Bladder dysfunction: Knowing what medical approaches and lifestyle changes can help. Dr. Alec Schwartz, urologist, discusses what you need to know.

 

Feel like you’re urinating frequently, or not frequently enough? If so, you’re not alone. Studies show that tens of millions of Americans experience bladder dysfunction in the form of an overactive bladder, underactive bladder or another bladder condition and can suffer from discomfort, inconvenience and/or embarrassment if it’s not appropriately treated/managed.

“Bladder dysfunction is extremely common among both men and women,” confirmed Alec Schwartz, MD, board-certified urologist at Bergen Medical Associates, which has six offices throughout Bergen County. “As many as half of the patients I see in the office on any given day complain of issues with their urinary function, whether it involves frequency, urgency or incontinence/loss of urinary control.”

According to Dr. Schwartz, “bladder voiding dysfunction” is a broad term that can take either obstructive or irritative forms.

“Symptoms of obstructive dysfunction, which relate to a blockage of urine, can include slow flow, straining to urinate, intermittency or hesitancy of urine, or a sense of incomplete emptying,” he said. “Irritative conditions are reflected by frequent urination during the day and/or night, discomfort while urinating, a sense of urgency and ‘urge urinary incontinence,’ where you leak with urge. Yet another condition known as ‘stress urinary incontinence’ – whereby leakage occurs following abdominal stressors such as coughing, sneezing, exercise, dancing and certain other movements — is also common in women after childbirth and in men after surgery for prostate cancer.

“However, some of the aforementioned can also be symptoms of a urinary tract infection (UTI), so that’s the first thing we’ll want to rule out,” he said.

While bladder dysfunction can affect men and women equally, Dr. Schwartz said that the genders may experience different symptoms. “Specifically, women more commonly present with irritative symptoms or stress urinary incontinence,” he explained. “In men, the bladder empties through the center of the prostate, and as the prostate grows the center hole shrinks, so a man with an enlarged prostate may be unable to urinate due to potential blockage. The bladder will subsequently compensate and generate more forceful contractions to squeeze urine through the narrower opening,” said Dr. Schwartz, who added that ironically, such obstruction can actually lead to the symptoms of overactive bladder and the need to urinate frequently.

Causes and Treatments

Dr. Schwartz said that common causes of overactive or underactive bladder conditions include UTIs, previous radiation for a pelvic cancer and diabetes. “These issues can affect people of all ages, including young women,” he said. “However, bladder dysfunctions tend to be more prevalent among people in their 60s and above and especially among older men, as the male prostate doesn’t start growing until age 40.

“At the same time, while these types of symptoms often become more of a lifestyle issue than something that’s medically concerning, excessive urine retention can lead to kidney failure in severe cases,” Dr. Schwartz said. “For that reason, it’s important to see a urologist if you’re experiencing any kind of abnormal or uncomfortable symptoms.”

For women who can’t empty their bladder at all, “treatment can include the use of a urinary catheter and/or medication designed to relax the opening of the bladder and make it easier to urinate,” Dr. Schwartz said. “Treatment for men is similar — we would decompress the bladder and prescribe medication for two to 14 days. If this approach proves unsuccessful, next steps may involve dealing with an obstructing prostate, which could require surgery.”

Dr. Schwartz noted that certain lifestyle changes can help reduce the risk or effects of bladder dysfunction. “As stress and anxiety can cause more common symptoms, reducing stress can help alleviate them,” he said. “In addition, caffeine, alcohol, and spicy or heavily seasoned food can cause irritation to the bladder, so sometimes avoiding those items can eliminate the problem.” Finally, he said, “Kegel exercises can often help women with stress incontinence by strengthening the pelvic floor.

“While some people feel embarrassed about their bladder dysfunction, these conditions are extremely common and we treat them on a routine basis,” Dr. Schwartz said. “In the end, we don’t want people to refrain from seeing a doctor out of embarrassment and subsequently neglect to have a potentially serious issue addressed. There are many treatments in our arsenal that we can offer to reduce our patients’ discomfort and help them better manage or eliminate these symptoms.”

For More Information

With offices in Emerson, Paramus (two), Ridgewood, Northvale and Montvale, Bergen Medical Associates offers primary care and 12 areas of specialized care. Patients enjoy the “one-stop shopping” approach where numerous medical services are provided under one umbrella. The multispecialty group fosters an environment of collaboration among the physicians, which results in a seamless continuum of care for patients. For more information, visit bergenmed.com or call 201-967-8221.