Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.

These are called Hunner s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner s ulcers are seen only in people with intestinal cystitis, it s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.

Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the  loo  as much as 40, 50, or 60 times a day.

Diagnosis
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner s ulcers are both a diagnosis of exclusion. This means that they re diagnosed only after a number of other conditions have been ruled out.

Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.

Treatment
There's no cure for IC, but Hunner s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.

Pain medicines are the first line of treatment to manage Hunner s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner s ulcers.

Hunner's Ulcer In Urinary Bladder - How They Can Be Treated?

An overactive bladder is a condition that is characterized by a problem in the bladder storage function; a problem that eggs one on to urinate frequently. This condition can cause problems in your social and work life. You may isolate yourself from others and feel embarrassed about the situation.

Symptoms
If you have an overactive bladder, you may exhibit symptoms of frequent urination, involuntary leakage of urine and frequent urge to urinate. These symptoms might disrupt your daily life; so it is important to seek advice from a medical practitioner.

Causes
To better understand what causes an overactive bladder, you need to know how the urination process works. Urine is produced by the kidneys, which flows to the bladder. During urination, the urine is excreted from an opening in the bladder and flows out via the urethra. As the kidneys secrete urine, the bladder starts to fill up. During this stage, nerve signals are sent to the brain; signals that trigger your body to urinate. The bladder muscles tighten that pushes the urine out of the body.

An overactive bladder results from the involuntarily contraction of the bladder, which might happen even if the content of urine in the bladder is low. These contractions create the urge to urinate. The various causes of an overactive bladder are:

Excessive fluid intake, if your fluid intake is high, then you may have the tendency to urinate frequently.
Presence of tumors or stones in the bladder can make the bladder overactive as well.
Excessive alcohol or caffeine consumption has the same effect as an excessive intake of fluids has.
Urinary tract infections may interfere with the entire process of urination, thus causing your bladder to swell up and become overactive.
Other diseases and conditions such as constipation and an enlarged prostate can hamper bladder functioning.
Treatment
There are multiple approaches to treat an overactive bladder; your doctor may use one or a combination of multiple methods.

Medications: Medications such as Trospium and Tolterodine help in relaxing the bladder. These medications help treat symptoms of frequent urination.
Bladder injections: Botox is a protein that is injected into the bladder that causes partial paralysis of the bladder muscles. This helps in treating the constant urge to urinate. However, its effects are temporary as they last for 6-9 months.
Lifestyle modifications: Certain lifestyle modifications such as incorporating exercises to strengthen the pelvic muscles, maintaining optimal weight levels and bladder training to control its functioning can help with managing an overactive bladder.
Surgery: If the other treatments do not produce the desired results, then surgery is usually recommended. The aim of the surgery is to enhance the storage capacity of the bladder and reduce bladder pressure.

Frequent Urination - Is It A Symptom of An Overactive Bladder?

An overactive bladder is marked by problems with one s bladder storage system that results in sudden urge to urinate. Involuntary and leakage of urine is also a possibility in such a case.

The problem of an overactive bladder arises when the muscles of the bladder contract involuntarily. The conditions contributing to overactive bladder are:
1. Excessive production of urine due to diabetes, poor kidney function or excessive fluid intake
2. Medications that increase urine production by the bladder
3. Acute infections in the urinary tract
4. Abnormalities in the bladder, for instance, bladder stones or tumors
5. Factors hindering bladder outflow such as constipation, enlarged prostate or earlier treatments for incontinence (loss of bladder control)
6. Excessive intake of alcohol or caffeine
7. Decline in one s cognitive abilities due to factors such as ageing, thus making it hard for the bladder to comprehend the signals it gets from the brain
8. Incomplete emptying of the bladder, leaving only a little storage space for the urine
9. Constipation
10. Neurological disorders

How it can be treated?

