Urinary bladder disease
The urinary bladder's function in the body is to hold liquid waste (urine) prior to excretion, and there are a number of potential diseases and conditions that can interrupt function. Because symptoms can be common to many types of conditions that vary in severity, obtaining an accurate diagnosis for the specific form of urinary bladder disease is critical to treatment.
Definition & Facts
- Cystitis. Cystitis happens when the bladder gets infected and then inflamed. The most common infections are UTIs (urinary tract infections) and yeast infections.
- Interstitial cystitis. When cystitis becomes chronic and symptoms include pain and a sense of continual urgency to urinate, it becomes interstitial cystitis. This condition is sometimes referred to as painful bladder syndrome.
- Overactive bladder syndrome. When the bladder becomes overactive, urination may happen up to 10 times daily. When the frequency is accompanied by leaking and urgency, the diagnosis is often overactive bladder, which is actually a type of urinary incontinence.
- Urinary incontinence. Urinary incontinence, or a loss of control over the bladder, can happen for a variety of reasons, but the most common reason is that the bladder and surrounding muscles are weak. It can happen occasionally or continually. More women than men are affected.
- Bladder cancer. Bladder cancer can be triggered by smoking, exposure to toxins or heredity. It is currently ranked sixth in the list of most common cancers.
Symptoms & Complaints
- Blood in the urine (hematuria).
- Pain while urinating.
- Urgency to urinate.
- Difficulty urinating.
- Pain in the abdomen or bladder area.
- Feeling of fullness in the bladder area.
- Spontaneous urination (incontinence) while coughing, laughing, bending, etc.
- Frequent nighttime urination (nocturia)
- Urine stream that starts and stops or is slow.
- Incontinence while sleeping (bed wetting, aka nocturnal enuresis).
Bladder diseases can be caused by different factors, including exposure to toxins, genetic factors and/or inherited conditions, lifestyle habits such as smoking and other factors. Obtaining a definitive diagnosis can help with tracing the disease back to its root causes.
One of the most common causes of bladder disease is exposure to an infectious agent, such as E. coli (for urinary tract infections) or overgrowth of yeast (for yeast infections). Taking some medications for other health reasons, such as antibiotics, can contribute to vaginal yeast infections for women in particular.
Women who are pregnant are often more prone to UTIs and yeast infections, as are individuals who suffer from diabetes mellitus. Men who have an enlarged prostate (benign prostatic hyperplasia) can also get bladder infections more frequently, as can individuals who have been diagnosed with a narrower than normal urethra. People who severely restrict fluid intake can also be more prone to infections of the bladder.
Smoking and exposure to chemicals or toxins as well as genetic predisposition are three of the most common known causes for bladder cancer. Bladder diseases and cancer of the bladder can also arise from unknown causes, in which case they are said to be idiopathic.
Diagnosis & Tests
Diagnosing urinary bladder disease typically involves a variety of medical tests. The treating physician typically begins by taking a thorough individual medical history as well as family history. The goal is to create a list of symptoms and also identify if other relatives may have experienced similar symptoms or have been diagnosed with bladder issues. The most frequently performed diagnostic tests include the following:
- Urinalysis or clinical urine tests. A urinalysis tests for levels of yeast and bacteria in the urine.
- Abdominal ultrasound. An abdominal ultrasound looks for urine retention in the bladder after urination, as well as tumors or other blockages in the bladder like urinary tract stones (bladder stone) and structural abnormalities.
- Cystoscopy. A cystoscopy is a test to look at the inside of the bladder and urethra. A small camera with a light is inserted up the urethra and into the bladder so the doctor can actually look at the entire area to diagnose what is causing the symptoms.
Treatment & Therapy
Once a definitive diagnosis for the bladder symptoms has been established, appropriate treatment can begin. Often the treatment will incorporate several different aspects, including medication, physical therapy, lifestyle changes and sometimes surgery.
Miconazole, tioconazole, terconazole, and butoconazole are all antifungal medications that are commonly used to treat vaginal yeast infections. Pentosan polysulfate is a drug used to repair the bladder lining in cases of interstitial cystitis. Antibiotics are commonly prescribed to address urinary tract infections.
If the bladder disease can be linked to nerve function, acupuncture or TENS (transcutaneous electrical nerve stimulation) can help restore normal function. Kegel exercises to strengthen the muscles in the pelvic floor, bladder and abdominal area are often prescribed as well.
Chemotherapy and radiation for bladder cancer. Transurethral resection is a surgery that may be performed to address certain cases of bladder cancer. Surgery may be recommended in other forms of bladder disease when there is a bladder blockage for some reason or if there are structural anomalies that are causing the symptoms.
Prevention & Prophylaxis
Urinary incontinence can sometimes be prevented by staying active and physically fit with regular exercise, and paying particular attention to the pelvic floor and bladder muscles.
One can reduce one's risk of having bladder cancer by quitting smoking or never beginning and avoiding secondhand smoke. To the extent that urinary tract infections are caused by sex or emerge as a complication of a different sexually transmitted disease, practicing safe sex may help reduce the risk of these infections.