5 most common bladder issues and what to do about them


by Baylor Scott & White Health

Nov 15, 2021

Are you running to the bathroom every hour because you can’t shake the urge to go? Or do you accidentally leak urine when you cough, sneeze or laugh? You’re not alone.

More than 25 million people in the US experience bladder leakage every day. Urine incontinence affects one in four women, a problem that increases with age.

Bladder control issues can be embarrassing and may even cause you to avoid taking part in daily activities. But help is available—most conditions can be corrected or controlled with medical or alternative solutions.

Don’t let inconvenient and often disruptive bladder issues get you down. You don’t have to live with urinary leakage. Below, we explore five common bladder issues and effective treatment strategies.

1. Bladder infections

If your body is fighting off a bladder infection, you might experience:

  • Increase in urination frequency
  • Urgency to go more often
  • Pain when you urinate
  • Blood in your urine

For an isolated infection, you will probably receive a round of antibiotics that only lasts a few days.

Chronic infections are defined as two or more bladder infections in six months or three or more infections in a year. If you experience recurrent bladder infections, your doctor may recommend a prolonged course of suppressive antibiotics.

2. Overactive bladder

An overactive bladder (or urge incontinence) occurs when you have a frequent and sudden need to empty your bladder. It’s normal to experience these symptoms once in a while,  but if these problems are recurrent and prevent you from functioning normally, it may be necessary to seek treatment.

There are a number of treatments to manage an overactive bladder, starting non-surgically with prescription medications that calm the bladder and reduce the urge you may feel to urinate constantly. Other treatments include:

  • Pelvic floor physical therapy: This specialized form of physical therapy strengthens your pelvic floor muscles and retrains the nerves that go from your brain to your bladder, so your brain controls your bladder rather than your bladder controlling your brain.
  • Botox injections: Botox is an FDA-approved method to treat overactive bladder, urinary urgency, frequency and urge urinary incontinence. During the in-office procedure, your doctor will inject small portions of Botox into numerous locations within your bladder to help temporarily paralyze muscle fibers.

If medication and physical therapy don’t work, your doctor may suggest a bladder pacemaker. By stimulating the sacral nerves, the pacemaker helps to improve bladder control.

3. Stress incontinence

Stress incontinence is the leaking that comes with physical stress on your bladder. Coughing, sneezing, laughing and even exercising are the usual culprits. Even lifting something heavy can put pressure on your bladder.

The condition usually happens when the muscles in the pelvis weaken. Stress incontinence is twice as common in women than in men.

Similar to overactive bladder, pelvic floor physical therapy can also help treat stress incontinence. Lifestyle modifications like weight loss and a healthy diet are also important.

However, the primary treatment is the surgical placement of a mid-urethral sling. There is also something called periurethral bulking for elderly patients or those who are not good surgical candidates, where the opening from the bladder to the outside is made smaller.

4. Urinary retention

People with urinary retention can’t empty their bladder when they go to the bathroom. Depending on the cause of retention, you may not even realize your bladder isn’t completely empty. You may experience:

  • Pain or pressure in your lower abdomen
  • Bloating
  • Urine leakage

Because there are so many different causes of chronic urinary retention, you should be evaluated by a doctor to ensure you’re receiving the best treatment for your symptoms.

Treatments range from a catheterization procedure to drain the bladder, medicines to treat the condition causing your pain, or a bladder or rectum lift.

While you should partner with your doctor to prevent your specific type of urinary retention, there are ways to improve your symptoms, including:

  • Change your bathroom habits. Don’t wait until you feel the urge to go and try to empty your bladder every couple of hours.
  • Avoid excessive use of alcohol, which can increase the frequency of urination.
  • Eat a diet high in fiber to avoid constipation, drink plenty of water and exercise regularly.

5. Bladder pain syndrome

Bladder pain syndrome (BPS), also known as interstitial cystitis (IC), is a chronic inflammatory health issue that causes pain—and often pressure—when the bladder fills. Symptoms range from mild to severe and can include pain in surrounding areas, such as the lower abdomen and pelvis.

Some people with the condition have additional health issues such as irritable bowel syndrome, fibromyalgia and other pain syndromes.

Experts aren’t sure what causes bladder pain syndrome, and there is no cure. But treatments are available to relieve the symptoms of bladder pain, urgency and frequency. Your doctor may suggest:

  • Diet and stress modification and bladder retraining
  • Physical therapy
  • Over-the-counter and prescription medications
  • Bladder instillation, or bladder bath, is a treatment involving a mixture of medicines inserted into the bladder and released after a short period
  • Electric nerve stimulation
  • Botox injections

Surgery to treat IC—such as cystoscopy with hydrodistention—is considered a last resort.

A combination of treatments is often required. Your doctor will be able to decide what is best for you.

How can I prevent bladder issues from occurring?

In all bladder issues, maintaining a healthy diet and body weight will help you avoid infection, pain and other problems associated with poor bladder health.

For bladder infections, in particular, one of the best ways to keep your risk of infection low is to drink plenty of fluids and exercise.

It may also be helpful to perform Kegel exercises to strengthen your bladder muscles. These exercises help build up the muscles that give you better control over urination output. These are the muscles you will want to focus on strengthening. To identify these muscles, try stopping your urine in midstream. Your doctor can also advise you on doing these exercises correctly to get the desired results.

Some people find cutting out or cutting back on certain spicy foods and beverages may help ease bladder flareups. Common irritants include:

  • Spicy foods
  • Certain acidic fruit—like oranges, grapefruit and lemons—and fruit juices
  • Chocolate
  • Tomato-based products
  • Caffeine
  • Alcohol
  • Carbonated beverages

Bottom line: it’s not normal to pee when you sneeze. Or cough. Or exercise. If you’re dealing with stress urinary incontinence, find a pelvic specialist today.

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