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Bladder Health Month and the Great American Smokeout - November 21st

In honor of both, today we are going to cover the damage that smoking nicotine products and tobacco use can do on the bladder.

Doctors have known for decades that smoking affects lung and heart health, greatly increasing risk of both lung cancer and heart disease. In recent research, they have been finding that smoking increases risk to various urologic diseases as well.

Bladder Cancer

Cigarette smoking triples the risk for bladder cancer when compared with the risk in nonsmokers, about 50% of bladder cancer in men and 20% in women can be attributable to smoking (Freedman, 2011). Cigarette smoke contains about 60 different carcinogens, and many of these are identifiable in the urine of smokers (Manatonski, 1981). Cigarette smoking is one of the largest risk factors we can control to prevent the development of bladder cancer in men and women.

Prostate Cancer

Although the cause of prostate cancer is not clear, some researchers believe it may be due to various factors including genetics, diet, inflammation, infectious agents, hormonal imbalance, or exposure to toxins like cigarette smoke (Dwivedi, 2012). A 2012 study by Dwivedi found that smoking increased inflammation in the prostate, increasing cancer risk and also making the disease more aggressive. The Johns Hopkins Medical center published in 2003 that cigarette smoking causes oxidative damage that could make prostate cancer worse for men who smoke vs. non smokers.

Kidney Cancer

Smoking tobacco is a risk in the development of cancer in the kidneys and ureters. A 2011 study in the UK estimated that 29% of cases in men and 15% in women were associated with or caused by smoking (Parkin, 2011). Kidney cancer risk also increases with the number of cigarettes you smoke a day as well as the amount of time you’ve been smoking. The risk of kidney cancer is 60% to 100% higher in the patients smoking 20 or more cigarettes daily compared with nonsmokers (Parkin, 2011). Fortunately in the same study, they found that quitting smoking, especially quitting for over 10 years had a measurable decrease in cancer risk.

Erectile Dysfunction


Smoking negatively affects your body’s vascular system and is tied to erectile dysfunction, since the penis relies on blood flow to reach full erection. The Olmsted County Study of Urinary Symptoms (Jacobsen, 1993) found that smokers had an increased incidence of erectile dysfunction vs nonsmokers, especially for men between the ages 40 and 79.

Kidney Stones


A 2013 study by Tamadon showed that smoking increased the risk of stone formation; 26.5% of the patients with stones were cigarette smokers, and only 14.9% in the control group were smokers. This shows a possible link between smoking and risk of kidney stone formation.

Incontinence

The nicotine in tobacco has been shown to irritate the muscle that controls the bladder (Wyman, Burgio, & Newman, 2009). Smokers are also likely to have a chronic cough which can create more pressure on the bladder and pelvic floor.

Infertility

Studies have shown smoking negatively affecting fertility in both men and women.
Soares (2008) found that compounds in tobacco disrupt the maturation of ovarian follicles as well as the uterine receptiveness to implantation. During pregnancy, smoking has been linked fetal growth retardation, fetal death, premature delivery, lactation problems, and long-term effects on the child (Mobley, 2015).


Cigarette smoking also reduces sperm production, increases oxidative stress, and DNA damage. Sperm from smokers have less ability to fertilize egg cells and embryos display lower implantation rates. It has also been found that exposure to tobacco compounds in the womb can lead to reduced sperm count in adult life (Soares, 2008).

Interstitial Cystitis

Tobacco can aggravate symptoms of Interstitial cystitis (IC) which includes painful bladder, increased urgency and frequency of urination, and pelvic pain. An Austrian study of 981 subjects, found that smokers with IC had the highest prevalence of more severe symptoms. Visit the National Kidney Foundation for more info.

How to Stop Smoking

For more information on smoking cessation check out the following online resource in addition to consulting with your doctor:

 

Resources


Mobley, D., & Baum, N. (2015). Smoking: Its Impact on Urologic Health. Reviews in urology, 17(4), 220–225.