Behavioral interventions help to manage overactive bladder effectively and without side-effects. They include-
Exercises to strengthen one s urinary sphincter and pelvic floor muscles
Maintaining a healthy weight
Regulating fluid consumption
Planning a schedule for trips to the toilet
Employing a catheter to empty the bladder entirely
Medications to alleviate the symptoms of incontinence and overactive bladder are-
Fesoterodine
Mirabegron
Darifenacin
Solifenacin
Trospium
Oxybutynin gel
Oxybutynin as a skin patch
Tolterodine
Injecting small doses of Botox (Botulinum toxin), protein-bacteria, directly into the bladder tissues to partially paralyze the bladder muscles, thus delaying urination.
Surgery to magnify bladder capacity
However, it is a must that you seek the guidance of a urologist on immediate basis. 

Overactive Bladder - Can Infection in Urinary Tract Lead To it?

The bladder is a hollow storage organ that collects urine from the kidneys and stores it until it can be passed out of the body through the urethra during the process of micturition or urination. It has a thin inner lining of cells called urothelial cells and a thick muscular wall, which exerts pressure to push the urine out of the body.

Causes of Bladder Tumors

In most cases, the bladder tumor develops on the inner layer due to a combination of some of the following factors.

1. Hereditary: A strong family history of cancer predisposes a person to cancer.
2. Gender: Men are 3 times more prone for bladder cancer than women.
3. Ethnicity: White people are more prone for bladder cancer black people.
4. Smoking: Smokers develop bladder cancer 2-6 times more frequently than non-smokers. cigarettes contain toxic, carcinogenic substances which reach the kidney and are stored in the bladder, leading to their damage.
5. Occupational hazards: Some workplaces have a higher likelihood of causing bladder cancers, especially dye and rubber industries. The effects can be damaging, and the person may develop cancers years after the exposure has happened.
6. Recurrent bladder infections: In some people, this can also lead to bladder cancer in the long run.

Types of Bladder Tumor

Depending on the extent of the cancerous spread, it can be of two types:

1. Non-muscle-invasive bladder tumors: The tumor spread is limited to the inner part of the bladder (urothelial cells)
2. Muscle-invasive bladder tumor: The tumor has spread to the thick muscular outer layer. This is more advanced and prognosis is poor compared to the noninvasive type.

The most common and diagnostic symptom of bladder cancer is the presence of blood in the urine, known as hematuria. This will be intermittent and happens whenever the tumor bleeding happens. Other symptoms include pain in the lower abdomen and frequent urination.

Diagnosis

From the most noninvasive to the most invasive diagnostic test, these include:

1. Urine microscopy to detect cancer cells in the urine
2. Cystoscopy A tube inserted into the urethra to look into the inner wall of the bladder is highly diagnostic
3. Ultrasound, CT Scan, and biopsy can also be further used to identify severity of the tumor.

Treatment

Once the tumor is diagnosed, treatment would depend on the severity of the tumor. For both invasive and noninvasive tumors, definitive therapy is surgery, known as transurethral resection of the bladder tumor (TURBT). The cancerous bladder tissue is removed through a cystoscope as done for diagnosis. The bladder is then flushed with chemotherapy agent to kill any residual cancer cells in the bladder. This is then followed by BCG vaccine, which is again done 1 to 4 weeks for several months to avoid recurrence. In some cases, radiotherapy may also be included.

Bladder Tumor and Its Common Causes

Bladder stones, not to be confused with kidney stones, are formed when substances such as calcium oxalate found in urine coalesce into solid lumps and form deposits in the bladder. Though usually small enough to be excreted during urination, sometimes they get trapped in the neck of the bladder. In such cases, as the residues continue to grow larger, they cause extreme pain, infections, and may need surgical attention.

