Bladder HealthBladder HealthPromotionPromotion

Community Awareness Presentation Content contributions provided by the Society of Urologic Nurses (SUNA)

National Association for Continence (NAFC)Simon Foundation for Continence

This presentation will review common bladderThis presentation will review common bladder

health concerns, their treatments and ways tohealth 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 System Urinary 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 Function

When you are ready toWhen you are ready tourinate, the brain relays aurinate, the brain relays asignal to the sphincter tosignal to the sphincter torelax and open and a signalrelax and open and a signalto the bladder to contract.to the bladder to contract.

After you urinate, theAfter you urinate, the

sphincter closes sphincter closes tightlytightly andand

the bladder relaxes and thethe 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 theSigns and Symptoms may include any or all of thefollowing:following:

•• Urine leakage Urine leakage

•• Blood in the urine Blood in the urine

•• Fever Fever

•• Feeling tired and achy Feeling tired and achy

•• Confusion in elderly Confusion in elderly

Risks Factors for Risks Factors for UTIUTI’’ss

__ Pregnancy and Childbirth Pregnancy and Childbirth

__ Gender Gender

__ Sexual Activity Sexual Activity

__ Enlarged prostate or prostate infection Enlarged prostate or prostate infection

__ Physical abnormalities, Physical abnormalities, ieie., strictures,., strictures,

birth defectsbirth defects

__ Weakened immune systemsWeakened immune systems

Prevention of Prevention of UTIUTI’’ss

__ Maintain proper fluid intake. If you Maintain proper fluid intake. If you suspectsuspect

an infection-increase fluid intake, especially an infection-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 contaminationpassing urine to avoid contamination

__ Wear cotton undergarments Wear cotton undergarments

__ Shower regularly, gently dry completely Shower regularly, gently dry completely

Treatment of UTI’s

__ Contact your healthcare provider for evaluationand 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 ofAny uncontrolled loss of

urine of any amounturine of any amount

Urgency and frequency of urination are notUrgency and frequency of urination are not

considered incontinence unless there is loss ofconsidered 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, liftingabdominal 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

incontinenceincontinence

Chronic Retention of Urine /Chronic Retention of Urine /Overflow IncontinenceOverflow Incontinence__ Overflow incontinence (a flaccid or Overflow incontinence (a flaccid or

enlarged bladder) occurs when theenlarged bladder) occurs when the

bladder canbladder can’’t fully emptyt fully empty

This can occur from an enlarged prostateThis can occur from an enlarged prostate

in men, diabetes, stroke, multiplein men, diabetes, stroke, multiple

sclerosis, spinal cord injury &/or othersclerosis, spinal cord injury &/or other

neurologic neurologic diseases as well as side effectsdiseases as well as side effects

of medicationsof medications

Signs and Symptoms of UISigns 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 bladder

or a need to strain when passing urine

Risk FactorsRisk Factors for Incontinencefor Incontinence

__ Congenital defectsCongenital defects

__ Limited mobility Limited mobility

ex. inability to getex. inability to get

to the bathroom)to the bathroom)

__ Pregnancy Pregnancy

__ Menopause Menopause

__ Enlarged prostate Enlarged prostate

__ Obesity Obesity

__ Constipation Constipation

__ Medications (ex. diureticsMedications (ex. diureticsand 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 injuriesdiabetes, spinal injuries

__ Urethral stricturesUrethral strictures

Prevention of IncontinencePrevention 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 yourBe aware of how certain medications effect your

bladder controlbladder control

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

learn learn 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

__ MedicationsMedications

__ Surgical : Sacral nerve stimulators and Surgical : Sacral nerve stimulators and

dennervationdennervation surgery surgery

Treatment forTreatment forOverflow IncontinenceOverflow Incontinence

__ Surgical repair of urethral strictures

__ Remove or reduce obstruction

__ Scheduled timed voiding

__ Clean intermittent catheterization

Signs and Symptoms ofSigns and Symptoms ofBladder 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 thecause of the symptoms.

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 cancer

causing ccausing chemicals in the workplacehemicals in the workplace

can decrease the risk of bladdercan decrease the risk of bladder

Prevention of Bladder CancerPrevention of Bladder Cancer

__ If you smoke: STOP!!!!!If you smoke: STOP!!!!!

Smokers are 2-3-times more likelySmokers are 2-3-times more likely

to develop bladder cancer thanto develop bladder cancer than

nonsmokersnonsmokers

Treatment for Bladder CancerTreatment for Bladder Cancer__ A specialized doctor called aA 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 tumor- Surgical 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 toAfter surgery, treatment and monitoring to

prevent recurrence will be discussedprevent recurrence will be discussed..

PromotingPromoting

Bladder HealthBladder Health

Promoting Bladder Health Promoting Bladder Health

__ Drink 6-8 cups of fluid daily, preferably water Drink 6-8 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 hygiene Maintain weight, good posture and hygiene

__ Keeping other medical conditions under control Keeping 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 kitchenbathroom and kitchen

sinks as reminders to drinksinks as reminders to drink

__ Reduce drinking fluids in the Reduce drinking fluids in the

evening to decrease nighttimeevening to decrease nighttime

urinationurination

__ Drink enough fluid for urine to be clear Drink enough fluid for urine to be clear

__ Drink evenly throughout day, not all at once Drink evenly throughout day, not all at once

Bladder HealthBladder HealthPromotion is anPromotion is an

important concernimportant concernfor everyonefor everyone

Thank you for yourThank you for yourattentionattention