Manatonski GM, Elliott EA. Bladder cancer epidemiology. Epidemiol Rev. 1981;3:203–229. [PubMed] [Google Scholar]

Freedman ND, Silverman DT, Hollenbeck AR, et al. Association between smoking and risk of bladder cancer among men and women. JAMA. 2011;306:737–745. [PMC free article] [PubMed] [Google Scholar]

Dwivedi S, Goel A, Mandhani A, et al. Tobacco exposure may enhance inflammation in prostate cancer patients: an exploratory study in north Indian population. Toxicol Int. 2012;19:310–318. [PMC free article] [PubMed] [Google Scholar]

  1. Prostate cancer is worse in men who smoke. Prostate Cancer Update. [Accessed October 21, 2015]. The James Buchanan Brady Urological Institute website. https://urology.jhu.edu/newsletter/prostate_cancer612.php.
  1. Parkin DM. 2. Tobacco-attributable cancer burden in the UK in 2010. Br J Cancer. 2011;195(suppl 2):S6–S13. [PMC free article] [PubMed] [Google Scholar]

Jacobsen SJ, Guess HA, Panser L, et al. A populationbased study of health-care seeking behavior for treatment of urinary symptoms. The Olmsted County Study of Urinary Symptoms and Health Status Among Men. Arch Fam Med. 1993;2:729–735. [PubMed] [Google Scholar]

Tamadon MR, Nassaii M, Ghorbani R. Cigarette smoking and nephrolithiasis in adult individuals. Nephrourol Mon. 2013;5:702–705. [PMC free article] [PubMed] [Google Scholar]

Wyman, J. F., Burgio, K. L., & Newman, D. K. (2009). Practical aspects of lifestyle modifications and behavioural interventions in the treatment of overactive bladder and urgency urinary incontinence. International journal of clinical practice, 63(8), 1177–1191. doi:10.1111/j.1742-1241.2009.02078.x

Soares, S. R., & Melo, M. A. (2008). Cigarette smoking and reproductive function. Current Opinion in Obstetrics and Gynecology, 20(3), 281–291. doi:10.1097/gco.0b013e3282fc9c1e

International Urogynecological Association., authors Interstitial Cystitis & Painful Bladder Syndrome: A Guide for Women. Washington, DC: International Urogynecoligal Association; 2011. []

What Our Patients Have to Say

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Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by Jamie M.

I have been going to see Heather for a while now, and I can't tell you enough how much she has improved my quality of life. Heather specializes in issues like pelvic floor, but I see her for other orthopedic issues.

I have a lot of chronic joint pain and dysfunction issues (back, hips, neck) that require that have ongoing physical therapy maintenance. The effects of my problem joints/areas overlap and interconnect with each other in complex ways, so helping me requires really having a complete understanding of the entire skeletal and muscular system. Pain does not always appear where the problem actually is, the human body is a twisty, many-layered puzzle. I have an exercise program I do at home and I am very functional, but there are just something things I need a PT to help me out with.

Read more: Testimonial by Jamie M.

Testimonial by R.H.

No one could tell me why I was having pain during sex--sharp pain, not just uncomfortable, pain. I was referred to Heather Jeffcoat after researching several different options. I had seen a specialist who told me physical therapy would not help and my only option was surgery. I really didn't want to go that route, so when we got a referral, I decided to try it--it can't hurt, I thought. I am so glad I did. She diagnosed the problem right away, which was a relief in itself.

To know why I was having pain eased my mind immensely. And to hear that she could fix it without surgery was another relief. She said she could fix the problem in 6 weeks. I think it was actually 4 for me. She was very methodical, and treated me as an intelligent human being capable of participating in my own recovery. I would absolutely recommend her to anyone. She did not try to prolong my session numbers, she worked hard to accommodate my schedule (and the fact that I had to bring a baby to sessions), and she was completely honest the entire time. It is so hard to find someone with these characteristics, much less a professional who is so good at what she does. She has my highest respect.

-- R.H.

Testimonial by S.P., Age 26

I would like to start off by thanking Heather Jeffcoat for educating me and curing me of Vaginismus. I had been married for almost three years before I was referred to Heather. I never knew about Vaginismus until almost three years into my marriage. I knew something was wrong when I went on my honeymoon and came back a Virgin. I had always imagined how magical my first night would be but boy was I wrong.

Read more: Testimonial by S.P., Age 26

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by R.M., Age 40

I can’t speak highly enough of the theapists at Femina Physical Therapy and how much they have helped me grow, discover, and love my body. I had had painful sex for my entire life, and didn’t know that there was anything that could be done about it. It was at the point where my husband and I were not having sex for MONTHs, because it was just too frustrating, and I hated feeling like I was the ONLY woman out there who had this problem, especially at my age. I finally brought it up to my doctor because I was turning 40 and my husband and I were barely having enough sex to conceive. And she brought up pelvic floor, PT. I didn’t even know this was a “thing”.

Read more: Testimonial by R.M., Age 40

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