Sensitive Bladder Tips

Our kidneys help in filtering waste and extra water from the blood through urination in the form of urea which is stored in the bladder. A healthy urinary system can hold up to around two cups of urine for 2-5 hours. On a normal routine, one urinates 4-8 times a day but urinating more than that and very frequently might indicate a health issue or just increased liquid consumption or overactive bladder syndrome. When there are other things like fever, stomach ache, vomiting, bloody or foggy urine, fatigue, pain while urinating, etc., with the need for frequent urination, then one might be suffering from urinary tract infection.

There can be many other causes for frequent urination: a diabetic patient may find a need to urinate frequently, during pregnancy, an enlarged prostate, discomfort or infection in bladder and pelvic part (interstitial cystitis), medications for high blood pressure, neurological problems. Some of the rare causes of frequent urination could be bladder cancer, bladder impairment, or radiation therapy.

If anyone finds these symptoms together with an urge to urinate frequently than usual, they should consult a doctor as it could be something big or can hinder their daily lives. One can go through certain medical examinations and tests to know the real cause of the problem as it could be serious. One should also inform the doctor if they find something unusual in their urination process.

Ease the Pain of Urinating

Any infection in the bladder or the urinary function can lead to painful urination. One can have various ways to ease the pain depending upon the reason for the frequent and painful urination.

● Antibiotics for treating urinary tract infection and prostate

● Hot baths or hot water bag ● Prostatic massages

● Medications ● Increase liquid intake to dilute the urine

● Avoiding chemical products near the genitals

Soothe the Bladder

One’s bladder can have many problems if not taken care properly. It is not always important that a serious health issue is the reason of the bladder dysfunction, but usually, it is because of the medications one is consuming or the unhealthy lifestyle. One can soothe the bladder by including a few things in their daily lives.

● Bladder training for overactive bladder syndrome;

● Strengthening pelvic floor through pelvic floor exercises known as Kegels, vaginal weights, and biofeedback;

● Retaining a healthy body weight;

● Terminate smoking;

● Lead an active lifestyle;

● Minimize constipation;

● Eating healthy food;

● Avoiding spicy food;

● Take medications prescribed by the doctor depending upon the reason of the infected bladder;

● Reduce or better terminate the intake of caffeine and alcohol;

● Increase the intake of water and liquids.

Take Away

Urination helps clean our blood and body from waste and extra fluids. But, if the need to urinate becomes unusual or one is having issues while urinating, then it is a matter of concern as it can affect the overall health and routine of the person. One should maintain and take care of bladder through simple ways of changing the lifestyle but should consult a doctor before taking decisions about medications.

Interstitial cystitis (IC), also known as painful bladder syndrome, is a difficult condition. It is difficult to diagnose and though there are treatments that can make life easier, there is no long-term cure. Interstitial cystitis is a lifelong bladder problem, that causes pressure and pain below the belly button. Symptoms can be constant, or they may fluctuate. It causes painful and urgent trips to the bathroom. In severe cases, you may need to urinate about 40 to 60 times a day.

What causes interstitial cystitis (IC)?

The bladder is a hollow, muscular organ that holds the urine your body needs to dispose of. The reason why IC occurs isn’t that clear, but there a few ideas:
1. An issue with bladder tissue allows chemicals in your urine to irritate the bladder.
2. Chemicals that are released when there is an inflammation in your body can cause the symptoms.
3. The bladder can be attacked by your immune system
4. Substances in your urine can damage your bladder
5. Nerve problems can wreak havoc on your bladder

Signs and Symptoms

People suffering from IC don’t display the same symptoms. The symptoms keep changing, be it every day, every week or every month. Sometimes, the symptoms may entirely disappear without treatment. Some common IC symptoms include:

1. Bladder pressure and pain that worsens after the bladder gets filled with urine
2. Pain in your urethra (the tube that drains the urine from your bladder), pelvis, lower back and lower tummy
3. Women experience vaginal pain (or the area behind it) or in the vulva
4. In men, a sensation of pain in the penis, testicles, scrotum or the region behind the scrotum
5. The urge to urinate, even if you had urinated a few moments ago
6. Women experience pain during intercourse
7. Men experience pain after sex or during orgasm

One common symptom shared by all people suffering from IC is a swollen bladder. There are certain things that can worsen your condition. These include:

1. Certain drinks or foods
2. Physical or mental stress
3. Menstrual cycles

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:

1. One may suffer from pain and pressure in the bladder as it continues to collect more and more urine.
2. This pressure in the bladder also puts pressure on the surrounding tissues in the abdomen including the pelvis, urethra, abdominal organs, uterus, etc.
3. Women may experience pain in the vaginal tract including vulva and behind the vagina.
4. Men may experience pain in the area of the scrotum, testicles, prostate, and penis.
5. 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.
6. This tendency and urge to urinate increases during nighttime.
7. For women, this urge to urinate and other symptoms including pain are worse during menstruation.
8. There could be pain during intercourse for both men and women.
9. There could be pain even otherwise, which can range from a mild dull ache to a piercing pain.
10. 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.

