Bladder Spasm - Causes, Diagnosis, and Management

Introduction

The urinary bladder is a sac-like structure that stores the urine formed by the kidneys. Spasms are contractions. Bladder spasms are contractions in the urinary bladder that happen when the bladder muscles contract or tighten. Continuous spasms may give rise to an urge to pass urine. Bladder spasm is often used with the term overactive bladder (OAB). Overactive bladder is also known as urgency incontinence. This is characterized by a desperate need to empty the bladder, thus causing involuntary urine leakage. A bladder spasm is sometimes only a symptom and not a disease itself.

What Does a Bladder Spasm Feel Like?

People who experience bladder spasms describe them as a cramping pain and a burning sensation. Women with severe bladder spasms describe the spasms as muscular contractions during menstruation and even labor pains experienced during childbirth.

What Causes Bladder Spasms?

Bladder spasms are common as one ages but are not typical of aging. Moreover, they may indicate other underlying health conditions. The conditions that may cause bladder spasms are as follows:

• Urinary Tract Infections - Infections of the urinary tract involving the kidneys, ureters, bladder, or urethra.

• Overactive Bladder (OAB) - In this condition, the individual has a strong urge to empty the bladder.

• Constipation - Hard, dry stools that are difficult to pass.

• Coffee or Alcohol - Drinking too much coffee or alcohol can also cause bladder spasms.

• Medications - Medications such as Bethanechol and Furosemide.

• Diabetes - A metabolic disorder that causes increased blood sugar levels.

• Kidney Dysfunction - Reduced kidney function.

• Stones - Bladder stones frequently cause bladder spasms.

• Menopause - Menopause is when a woman no longer has monthly menstrual cycles. The risk of heart disease, osteoporosis, and urinary incontinence increases after a woman undergoes menopause.

• Interstitial Cystitis - This chronic condition causes bladder pain, bladder pressure, and pelvic pain.

• Prostate Enlargement - An enlarged prostate gland can cause bladder spasm in men.

• Neurological Disorders - Disorders such as Parkinson's disease (a disorder of the brain that causes uncontrolled movements like shaking and difficulty in maintaining balance and coordination), Alzheimer's disease (a brain disorder that gradually impairs memory and thinking skills eventually, the ability to carry regular work), and multiple sclerosis (a disabling condition of the brain and spinal cord) can cause bladder spasms.

• Soreness due to a urinary catheter.

• Recent surgery of the bladder or pelvic floor.

• Chronic stress.

What Are the Symptoms of Bladder Spasms?

The bladder spasms lead to an urge to pass urine, causing urinary incontinence. Sometimes bladder spasms can also lead to a painful cramping sensation in the bladder that does not result in urination. The symptoms include;

• A sudden urge to pass urine.

• An increased frequency of urination.

• Nocturia (when the person wakes up at night to pass urine).

• Urinary Incontinence - A condition in which there is involuntary urine leakage.

• Pain in the abdomen.

• Numbness, tingling, or weakness in the legs.

• Hematuria - The presence of blood in the urine.

• Pelvic pain.

How Is Bladder Spasm Diagnosed?

• Medical History - A detailed medical history determines whether the person takes any medications.

• Physical Examination - A thorough examination is performed to rule out any other possible condition.

• Urinalysis - A routine urine test that checks for bacteria, blood, or other infections.

• Neurological Examination - If the previous tests cannot find any cause, a neurological examination is performed to check for sensory issues and reflexes.

How Is Bladder Spasm Treated?

The treatment of bladder spasms is symptomatic. Therefore, a combination of several treatment modalities works best.

• Botox- Botulinum - A toxic has been found to reduce nerve-related bladder spasms in kids and adults. Botox prevents the nerves from producing chemicals that contract the muscles. Botox is directly injected within the muscular wall of the bladder.

• Diet Change - Check certain foods and beverages that induce bladder spasms.

• Timing Voiding - Timing voiding means making timed visits to the restroom to pass urine every one to two hours. This is beneficial in the case of kids.

• Pelvic Floor Exercises (Kegels) - Kegels and other exercises help to strengthen the bladder and associated muscles that help the body hold urine. In kegel exercise, one has to squeeze the muscles like one tries to stop the urine flow. It takes practice, as tightening a different muscle can put additional pressure on the bladder.

• Medications: Drugs to relax the bladder, such as Detrol LA, Ditropan, Enablex, Oxytrol, sanctuary XR, and Vesicare, are used. These medications relax the bladder and prevent contraction. In addition, an antidepressant drug called Tofranil relaxes the bladder muscles decreasing the spasms. Medications known as alpha blockers also relax the bladder and allow the bladder to empty fully.

• TENS (Transcutaneous Electrical Nerve Stimulation) - Electrical stimulation through the skin sends electrical vibrations to the bladder via patches applied to the skin. These electrical signals help one to feel better by increasing the blood flow and releasing the hormones blocking pain. TENS is also used to relieve muscle or back pain.

• Electrical Stimulation Implant (Interstim or Axonics) - This implant is placed under the skin to give gentle electrical stimulation to the bladder at regular intervals.

• Painkillers and Sedatives - Patients with catheter-related spasms after surgery are usually given pain killers.

• Lifestyle Changes - Certain changes in the lifestyles may help with bladder issues, such as changing fluid and diet. Tracking down any food causing bladder spasms by maintaining a diary. Foods such as citrus fruits, fruit juices, tomatoes, spicy foods, sugar, artificial sugars, chocolate, carbonated beverages, tea, and coffee can cause bladder spasms.

• Complementary and Alternative Therapies - Alternative therapies such as acupuncture may reduce bladder muscle spasms.

• Biofeedback - Biofeedback is a method that teaches the mind to control normal body functions. Bladder training is such biofeedback. Some believe biofeedback and behavioral changes work better than medications in treating bladder spasms. Though a combination of both drugs and biofeedback might work wonders.

What Are the Complications of Bladder Spasm?

Bladder spasms can lead to urinary incontinence, increased frequency of urination, and excessive urination at night. All of these can complicate one's life leading to:

• Emotional disturbances.

• Insomnia (a condition where the person cannot have a sound sleep).

• Decrease in confidence.

• Depression.

Conclusion

Bladder spasms are contractions of the bladder due to certain underlying conditions. There are several causes associated with bladder spasms. It is not a life-threatening condition. Lifestyle changes and other treatments can help one manage and reduce spasms. However, bladder spasms can be uncomfortable, painful, and embarrassing, affecting the individual's confidence level. But the great news is that it can be treated by treating the underlying condition. Medications, surgeries, and lifestyle modifications can reduce the occurrence of bladder spasms and help the individual regain confidence and comfort.