Leakage of urine, sudden urgency to go to the toilet, strong-smelling urine, pain or burning sensation during urination – sounds familiar?

Well, you are not alone. Millions of women worldwide suffer from these discomforts and more!

One of the most common issues faced by women of all ages, especially those who have children, is urinary bladder-related. From disturbing our day-to-day life to affecting our emotional well-being and sexual health, bladder-related issues can have far-reaching consequences.

Let’s decode the what, why and how of it and understand how women can address these issues and make their lives more comfortable.

The Urinary Bladder

An essential part of our body, the urinary bladder is a sack-like organ located in the lower part of the abdomen which holds the urine sent from the kidneys, until it is released from the body.

A Look at 6 Common Bladder Issues

Let’s take a look at six common issues that we should know about:

1. Urinary Tract Infections

Urinary tract infections, commonly known as UTIs, are a known evil that most women suffer from at least once in their lifetime. It is caused when bacteria enter the urinary tract through the urethra and then multiply in the bladder. Any part of the urinary system can get infected including the bladder, urethra, ureters and kidneys.

UTI can be very painful and uncomfortable. If untreated, the infection can travel to the kidneys and lead to more serious issues. Common symptoms of UTI include a burning sensation during urination, an urgent need to urinate and a lethargic feeling all the time. Severe symptoms include fever and chills, pain in the back and lower portion of the abdomen, passing a small amount of urine although feeling an urgent need to urinate, and dark, bloody, cloudy, strange-smelling urine.

If you face any of the above symptoms, meeting a doctor is recommended. Proper treatment can prevent the infection from spreading to other parts of the body.

2. Urinary Incontinence

Probably the most common issue, urinary incontinence can take various forms:

• Temporary urinary Incontinence: This is a short-lived episode often faced by women, mostly by elderly women or those who have been hospitalised. In most cases, these are a side effect of medications (such as diuretics and sleeping pills) that reduce the cortical control over the urinary bladder or increase the production of urine. This can be commonly caused due to pregnancy, surgery, urinary infections, irritated or inflamed bladder, vagina or urethra or severe constipation. Temporary incontinence is cured as soon as the causative factors are identified and corrected.
• Stress incontinence: Have you ever accidentally peed while coughing, sneezing, laughing or during vigorous exercise? This is very common and is known as stress incontinence. When the pelvic floor is strong, the muscles contract on reflex when there’s an increase in intra-abdominal pressure. The contraction shuts off the urethra thus preventing the escape of urine. However, when the supports are weakened, any increase in pressure leads to flow out of the urine through the open urethra. So, what causes the muscles to weaken? There can be various reasons such as pregnancy or childbirth-related changes, thinning caused by menopause and others. The oestrogen level may drop during specific phases of the menstrual cycle weakening the urethra. This can also trigger stress incontinence. Surgical and non-surgical options are available to treat stress incontinence.
• Urge incontinence: Abnormal nerve signals or nerve damage can cause a loss of bladder control, leading to urge incontinence. Such nerve damage can be caused by cerebrovascular accidents, diabetes or an infection. This loss of bladder control can lead to a sudden strong and abrupt urge to urinate without prior warning, followed by an escape of a significant amount of urine suddenly. Thus, women suffering from this issue often leak urine on their way to the toilet, urinate more than eight times a day or have to go to the toilet more than twice at night.
• Mixed incontinence: Mixed incontinence is characterised by a combination of sudden leakage during sneezing and coughing and episodes of urgent need to urinate – a mixture of stress and urge incontinence. The factors that trigger stress and urge incontinence also trigger mixed incontinence.
• Functional incontinence: Functional incontinence, unlike other types of incontinence, is not caused by abnormalities in the urinary system, muscles or nerves. Sometimes a woman may be unable to use the toilet on time due to mental or physical limitations and urinate where she is. This is known as functional incontinence. This problem is faced by women who suffer from a broken leg, arthritis, Alzheimer’s disease or Parkinson’s disease. As they are unable to move to the toilet when the urge comes, they have no option other than urinating where they are. Functional incontinence is essentially a side effect of some other medical health or mental issue.
• Overflow incontinence: Overflow incontinence is the involuntary leakage of small amounts of urine when the bladder exceeds the maximum capacity. This is usually faced by women who have weak bladder muscles, kidney stones, scarred tissue, pelvic organ prolapse, blocked urethra, multiple sclerosis or diabetes. In overflow incontinence, the bladder tends to overfill rapidly or contains a substantial amount of residual urine leading to overflow of urine within a very short time. This needs immediate medical attention as overflow incontinence can lead to a bladder infection.