Bladder is an organ of the lower abdomen which stores urine. Though it is a problem common to both men and women, women are two times more prone to be affected than men. 

The following are some of the causes that give rise to bladder pain.

1. Bacterial infection or urinary tract infection is one of the common causes of bladder pain. Women are more likely to encounter urinary tract infection. It occurs if bacteria sneak in through the urethra leading to develop an infection in the urinary tract, which in turn affects the urinary bladder.
2. Sometimes bladder stones can also give rise to bladder pain.
3. Painful Bladder Syndrome is yet another cause, wherein your bladder holds pee after your kidneys have filtered it but before you pee it out. This condition causes pain and pressure below your belly button, causing pain in the bladder.
4. Chronic pelvic pain is a pain in the area below your bellybutton and between your hips that lasts six months or longer. There are multiple causes of such pain.
5. Bladder cancer is another possible cause of bladder pain. If uncontrolled cancer cells are formed in the bladder, then it gives rise to bladder cancer. Bladder cancer is one of the most common cancers and generates unbearable pain in the bladder.
6. Interstitial cystitis is another condition which gives rise to severe bladder pain. This condition is more commonly seen in women. The bladder becomes inflamed and irritated and the pain gets worse when the bladder is full or during menstruation. It is a chronic condition.
7. Urethral stricture is another cause of bladder pain. Men are likely to be more affected by this condition. In this case, the urethra becomes inflamed and narrow creating difficulties to pass urine.
8. Yeast infection also is known as Torulopsis is another cause of bladder pain.

Bladder pain can vary from being mild to severe. But, no matter what the degree of pain is, it requires serious medical attention. It is highly recommended that if you are suffering from bladder pain you must consult and seek a doctor's advice right from the beginning.

Diagnosis -
The following may be helpful in diagnosing interstitial cystitis:

• Medical history and bladder diary - Your doctor will ask you to describe your symptoms and may ask you to keep a bladder diary, recording the volume of fluids you drink and the volume of urine you pass.
• Pelvic exam - During a pelvic exam, your doctor examines your external genitals, vagina and cervix and feels your abdomen to assess your internal pelvic organs. Your doctor may also examine your anus and rectum.
• Urine test - A sample of your urine is analyzed for signs of a urinary tract infection.
• Cystoscopy - Your doctor inserts a thin tube with a tiny camera (cystoscope) through the urethra, showing the lining of your bladder. Your doctor may also inject liquid into your bladder to measure your bladder capacity. Your doctor may perform this procedure, known as hydrodistention, after you've been numbed with an anesthetic medication to make you more comfortable.
• Biopsy - During cystoscopy under anesthesia, your doctor may remove a sample of tissue (biopsy) from the bladder and the urethra for examination under a microscope. This is to check for bladder cancer and other rare causes of bladder pain.
• Urine cytology - Your doctor collects a urine sample and examines the cells to help rule out cancer.
• Potassium sensitivity test - Your doctor places (instills) two solutions — water and potassium chloride — into your bladder, one at a time. You're asked to rate on a scale of 0 to 5 the pain and urgency you feel after each solution is instilled. If you feel noticeably more pain or urgency with the potassium solution than with the water, your doctor may diagnose interstitial cystitis. People with normal bladders can't tell the difference between the two solutions.

Treatment -

No simple treatment eliminates the signs and symptoms of interstitial cystitis, and no one treatment works for everyone. You may need to try various treatments or combinations of treatments before you find an approach that relieves your symptoms.

• Physical therapy - Working with a physical therapist may relieve pelvic pain associated with muscle tenderness, restrictive connective tissue or muscle abnormalities in your pelvic floor.
   
• Oral medications - Oral medications that may improve the signs and symptoms of interstitial cystitis include:
  • Nonsteroidal anti-inflammatory drugs, such as ibuprofen (advil, motrin ib, others) or naproxen sodium (aleve), to relieve pain.
  • Tricyclic antidepressants, such as amitriptyline or imipramine (tofranil), to help relax your bladder and block pain
  • Antihistamines, such as loratadine (claritin, others), which may reduce urinary urgency and frequency and relieve other symptoms.
  • Pentosan polysulfate sodium (elmiron), which is approved by the food and drug administration specifically for treating interstitial cystitis. How it works is unknown, but it may restore the inner surface of the bladder, which protects the bladder wall from substances in urine that could irritate it. It may take two to four months before you begin to feel pain relief and up to six months to experience a decrease in urinary frequency.
     
