Diseases

Bladder Dysfunction – Causes, Symptoms & Treatment

Bladder dysfunction

Bladder dysfunction is a collective term for all functional disorders of the urinary bladder. This includes all bladder emptying and urinary storage disorders.

What is bladder dysfunction?

The diagnosis of bladder dysfunction is made when the bladder function is disturbed. However, bladder dysfunction is not an independent disease, but rather a collective term for all urinary storage and bladder emptying disorders. In the case of urinary storage disorders, the reservoir function of the bladder is impaired.

Intentional urination is not possible. In bladder emptying disorders , it is very difficult to empty the bladder. Functional, mechanical, neurological and psychogenic factors can be the cause of both forms of bladder dysfunction.

causes

Mechanical causes are mostly responsible for bladder emptying disorders. A mechanical blockage is caused by an outflow obstruction. The pressure increases in the part of the urinary tract that is in front of the occlusion. Possible mechanical causes of bladder dysfunction are urethral strictures, a urethral valve, bladder stones or a narrowing of the bladder neck.

A narrowing of the urethral opening and a spherical widening of the ureter in the bladder, a so-called ureterocele, can also impair bladder function. In men, bladder emptying disorders can also be caused by benign prostate enlargement or prostate carcinoma .

Another cause is a pronounced narrowing of the foreskin (buttonhole phimosis). If the nerve supply to the urinary bladder is disturbed, a neurogenic bladder develops. This neurogenic disorder is usually caused by damage to the spinal cord. More rarely, the cause lies in the presacral plexus.

A neurogenic bladder can also develop as part of Fowler-Christmas-Chapple syndrome . Multiple sclerosis is often the underlying cause of the neurogenic bladder emptying disorder. Three quarters of all multiple sclerosis patients develop bladder dysfunction during the course of the disease. If the disease lasts more than ten years, almost 100 percent of the patients have bladder dysfunction. Multiple sclerosis can also be the cause of a urinary storage disorder.

Bladder dysfunction in the form of a urinary storage disorder primarily affects older women. Risk factors are cystitis , obesity and diabetes mellitus . Stress urinary incontinence often occurs in women who have given birth to multiple children naturally. Urinary storage disorders can also occur in childhood and adolescence.

If there is involuntary wetting in children without a recognizable physical cause, this is referred to as enuresis . Bladder dysfunction can also be congenital. The most common causes here are malformations of the urinary bladder. An example of such a malformation is the fission bladder. Here the urinary bladder is exposed to the outside.

Symptoms, Ailments & Signs

In the case of a urinary storage disorder, the urine cannot be stored in the urinary bladder without loss. The result is urinary incontinence . There are different forms of urinary incontinence. The most common form is urge incontinence. A sudden strong urge to urinate is characteristic of this. This urge is so strong that the toilet cannot be reached in time.

In stress incontinence, the loss of urine is caused by increased abdominal pressure. The abdominal pressure increases, for example, through strain, pressing, lifting, carrying, laughing, sneezing or coughing. Stress incontinence is also known as stress incontinence . There is also a mixed form of urge and stress incontinence. This is called mixed incontinence.

Overflow incontinence is more a consequence of the bladder emptying disorder. If urine remains in the urinary bladder due to drainage problems, an overflow bladder develops. The pressure in the bladder increases until it exceeds the pressure in the urinary tract. This creates a constant dribbling of urine.

Bladder emptying disorders usually show up as difficult urination ( dysuria ). This dysuria often occurs in combination with a so-called pollakiuria. In the case of pollakiuria , the affected patients urinate more, but they only ever excrete small amounts of urine. Despite frequent urination, the total amount of urine does not increase.

Diagnosis & History

If bladder dysfunction is suspected, a detailed anamnesis and a clinical examination are carried out first. The doctor feels the abdominal cavity. In women, an assessment of the pelvic floor muscles should also take place. In men, a rectal exam is done to evaluate the prostate. In addition to this clinical examination, imaging methods such as sonography can provide further information.

With the help of these procedures, many causes of bladder emptying disorders can be made visible. Bladder manometry, a urodynamic examination, can be used to evaluate the emptying process from a functional point of view. Bladder function can also be assessed using uroflowmetry. The urine flow is measured. In cystometry , on the other hand, the bladder pressure is assessed during the emptying and storage phases.

catheter is inserted into the bladder for this purpose. Urinary tract infections should be ruled out as a possible cause with urine and laboratory tests. If the examinations do not provide clear results, a cystoscopy can also be carried out. A mini-endoscope is inserted into the bladder via the urinary tract.

The doctor treating you can thus gain an insight into the urinary tract and the urinary bladder. Ultrasound , computed tomography or magnetic resonance imaging are other options for imaging the bladder and the urinary tract.

complications

Since bladder dysfunction is a collective term for various functional disorders in the area of ​​the urinary bladder, possible complications depend on the exact cause. If an underlying disease is responsible for the bladder emptying disorder, its treatment is the priority. With an effective therapy, the complications of bladder emptying and urinary storage disorders can be largely prevented.

Urinary retention (ischuria) is the most feared complication of bladder dysfunction. It can lead to an inability to empty the bladder for a variety of reasons. These include: drainage congestion in the bladder or urethra, inflammation of the prostate or urinary tract, bladder stones , benign prostate enlargement (benign prostatic hyperplasia) and neurogenic bladder emptying disorders.

