Bladder & Bowel Archive

In the journals

Men who battle with nocturia — waking up at night to urinate — may find relief by reducing the amount of salt in their diet, according to research presented March 24, 2017, at the European Society of Urology congress in London. Nocturia can interfere with your sleep, which may lead to problems like increased stress, irritability, and tiredness.

In the study, researchers from Nagasaki University in Japan examined 321 older adults — about half of whom were men — who had both a high-salt diet and problems sleeping due to nocturia. The participants were then advised on how to reduce their daily salt consumption, which they followed for 12 weeks.

Don't be surprised if your doctor doesn't rush you into treatment.

 Image: © iStock

Urinary tract infections (UTIs) can be tricky in older age. They're not always as easy to spot or treat as in youth. And the decades-long approach to treatment is changing. "We've been hasty in using antibiotics, and we're learning there are significant consequences that can range from side effects of medication to infections with antibiotic-resistant bacteria," says Dr. Helen Chen, a geriatrician at Harvard-affiliated Hebrew Rehabilitation Center.

About UTIs

UTIs can occur anywhere in the urinary tract. The most common places are the bladder (where urine is stored) and the urethra (the tube through which you urinate). Less common, but more serious, is infection of the kidneys, which filter waste and extra water from the blood and make urine. Infections may be triggered by sexual activity, catheters, kidney stones, decreased estrogen in the lining of the vagina, or urine that's pooled in the bladder.

Women use kegels to strengthen their pelvic floor muscles, but men may also benefit from doing these exercises.

Image: © Eraxion /Thinkstock

Kegel exercises to strengthen pelvic floor muscles have long been seen as just for women, but they may be a way for men to address some common unpleasant issues as they age.

"Men also can have issues with these muscles, which can cause urinary leakage, bowel trouble, and even erection problems," says physical therapist Celia Brunette, with Harvard-affiliated Spaulding Rehabilitation Center.

The risk of developing stress incontinence or urge incontinence increases along with BMI and body fat percentage. Stress incontinence is also associated with declines in grip strength.

 Scientific evidence doesn’t support taking cranberry extract to prevent urinary tract infections.

Women who used Tät, a smartphone app, did more pelvic floor exercises and had greater reductions in episodes of stress incontinence.

Exercises, lifestyle change, medications, and procedures can alleviate incontinence and give you your life back.

A leaky bladder or a sudden urge to go to the bathroom is uncomfortable andembarrassing. But you can take steps to alleviate the problem. "Some people tell me they would have sought treatment sooner if they'd known it was this simple," says Dr. Anurag Das, director of the Center for Neurourology and Continence at Harvard-affiliated Beth Israel Deaconess Medical Center.

Lifestyle changes

One of the first lines of defense is pill-free and costs nothing: lifestyle change. For urge incontinence (see "Types of incontinence"), you can try timed voiding (urinating on a schedule) and bladder guarding, which teaches you to cope with triggers that set off the urge to go, such as washing dishes or hearing water. "You squeeze your muscles to hold in urine before a trigger, which sends a message to the brain that this is not the time to go," says Dr. Das. Other lifestyle changes include watching fluid intake; quitting smoking, to reduce coughing and pressure on the bladder; and minimizing bladder irritants such as caffeine, alcohol, and carbonated drinks.

If you feel a strong urge to urinate even when your bladder isn't full, it might be related to overactive bladder, sometimes called urge incontinence. This condition occurs in both men and women and involves an overwhelming urge to urinate immediately, frequently followed by loss of urine before you can reach a bathroom. Even if you never have an accident, urgency and urinary frequency can interfere with your work and social life because of the need to keep running to the bathroom.

Urgency is caused when the bladder muscle, the detrusor, begins to contract and signals a need to urinate, even when the bladder is not full. Another name for this phenomenon is detrusor overactivity.

When the skin comes in contact with fecal material for a length of time, it can become irritated and inflamed. That means proper care of the skin in the anal area is essential to maintaining comfort and preventing skin deterioration. Skin irritation is more than a misery. It can invite infection and even compromise your treatment if the skin becomes too sore for your muscles to work well. 

Skin should be cleansed after each episode of incontinence. Choose an extremely mild, nonalkaline soap — such as Dove or Basis — or buy one of the special cleansers designed to gently dissolve and remove stool and urine (such as Aplicare Antiseptic Perineal Wash). These are nonirritating, soap-free cleansing lotions; some are available in portable disposable wipes (Clinell Continence Care Wipes). They eliminate the need to scrub areas of tender skin, and some do not require that you rinse the skin after use.