3. Frequent Urination

Another common issue is urinating more than normal. The ideal number of urination is difficult to define since it can be different for different people. However, if you feel that your urination urges are interfering with your daily life, then speaking to a doctor is recommended.

4. Urinary Urgency

If you are facing sudden and strong urges to urinate, without any proper cause (such as those discussed in urge incontinence), then it can be a case of urinary urgency. This can often be coupled with pain and a general discomfort in the abdomen. Urinary urgency is often faced together with frequent urination.

UTIs can be the main reason for urinary urgencies. Other reasons can be drinking too many caffeinated or alcoholic drinks, consuming too much liquid in a short period, anxiety, chronic bladder infection, vaginal infection or pregnancy. Consult a doctor if this interferes with your daily life.

5. Nocturia

Do you wake up multiple times each night to urinate? Has it increased over time? Then it can be nocturia, a condition that makes you wake up at night and urinate. Although nocturia can happen at any age, it is most common above the age of 60. This can be caused due to drinking too much liquid, but can also be due to more complex conditions such as bladder obstruction or inflammation, diabetes, sleep disorder, heart failure or a side effect of a medication.

6. Haematuria

Haematuria is a condition characterised by the presence of blood in the urine. The blood can sometimes be seen with the naked eye, a condition known as gross haematuria. When the blood cannot be seen with the naked eye, it is known as microscopic haematuria. In both cases, it calls for further investigation because while in some cases this can be harmless, in others this can be a sign of a serious illness. In the end, the cause determines the treatment.

Tips to Prevent a Urinary Tract Infection

Here are our top tips for preventing a UTI:

• Drinking plenty of fluids especially water keeps your bladder tissue hydrated, dilutes your urine and also lowers the concentration of bacteria in the bladder. In fact, drinking enough water can clear a UTI on its own. Ensure to drink at least 1.5 litres of water every day.
• Empty your bladder regularly to ensure that urine is not stored in your bladder for a long time. Bacteria prefer a wet and warm environment to grow. Urine stored in the bladder creates a conducive living condition for the bacteria. Emptying your bladder 4 to 8 times per day is normal.
• It is essential to urinate after sex to prevent UTIs. Intercourse can cause bacteria to get very close to the urethra. Urinating after intercourse removes some of the bacteria, thus preventing an infection.
• Studies have found that cranberries and cranberry supplements have excellent effects on curing and preventing UTIs. In fact, concentrated cranberry supplements have shown better promise. Hence, if you would like to try this out, you can opt for an over-the-counter supplement.
• Wiping front to back after urination and bowel movement prevents the growth of bacteria in the anal region and their spreading to the vagina and urethra.

Talk to a doctor if you have been suffering from two or more infections a month. Recurring UTIs should not be taken lightly as they can lead to further health issues.

How to Keep Your Bladder Healthy?

Here are some tips to maintain the general health of your bladder:

• Follow a healthy lifestyle. Stay hydrated, limit caffeine and alcohol, avoid smoking, exercise and maintain a healthy weight.
• Be aware of what you eat. Consumption of artificial sweeteners, sodas, too much junk food and spicy food can worsen a bladder issue.
• Seek help for constipation
• Include pelvic floor muscle exercises in your exercise routine
• Take enough time while urinating so that the bladder is empty
• Be in a relaxed position while urinating
• Wipe your front to back after urination
• Urinate after sex
• Wear cotton underwear

Be aware of the side effects of your medicines. Some medicines can affect your bladder, thus leading to leakage of urine.

Sources:

• https://www.advancedurologyinstitute.com/bladder-control-problems-women/
• https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes
• https://www.womenshealthaz.com/the-top-5-female-bladder-problems/
• https://www.dignityhealth.org/conditions-and-treatments/womens-services/gynecology/bladder-issues
• https://www.news-medical.net/health/Types-of-bladder-control-problems-in-women.aspx
• https://newsnetwork.mayoclinic.org/discussion/bladder-issues-common-for-women-of-all-ages/
• https://www.mayoclinic.org/diseases-conditions/blood-in-urine/symptoms-causes
• https://newsnetwork.mayoclinic.org/discussion/5-tips-to-prevent-a-urinary-tract-infection/
• https://www.bladdermatters.co.uk/