Lungs & Bladder: What's the Link?

The good Lord must have had a funny sense of humor when he put Adam & Eve together.  Little did we know that S/He connected our lungs to our bladder!

How's that again?  In a nested case-control study published earlier this week in the Archives of Internal Medicine, amongst both men & women with chronic obstructive pulmonary disease (COPD), those who used inhaled anticholinergic drugs, whether short-acting or long-acting, had an increased risk of developing acute urinary retention severe enough to require hospitalization, same-day surgery, or an emergency department visit, compared to non-users.

Men with an enlarged prostate (benign prostate hyperplasia or BPH) had an even greater risk, which makes sense given the obstructive issues associated with BPH.  Worse, men who required the use of both short-acting and long-acting inhaled anticholinergic drugs to control their COPD symptoms had greater risk of acute urinary retention compared to those men who were taking one or the other, or none at all.

So now we have to choose between breathing a little bit more easily versus being able to empty our bladder adequately?  Well, that's where we, as family physicians, come in.  We're trained to look at the person as a whole, not just as individual organ systems independent of each other.  After all, how many patients live with just one chronic disease in isolation?  Most have two or more!  So family physicians (and geriatricians) take the time to involve the patient in his/her health decision making process after discussing the various risks, benefits & alternatives.  We just have to remember to add acute urinary retention to the list when we talk with our patients w/COPD.