Bladder Problems

10 Things Your Bladder Says About Your Health
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Bladder problems are often associated with the very old and infirm. But guess what? Adults of all ages, including many who are seemingly healthy, can have unusual bladder symptoms -- and they can be warning signs of problematic health conditions.

"The urinary system can be a real canary in the coal mine," says Jill Rabin, chief of ambulatory care and urogynecology at the Albert Einstein College of Medicine in Hyde Park, New York, and coauthor of Mind Over Bladder. "If you have a significant change in your bladder habits, you may have a problem with the bladder itself or the pelvic organs, or it may be a sign of a larger systemic problem."

Here are ten problems that unusual bladder symptoms may signal:

1. Possible bladder message: Sleep apnea

What it is: Sleep apnea is a breathing disorder in which abnormal pauses in breathing during sleep can last a minute or longer, causing the person to abruptly wake up. (Apnea is a Greek word "meaning without breath.") "Untreated sleep apnea is becoming more and more commonly diagnosed by urologists," says Adam Tierney, a urologist with Dean Clinic in Madison, Wisconsin. That's because regular doctors can't see it during checkups; it's the night urination that's noticed first.

More than 12 million people have sleep apnea, and many more are thought to have it but not know it. In March 2011, Israeli researchers reported that in a group of men aged 55 to 75 who had benign prostate enlargement (BPE) and reported nocturia -- the need to get up at night to urinate -- more than half of their night wakings were probably actually attributable to sleep apnea.

What you may notice: Awakening at night to urinate as often as every two or three hours. With sleep apnea, the person wakes up because of the breathing lapse and then decides almost on autopilot to use the bathroom. By morning, he or she is aware that, "Gee, I'm getting up at night to pee a lot," rather than that breathing has been briefly stopping. Other sleep apnea symptoms include snoring and daytime sleepiness.

What you can do: Report excessive night urination to your doctor so its true cause can be pinpointed. Sleep apnea is treatable with several different devices designed to facilitate breathing, as well as surgery.

2. Possible bladder message: Out-of-control diabetes

What it is: When blood sugar is poorly controlled, nerve damage can result. Diabetics usually know that this can result in a loss of sensation in the extremities. But nerve signals may also be unable to appropriately reach the muscles that govern urination, Rabin says.

What you may notice: A frequent feeling of needing to use the bathroom, even when you don't, or a lack of sensation that it's time to void, which causes you to wet yourself. You may also be excreting larger-than-normal amounts of urine with poorly managed diabetes. That's because the body tries to rid itself of excess glucose through the urine.

What you can do: Talk to your doctor about ways of better controlling blood sugar through diet and exercise. Many diabetics don't think to report incontinence symptoms because they don't link them to their disease.

More things your bladder says about your health

3. Possible bladder message: Hypothyroidism

What it is: Untreated hypothyroidism -- slow functioning of the thyroid gland, which helps regulate metabolism -- can also cause problems in the way that nerve signals reach muscles, says urogynecologist Jill Rabin. Women are affected more often than men.

What you may notice: Urge incontinence, or the need to "go," whether there's an actual need or not. This is usually a secondary symptom of hypothyroidism, the primary symptoms being extreme fatigue, a sense of being cold, weight gain, dry skin, and sometimes hair falling out.

What you can do: Report symptoms to your doctor, and be sure to mention any other unusual symptoms you are experiencing. Treating the hypothyroidism usually eases incontinence symptoms.

4. Possible bladder message: Prostate problem

What it is: The prostate, a doughnut-shaped gland that encircles the male urethra and plays a role in both urination and reproduction, tends to enlarge over time. This squeezes the urethra (urinary passage), causing a relatively harmless condition called benign prostate hyperplasia (BPH). BPH is most common in men over 50, as is prostate cancer. Another common prostate complication, more common in younger men, is prostatitis, an infection. One of these conditions doesn't necessarily lead to the next.

What you may notice: A sudden and urgent need to pee (urge incontinence), night waking to use the bathroom, dribbling urine after you think you're finished, difficulty beginning to urinate, and more frequent urination day or night.

What you can do: Because prostate problems range in seriousness but can manifest in many different ways, any change in urinary symptoms is worth reporting as soon as you start wondering or worrying about it. Prostate cancer is typically ruled out first through an exam that includes a digital exam and a prostate-specific antigen (PSA) blood test.

5. Possible bladder message: Chronic urinary tract infection

What it is: Urinary tract infections (UTIs) are the second most common kind of infection in the human body. Both men and women get them, though they're most common in women.

