Bladder Health Promotion

Bladder Health Bladder Health PromotionPromotion

Community Awareness Presentation

Content contributions provided by:Society of Urologic Nurses

(SUNA) 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 System Urine: 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 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 (UTI’s)Urinary Tract Infections (UTI’s)

• • Painful urinationPainful urination

•• Cloudy, foul smelling Cloudy, foul smelling

urineurine

•• Irritative symptoms Irritative 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 UTI’s Risks Factors for UTI’s

●● Pregnancy and Childbirth Pregnancy and Childbirth

●● GenderGender

●● Sexual ActivitySexual Activity

●● Enlarged prostate or prostate infectionEnlarged prostate or prostate infection

● ● Physical abnormalities, ie., strictures, Physical abnormalities, ie., strictures,

birth defects birth defects

● ● Weakened immune systemsWeakened immune systems

Prevention of UTI’s Prevention of UTI’s

●● Maintain proper fluid intake. If you Maintain proper fluid intake. If you suspect suspect

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 contamination passing urine to avoid contamination

●● Wear cotton undergarments Wear cotton undergarments

●● Shower regularly, gently pat dry completelyShower regularly, gently pat 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

● ● Cranberry capsules

●● 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 – leakage of urine due to an increase in Stress – 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 – leakage of urine with a strong urge to urinate, Urge – leakage of urine with a strong urge to urinate,

usually on the way to the bathroomusually on the way to the bathroom

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

incontinence incontinence

Overactive Bladder (OAB)Overactive Bladder (OAB)

Frequency (8 or more times/day) Urgency of urination Nocturia (getting up 2 or more times at

night) +/- incontinence

Types of Incontinence Cont.Types of Incontinence Cont.

●● Overflow incontinence (a flaccid or enlarged Overflow incontinence (a flaccid or enlarged

bladder) occurs when the bladder can’t fully bladder) occurs when the bladder can’t fully

emptyempty

● ● This can occur from an enlarged prostate This can occur from an enlarged prostate

in men, diabetes, stroke, multiple sclerosis, in men, diabetes, stroke, multiple sclerosis,

spinal cord injury &/or other neurologic spinal cord injury &/or other neurologic

diseases as well as side effects of medicationsdiseases as well as side effects of medications

Signs and Symptoms of UI Signs and Symptoms of UI

●● StressStress-l-leakage of urine with physical activities, eakage of urine with physical activities,

exercise, coughing, laughing or sneezingexercise, coughing, laughing or sneezing

●● UrgeUrge-- strong urge to urinate followed by strong urge to urinate followed by

uncontrollable leakageuncontrollable 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 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. Parkinson’s, MS,Disease (ex. Parkinson’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 schedule determine 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

● ● Learn how to correctly perform pelvic floor Learn how to correctly perform pelvic floor

exercises (kegels)exercises (kegels)

Prevention of Incontinence Prevention of Incontinence

● ● Attend lectures, seminars and health Attend lectures, seminars and health

fairs to learnfairs to learn more about the treatment more about the treatment

options for maintaining controloptions for maintaining control

Treatments for Stress IncontinenceTreatments for Stress Incontinence

●● Lifestyle changes: weight loss, reducing

dietary irritants, smoking cessation

●● Pelvic floor muscle exercises

●● In women, pessary placement

●● Injection of bulking agent

●● 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 exercisesPelvic floor muscle exercises

● ● Bladder retrainingBladder retraining

● ● Medications Medications

● ● Surgical : Sacral nerve stimulators and Surgical : Sacral nerve stimulators and

dennervation surgery; Botoxdennervation surgery; Botox

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 Cancer

Bladder 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.

●● Limiting exposure to cancerLimiting exposure to cancer

causing chemicals in the workplacecausing chemicals 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 2-3-times more likely Smokers are 2-3-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 your treatment options.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 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 6-8 cups of fluid daily, preferably waterDrink 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 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 doing

pelvic floor exercisespelvic floor exercises

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

voidingvoiding

●● 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 urgency, pain or

blood in the urine to your 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