Bladder Pain - An Overview

What Is Bladder Pain?

The urinary tract contains organs that are designed to perform their specific functions. The urinary bladder is one of the most crucial urinary tract organs. It is a balloon-like structure that holds the urine temporarily. It receives urine from the tube-like structures known as the ureters. The urine exits from the bladder with the help of a tube known as the urethra. Certain muscles are present at the meeting point of the bladder and the urethra. These muscles contract and relax as the urine flows through the bladder. Bladder pain is a common condition and can occur in men and women. Bladder pain or interstitial cystitis is a part of the spectrum of diseases that form painful bladder syndrome. The patient feels pain and pressure in the bladder and the pelvic region. The pain and the other symptoms might disappear in a few days or persist for a prolonged period.

What Are the Causes of Bladder Pain?

There are a variety of medical conditions responsible for bladder pain. However, the three most common causes of bladder pain are listed below:

1. Urinary Tract Infections or Bladder Infection: Urinary tract infection is a term used to describe the infection that can occur in any urinary tract organ. A bladder infection can affect a person at any age and needs to be treated at the earliest. Several healthy bacteria are present in the skin and the bowel, but they are not allowed to enter the urinary system. In the case of bladder infection, these bacteria enter the urinary tract through the skin or the stools and cause problems after entering the bladder.

2. Interstitial Cystitis: Interstitial cystitis, also known as bladder pain syndrome, is characterized by the irritation and inflammation of the bladder. Due to the inflammation, the bladder wall becomes stiff, making it difficult for the bladder to expand when it is full. However, scientists believe that a defect in the bladder lining, trauma, and spinal cord injury are the reasons for interstitial cystitis.

3. Bladder Cancer: The human body comprises billions of cells that grow rapidly and regulate the important activities of the body. The body contains genes that regulate cell growth. These genes make sure that the cells do not grow in excess. However, the problem arises when the genes fail to function or are defective. As a result, uncontrolled cell division occurs, leading to cancer. When cancer originates from the bladder, it is known as bladder cancer. Bladder cancers are of different types, but transitional cell carcinoma is the most common. Bladder pain is one of the most common symptoms of bladder cancer.

What Other Symptoms Are Seen Along With Bladder Pain?

Bladder pain is a symptom and not a condition. So, the patient presents with the following symptoms along with bladder pain:

1. Dysuria (painful urination).

2. Burning sensation while passing urine.

3. Urinary incontinence (leakage of urine).

4. Urinary frequency, or a need to urinate more than eight times a day.

5. Difficulty in starting the urine stream.

6. Hematuria (blood in the urine).

7. Pelvic pain.

8. Pain during intercourse.

9. Pain in the area between the anus and the scrotum (perineum).

10. Lower back pain or abdominal pain.

11. Weakness.

12. Fever, vomiting, and nausea.

13. The urine appears cloudy and smells bad.

What Tests Are Done to Diagnose Bladder Pain?

Bladder pain might occur due to several causes, so diagnosing the exact cause of pain becomes important. The doctor will be able to proceed with the treatment only when the cause is known. The following diagnostic methods are recommended to know the reason behind bladder pain:

• Medical History: The medical history provides details about the general health of the patient. It consists of questions related to the symptoms of the condition, the time of their onset and progression, the drug history, and the family history. The following questions might also be asked:

  • How many times does the patient pass urine during the day?

  • Does the patient experience any trouble while urinating?

  • Does the urine leak before reaching the toilet?

• Physical Examination: A pelvic examination is done to check the physical signs of bladder pain. The doctor examines the vagina, cervix, internal pelvic organs, and abdomen to check for pain and swelling.

• Bladder Diary: The doctor might have asked the patient to maintain a bladder diary. It contains all the information about the fluids consumed by the patient and the amount of urine passed.

• Laboratory Tests: The following laboratory tests are usually recommended:

  • Urinalysis: In this test, the patient collects the urine in a container or a sterile bag provided by the hospital. The urine sample is examined under a microscope or with a dipstick. The presence of blood, bacteria, and white blood cells in the urine indicates infection.

  • Potassium Sensitivity Test: It is a simple procedure used to diagnose interstitial cystitis. First, a catheter is inserted into the bladder through the urethra. Next, the doctor injects water and potassium into the bladder. The patient is asked to rate the severity of pain on a scale of one to five after each solution. If the patient feels more pain with a potassium solution, interstitial cystitis can be suspected.

• Imaging Tests:

  • Cystoscopy:A telescope-like instrument is inserted into the bladder to visualize the bladder lining. The doctor might inject a liquid into the bladder to check the bladder capacity.

