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Home , Interstitial cystitis

Bladder Health: Specific Condition and Background Information

Bladder Control

An estimated one-third of American adults ages 40 and over report at least “sometimes.”1 Despite negative health consequences, less than half of patients seek treatment for their bladder control problems.2,3 A majority of those that do talk to their health care providers delay for more than a year from symptom onset.4 Reasons cited for not seeking help include the belief that bladder problems are untreatable, natural consequences of aging, and hygiene problems rather than treatable medical concerns.5 Nursing home admissions due to urinary incontinence are estimated to cost $6.0 billion annually.6

Millions of Americans have neurogenic bladder – a lack of bladder control due to a brain, spinal cord or nerve problem such as spinal cord injury, diseases such as multiple sclerosis (MS), Parkinson’s disease, stroke or spina bifida, or nerve problems caused by diabetes or major pelvic . 7 At least 80 percent of Americans living with Multiple Sclerosis report bladder symptoms at the time of diagnosis, yet studies have shown that only 43 percent of people with MS experiencing moderate to severe bladder symptoms had ever been evaluated by a urologist.8,9

Urinary Tract Infections Urinary tract infections cause over 8 million health care provider visits each year (over 1.3 million for children, over 1.2 million for men and over 5.3 million for women).10 Urinary tract infections can lead to urosepsis and death, especially among vulnerable populations such as the elderly and people with MS or spinal cord injury.11

Interstitial Cystitis An estimated 4 to 12 million Americans (men, women, and children of any age or race)12 may have interstitial cystitis (IC). IC is a condition characterized by recurring , pressure, or discomfort in the bladder and pelvic region, and urinary frequency (needing to go often – up to 60 times a day in severe cases) and urgency (feeling a strong need to go). There is currently no known cause, diagnostic test, or cure for interstitial cystitis, which is responsible for over 2.2 million physician office visits yearly.10 IC also has limited effective treatments.

Bladder Cancer

An estimated 76,960 Americans (about 58,950 men and 18,010 women) are diagnosed with each year. An estimated 16,390 people (about 11,820 men and 4,570 women)13 will die from Bladder Cancer this year, and more than 575,000 Americans currently live with bladder cancer.14

Veterans’ Bladder Health

More than 1 in 10 military service members injured in Afghanistan and Iraq have “urotrauma” injuries (damage to the urinary tract or reproductive organs). While urotrauma may not be as visible as amputations or as widely discussed as post-traumatic disorder (PTSD), it is no less physically and psychologically debilitating.15

Iraq and Afghanistan veterans with PTSD or other mental health diagnosis are twice as likely to have lower urinary tract symptoms than veterans without a mental health diagnosis.16 Among women veterans, those with PTSD were more likely to experience urgency and mixed urinary incontinence.17 Unfortunately, this means that many our most vulnerable veterans are doubly burdened with bladder problems, as well as their mental health issues.

1 Coyne KS, Sexton CC, Vats V, Thompson C, Kopp ZS, Milsom I. National community prevalence of in the United States stratified by sex and age. . 2011;77(5):1081-1087. 2 Huang AJ, Thom DH, Kanaya AM et al. Urinary incontinence and in Asian-American women. Am J ObstetGynecol 2006 November;195(5):1331-7. 3 Benner JS, Becker R, Fanning K, Jumadilova Z, Bavendam T, Brubaker L. Bother related to bladder control and health care seeking behavior in adults in the United States. J Urol 2009 June;181(6):2591-8. 4 Dmochowski RR, Newman DK. Impact of overactive bladder on women in the United States: results of a national survey. Curr Med Res Opin 2007 January;23(1):65-76. 5 Newman DK. Talking to patients about bladder control problems. Nurse Pract 2009 December; 34(12):33-45. 6 Morrison A, Levy R. Fraction of nursing home admissions attributable to urinary incontinence. Value Health. 2006 Jul- Aug;9(4):272-4. 7 http://www.urologyhealth.org/urologic-conditions/neurogenic-bladder, accessed 12/29/15. 8 Foster, H. Bladder symptoms and MS, MS Quarterly Report 2002, 21 (Spring). 9 Mahajan ST, Patel PB, Marrie RA. Under treatment of overactive bladder symptoms in patients with multiple sclerosis: an ancillary analysis of the NARCOMS Patient Registry. J Urol. 2010 Apr;183(4):1432-7. 10 Litwin MS, Saigal CS, editors. Urologic Diseases in America. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2012; NIH Publication No. 12-7865 pp. xi. 11 Rabadi MH, Aston C. Evaluate the impact of neurogenic bladder in veterans with traumatic spinal cord injury. J Spinal Cord Med. 2015 Jun 25. 12 http://www.ichelp.org/about-ic/what-is-interstitial-cystitis/4-to-12-million-may-have-ic/, accessed 12/29/15. 13 Siegel, R. L., Miller, K. D. and Jemal, A. (2016), Cancer statistics, 2016. CA: A Cancer Journal for Clinicians. doi: 10.3322/caac.21332. Online version accessed at http://onlinelibrary.wiley.com/doi/10.3322/caac.21332/full on 1/11/2016. 14 American Cancer Society. Cancer Facts & Figures 2015. Atlanta: American Cancer Society; 2015. 15 http://www.urologyhealth.org/patient-magazine/magazine-archives/2013/spring-2013/urotrauma, accessed 12/29/15. 16 Breyer BN, Cohen BE, Berthenthal D, Rosen RC, Neylan TC, Seal, KH. Lower Urinary Tract Dysfunction in Male Iraq and Afghanistan War Veterans: Association with Mental Health Disorders: A Population-based Cohort Study. Journal of Urology, 2014 Feb; 83(2): 312-319. 17 Bradley CS, Nygaard IE, Mengeling MA, Tomer JC, Stockdale CK, Booth BM, Sadler AG. Urinary Incontinence, and Post-traumatic Stress Disorder in Women Veterans. American Journal of Obstetrics and Gynecology. 2012 Jun; 206(6): 502e1-502e8.