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Bladder Diseases and Problems Introduction The bladder is a hollow organ in your lower abdomen that stores urine. There are many problems that can affect the bladder. Treatment for bladder diseases and problems depends on the cause. Treatment may include antibiotics, other medicines, surgery, or other treatments. This reference summary will help you understand diseases and problems that affect the bladder. It discusses common diseases and problems of the bladder, as well as diagnosis and treatment. The Bladder and the Urinary Tract Your bladder is part of the urinary tract. The urinary tract is made up of organs that make and release urine. These include the: • Kidneys • Ureters • Bladder • Urethra Kidney Ureter Bladder Urethra We have two kidneys. The kidneys continuously filter the blood and make a liquid waste called urine. Urine passes from each kidney into the bladder through a long tube called a ureter. Your bladder is a hollow organ in the lower abdomen. The bladder stores urine until it passes out of the body. When a person goes to the bathroom, urine leaves the bladder and travels to the outside of the body through a shorter tube called the urethra. The wall of the bladder has layers of tissue. These layers are known as the inner, middle, and outer layers. The inner layer of tissue is also called the lining. As your bladder fills up with urine, the transitional cells on the surface stretch. When you empty your bladder, these cells shrink. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/29/2016 urf00101 1 The middle layer is muscle tissue. When you empty your bladder, the muscle layer in the bladder wall squeezes the urine out of your body. The outer layer covers the bladder. It has fat, fibrous tissue, and blood vessels. Symptoms Many bladder diseases and problems have similar symptoms. The main symptoms of bladder diseases are a frequent urge to urinate and pain or burning when you use the bathroom. Other common symptoms of bladder diseases and problems include: • Fever, tiredness or shakiness • Pressure in your lower belly • Urine that smells bad or looks cloudy Some bladder diseases and problems may also cause: • Back pain • Blood in your urine • Loss of bladder control • Nausea If you notice any of these symptoms or other changes, talk to your healthcare provider. Finding a problem early makes treatment easier in most cases. Bladder Infections One of the most common bladder problems is cystitis. Cystitis is a urinary tract infection, or UTI, in the bladder. UTIs are the second most common type of infection in the body. Most UTIs are caused by bacteria that live in the bowel. This bacterium is called Escherichia coli, or E. coli for short. People of any age or sex can get UTIs. But about 4 times as many women get UTIs as men. This is because women have a shorter urethra, which makes it easier for bacteria to reach the bladder from the outside. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/29/2016 urf00101 2 UTIs are also common in people who: • Have diabetes or problems with the body’s natural defense system • Have problems with the urinary tract • Have spinal cord injuries or other nerve damage • Need a tube to drain their bladder The most common symptoms of a UTI are pain or burning when you use the bathroom and an urge to use the bathroom often. Urine that smells bad or looks cloudy is also a sign of a UTI. Most UTIs are not serious, but some infections can lead to serious problems. If you think you have a UTI, it is important to see your doctor. Treatment with antibiotics can kill the bacteria causing the infection. Make sure to follow your healthcare provider’s instructions on when to take your antibiotics. Drinking lots of fluids and urinating frequently will also speed up healing. If needed, you may take over-the-counter medicines to relieve the pain of a UTI. A heating pad on the back or abdomen may also help. Drinking cranberry juice can help prevent UTIs. Cranberry juice causes the urine to be more acidic and may prevent the bacteria from growing in it. Interstitial Cystitis Interstitial cystitis, or IC, is a chronic problem in which the bladder wall can become inflamed and irritated. It is much more common in women than in men. Some doctors have started using the term painful bladder syndrome, or PBS, to describe interstitial cystitis. This is because the condition often causes bladder pain, as well as a need to urinate frequently and urgently. The condition may also be called IC/PBS for short. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/29/2016 urf00101 3 Doctors do not know what causes IC/ PBS. IC/ PBS is diagnosed if other causes of your symptoms are ruled out, including: • Bladder cancer • Bowel disorders • Endometriosis, when tissue that normally lines the uterus appears in other places outside the uterus • Infection Endometriosis is when tissue that normally lines the uterus, or womb, appears in other places outside of the uterus. No one treatment for IC/ PBS has been found that works for everyone. Your healthcare provider will work with you to find a treatment that meets your needs. Treatment for mild IC/ PBS may include: • Diet and lifestyle changes • Physical therapy • Reducing stress • Retraining your bladder to hold more urine Distending, or inflating, the bladder may also help with IC/ PBS. During this procedure, the bladder is stretched by filling it with liquid. Medicines may also help. These can include oral medicines or a liquid medicine placed in the bladder. If these treatments do not help, your healthcare provider may recommend nerve stimulation. This treatment sends mild electrical pulses to the nerves that control the bladder. It helps relieve the symptoms of some patients. Surgery may also be considered for severe IC/PBS that does not improve with other treatments. