While not as popular as it once was in the UK, thanks to efforts such as World No-Tobacco Day (31 May), smoking continues to be a habit that over 15% of people in the UK still enjoy

Most people are aware of the significant health risks posed by smoking such as cancer and heart disease, but there are still quite a few lesser-known illnesses, diseases and conditions that that can be caused by smoking – including urinary incontinence.

The impact of smoking on urological health

There’s a growing body of evidence to suggest that smoking can be harmful to urological health. Studies have shown that smokers are three times more likely to develop bladder cancer than non-smokers. Smokers are also at elevated risk of prostate cancer, kidney cancer, erectile dysfunction (ED), interstitial cystitis (IC), nephrolithiasis (kidney stones), infertility, benign prostatic hyperplasia (BPH), prostate-specific antigen (PSA) and urinary incontinence.

What is urinary incontinence?

Urinary incontinence is a condition whereby a person loses control of their bladder, causing involuntary leakage or urination. While not life-threatening, nor a disease itself, it can be symptomatic of there being an underlying medical problem. There are different types of urinary incontinence that can often be linked to symptoms and how the condition presents itself.

The different types include when the bladder is under pressure through exercise or coughing (stress incontinence), having a sudden urge to urinate (urge incontinence) and overflow causing the bladder to be improperly emptied (overflow incontinence). Conversely, total incontinence happens as a result of a person being unable to store urine in their bladder, whereas functional incontinence occurs when a person is physically, mentally or intellectually prevented from being able to relieve themselves.

There’s a range of causes behind urinary incontinence and the severity to which an individual experiences it. Women are twice as likely as men to be affected by urinary incontinence.

How smoking impacts urinary incontinence

One of the causes of urinary incontinence is thought to be smoking tobacco or being around tobacco smokers. While it’s still unknown why smoking affects the bladder, there are several leading theories as to why smoking causes incontinence.

One possible reason is that the smoke enters the body and, for the toxins to leave the body, they have to go through the urinary tract. These toxins are thought to be bladder irritants, causing incontinence. Nicotine, for example, is cited as a possible factor in causing bladder contractility.

Another possible explanation links the condition in smokers to chronic coughing caused by smoking (known as the ‘smoker’s cough’). As coughing can put extra pressure on the pelvic muscles and bladder, a chronic cough causes the bladder to be stressed and, therefore, induce incontinence. This is why coughing is associated with stress incontinence.

Studies linking urinary incontinence to smoking

One of the most cited studies linking urinary incontinence to smoking is a large case-control study of 606 women, half of whom were smokers and half who were not, by Bump and McClish in 1992. They found that smoking was a significant factor in stress incontinence among participants – irrespective of a woman’s weight, age, and pregnancy and/or menopausal status. This not only applied to current smokers but former smokers too.

As urinary incontinence has been linked to COPD, this led Bump and McClish to theorise that coughing (a symptom of COPD and smoking) was causing the elevated levels of urinary incontinence in smokers when compared to non-smokers. A link was also established between smokers (and former smokers) with urge incontinence.

Other studies have also established a link between smoking and a stronger need to urinate. One survey in an academic journal found that women who smoked were three times as likely to suffer urge incontinence as non-smokers.

Reducing the risk of urinary incontinence to smokers

If you’re experiencing urinary incontinence, it’s important that you talk to your GP as the condition could be linked to a wider medical issue. Urinary incontinence can often be corrected and controlled through a combination of diet and bladder/pelvic muscle training. This may include losing weight, drinking more fluids and cutting certain foods out of your diet.

For smokers, the only way to effectively reduce or eliminate their urinary incontinence, or the risk of incontinence, is to either cut back on or quit smoking tobacco completely. Quitting techniques can include having a support network to help you deal with the changes, and to make use of aids to help deal with withdrawal symptoms (such as patches or gum).

When a urinary catheter may be needed

If you experience more moderate to heavy incontinence, or are finding that your attempts to control your incontinence are not successful, you may need a urinary catheter to help empty urine from your bladder and into a drainage bag.

Catheters can either be inserted through the urine-carrying tube connected to the bladder (known as a urethral catheter) or through a small incision in the lower stomach area (known as a suprapubic catheter, which is left in place). The former is often preferred and the latter is often only turned to if a urethral catheter fails to remedy the problem.

Urethral catheters come in two forms: intermittent catheters and indwelling catheters. Intermittent catheters are temporarily placed in the bladder to empty it. Once this has been done, the catheter is often removed. Indwelling catheters, on the other hand, remain in place for longer (sometimes weeks) and are kept in position within the bladder via an inflated balloon.

For men, an external catheter can also be used. This is fitted around the penis and does not require anything to be inserted into the urethra.

Risks of a urinary catheter

Those using indwelling or suprapubic catheters run the risk of a particular form of urinary tract infection. This is due to these catheters being used longer term and positioned within the body. Bacteria can gain easier access to the bladder over a long time, allowing it to multiply. An increase in bacteria can lead to what is called catheter-associated urinary tract infections (CAUTIs).

CAUTI can occur naturally as bacteria will become settled on the outside surfaces of the catheter in contact with the body. It also occurs on the inside of the catheters, as urine flow is quite weak and unable to naturally dislodge excessive build ups of the plaque that hosts the infection.

Other factors contribute too, such as when the catheter isn’t cleaned properly or regularly, when faecal bacteria contaminate the catheter, when the drainage bag is not emptied regularly or if the urine flows backwards from the bag into the bladder. CAUTI can also arise when the catheter has become contaminated during the insertion process.

CAUTIs should be treated immediately – if left untreated, they can be life-threatening.

UroShield helps with urinary incontinence

It can be challenging to manage the effects and potential risks of CAUTIs when living with a suprapubic or indwelling catheter. However, it’s possible to effectively manage and reduce the chance of infection with UroShield – a small, external device designed to prevent bacteria formation on urethral and suprapubic catheters.

UroShield works by generating painless low frequency, low-intensity ultrasound waves to stop the formation and colonisation of bacterial biofilm on catheters – one of the primary causes of CAUTIs.

Additionally, UroShield can help to reduce encrustations and blockage on the catheter, eliminate reliance on antibiotics, as well as minimise any discomfort, pain and spasms that can occur when using an indwelling catheter. Easy to use, unobtrusive and portable, UroShield can offer a better quality of life for catheter users.

For more information on how UroShield works and how it can help you, give us a call on 020 8773 7844 or fill out the online form.

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Nothing in this article should be taken as qualified medical advice. This article is for information purposes only. You should always discuss medical issues and symptom with your own doctor.