What you may notice: A persistent urge to urinate, a burning sensation while urinating, frequent urination, or urine that's reddish or cloudy and sometimes foul-smelling. You may also experience fever, localized pain, and a sensation of pressure.

What you can do: See your doctor. Prescription antibiotics usually clear up the infection within a day or two. When infections are continuous, a stronger drug or longer regimen may be prescribed. People who get repeated UTIs tend to have an underlying condition that predisposes them (such as diabetes or pregnancy) or have habits that promote them. Women with chronic UTIs should use sanitary pads rather than tampons; avoid douching; urinate before and after intercourse; and avoid excessive alcohol or caffeine, which are bladder irritants.

More things your bladder says about your health

6. Possible bladder message: You weigh too much

What it is: You probably don't need your bladder to tell you what your mirror and scale already know. But the effects of obesity are sometimes easy to ignore, at least until everyday functioning is affected, all day long. Excess weight means that the pelvic-floor muscles involved in supporting a woman's urinary system are under extra pressure. Over time, they can weaken, especially the urinary sphincter, which keeps the urethra capped when you're not urinating.

What you may notice: Leaking urine when you cough, sneeze, exercise, or move the wrong way -- any kind of physical stress can produce what's known as stress incontinence.

"People don't often connect weight and urine, but there's a clear association," says urologist Adam Tierney. "And overweight people are more likely to have diabetes, which can cause urge incontinence on top of the stress incontinence."

What you can do: Pelvic floor exercises and other therapies for stress incontinence can help shore up weak musculature and lessen episodes of leakage. Not smoking is another remedy, since the cough that smoking produces further aggravates weak musculature.

But the very best remedy for stress incontinence for those who are overweight is to work to achieve a body-mass-index in the normal range. A 2009 study in the New England Journal of Medicine found that overweight women who lost an average of just 8 percent of their body weight (17pounds) saw their weekly incontinence episodes cut in half.

7. Possible bladder message: Interstitial cystitis

What it is: A chronic inflammatory disorder of the bladder, including irritation of the bladder lining and wall, interstitial cystitis (also called painful bladder syndrome and bladder pain syndrome) affects both sexes, especially women. The cause isn't fully understood.

Interstitial cystitis is often associated with sleep disorders, migraines, depression, and other pain syndromes, such as fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, Tierney says.

What you may notice: Very frequent urination (several times an hour, all day), pain on urinating, general pain in the pelvic area. (Normally, people need to urinate no more than seven times a day, according to the American Urological Foundation Association.) Pain is usually experienced in flare-ups that can be related to menstruation, having sex, stress, and illness. It often resembles a urinary tract infection, but testing shows no evidence of bacteria.

What you can do: There are no reliable tests or remedies for interstitial cystitis, but a thorough medical exam can point to treatment of other possible causes of the symptoms. Treatment of interstitial cystitis itself often focuses on medications and lifestyle changes that can help sufferers better manage their symptoms. For example, many people have success with dietary changes, avoiding foods that irritate the bladder, such as caffeine and acidic items.

8. Bladder message: Falling organs

What it is: Especially following childbirth, women are vulnerable to a condition called bladder prolapse -- which refers to the dropping of the organ from its customary position, sometimes into the vaginal opening. This happens because the pelvic floor muscles and ligaments of the "hammock" that supports the bladder have been weakened by stress. Heavy lifting, chronic coughing (as by a smoker), obesity, and menopause (because of shifting hormones) can also lead to prolapse.

What you may notice: Frequent urination or urge incontinence; not feeling relief after urinating; discomfort or pain in the vagina, pelvis, groin, or lower back; heaviness in the vaginal area (which may ease when lying down).

What you can do: For mild cases, shoring up weak muscles with physical therapy can be effective. More extreme cases may need estrogen replacement therapy, electrical stimulation, or a pessary (vaginal support device) to provide better support for the organs. Surgery can be an effective last resort.

More things your bladder says about your health

9. Possible bladder message: Dehydration

What it is: Dehydration simply means the body doesn't have as much liquid as it should. Anyone can become dehydrated, although older adults are especially vulnerable. Common causes: having diarrhea and/or vomiting, sweating a lot through exercise or because of fever, and being diabetic (elevated blood sugar levels lead to more frequent urination as the body tries to get rid of the excess).

