The bladder is a hollow, distensible organ located in the pelvis that serves to both store and expel urine from the body. A variety of different causes can result in bladder dysfunction. If you suspect that you or someone you know is suffering from bladder problems, medical consultation is advised so that proper evaluation and treatment can be undertaken.
Infection
Infection of the bladder is known as cystitis or urinary tract infection (UTI). These tend to occur more in women and symptoms include fever, discomfort with urination (known as dysuria), an urge to use the bathroom more often (known as urinary frequency), and blood in the urine. This is easily treatable with antibiotic therapy, thus prompt medical consultation is advised.
Urinary Incontinence
This is a loss of bladder control and tends to increase with older age. Symptoms can range from occasional urinary wetting to uncontrollable leakage of urine. One possible cause is weakness of the muscles that keep the bladder from expelling urine. As a result, activities, such as coughing, laughing or lifting a heavy object, can result in accidental leakage. Another cause is if the same muscles are too active, which result in urges to use the bathroom despite low volumes of urine in the bladder. Additionally, problems with the prostate or nerves that control the bladder can result in loss of control over normal urinary activity.
Interstitial Cystitis
This is also known as painful bladder syndrome. It is characterized by chronic pelvic pain that is often worsened by increased urine in the bladder. Other symptoms include increased frequency of urination (especially at night), discomfort during urination, and frequent urges to urinate. It is considered a "diagnosis of exclusion" by physicians; this means that it is only diagnosed when all other possible conditions have been ruled out by testing. Possible causes include damage from radiation, infection that is not detected, and various gynecologic disorders that cause pelvic discomfort that can mimic painful bladder syndrome.
Cystocele
This describes a condition when a weakness in the pelvis results in the bladder dropping from its position in the body into the vagina of a woman. This can result in pelvic discomfort and problems with releasing urine from the bladder. If urine buildup in the bladder reaches excessive levels, it can cause problems with the rest of the urinary tract, which includes vital organs, such as the kidneys. Causes include weakening of the muscles from the strain of childbirth, repeated straining during defecation, and decreased levels of estrogen (such as in menopause), which normally keeps the muscles around the vagina strong.
Urinary Retention
This condition occurs when there is a problem with urinary expulsion from the bladder. It is characterized by pelvic discomfort, weak urinary stream, urinary dribbling, a delay from trying to urinate to the actual flow beginning to leave the body, and a sense that the bladder still has urine after going to the bathroom. If enough urine builds up in the bladder, it can distend beyond its limits and possibly even tear. In addition, the urine can "backflow" into the kidneys causing damage with eventual kidney failure being a possibility. Causes include increased prostate size, damage to the nerves that control the bladder, diabetes and medications (such as the anticholinergic class, opiates, and antidepressants).
Cancer
Cancer can occur in almost any organ in the body, the bladder being no exception. It often arises from the inner lining of the bladder, with risk factors including smoking, chemical exposure (such as dyes), and a family history of the disease. Symptoms include weight loss, back pain, blood in the urine (known as hematuria), frequent urges to urinate and pain when urination occurs. Treatment can include surgery, immunotherapy (boosts your body's own ability to fight cancer), radiation or chemotherapy.
References
- "Campbell-Walsh Urology, 9th Edition;" Wein; 2007
- "American Family Physician;" Diagnosis and Treatment of Bladder Cancer; Sharma, S et al. Volume 80; October 2009
- "Medical Clinics of North America;" Urinary Incontinence: Selected Current Concepts; Wilson, M. Volume 90; September 2006