  • Ultrasound: It is an imaging test done to diagnose urinary tract problems. As the patient is not exposed to X-rays, this procedure is usually recommended for children and pregnant females. The doctor moves a device known as a transducer over the abdomen to send sound waves to the body. The images help to detect the abnormalities present in the bladder.

• Biopsy: Biopsy is usually done along with cystoscopy. When the doctor inserts a cystoscope, he might take a tissue sample from the bladder to check for bladder cancer and other causes of pain.

How to Manage Bladder Pain?

There is no specific treatment plan for bladder pain. Some might get relieved of the pain after taking the medication, while some require surgical intervention. The treatment options for bladder pain are listed below:

1) Medications: Certain medications help to treat mild bladder pain. The medications are listed below:

• Antihistamines: Loratadine (helps to reduce urinary frequency).

• Antidepressants: Amitriptyline and Imipramine (helps to relax the bladder muscles).

• Pentosan Polysulfate Sodium (Elmiron): It has been approved by the Food and Drug Administration (FDA) to treat interstitial cystitis. It helps to restore the inner lining of the bladder and must be taken for six months to achieve the results. Eye problems are one of the most common side effects of this drug.

2) Bladder Distension: A liquid is injected into the bladder to stretch the bladder wall during cystoscopy. Some patients are relieved of the symptoms after bladder distension because their bladder capacity increases.

3) Bladder Instillation: A catheter is inserted to fill the bladder with medications like Dimethyl Sulfoxide, Heparin, or a local anesthetic. The patient holds these medications for 15 minutes and then is asked to urinate. Initially, the treatment is done weekly for six to eight weeks. As the condition improves over time, the patient might require bladder instillation once a year.

4) Nerve Stimulation: Nerve stimulation is mainly done to improve the blood supply to the bladder. The techniques of nerve stimulation are listed below:

• Transcutaneous Electrical Nerve Stimulation (TENS): It is a procedure in which wires are placed on the lower back to send electrical pulses to the pelvic region. These pulses help to improve the blood supply of the bladder, reduce pelvic pain, and stimulate the release of substances that reduce pain. When blood circulation is improved, the bladder muscles start working correctly.

• Sacral Nerve Stimulation: Sacral nerves connect the spinal cord and the bladder nerves. If these nerves are stimulated, the patient is relieved of the symptom of urinary urgency. A wire is placed near the sacral nerve to send electrical impulses to the bladder. When the bladder nerves get stimulated, the patient is relieved of pain, urinary frequency, and urgency symptoms.

5) Surgery: Surgical intervention is rarely required in bladder pain. However, the doctor might recommend the following surgical procedures:

• Bladder Fulguration: It is a minimally invasive procedure in which a resectoscope is inserted into the bladder through the urethra. This instrument helps visualize the bladder and destroy ulcers or tumors by using heat.

• Cystoplasty: Cystoplasty or bladder augmentation is a procedure to increase bladder capacity. A part of the intestine is attached to the bladder to enlarge the bladder size. It helps the patient to hold more amounts of urine.

How to Prevent Bladder Pain?

Home remedies and lifestyle changes help to prevent mild to moderate bladder pain. The following changes can be made to prevent bladder pain:

• It is essential to go to the bathroom every two to three hours to urinate instead of rushing when the need arises.

• If the patient cannot empty the bladder at once, he needs to wait and try again for the same.

• The consumption of caffeine, carbonated, and aerated drinks should be reduced as they increase the risk of urine leakage and bladder pain.

• Chocolates and spicy and salty food items should be avoided as they increase bladder activity resulting in frequent urination or urine leakage.

• Avoid wearing tight clothes as they put pressure on the abdomen.

• Do stretching exercises daily to prevent bladder pain.

• The acupuncture technique also helps to reduce bladder pain and discomfort. During this technique, thin needles are placed in specific body areas to relieve pain.

Conclusion:

Bladder pain is a common symptom of various medical conditions that affect the urinary system. The urinary bladder is like a reservoir that holds the urine until the person gets a message that he needs to urinate. Sometimes, the efficiency of the bladder decreases, and the patient experiences pain, inflammation, and pressure in the bladder. There are several causes of bladder pain, including urinary tract infections, constipation, and bladder cancer. The treatment depends upon the cause and mainly aims to restore the bladder lining, blood supply, and muscle strength. Bladder pain is not a life-threatening situation, but the patient must undergo treatment at the earliest. Both surgical and non-surgical options are effective in treating bladder pain. Consult the doctor to know more about the treatment options for bladder pain.