What you may notice: Abnormally dark (amber to brown) or strong-smelling urine. The appearance of urine isn't a highly reliable indicator of health problems (aside from blood in the urine), says the Dean Clinic's Adam Tierney. Whether it's cloudy or fizzy or a particular hue often has more to do with diet and medication than an underlying disorder. When it looks dark and concentrated, however, dehydration is a concern.

Other symptoms of dehydration: Decreased urine output, headache, lethargy or sleepiness, dry skin and dry mouth, dizziness, and increased confusion.

What you can do: Fluid replacement resolves dehydration. The form of fluid may depend on the severity of the situation. An IV, for example, is used in advanced cases. For more mild dehydration, consuming frequent, small amounts of clear liquids helps, or a doctor may suggest an oral rehydration solution. To avoid dehydration, make sure older adults, in particular, drink six to eight cups of liquid a day or consume foods high in liquid content, such as soup and watermelon.

10. Possible bladder message: Cancer

What it is: Cancer can develop in the bladder, the kidneys, the renal pelvis (the area of the kidneys where urine is collected), or the ureter (the tubes that carry urine from the kidneys to the bladder). Transitional cell cancer of the renal pelvis and ureter is a common form of cancer, where cancerous cells in the lining of these parts travel to other parts of the body.

What you may notice: Blood in the urine (which may appear pinkish, brownish, or red), pain while urinating, or a frequent urge to urinate whether or not anything is produced. More often in men, tumors may also block the normal traffic of urine and cause overflow incontinence, in which you can't control output well.

What you can do: See a doctor. Symptoms that might signal cancer of the urinary system can mean many other things besides cancer. But they always merit medical help, to rule out other problems and to pinpoint a diagnosis.

Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio

about 2 months, said...

after sleeping a hour or all night all most impossible to push the urine out .I have to strain very hard .but after the first one its allot better what could this be .male by the way 53yrs old

6 months, said...

I'm 17 I suffer with bladder problems have my whole life it had countless UTI's I suffer from urges out of nowhere to pee some times/ most times I have no control and pee my self it takes a very long time to be I will have to go bad and I will be sitting on the toilet for 30 mins - a few hours trying to pee it won't come out I have to take my fist or arm and press really hard into my bladder for a while to pee sometimes that won't even help it's just getting worse and worse I do. wer the bed I fall asleep and wake to find me laying in pee why doesn't my bladder tell me when I have to pee and wake me up ???!!!!!! I'm getting just like my mom I cough or sneeze or just walk and pee and also when I can't pee while I'm on toilet i give up u know pull up ny pants and all go to wash my hands or walk out the bathroom door and I will just pee right there I can't feel it WHY ????!!!!!!!!!!! The older I get the worse the problems get what's wrong with my bladder?????!!!!!!!!!!!!!!!

about 1 year, said...

Why can't I urinate after it gets dark

about 1 year, said...

I am a 23 year old female, I am currently waiting to be referred to a urologist, I believe I may have interstitial cystitis. For the past few years I've been dealing with painful flares AFTER urinating. Even when I'm not having a flare.. I MUST MUST wait till I can't hold it anymore before I can urinate, anytime before that and I will immediately start a flare. They can last anywhere from a few hours.. to a few weeks. The only thing I've found so far to help deal with a flare is take a Motrin and put an ice pack down there.. or just sitting on the toilet for a couple hours. Even though I haven't been officially diagnosed yet, I've tried the dietary change.. but unfortunately for me, I smoke, and there's no way of cutting out coffee lol! If anyone has any other suggestions, I'd love to hear them please!! A flare puts a major hold on my life.. there's no "ignoring it" or going about with my days.. and I have a pretty good pain tolerance, but not with these flares..

about 1 year, said...

i know this forum or discussion hasn't been responded to in a bit but i thought i would give it a shot to figure what is going on with me. i am a 24 year old female, mostly healthy i would say. i don't exercise much but i am up on my feet 8 to 10 hours per day about 5 or 6 days a week due to being a nurse. yes a nurse and still have no clue what is wrong. yesterday all of the sudden i had a serious urge to urinate. normally if i need to urinate ill wait a bit or however long till i have a quick break and then go. i've never had an issue with not being able to make it to the bathroom. some of the urges were worse then others but a couple of those urges came out of thin air and i thought i wasn't going to make it to the bathroom in time. then later on it happened. i had an urge. attempted to hold it for maybe 10 minutes to 15 minutes at most while driving. pulled into my driveway and while running to the door, there was a flood. i am going every single time i get an urge and it's a large amount. my urine looks better then normal, clear very light yellow no smell. no abdominal pain or distinction no fever no discomfort with urination. i mean what in the world i'm only 24 i shouldn't be dealing with issues related to being suddenly incontinent. PLEASE HELP!!

over 1 year, said...

