneeze.

A study in the Dec. 18, 2018, issue of JAMA found that women who delivered their first baby by cesarean had half the risk of developing stress urinary incontinence (which causes urine to leak when you cough or sneeze) or overactive bladder, compared with first-time moms who had a spontaneous vaginal birth.

Ask the doctors

Q. I have hemorrhoids. Could this increase my risk of colon cancer?

A. In short, no. Hemorrhoids don't cause or increase your risk for colon or rectal cancer. However, the two conditions may be mistaken for one another because they can produce similar symptoms, such as rectal bleeding, itching, and pain.

Diverticular disease develops due to a lack of dietary fiber, and is most common in the elderly, but many people never realize they have it because there are few symptoms.

Having your sleep interrupted by the need to urinate (the medical term is nocturia) is a common cause of sleep loss, especially among older adults. Nearly two-thirds of adults ages 55 to 84 deal with this problem at least a few nights per week.

People with mild cases may wake two times a night; in severe cases, it may be as many as five or six times. The result can be significant sleep loss and daytime fatigue.

Ask the doctors

Q. I'm hoping to prevent urinary incontinence. Is there anything I can do?

A. Nearly half of all women experience some type of urinary incontinence during the course of their lives. It may not be possible to prevent all of these cases, which can be caused by pregnancy, childbirth, or hormonal shifts that occur around the time of menopause. Here are some strategies that may help to reduce your risk.

On call

Q. When should I worry about changes in the color of my urine? What color is considered healthy?

A. If a person is well hydrated, the normal color of urine is a pale yellow. Someone who drinks large amounts of fluid or takes diuretics (water pills) can have almost clear-looking urine. A dark yellow color may indicate a need to increase your fluid intake.

In the journals

Men often rely on drugs to manage overactive bladder symptoms, such as frequent urination, urgency, incontinence, and nocturia (having to use the bathroom at night). However, a study published online Jan. 13, 2020, by JAMA Internal Medicine suggests that adding behavioral therapy may lead to better results.

Scientists recruited more than 200 men (average age 64) with overactive bladder symptoms and divided them randomly into three groups. One group received only drug therapy. One received only behavioral therapy, which consisted of learning pelvic floor exercises and relaxation techniques to help suppress urges and prevent urine loss. The third group had both behavioral and drug therapy.

Most people take bladder control for granted — until the unintended loss of urine interrupts the ability to carry on an ordinary social and work life.

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