function may also be affected by the diseases of other tissues and
organs present in the body.Bladder problems can be divided in to two categories which include, Problems in the bladder itself and problems concerning bladder functions.
A). Problems of the bladder itself:
1. Bladder cancer:
The cancer that forms in the tissues of the bladder is called
bladder cancer. Majority of bladder cancers start from the inner
lining of the bladder, called transitional cell carcinoma. Other
types of cancers include squamous cell carcinoma which occurs in the
flat, thin cells and adenocarcinoma that occurs in cells that
secrete mucus and other fluids are also present.
Although the exact cause of bladder cancer is not known, many
doctors have identified cigarette smoking as the potential cause for
it. The person's risk of developing bladder cancer increases with
smoking, exposure to chemical substances, high fat diet, age, sex,
race, family history of bladder cancer, cellular abnormalities, and
chronic bladder inflammations.
Signs and symptoms:
Blood in urine is the first warning sign of bladder cancer. But the
blood is unlikely visible to the naked eye, and can be detected
through a simple urine test. Other common symptoms also include pain
while urinating and changes in bladder habits.
Often bladder cancer does not show any symptoms until it reaches an
advanced stage which is quite difficult to cure.
Urine sample is tested for any abnormal cells, called urinary
cystography, which may sometimes give false-positive test and
vice-versa. This makes urologist recommend other tests, which
include imaging tests, biopsy and cystoscopy. If any cancerous cells
are detected from the above tests, then chest x-rays, CT scan, MRI
scan and a bone scan is conducted to determine whether the cancer is
limited to its area of origin or not.
Treatment options for bladder cancer depend on its type, its
advancement, general health of the patient and their preferences.
Early stages of bladder cancer can be treated through surgical
removal of the portion of bladder that has cancer cells.
Radical cystectomy is the procedure where the whole bladder and the
nearby lymph nodes are removed surgically.
Immunotherapy, chemotherapy and radiation treatments are used in
conjunction with other treatment methods to further prevent cancer
Cystitis, also called urinary tract inflammation is caused by a
number of conditions, most commonly by the bacteria. When caused by
bacteria, it is referred to as urinary tract infection. It often
causes serious pain and discomfort, and affects more women than men.
Cystitis may be caused due to a number of conditions, such as
individuals with short urethra, damage caused to bladder when
changing urinary catheter, women using diaphragm for contraception,
incomplete emptying of the bladder leading to bacterial growth,
block in parts of the urinary tract system, kidney or bladder
problems, and frequent or vigor sex.
Signs and symptoms:
Cystitis symptoms include blood in urine, dark or cloudy urine, pain
in lower back, abdomen, and above pubic bone, frequent urination,
burning sensation while urination, and older women may experience
fever and feel weak.
Urine analysis and urine culture is often done to confirm the
presence of bacteria. While urine analysis is performed to find out
the various components of the urine including bacteria, urine
culture is performed to identify the specific type of bacteria
causing the infection.
For concurrent cystitis, the doctor may recommend the following
tests; ultrasound scan, cystoscopy, CT scan, X-ray or blood culture
Moderate to severe cystitis is treated with short course antibiotics
treatment which involves using oral antibiotic drug for a period of
around 3 days. For recurrent cystitis, continuous antibiotic
treatment is given by the physician.
3. Bladder stones:
They are small mineral masses that form in the bladder, especially
when the urine becomes thick. These stones are often called calculi.
The most common cause of bladder stones is due to the inability of
the bladder to empty itself completely. Therefore, the stagnant
urine which consists of urea clumps together, resulting in the
formation of crystals.
The risk factors that increase the likelihood of developing bladder
stones include age, weakened bladder wall, deficiency of vitamin
A/B, high fat, sugar or salt diet, and people with bladder outlet
obstruction, damaged nerves that controls bladder function,
recurrent bladder infections, urinary catheters, or kidney stones.
Signs and symptoms:
Bladder stones do not always cause any signs or symptoms and
sometimes pass on their own. It might be discovered only during
tests for other problems. When symptoms occur, it may be from
abdominal pain, painful, difficult or frequent urination, dark
coloured urine and blood in the urine.
Urine analysis is typically the first test done to examine the
presence of crystalline substance, blood and bacteria's in the urine
sample. If blood cells are seen, a cystoscopy is performed with a
scope of looking into the bladder. Since most stones are made of
calcium, an X-ray analysis also helps to show up these stones, but
not uric acid stones.
Drinking plenty of fluids may dilute the urine and help the stone to
pass. But many a times, bladder stones are due to the inability of
the bladder to empty its contents completely. In such cases, other
treatment procedures are performed.
