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?

A large number of women visit the doctor for common ailments like involuntary urination or incontinence, which occurs due to weakening of the sphincter muscles around the urethra. An overactive bladder is an embarrassing as well as an annoying condition and it comes in forms like urinary urgency, urge incontinence, nocturia and frequency. Yes, there are solutions to this problem and the main solution that can be adapted is a change in lifestyle.

Imperative tips to follow to treat an overactive bladder

It is very important that the diet pattern be changed and food items as well as drinks that worsen the condition be avoided.
It is best to avoid spicy food, especially those that contain hot peppers. Citrus fruits like grapefruit, orange and tangerine must be avoided; tomato products and tomato paste must be avoided.
It is also best to avoid alcoholic beverages and even drinks that contain caffeine.
It is important to maintain a healthy diet. To improve bladder problems, it is obligatory that food products that contain more fiber are included in the diet.
These fibrous food items could include whole wheat bread, fresh fruits, cereals and beans. To maintain bowel regularity, it is very important that women follow a regular exercise program.
Women must take charge of their treatment and it is most important that before taking any medication, they must make behavioral modifications. It is important to record the input of the fluid consumed as well as to keep a check on the number of times they urinate. Women must not only maintain a healthy weight, but also quit smoking. Smoking cigarettes can irritate the muscles of the bladder and excess coughing can lead to leakage of urine. Non-irritating fluids that can improve the bladder condition can be taken 3-4 times in a day; so it is best to avoid beverages that are acidic or caffeinated. The techniques that would help you to control an overactive bladder can be learnt under the guidance of a doctor to decrease the urge to urinate.

Consult your doctor for medications to treat an overactive bladder. Some doctors even prescribe certain medications to treat an overactive bladder and these include anticholinergics. These drugs help to control the muscle spasms, which mainly lead to an overactive bladder. The most common anticholinergics recommended by doctors are solifenacin, oxybutynin, fesoterodine, propantheline and dicyclomine.

Overactive Bladder - Is There A Solution?

Urinary Tract Infections are a group of diseases that affect one s urinary system such as the urethra, bladder, ureters or kidneys. Women are more prone to contracting UTIs than men. They may be accompanied by symptoms such as a constant urge to urinate frequently along with a burning sensation in the concerned parts and pelvic pain. The urine may have traces of blood in it. These infections are usually treated with antibiotics.

Causes behind Urinary Tract Infection:

Urinary Tract infection generally occurs when the bacteria enter the urinary tract via the urethra and begin to proliferate in the bladder. Although the urinary system is structured to ward off such invaders, at times, the defense mechanism fails. In that case, the bacteria may evolve into a full-blown infection in the urinary tract.

Few risk factors are:

Female anatomy: A woman s urethra is shorter as compared to a man s, thus lessening the distance the bacteria need to travel to the bladder. This increases the chances of UTIs in women.

Using diaphragms and spermicidal agents for birth controls

A dip in the levels of estrogen post menopause

Abnormalities in the urinary tract that hinder the discharge of urine or cause the urine to travel back into the urethra.

Enlarged prostate or kidney stones that cause the urine to be trapped in the bladder.

An impaired immune system because of diabetes and other ailments

Using catheters (tube) to urinate is one of the common risk factors because of the chances of infections.

Urinary Tract Infection - Reasons behind 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

Causes of bladder control problems in women

Urinary incontinence is the term used to describe bladder control problems that affect several people. Many think it only occurs among older, menopausal women but it actually isn't uncommon amid young and active women.

Inability to control the bladder accompanied by pain can be symptomatic of various disorders ranging from a minor infection to cancer. Fortunately, bladder cancer is rare, and bladder pain is usually not serious.

The varied causes of urinary incontinence in women are as follows:

1) Urinary Tract Infection - This is the most common cause of urinary incontinence and it affects women more than men due to anatomical factors. It can also happen at any age.

2) Medicinal Side Effect: The inability to control one's bladder may be a result of the administration of certain medicinal substances such as alpha-blockers, antidepressants, sleeping pills and various narcotics.

3) Changes in the Reproductive System - Pregnancy and fluctuations in hormone levels can cause bladder irritation, which leads to urinary incontinence.

4) Impacted Stool - When stool gets tightly packed in the lower end of the digestive system and rectum, bladder control is affected. Chronic constipation and constraint strain on the lower intestines leads to the weakening of bladder muscles and hampers the bladder control.

5) Surgical Side Effects - Temporary loss of control of the bladder is often a result of prior surgery and radiation therapy in the pelvic region.

6) Nerve Damage and Neurological Disorders - Strokes and spinal cord injuries have a heavy impact on bladder control and amount to urinary incontinence. Diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis also lead to the same.

7) Health Complications - Disorders such as diabetes and obesity directly affect the bladder and the ability to exercise control over it.

8) Disability and Impaired Mobility - For women who are physically impaired and suffer from problems of arthritis, urinary incontinence is a major problem as they are unable to reach the toilet easily.

9) Bladder Cancer - Even though it is extremely rare, bladder cancer affects a number of women every year and is treated through surgery and chemotherapy.



What Causes Bladder Control Problems in Women?

Urinary tract infection (UTI) is usually caused by inflammation or bacteria in the urinary tract. Pregnant mothers are most susceptible to this infection, especially after the sixth week and before the twenty fourth week of pregnancy. This usually happens due to the alterations that take place in the urinary tract during pregnancy.

Also, a growing uterus can block the urine drainage from this part of the body, leading to the accumulation of bacteria which causes infection. The symptoms are uncomfortable and even painful. These include pain and burning sensation, frequent urination, fever and chills. So how can you prevent UTI during pregnancy? we have a few tips for you!

- Hydration: The best thing you can do to both prevent and treat a urinary tract infection is to start drinking at least six to eight glasses of water in a day. Another good way to prevent and treat UTIs is with the help of cranberry juice which has powerful antioxidants that flush toxins out of your system effectively. You will, however, need to ensure that the cranberry juice is fresh and natural, without any sweeteners.

- Hygiene: Keeping yourself clean is one of the most important ways in which you can avoid UTI. It is best to clean from front to back, rather than the other way, so that you drive away bacteria and dirt. Also, make sure that you wash your private parts with warm water infused with a few drops of normal liquid antibacterial, so that you can be sure that the bacteria do not get a chance to thrive and affect your system. Also, remember to use soaps, washes and creams that have a mild formula, rather than a harsh chemical concoction. Hygiene for this area of the body includes keeping it dry.

- Diet: Your diet should have plenty of fluids and lemons or other citrus food that are rich in vitamin c, as this is a good vitamin to keep bacteria at bay. Also, you should eliminate sweet and refined products to ensure that you do not contract UTI. Other foods to avoid include caffeine and alcohol.

- Clothing: Wear airy and cotton based undergarments that are breathable and have a soft texture. This non abrasive type clothing can also help in keeping the area dry, so that bacteria does not get a chance to develop, as they typically need a damp environment for growth. Change your undergarments twice a day, if need be, and avoid wearing trousers and shorts that are too tight.

These tips and many others including urinating as soon as the urge sets in, can help in fighting the risk of contracting UTI during pregnancy.

Tips To Prevent UTI During Pregnancy

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