• Nerve stimulation - Sacral nerve stimulation.
• Nerve stimulation techniques include:
  • Transcutaneous electrical nerve stimulation (tens. With tens, mild electrical pulses relieve pelvic pain and, in some cases, reduce urinary frequency. Tens may increase blood flow to the bladder. This may strengthen the muscles that help control the bladder or trigger the release of substances that block pain.
  • Electrical wires placed on your lower back or just above your pubic area deliver electrical pulses — the length of time and frequency of therapy depends on what works best for you.
  • Sacral nerve stimulation. Your sacral nerves are a primary link between the spinal cord and nerves in your bladder. Stimulating these nerves may reduce urinary urgency associated with interstitial cystitis.
  • With sacral nerve stimulation, a thin wire placed near the sacral nerves sends electrical impulses to your bladder, similar to what a pacemaker does for your heart. If the procedure decreases your symptoms, you may have a permanent device surgically implanted. This procedure doesn't manage pain from interstitial cystitis, but may help to relieve some symptoms of urinary frequency and urgency.

Bladder is an organ of the lower abdomen which stores urine. Though it is a problem common to both men and women, women are two times more prone to be affected than men. 

The following are some of the causes that give rise to bladder pain.

1. Bacterial infection or urinary tract infection is one of the common causes of bladder pain. Women are more likely to encounter uninary tract infection. It occurs if bacteria sneak in through the urethra leading to develop an infection in the urinary tract, which in turn affects the urinary bladder.
2. Sometimes bladder stones can also give rise to bladder pain.
3. Painful Bladder Syndrome is yet another cause, wherein your bladder holds pee after your kidneys have filtered it but before you pee it out. This condition causes pain and pressure below your belly button, causing pain in the bladder.
4. Chronic pelvic pain is pain in the area below your bellybutton and between your hips that lasts six months or longer. There are multiple causes for such pain.
5. Bladder cancer is another possible cause of bladder pain. If uncontrolled cancer cells are formed in the bladder, then it gives rise to bladder cancer. Bladder cancer is one of the most common cancers and generates unbearable pain in the bladder.
6. Interstitial cystitis is another condition which gives rise to severe bladder pain. This condition is more commonly seen in women. The bladder becomes inflamed and irritated and the pain gets worse when the bladder is full or during menstruation. It is a chronic condition.
7. Urethral stricture is another cause of bladder pain. Men are likely to be more affected by this condition. In this case, the urethra becomes inflamed and narrow creating difficulties to pass urine.
8. Yeast infection also known as, Torulopsis is another cause of bladder pain.

Bladder pain can vary from being mild to severe. But, no matter what the degree of pain is, it requires serious medical attention. It is highly recommended that if you are suffering from bladder pain you must consult and seek a doctor's advice right from the beginning.

Not always nature’s calls can be answered immediately. Sometimes, situations demand that you control the urge for a while. When you are not able to control the urge, things may go haywire.

If you are experiencing a frequent urge to urinate and unable to control it, it might be a case of overactive bladder which can be quite embarrassing and can disrupt normal routine to a considerable extent. But if you consult a Urologist regarding this it can be managed and treated, so no need for concern. Know about the ways it can be handled efficiently as mentioned below.

Managing the condition
Practising pelvic floor exercises and bladder training are some of the most effective natural treatments for overactive bladder. Research indicates that these non-drug remedies are immensely useful for many women and they don’t have any side effects.

1. Pelvic floor exercises- There are many workouts available for strengthening the muscles controlling urination. While practising the pelvic floor exercises, you will be able to hold, tighten and then relax the muscles which you use for starting and stopping the flow of urination. A particular type of training known as biofeedback can help in locating the right muscles that assist in squeezing. You can begin with Kegel exercises and slowly work the way up.
2. Bladder training- This is another essential treatment for overactive bladder which doesn’t involve any medication. It helps in changing the way one uses the bathroom. In place of urinating whenever you feel the urge, you will allow your body to urinate at set times of the day, a phenomenon termed as scheduled voiding.
3. Treatment through drugs-In people suffering from overactive bladder, the muscles present in the walls of the bladder start working at the wrong time. A group of medications termed as anticholinergics can treat the problem by blocking the nerve signals associated with the bladder muscle contractions. Common drugs of this category include Trospium, Tolterodine, Solifenacin, and others. The primary side effect of this drug is dry mouth though in specific instances it can cause blurred vision and rise in a heartbeat.