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/29/2016 urf00101 4 Urinary Incontinence Some people have bladder control problems. This is known as urinary incontinence. Urinary incontinence happens when a person is unable to control the flow of urine. Symptoms can range from mild leaking to uncontrollable wetting. It can happen to anyone, but it becomes more common with age. There are a number of causes for incontinence. Most bladder control problems happen when the muscles are either too weak or too active. If the muscles that keep your bladder closed are weak, you may have accidents when you sneeze, laugh or lift a heavy object. This is called stress incontinence. If the bladder muscles become too active, you may feel a strong urge to go to the bathroom when you have little urine in your bladder. This is known as urge incontinence or an overactive bladder. There are also other causes of urinary incontinence. These can include nerve damage or prostate problems in men. The prostate is a gland in the male reproductive system. The prostate surrounds part of the urethra just below the bladder. Treatment depends on the type of problem you have and what best fits your lifestyle. Your doctor may suggest that you try to gain control of your bladder through training. With bladder training, you can change how your bladder stores and empties urine. For women with stress incontinence, some doctors may suggest a small, tampon-like urethral plug or vaginal insert called a pessary. A pessary is an elastic or rigid device that is inserted into the vagina to support the uterus, which helps prevent the accidental leakage of urine. Medicines can be prescribed to treat incontinence. The medicine you are prescribed depends on the cause of your incontinence. To treat stress incontinence, a doctor can inject an implant into the area around the urethra. The implant adds bulk. This helps close the urethra. Injections may have to be repeated after a while because the body slowly gets rid of these substances. Implants Urethra This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/29/2016 urf00101 5 Sometimes surgery can improve or cure incontinence if it is caused by a problem such as a change in the position of the bladder or blockage due to an enlarged prostate. Surgery may also be an option for other causes of incontinence. However, other treatment options are usually tried first. Bladder Cancer Problems in the bladder may also be caused by cancer. Cancer begins in your cells, which are the building blocks of your body. Normally, your body forms new cells as you need them, replacing old cells that die. Sometimes this process goes wrong and a tumor forms. If a tumor is cancerous, cells from the tumor can invade other tissues throughout the body. Cancerous cells can spread to different parts of the body through blood vessels and lymph channels. Cancers in the body are given names, depending on where the cancer started. Cancer that begins in the bladder will always be called bladder cancer, even if it has spread to other places in the body. Bladder cancer is a common type of cancer. Smoking tobacco is the biggest risk factor for bladder cancer. People who smoke for many years have a higher risk than nonsmokers or those who smoke for a shorter time. Other people who are at increased risk for bladder cancer include those who: • Are exposed to cancer-causing chemicals at work • Have a family history of bladder cancer • Have been exposed to high levels of arsenic • Have been treated for a different type of cancer Treatment for bladder cancer may include surgery, chemotherapy, biological therapy, and radiation therapy. Often some combination of these treatments is used. Chemotherapy is the use of drugs to kill cancer cells. Biological therapy helps boost your body’s natural defenses to kill cancer cells. Radiation therapy uses high-energy rays to kill cancer cells and stop them from growing and spreading. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/29/2016 urf00101 6 Summary The bladder is a hollow organ in your lower abdomen that stores urine. There are many problems that can affect the bladder. Common problems include infection, interstitial cystitis, incontinence, and bladder cancer. Treatment for bladder diseases depends on the cause. Treatment may include antibiotics, other medicines, surgery, or other treatments. It may also include chemotherapy, biological therapy, or radiation therapy if the cause is cancer. Talk to your healthcare provider if you notice any abnormal changes or bladder symptoms. Finding a problem early makes its treatment easier in most cases. This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the advice of a doctor or a healthcare professional for your specific condition. ©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com Last reviewed: 02/29/2016 urf00101 7