Healthy Body

‘I’m a Urologist, and These Are the Most Common Questions I Hear About Bladder Health’

Isadora Baum

Isadora BaumSeptember 1, 2020

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Photo: Getty Images / Kentaroo Tryman

Your bladder is probably the last thing on your mind when thinking about how to improve your overall health and well-being. Heart health? Yes. Brain health? Of course. Gut health? Check and check. But the bladder often doesn’t get enough credit (or attention).

However, anyone who has ever encountered bladder issues before knows that this particular organ has a huge impact on your quality of life. A malfunctioning bladder can make it harder to go places or travel for long distances, and can make day-to-day life uncomfortable. (Unless you particularly like spending lots of time in the bathroom.)

To better understand this organ, we talked to some urologists to answer some of the most common questions they get about bladder health. They offer up tons of bladder facts that will help you gain a new appreciation for your urinary tract—and hopefully know how to better take care of it. It might not be your number one favorite organ…but it still deserves your attention.

1. What can it mean if it burns when you pee?

Burning when you pee is an unpleasant symptom of several bladder conditions. But the two most common culprits that can cause it are urethritis and cystitis, which are inflammation of the urethra and bladder usually caused by infections, says Peter Stahl, MD, an assistant professor of urology at Columbia University College of Physicians and Surgeons and the clinical director at health-care startups Hims and Hers.

“[People with uteruses] are more prone than [people with penises] to urinary tract infections (UTIs) because the female urethra is short, which makes it easy for bacteria from the vagina to ascend into the urethra and bladder and cause a clinical infection,” he says. Sexually transmitted infections, such as gonorrhea and chlamydia, can also cause urethritis and burning during urination.

However, infections aren’t the only reason why it can burn while you pee. “Other non-infectious causes of burning include minor traumas that cause small, sensitive lacerations of the urethra; urethral exposure to irritations like soap, or fungal infections of the foreskin in men,” Dr. Stahl says.

If you experience burning while you pee that is severe, lasts more than a day, or comes with other symptoms like a fever or discharge, you should visit your health-care provider ASAP to see what’s going on. You might need an antibiotic if you have an infection or other types of treatments, depending on the cause. Either way, definitely not a case for Dr. Google.

2. Why do you leak urine when laughing or sneezing?

Bladder leakage or urinary incontinence (UI) is loss of urine beyond your control. Specifically, “stress urinary incontinence (SUI) refers to urinary leakage with increases in abdominal pressure,” Dr. Stahl says. “These increases [in pressure] typically happen when you sneeze, laugh, cough, or lift something heavy.”

Holding onto urine with a full bladder when you experience these kind of pressure changes requires healthy, strong and intact pelvic floor muscles and connective tissue; if they’re weak or damaged, you can encounter leakage.

“Anything that weakens or stretches these tissues in your pelvis—or affects the nerves that innervate them—can cause stress incontinence,” Dr. Stahl says. In people with uteruses, vaginal childbirth is by far the most common cause of SUI, while in people with penises, surgery for prostate cancer is.

As for how much you leak, it depends. “Volume of leakage can range from a mild couple of drops of urine, to high volume bladder leakage that leaves you soaked,” Dr. Stahl says.

3. What are kegels and do they help UI and bladder health?

Kegels are exercises where you repeatedly squeeze and contract your pelvic floor muscles, aka the muscles surrounding the bladder, vagina, and rectum. “You lift or pull these muscles up and in without contracting your abdominal muscles or buttocks. It’s best to do 10 squeezes in a row, 3 times a day,” says Jeannine Miranne, MD, a urogynecologist, assistant professor at Harvard Medical School, and medical advisor to Attn: Grace.

“A lot of [people] are understandably not doing Kegel exercises correctly,” she says. Although it can be difficult to isolate the pelvic floor muscles, there are pelvic floor physical therapists who can help you learn the correct technique, so seek one out if you’re struggling to get the practice down.

4. At what age does bladder leakage typically start for women?

Short answer, there is no typical age for bladder leakage. There are women as young as the teens and up to their 90’s living with UI, says Dr. Miranne. The majority of women who experience bladder leakage are in their 30s to 80s.

Younger patients are more likely to experience UI after pregnancy (since that can put strain on the bladder and the surrounding muscles). Fluid overconsumption, excessive bladder irritant use, and delayed urination (holding it in!) can also contribute to symptoms, Dr. Miranne says. “Additionally, women who play high-impact sports or who are overweight may have UI,” she adds.

5. Is there anything that can be done to help UI?

There are broadly two types of urinary incontinence, Dr. Miranne says: stress UI, as mentioned above, and “urgency UI, which is leakage that occurs with a sudden urge to urinate.” Both can be treated with a variety of options, she says, including behavioral and dietary modifications, as well as pelvic floor muscle exercises (kegels), and pelvic floor physical therapy.

“Depending on severity, management of SUI can be accomplished with exercises to strengthen the pelvic floor, medications, or surgery,” Dr. Stahl adds.

The need for treatment is a personal choice, and of course what treatment is best varies depending on your particular situation and the advice from your doctor. But if UI is affecting your quality of life, know that help is out there—and worth seeking out if you can.

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