What causes bladder stones?
The most common causes of bladder stones are-

A diet which is high in oxalic acid can cause bladder stones.
Dehydration and a reduced intake of water cause bladder stones.
A protracted use of a urinary catheter, infections of the urinary tract, or an injury that might have impaired bladder function can cause stones to form.
Most often, stones originate somewhere else in the urinary tract and move downwards obstructing the neck of the bladder. There are significant hereditary factors at play here.
Symptoms-

Blood in the urine usually apparent only in the last few drops.
Interruption of the stream of urine and an inability to do so except in certain positions.
Dark-coloured urine.
Diagnosis-

1.Physical Exam
The physician will physically examine to evaluate if the bladder or the rectum are enlarged.

2.Urinalysis
A sample of your urine will be tested for the presence of bacteria, blood and crystallized minerals.

3.CT scan
A CT scan to build a detailed image of the internal organs.

Treatment-

If the size of the bladder stones is small then a simple increase in water and fluid intake should be enough to excrete them out naturally.
If they are too large to flush out from the system naturally, they will either be broken down to smaller sizes using laser ray or similar other energies, or surgically removed.
In order to prevent bladder stones from recurring, here are 5 foolproof methods-

1.Increase the daily fluid intake
A sure-fire way to prevent bladder stones is to increase the amount of water you drink every day. The idea is to reduce the concentration of your urine. A minimum of 2-3 litres of water per day is absolutely necessary.

2.Urinate more often.
If you drink more water throughout the day, you are going to have to urinate more frequently anyway. Do not put it off because you are worried that you will be mocked for having an old lady s bladder.

3.Laxatives.
If you feel like you are constipated, use a laxative. There is no shame in wanting to regulate your bowel movements.

4.Regular Tests.
Get a sample of your urine tested regularly to ensure that your kidneys and bladder are functioning properly and there are no irregularities.

5.Eat fruits.
Get the essential sugar component of your diet from fresh fruits. Say no to saturated sugar and fizzy drinks. Opt for fruits with high water content like melons to add more fluids in your diet.

5 Full-Proof Methods To Prevent Bladder Stones!

The kidneys make urine, which is a fluid through which wastes from the body including urea are eliminated from the body. There are two kidneys on the right and left side, which make urine, and pass it down to the bladder through tubes known as ureter. The bladder acts as a reservoir of the urine that is formed in the kidneys. It is stored temporarily there before being excreted out of the body through the urethra. The urinary bladder is a highly muscular organ and has a rich connective tissue. 

Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a very common condition, which affects females more than males. While the exact etiology is not known, it could be age-related and also lifestyle related. People who are used to controlling the urge to pass urine are highly likely to develop this condition. The simple logic is that there is additional pressure on the bladder from the urine that is contained for longer period of time. As such, the muscular wall stretches and begins to feel stressed.

When this habit continues over a period of time, the bladder wall may become irritated or inflamed or even scarred in severe cases. There is no role of bacteria in this condition, and antibiotics are of no help in managing this condition (though the name cystitis usually indicates infection).

The following symptoms are seen as a result of this constant irritation and inflammation.

One may suffer from pain and pressure in the bladder as it continues to collect more and more urine.
This pressure in the bladder also puts pressure on the surrounding tissues in the abdomen including the pelvis, urethra, abdominal organs, uterus, etc.
Women may experience pain in the vaginal tract including vulva and behind the vagina.
Men may experience pain in the area of the scrotum, testicles, prostate, and penis.
There is an increased urge to urinate, which may be as much as 9 to 10 times a day. As the condition progresses, there could be more visits, as many as 40 to 50 visits a day.
This tendency and urge to urinate increases during nighttime.
For women, this urge to urinate and other symptoms including pain are worse during menstruation.
There could be pain during intercourse for both men and women.
There could be pain even otherwise, which can range from a mild dull ache to a piercing pain.
At a structural level, this constant pressure leads to pinpoint bleeding (glomerulations) and sometimes even ulcers in the bladder wall.
There is no definitive treatment for IC or PBS. However, bladder distention and instillation are proven methods of increasing bladder capacity, which therefore helps in relieving symptoms.

Painful Bladder Syndrome - Know The Signs!

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