There are around 14 million people in the UK today with some form of bladder problem – this is more than those with asthma, diabetes and epilepsy put together. Bladder problems affect one in three women and one in five men.
However, Jan Chaseley, our Clinical Nurse Specialist in Continence Care at Benenden Hospital, says they can often be easily treated. Jan, along with her expert team treat stress incontinence in men and women, overactive bladder syndrome, prolapse and many other bladder issues
Mr Abhishek Gupta is our Consultant Gynaecologist at Benenden Hospital who also specialises in female incontinence and prolapse. Mr Gupta, whose only private practice is at Benenden Hospital says: “I feel really proud and happy to provide these expert services here because when it comes to urogynae, it is important that the hospital can provide high standards of care for patients both pre and post-surgery. I believe it’s not just about the treatment itself but about the whole patient journey and we have excellent facilities here to provide a good pathway.”
What are the symptoms of bladder problems?
Bladder problems and problems with flow will vary from person to person. Your symptoms can vary because of the type and severity of the bladder issue. Common signs and symptoms include:
- Bladder leakage
- Pain or a burning sensation when peeing
- Cloudy urine
- A strong and persistent urge to pee
- Strong smelling urine
- Pain during sexual activity
- Pain or pressure in the lower abdomen
- Needing to pee more often than usual during the night
- Blood in your pee
- Pain in your tummy or in your lower back, just under your ribs
What causes bladder problems?
In women, the urethra or tube carrying urine from the bladder is shorter and more prone to leaks. Stress incontinence in women can happen after childbirth, because of extra strain on the pelvis or childbirth problems. Either can weaken the pelvic floor muscles which hold the bladder and bowel in place and help to stop leaks. Some women also develop stress incontinence after menopause as hormone changes weaken the pelvic floor. But, according to Jan, bladder problems should never be viewed as a normal part of ageing.
Stress incontinence in men can develop after surgery for prostate cancer. As they age, and the prostate which surrounds the urethra grows, they may also have difficulty emptying their bladder fully.
How can bladder problems be prevented?
Simple lifestyle changes can make a difference. Avoid drinks containing caffeine, which can irritate the bladder and fizzy drinks that can contain caffeine and artificial sweeteners. In addition to this, alcoholic drinks and acid in fruit juices can make problems worse.
But be sure to drink plenty of water, as drinking too little can make the bladder more prone to infection. “When you’re not drinking enough, the bladder gets used to holding smaller amounts of urine and can become overly sensitive," says Jan.
Being overweight can also put excessive pressure on the bladder and pelvic floor muscles, so weight loss can prevent continence problems.
Avoid constipation and follow a healthy diet. When the bowel does not empty properly it will swell up and push down onto the bladder, causing leakage.
Smoking and some medication can also irritate the bladder.
“Practising regular pelvic floor exercises to strengthen the muscles of the pelvic floor is effective, and we can teach patients to do their exercises properly,” says Jan. “We also teach bladder re-training exercises, so people wait longer and control their pelvic floor muscles, so the bladder gets used to holding more again.”
When should you ask for support?
When bladder problems affect people's lives and it becomes difficult for them to enjoy the theatre, undertake long journeys, or go on holidays, it's time to ask for help, says Jan.
''Urinary incontinence causes huge embarrassment and inconvenience but there are often simple measures which can help.”
Which bladder problems do we treat?
1. Overactive bladder
Symptoms of an overactive bladder include urinary urgency (needing the toilet with little warning), frequency (going to the toilet more than 7-8 times daily), and sometimes not being able to make it to the toilet (urge incontinence). You may also be woken up at night because you need to pass urine.
Our overactive bladder treatment includes undergoing regular Botox injections to reduce over-activity. Patients who find that they need to frequently get up to use the loo at night can also be taught to use a small catheter, to re-train the bladder to empty itself properly.
2. Stress incontinence
Symptoms of stress incontinence include urine leaking on coughing, sneezing, laughing and physical exercise. This can sometimes occur after childbirth and during the menopause due to weakening of the pelvic floor muscles.
Stress urinary incontinence is not related to psychological stress. It is extremely common and there are approximately nine million people in the UK experiencing some form of stress incontinence. It can affect women and men of all ages, although it is more common among women. Men can develop stress incontinence after radical surgery for prostate cancer. Surgery to tighten or support the bladder outlet can also help.
Practising pelvic floor exercises regularly can help to strengthen the muscles and make the bladder less prone to leaking; specialist nurses can teach these exercises. Lifestyle measures such as weight loss can also be effective.
We also now offer percutaneous tibial nerve stimulation (PTNS), where an acupuncture needle linked to a TENS machine can stimulate the tibial nerve in the ankle. This acts on the nerve controlling the bladder. “This is effective, though it takes up to 12 weekly sessions to work – it feels like a pleasant tingle,” says Jan.
3. Pelvic organ prolapse
Weakened pelvic floor muscles can cause one or more of the pelvic organs to “drop” into the vagina. This can also affect your bladder or bowel function. Pelvic floor exercises are nationally the recommended first-line treatment, but it can be difficult to know if you are doing these correctly so our experts can help you make sure you are doing them properly.
4. Other urology treatments
The nursing team can also refer you to gynaecology or urology teams who can offer further tests, such as:
- Urinalysis
- Flow test
- Measure of urine residual (amount of urine left in the bladder after emptying)
- Urodynamic testing (takes a look at how parts of the urinary tract such as the urethra, bladder and
sphincters are storing and releasing urine)
They can also refer you to gynaecology, or urology teams who can further tests such as:
- Blood tests
- Cystoscopy (a long, thin instrument that is used to look inside the bladder and urethra
- Imaging tests such as X-rays, CT scans, MRI scans, and Ultrasounds
An assessment with our specialists can give you the proactive steps to better understand and manage your condition.
Get in touch
If you have any questions regarding and the different options available, contact us using our online enquiry form or by contacting our Private Patient Team via Livechat or on 01580 363158. We look forward to speaking with you soon.
Published on 17 June 2023