There are certain rules for maintaining bladder health that many are made well aware of from an early age: Drink plenty of water, wipe from front to back if you have a vulva, and always change out of a wet bathing suit as quickly as possible. But that’s just the tip of the iceberg when it comes to optimal urinary health, which is why it can be fascinating (if not incredibly beneficial) to know what urinary system experts themselves do or don’t do daily as a result of the depth of knowledge they gained from their fields.
To get the scoop on bladder health dos and don’ts both in the office and IRL, we spoke with three expert urologists about their (ahem) golden rules, including what they always avoid doing in the name of bladder health.
3 things a urologist always does IRL for optimal bladder health
“I avoid drinking water before bed.”
“As a urology expert, I avoid drinking in the evening after dinner to avoid waking up at night to urinate,” says Maude Carmel, MD, a urology specialist and an associate professor in the department of urology at UT Southwestern Medical Center. “Waking up to pee at night can not only be a nuisance, but it also disrupts your quality of sleep and is actually a sizable injury risk because of how easy it is to fall down between the bed and the bathroom.” Of course, according to Dr. Carmel, it’s not harmful to your health to drink water before bed—this is just a general general guideline to follow.
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“The simplest thing to do to avoid waking up at night to pee is to avoid fluids after dinner and avoid bladder irritants in the evening, including caffeine, carbonated beverages, and alcohol,” agrees Karyn Eilber, MD, a board-certified urologist and an associate professor of urology and OB/GYN at Cedars-Sinai Hospital. “If you are a very light sleeper—or you are prone to waking up for other reasons—and tend to just decide to go pee since you’re already awake, I recommend consulting a physician about ways to sleep better.”
“I always stay hydrated.”
“Hydrating is one of the most important things that you can do for bladder health for a lot of reasons,” says Dr. Carmel. Staying hydrated, she says, is not only healthy for your body overall, but it can support optimal kidney function, prevent urinary tract infections, and help you expel waste regularly.
“I pee regularly and try to never hold my pee.”
“In addition to hydrating, I also try to void—which is the official urology term for peeing—every four hours,” says Dr. Carmel. “Not holding your pee in is really important for your pelvic floor muscles, bladder health, and preventing urinary tract infections (UTIs).” This is because the sensation of needing to pee means that your kidneys are filled with waste materials that need to be expelled from your body. “You don’t want to hold your bladder at max capacity when you really need to go because that puts excess pressure on those muscles,” Dr. Carmel adds.
3 things that a urologist avoids doing at work
“I never shrug off ‘common’ bladder symptoms as ‘normal’ or ‘expected’ experiences.”
“Just because a symptom is common doesn’t always mean that you should be experiencing it,” says Aleece Fosnight, MD, MSPAS, PA-C, urologist and women’s health specialist of Aeroflow Urology. “For example, something like urinary incontinence after giving birth. Although common, it doesn’t have to be normal, and you don’t have to put up with those symptoms. You have options, and I always want my patients to know what their choices are,” she says.
The mindset that something is “normal” can get in the way of solving the symptoms and getting you back to feeling your best. Remember: There’s nothing to be ashamed of when it comes to urinary symptoms like frequent urges to pee or incontinence.
“I avoid prescribing antibiotics without testing for a UTI.”
“I try not to prescribe antibiotics for every urinary symptom that could potentially be a UTI—I always want confirmation by a urine culture that this is a true UTI,” says Dr. Fosnight. “This can be really useful in narrowing down what’s going on with your symptoms. It also protects you from unnecessary rounds of antibiotics in the event that something else is going on.” In short, you want antibiotics to work for you when you need them, and taking them when you don’t have a confirmed infection can put you at risk for increased resistance. This is especially important in cases of conditions like interstitial cystitis, which is characterized by chronic UTI pain without an infection.
“I try to always perform (consensual) exams on patients with concerns.”
“If a patient has a pelvic concern, I always perform a pelvic exam as long as they consent. I have so many of colleagues that never look at a patient’s genitals when there is a concern, and they miss so many diagnoses,” says Dr. Fosnight. There are a lot of things that a practitioner can learn from an IRL exam of the area if you trust them and are comfortable with that process. This is also something to incorporate into your search for treatment—it’s a green flag if your provider wants to look at the physical symptoms you’re experiencing.
Keep in mind, Dr. Fosnight adds, that you definitely have the right to consent or revoke your consent to an exam at any time. “I ask consent for all pelvic exams. Just because a patient is there for a pelvic concern doesn’t mean they always want to have a pelvic exam,” she says.
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