Treatment of large bladder stones typically involves the surgical
removal of it through an incision in the lower abdomen. For smaller
stones, laser or ultrasound waves is used to break it down into
smaller pieces and then washed out with normal urination. If bladder
stones are due to any other diseases or abnormalities, they should
be looked into first and treated immediately, in order to prevent
more stone formation.
In women, the front wall of the vagina that supports the bladder
weakens with age which causes it to descent into the vagina causing
bladder prolapse or cystocoele. It can take in to 4 different forms
depending on its severity. Bladder prolapse may lead to urinary
difficulties, stress incontinence and discomfort.
Bladder prolapse is often caused sue to factors like menopause,
childbirth and straining that causes damage to the pelvic floor
Signs and symptoms:
The first typical symptoms experienced by women suffering from
cystocoele are the presence of tissue protruding in the vagina that
gives a feel like a ball. Other common symptoms such as, difficulty
in urination, pain in pelvic area, painful intercourse, bladder
infections, lower back pain, stress incontinence, and a feeling that
the bladder is full even after urination.
Pelvic examination is done in order to diagnose prolapsed bladder
among women. Cystoscopy, x-ray examination and urodynamics are also
performed to help with further diagnosis.
Treatment options for bladder prolapse depend on the severity of the
condition. Non-surgical treatments include pessary, estrogen
replacement therapy and kegel's exercises. Severe conditions of
cystocoele require surgery to correct them.
5. Nocturnal enuresis:
This is commonly referred to as bedwetting, which is the
unintentional passage of urine during sleep. It is very common among
children below 5 years. Also, it is important to note that often
children learn to control their bladders ta different ages. So
unless, there is any neurological problem, children eventually learn
to stop bed wetting.
In most cases of bedwetting, no cause will be found. In rare cases,
it may be a problem of an underlying disease which include
constipation, or type I diabetes.
There is no single approach in treating the condition. Self-help
techniques like restricting the amount of fluids consumed in the
evening may be helpful in certain cases. Bed wetting alarms are
often recommended by physician, which helps train the child to wake
up once their bladder becomes full.
B). Problems concerning bladder functions:
The bladder muscles may become weak causing incomplete emptying of
the bladder while urinating, and on the other hand, the bladder
muscles become overactive causing incontinence or frequent
1. Overactive bladder:
It is the sudden contraction of the muscles in the bladder wall
causing unstoppable, involuntary urge to urinate.
Detrusor, the largest muscle of the bladder becomes too active and
contracts more than normal and at inappropriate times, while the
bladder is filling with urine. This causes the person to feel a
sudden, overwhelming urge to urinate even when the urinary bladder
is not full.
Although the reason for this contraction is not clear, it is
believed that the nerve signals that runs between brain to bladder
Symptoms of overactive bladder include the overwhelming urgency to
urinate, frequency of having to go to the toilet increases and there
will be a strong, sudden need to go toilet.
Urodynamic tests are performed to assess the bladder function and
its ability to empty itself. Other tests that helps diagnose and
analyse the condition better may include uroflowmeter to measure
urine flow, cystometry to measure bladder pressure, electromyography
to measure bladder nerve impulses, X-ray to create images of bladder
function and cystoscope to look inside the bladder to check
A combination of treatment strategies may be used to treat an
overactive bladder. Behavioral intervention is use which include
bladder training, double voiding, scheduled toilet trips, kegel's
exercise, absorbent pads and intermittent catheterizations.
Drugs are given to relax the bladder which helps to alleviate the
symptoms of overactive bladder. For people with severe symptoms that
do not respond to other treatment methods, surgical removal of the
bladder or surgery to increase bladder capacity is done.
2. Urinary incontinence:
It is one of the most common but embarrassing problem which causes
due loss of bladder control. Its severity may range from occasional
leaking to a strong, sudden urge to urinate, that affects day-to-day
Urinary incontinence may be caused by some physical problems like
pregnancy or childbirth, aging, hysterecetomy, interstitial
cystitis, enlarged prostate, bladder or prostate cancer, and
neurological disorders, underlying medical conditions such as
constipation and UTI, or everyday habits like alcohol, overhydration
Signs and symptoms:
Incontinence symptoms may include continuous leakage from the
bladder, frequent or sudden urge to use toilet, loss of urine when
changing positions, physical activity and loss of bladder control.
Treatment procedures for urinary incontinence include behavioral
therapies and a minimally invasive procedure called urinary
incontinence slings that restore urethra to its normal anatomical
Bladder problems can occur at any age, but elderly are more likely
to suffer from it. Proper diagnosis and treatments that meet
specific needs and lifestyle can helps to overcome bladder problems
in a better way.
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