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Keeping your bladder healthy

As we get older, we exercise to keep our hearts healthy, do crossword puzzles to keep our brains agile and even have regular prostate exams.

But there’s one organ we use many times a day that doesn’t get much attention until it’s not working well: the bladder.

A small, stretchy, balloon-shaped organ that sits just behind the pubic bone, the bladder can hold about two cups of urine when healthy.

With age, the bladder’s elasticity naturally decreases, which can mean that it gets “full” faster, leading to more frequent urination.

In addition, the muscles that make up the bladder wall and pelvic floor can grow weaker, making it more difficult to empty the bladder completely. Leakage can also happen.

Here are some of the most common age-associated bladder problems, and a guide to keeping your bladder healthy at any age.

Urinary tract infections

Incomplete emptying of the bladder can lead to bacterial buildup and urinary tract infections, or UTIs. Caught early, UTIs are generally minor irritations, but if they are left untreated for long periods, they can cause kidney damage.

UTIs are harder to detect in kupuna, who often don’t exhibit the frequent, burning urge to urinate that is the hallmark symptom of a UTI. Instead, confusion or abdominal pain may be the only symptoms of a UTI in elders. UTIs are more common in women, who have a shorter urinary tract.

Lower urinary tract symptoms

Often the diagnosis with kupuna is simply LUTS, for lower urinary tract symptoms, which can include very frequent urination, particularly at night; difficulty beginning urination; straining to urinate; incomplete urination; and incontinence.

LUTS can be managed with the right care and professional advice. Speak with your doctor if you experience any of the uncomfortable symptoms mentioned above.

Bladder cancer

Bladder cancer, which affects more men than women, is one of the more common cancers — and incidence increases with age. Considered highly treatable in its early stages, bladder cancer shares some symptoms with less serious conditions: painful urination, blood in urine and frequent urination. Talk to your doctor if you experience these symptoms.

Guide to a healthy bladder

There are many things you can do to make sure your bladder functions as well as possible.

>> Drink enough fluid. It can be tempting to drink less when faced with bladder difficulties, but drinking enough fluid is the National Institute on Aging’s No. 1 tip for bladder health. Aim to drink at least one large glass of fluid with each meal, and another large glass in between. The goal is to never feel thirsty.

>> Manage weight. Carrying extra pounds makes bladder problems more likely.

>> Stay active. When bladder function is compromised, some kupuna stay home in order to avoid embarrassment — but a sedentary lifestyle can weaken muscles further. Some studies have shown that prolonged sitting also raises the chances of a UTI. Find activities you enjoy, and don’t be afraid to use pads or other supports.

>> Eat a healthy diet. A fiber-rich diet can alleviate constipation, which can impair bladder function.

>> Manage chronic conditions like diabetes, which can damage nerves near the bladder and lead to loss of control; and high blood pressure, which can cause frequent urination.

>> Limit caffeine and alcohol, which can affect how much control you have over your bladder and how often you feel you need to go.

>> Exercise your pelvic floor. Also known as Kegels, pelvic floor exercises strengthen the muscles that control urine flow. A strong, toned pelvic floor can prevent leaks.

>> When urinating, empty your bladder completely. Complete urination flushes out the bacteria that can lead to urinary tract infections.

An aging bladder doesn’t have to keep you inside. Everyday wise choices can make all the difference in keeping your bladder healthy.

Dr. Ann M. Aspera is a urologist at Kaiser Permanente Hawaii.

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