Bladder & Bowel Archive

In the journals

Observation only may be the best medicine for men with early-stage prostate cancer, suggests a 20-year study published online July 13, 2017, by The New England Journal of Medicine. Early-stage prostate cancer means the cancer is small, confined to the prostate gland, and can only be detected with a biopsy.

Researchers randomly assigned 731 men, average age 67, with localized prostate cancer to receive either surgery or observation only. At the 20-year follow-up, 62% of the men who had prostate cancer surgery had died of other causes, while only 7% died from prostate cancer. In comparison, 67% of the men assigned to observation died from other causes and 11% from prostate cancer. The absolute differences in mortality were not significant.

Research we're watching

Recent evidence suggests that antibiotics, which affect the makeup of intestinal bacteria, might be associated with an increased risk of colorectal cancer. A team led by researchers from Harvard Medical School wanted to see if antibiotic use is also associated with adenomatous polyps, precursors of colon cancer that significantly increase the risk of developing the disease.

The team analyzed data from 16,642 women ages 60 or older participating in the Nurses' Health Study. They first looked at participants' antibiotic use from ages 20 through 59 and in the most recent four years. They also checked the results with the women's colonoscopies and found 1,195 cases of adenomatous polyps.

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.

Most people who are suffer from fecal incontinence do so in silence. As a result, the number of people with the condition — which results in the involuntary release of gas or stool — isn't known. But the scant evidence at hand indicates that it usually begins during one's 40s or 50s.

You don't have to live with incontinence — there are treatment options, which include dietary changes and bowel training regimens, and surgery for some people.

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.

Interstitial cystitis is a chronic inflammation of the bladder that causes people to urinate -- sometimes painfully -- as often as 40, 50, or 60 times a day. Their quality of life, research suggests, resembles that of a person on kidney dialysis or suffering from chronic cancer pain. Not surprisingly, the condition is officially recognized as a disability.

There's no cure for interstitial cystitis, but many treatments offer some relief, either on their own or in combination.

 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.