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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.


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.


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:



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


Testimonial by S.S., age 54

Heather is the best! I saw her today for terrible hip/groin pain. I was so impressed with the safety measures in place and felt completely safe . Thanks for the healing hands.

S.S., age 54

Testimonial by Lauren B.

Femina PT (née Fusion Wellness & Physical Therapy) has been such an answer to prayer, i'm so glad I found them! I've been struggling with vaginismus my whole life, but didn't have a name for it until about 6 or 7 months ago. Even once I did have a name for it though, I didn't know where to begin in getting help. My OB/GYN had me get a set of dilators, but I couldn't even insert the smallest one by myself. Most times I tried I just ended up frustrated and in tears. I felt really alone, like I was broken and didn't have the energy to keep trying. When I got engaged a few months ago though, I realized I needed to get answers so i wasn't dreading my honeymoon.

Read more: Testimonial by Lauren B.

Testimonial by M.N., age 28

A personal journey and testimonial from one of my patients:

I was diagnosed with vaginismus 4 years ago. I never heard of such medical condition until after I got married. At first my husband and I didn't know what to do, we didn't know what the issues were or how to overcome it. Being born and raised in Armenia and being Christian I wasn't that open about talking to sex with others and so it wasn't easy to seek help. But eventually I went to an Ob-Gyn and luckily she knew about the medical condition (not many doctors know). She referred me to a physical therapist and I couldn't believe it and thought it's something I can handle myself. I ordered a kit from vaginismus.com and started practicing with dilators. There was some small progress but wasn't much helpful.

Read more: Testimonial by M.N., age 28

Testimonial by R.D., age 38

"I had a severe tear during childbirth that was not stitched together correctly and therefore healed poorly. Even after having a surgery a year later to remove the scar tissue, I was still having pain, and no one could explain why -- there was no overt 'reason' to explain the pain. I had tried other 'specialists' and even saw another physical therapist who had me do hip / leg stretches -- what a joke! I was about to give up and just 'live with it' until thankfully I kept searching online and found Heather.

Read more: Testimonial by R.D., age 38

Testimonial by A.B.

Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
-- A.B.

Testimonial by Alexandra B.

Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

-- Alexandra B., 5/20/2015 via Yelp!

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