But this category of drug is not suited for everyone, and such people are prescribed with beta-3 adrenergic agonists. They work by activating the protein receptor present in the bladder muscles which relaxes and aids the bladder to store urine. Botox injections, which are commonly used for alleviating wrinkles are sometimes injected into the bladder muscle to help it relax. It helps in increasing the capacity of the bladder and reduce the level of contractions. But it is only given to people who are not able to control their symptoms with other forms of treatments.

Other simple measures such as avoiding drinking caffeine or a lot of fluids before any activity or before going to bed are advised. If the condition arises due to an underlying medical condition, your physician will provide the treatment accordingly. So, follow the instructions entirely to avail relief and cure.

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.

A problem pertaining to the storage function of the bladder that results in bouts of sudden, often uncontrollable urge to urinate is referred to as an overactive bladder. This condition which is marked by unconditioned or involuntary loss of urine can sometimes be quite difficult to stop. People who experience such a condition often feel humiliated and as such tend to limit their social and work life. Despite such, only a few are conscious that a brief evaluation can help them manage and overcome an overactive bladder.

Mechanism of Urination

During urination, the urine proceeds from the bladder and flows into the urethra which is located at the tip of the penis in men and above the vagina in women. As the bladder fills, the nerve signals in the brain prompts urination by coordinating the relaxation and contraction of the urinary sphincter muscles.

Causes and Symptoms of an Overactive Bladder

Primarily caused due to involuntary contraction and relaxation of sphincter muscles, several conditions can lead to overactive bladder. 

Some of them are: 

1. Parkinson's disease, Alzheimer's and other neurological disorders
2. Poor kidney function due to diabetes
3. Medications that lead to increased production of urine
4. Bladder abnormalities like tumors or stones
5. Constipation
6. Excessive consumption of caffeine or alcohol

Some of the common signs of an overactive bladder are:

1. Bouts of sudden, uncontrollable urge to urinate
2. Awakening at night frequently to urinate
3. Urinating more than eight times a day

Risks

The risk of an overactive bladder gradually increases with age. Conditions such as diabetes and an enlarged prostate results in the increased likelihood of an overactive bladder. People who have previously faced strokes and heart attacks experience cognitive decline which often times lead to the development of an overactive bladder.

Urinary incontinence as well as a host of associated factors can be detrimental to your life. Emotional distress, interrupted sleep cycles and depression are some of the observed complications of this condition.

Thus if you experience or entertain suspicion of an overactive bladder, you should consider visiting a general physician who might refer you to a specialist, if need be.

The condition of enlarged prostate occurs due to the enlargement of a man’s prostate gland, with the passage in time. Also known as benign prostatic hyperplasia (BPH), it is more common in men over the age of 60. Some cases might have symptoms and others may be symptomless. Although the causes are relatively unknown, it is evident that BPH is not a form of cancer, neither does it cause cancer.

The prostate is located below the bladder and is responsible for producing the fluid needed by semen. The growth of the prostate tissue that is associated with benign prostatic hyperplasia begins near the inner prostate which is a tissue ring around the urethra. Its growth is generally inward.

Causes

It is of common knowledge that in males, the urine originates from the bladder and flows through the urethra. BPH is a condition where the prostate experiences a benign i.e. non cancerous enlargement which leads to blockage of urine flow through the urethra (the urinary duct). The resultant enlargement, caused due to the gradual multiplication of cells, subjects the urethra to extra pressure. Further narrowing of the urethra causes more contraction of the bladder, resulting in the urine being forcefully pushed out of the body.

With time, the condition leads to the bladder muscles gradually becoming thicker, stronger and oversensitive. Contraction occurs even due to the presence of small amounts of urine, giving rise to frequent needs of urination. At one point, the bladder muscle is unable to overcome the effects of the narrowed urethra. Due to this, urine does not pass properly and the urethra is not emptied.

Some of the common symptoms of enlarged prostate include:

1. Frequent urination
2. Urgency to urinate
3. Difficulty during urination
4. A slow or weak urinary stream
5. Requirement of extra effort to urinate
6. Interrupted sleep due to need of urination

Further risks

Sometimes, when the bladder is not emptied completely, a risk of urinary tract infections develops. Some other serious problems which can be a result of enlarged prostate include blood in urine, bladder stones as well as acute urinary retention (inability to urinate). In some rare cases, kidney and/or bladder damage might also result from such a condition.