I get up at least 6 times a night to piss. It is very annoying. My question is this: does Extendz work? Anybody know? As far as peeing too much at night, try cutting back on the booze before bedtime you lush.

almost 2 years, said...

I'm a 30 year old male. I suffered for years of urine problems(waking at night, not able to empty, pain) I'm writing this because I'm symptom free now. For years I had to take prostate medicine. I stopped the medicine because it wasn't working. This is hard to say but I had my prostate milked. Look up the process of you are unfamiliar. It is strange because you have to have a finger in your butt, however after it was done I started to have relief right away. I'm straight and married and it was uncomfortable but it works. It helps promote blood flow in the area and it works. It solved my problem that I had for years. I hope this helps some of you out there.

about 2 years, said...

hi !I am bryan.I am 20 years old. I had suffer can't pee much and my urine was yellow. I can't sleep much at night.

over 2 years, said...

hey i am a 18 year old male suffering from urge urination. need to urinate after every 2 minutes. it makes very difficult for me to go out from home even to school. Visited doctors but they said this is due to stress but have no stresss. please help me to overcome the problem its getting worse day by day. Having this prob from last 5 years. please help me out. its a humble request

over 2 years, said...

I'm 35 and have had quite a bit of back surgery and nerve damage with well over 2 dozen spinal injections. They put a nerve stimulator in and none of it worked. 3 surgergeons have turned me away and said I have FBSS (failed back surgery syndrome) and I also have sleep apnea on the higher side of stopping breathing per hour. If I take a nap with out my machine I do not get any indication or alerts about having to go, I just wet me self. I've been to a urologist and he said everything looks fine. Is this tied into all the nerve damaged? This never happened until all these surgeries and spinal/nerve problems.

almost 3 years, said...

Very interesting, My father is diabetic and I think I might be too because I drink water excessively. Probably 15 or 18 glasses a day. Lately I have been peeing in my sleep. Not a lot but it wakes me up. I think it's either because of diabetes or menapausal problems but I need to find out the problem!

about 3 years, said...

Was very helpful information. Thanks for sharing.

about 6 years, said...

increased knowledge and awareness

over 6 years, said...

very useful informations,thanks.I am 70,male,otherwise healthy but have some of the above symptoms,i.e.night waking,sudden urge,slow urination

over 6 years, said...

Too vague for my tastes

over 6 years, said...

thanks for this avenue of useful health informations

over 6 years, said...

very enlightening .

over 6 years, said...

Lots of stuff I never knew here. Unfortunately when symptoms began I was told I was being a hypochondriac and to ignore it--but blood and clotting in the urine finally led me to a doctor who found a baseball sized tumor above the kidney. I will have this removed by Christmas, and I was told this was cancerous. Never let anybody convince you it is only nothing!

over 6 years, said...

Although diabetic neuropathy (nerve damage) can caused bladder dysfunction, it occurs in advanced disease. The early warning sign of excessive urine formation is due to the high blood sugar (glucose) itself. With blood glucose levels below 180 mg/dl, all the glucose that is presented to the kidneys and filtered into the pre-urine is returned to the blood. Above that (approximate) level, the mechanism is overwhelmed, and glucose appears in the urine. Since we can't excrete sugar cubes, it has to be dissolved in water, so the glucose carries with it water. The early warning signs of diabetes mellitus are hyperuria (excessive urination), hyperphagia (increased appetite to keep the blood glucose elevated), hyperdypsia (great thirst to make up for the water lost in the urine). All of these reflect high blood sugar, but we must remember that levels below that threshold of (approximately) 180 mg/dl will not cause these signals of danger, which is one reason we do laboratory blood tests during annual examinations.

over 6 years, said...

The information and standard of the artical is fine. It offered facts that could be taken into account when looking at Bladder problems without being writen in a mannor that makes you think "Thats me Thats me."

over 6 years, said...

Many people have mild wheat allergies that over time cause many bladder symptoms including diabetes. I once had many symptoms I was linking to aging (I'm in my mid-forties). One symptom was getting up to pee in the night, also arthritis, frequent headaches after one or two glasses of wine, etc. all symptoms linked to mild inflammatory conditions developed over a lifetime of eating bread. Six weeks after quitting bread I felt 20 years younger and haven't had to pee in the night in over a year.