Depending on the symptoms that occur, doctors differentiate between painful, acute urinary retention and a symptom-free, chronic form. Chronic urinary retention often results in overflow incontinence. Acute urinary retention is an emergency because of the risk of bladder rupture.

If ischuria persists for a long time, the urine backs up into the ureters and kidneys. As a result, the renal parenchyma is damaged with the possible consequence of a shriveled kidney .

Other complications of bladder dysfunction include:

  • Sepsis,
  • inflammation of the kidney pelvis (pyelonephritis),
  • urine poisoning (uremia),
  • chronic renal failure,
  • recurrent urinary tract infections.

When should you go to the doctor?

Not every bladder function disorder requires treatment. A harmless bladder infection can also be cured with good old home remedies such as warmth and bladder tea. It doesn’t always have to be antibiotics. But it should improve after a few days. If this is not the case and there is also fever or recurring urinary tract infections, a doctor, ideally a urologist , should be consulted to clarify the cause. If a bacterial infection is behind the bladder problems, treatment with antibiotics makes sense, with a fungal infection with antimyotics.

In addition to urinary tract infections, bladder or kidney stones or bladder tumors can also cause bladder dysfunction. These are anything but harmless and should be examined by a doctor immediately to avoid complications. Strictures of the urethra and urinary retention are also cases for the urologist, as a rule incontinence also requires medical help, sometimes psychological support. Basically, it is not wrong to consult a doctor first if you have bladder problems.

Treatment & Therapy

Therapy for bladder dysfunction always depends on the cause. In the case of mechanical voiding disorders, the obstacle that causes the occlusion must be removed. Neurogenic bladder emptying disorders are usually treated with medication.

Treatment with sacral neurostimulation or sacral neuromodulation is also possible. A bladder pacemaker is implanted, which restores the control function of the bladder by delivering weak electrical impulses.

Outlook & Forecast

The prognosis for bladder dysfunction depends on the exact type of bladder dysfunction. There are cases in which full or partial return of bladder control and function can be expected and cases in which this cannot be expected.

In the case of mechanical bladder dysfunction, in most cases an operation can be found to restore bladder function. The fault here is usually in the urethra or the bladder sphincter, which allows for a good prognosis. Retention of urine due to an overstretched bladder can be corrected by temporarily inserting the catheter to drain the urine.

Urinary stones and the like can also usually be treated without any problems. Bladder dysfunction caused by inflammation will usually go away as the infection clears. In cases where bladder function is disturbed under certain conditions (pressure, stress, etc.), the prognosis depends on the ability to treat. Medication can often help.

In cases in which the bladder function is no longer guaranteed due to nerve damage, no improvement with medication can be expected. Bladder pacemakers can help, but there is no guarantee of success here either.

There are those affected by bladder dysfunction who will be dependent on a catheter for the rest of their lives. This is particularly true in relation to multiple sclerosis .

prevention

Most voiding disorders are very difficult to prevent. Urinary storage disorders are often the result of weak pelvic floor muscles. Targeted pelvic floor training can strengthen the pelvic floor muscles and thus prevent incontinence.

aftercare

The term “bladder dysfunction” includes a number of functional disorders. The extent to which follow-up care is necessary depends on the underlying disease. There are cases in which follow-up treatments are omitted because there are no longer any complaints. This is the case, among other things, with a mechanical dysfunction.

A surgical procedure quickly leads to the relief of the symptoms. For other people, however, follow-up care becomes a lifelong issue. A large proportion of multiple sclerosis patients depend on a catheter. Like all other sick people, you should also pay attention to daily intimate hygiene.

Certain types of tea also promise to alleviate the signs. Cold seats should always be avoided. Sometimes it also helps if sufferers of bladder dysfunction drink a lot of water and do sports. The symptoms of kidney stones can be reduced in this way. The situation is different when psychological causes cause the dysfunction.

Regular treatment proves to be quite expensive here. A doctor orders psychotherapy to correct harmful lifestyle habits. Experience has shown that stress and pressure occur again and again in everyday life, which is why the symptoms can arise again when you are upset. Psychological and many other long-term causes are often treated with medication.

You can do that yourself

In the case of bladder dysfunction, the effective measures always depend on the cause. For example, urinary retention as a result of kidney stones can be alleviated by drinking a lot and exercising, while large amounts of water should be avoided in the case of bladder emptying disorders after prostate hyperplasia.

In general, increased personal hygiene should be ensured during the illness. Those affected can also contribute to rapid healing of the inflammation by avoiding cold sitting surfaces and wearing warm functional underwear. Various care products from the drugstore also help to strengthen the bladder function. A proven remedy from nature is horsetail .

The plant can be taken as a tea or in the form of a steam bath and has anti-inflammatory and pain-relieving effects. Couch grass tea has a similar effect . Herbal teas as well as horseradish , corn tea and foods containing calcium are also considered helpful for urinary tract infections or kidney semolina . In combination with diuretic tea and rest, this can usually alleviate the symptoms.

Regardless of the tips mentioned, the cause of the bladder dysfunction must be determined and, ideally, treated medically. Together with the doctor, effective treatment steps can then be initiated.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.