Your bladder is one of those body parts you probably don’t
think about until it stops working properly. The first thing
to realize is bladder conditions are extremely common. The
good news is by making simple lifestyle changes, like diet and
exercise, you can reduce your risk of developing problems.
Recently, we sat down with urologist Dr. John Cooper of the
CalvertHealth Medical Group to discuss what men and women
can do to take a more active role in keeping their urinary system
(kidneys, ureters, bladder and urethra) healthy.
Q. What are some tips to improve overall urological health?
Drinking more water often helps with many urinary issues, including
overactive bladder, BPH (enlarged prostate) and kidney stones. Other beverages,
especially coffee, tea and soda, can contain irritants. Water is very soothing to the
bladder and kidneys, leading to fewer urgent episodes of needing to urinate. It also
helps prevent the formation of stones as well as keep existing stones from getting
larger and more difficult to treat or pass. So, how much is enough? The answer is:
it depends. Most people require around 64-80 ounces of water per day but this
can vary based on the season and weather. In general, a good rule of thumb is to
drink enough water to maintain clear or very light yellow urine.
Diet and exercise also
play an important role in
the prevention of many
urologic conditions in men
including enlarged prostate,
low testosterone, erectile
dysfunction, and even certain
cancers like prostate and kidney
cancer. Multiple studies have
shown the high-carb and highfat
“Western diet” is associated
with a significantly increased
risk from prostate and kidney
cancers when compared to
a more balanced diet higher
in fruits and vegetables.
Additionally, these diets are also
associated with accelerated
enlargement of the prostate and
decreased levels of testosterone.
Finally, smoking and tobacco
use significantly increase
the risk of cancers including
prostate, kidney and bladder
cancer and can also lead to
early-onset erectile dysfunction.
Q. What diet changes
can help with an
overactive bladder?
The caffeine and carbonation
found in coffee, tea and soda
can lead to involuntary bladder
spasms and increase the sensation of needing to urinate more
frequently and urgently. Similarly,
spicy foods and artificial sweeteners
can have the same effect in certain
individuals. Finally, maintaining a
balanced diet to stay at a healthy weight
and eating foods high in fiber to prevent
constipation can also have beneficial
effects to increase your bladder
capacity and reduce frequency and
urgency episodes.
Q. When is frequent urination
at night a problem?
Urinating frequently overnight, or
nocturia, is a common symptom
especially for patients with an enlarged
prostate or overactive bladder.
Urinating up to once overnight is
considered normal, while twice or more
is considered abnormally frequent.
This can be due to or worsened by
excessive urine production overnight
from common medical conditions such
as obstructive sleep apnea or diabetes.
Overnight urinary frequency is a
problem when it lessens one’s quality
of life. While this condition is not an
emergency and there are no long-term
complications that would potentially
shorten one’s life, patients should make
their own treatment decisions based
on how much it bothers them and by
balancing the benefits of treatment with
potential side effects.
Q. What are some simple
steps for preventing
kidney stones?
The single most important step to
preventing kidney stones is to drink
more fluids, especially water. I tell all of
my patients to remember that “dilution
is the solution.” Diet changes can
also help. I often recommend adding
2 teaspoons of pure lemon juice to
an 8-ounce glass of water to create a
homemade lemonade. Foods high in
oxalate, a mineral that commonly binds
with calcium to form stones, should
generally be avoided or limited – these
include spinach, nuts, chocolate, rhubarb
and most teas. Additionally, foods high
in salt and sugar should be limited
along with animal proteins.
Finally, it is a common
misconception that because most
stones are calcium-based that one
should limit or avoid calcium intake.
While it is true that excessive calcium
should be avoided, it is important to
maintain normal dietary calcium intake
to eliminate harmful oxalate in the gut
and prevent absorption to the kidney
where it can lead to stone formation.
Q. What are some strategies
to improve incontinence?
Incontinence is generally divided into
three categories: urge incontinence,
where leakage occurs with a sudden
urge to urinate and the inability to
make it to the bathroom on time;
stress incontinence, where leakage
occurs when strain or pressure is put
on the bladder and you’re unable to
hold urine in (i.e. during coughing,
laughing or sneezing); and mixed
incontinence, where a combination
of both of the above occurs. Strategies
to prevent and improve incontinence
generally differ based on the type
of incontinence. All types, however,
will improve with weight loss to take
pressure off of the bladder and Kegel
exercises to strengthen the muscles
that support the bladder.
Urge incontinence is often a
symptom of overactive bladder,
which may require a prescription for
medication or sometimes a minimally
invasive surgical procedure to help
treat. Stress incontinence is sometimes
treated with surgical procedures as
well. Ask your doctor if a medication
or surgical procedure will benefit you
based on your symptoms.