Bladder & urinary tract conditions at a glance
- Numerous conditions can affect the bladder and other parts of the urinary tract, the system that processes urine and carries it out of the body.
- Some of these conditions are specific to men, others to women, and some affect both sexes.
- Whenever men or women suspect they have a health issue with the bladder or the urinary tract, they should consult a physician.
- Left untreated, these conditions can affect health and potentially cause kidney damage, which can be very serious.
Overview of bladder & urinary tract conditions
The urinary tract is the system of organs that processes liquid waste in the body converting it to urine and carrying it out of the body. The urinary tract includes:
- The kidneys, two bean-shaped organs in the lower back that process waste into urine.
- The ureters, two tubes that carry urine from the kidneys to the bladder.
- The bladder, a pouch that stores urine in the body until it is convenient for a person to urinate.
- The urethra, the tube that carries urine out of the body.
In men, the urinary tract system overlaps with the reproductive system. For this reason, the urologic system in men also includes:
- The penis, which contains the urethra (carries urine and semen from the body).
- The prostate, a small, walnut-shaped organ that produces semen, the fluid that transports and nourishes sperm. The urethra runs through the prostate.
- The testicles, which produce and store sperm, and the scrotum, the sac that holds the testicles.
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The list below includes an overview of several major conditions that can affect the urinary tract and the bladder.
A dysfunction is simply any type of abnormality or impairment in the way an organ in the body works. People may experience one or more types of dysfunction in the bladder. Dysfunctions can include incontinence, incomplete bladder emptying and numerous other problems, which can occur because of illness, injury, pregnancy or aging.
It is important that a person with a bladder dysfunction consults a physician to determine the root cause and work to treat it or to minimize symptoms.
Bladder infections are the most common type of urinary tract infection (UTI) in women, but infection can occur in any part of the urinary tract. Most UTIs do not cause long-term damage as long as they are treated promptly. But they can be painful.
All types of UTIs occur when bacteria that is normally present in the stool somehow enters the urethra. These bacteria can travel up the urethra to the bladder to create a bladder infection or work their way farther into the body to cause a kidney infection.
Some women have recurring UTIs and doctors might prescribe preventive antibiotics to these patients. When men have UTIs, they might be a symptom of prostatitis or benign prostatic hyperplasia (BPH).
People who have a UTI usually feel pain or burning when urinating and have an urge to urinate frequently (even if they pass very little urine). Kidney infections may have more symptoms, including a fever and flank pain. It is important to see a physician for these symptoms so the source of the infection can be treated. Most UTIs are simple to treat with antibiotics.
Bladder stones (calculi)
Bladder stones, which are most common in men age 30 and older, are hard masses of minerals that form in the bladder when urine becomes concentrated. Often this is because a person is unable to empty the bladder completely. This can happen during illness, after nervous system damage or because of BPH. Bladder stones are not the same as kidney stones, although kidney stones can move into the bladder, where they might form bladder stones.
Sometimes the body is able to pass small bladder stones without medical assistance. This process may cause severe pain and/or blood in urine as the stone irritates the urethra. A person who has these symptoms should see a physician for treatment.
Larger stones may cause problems. These stones might need to be broken apart or removed surgically. Most often, physicians can use a cystoscope (a small tube with a camera on the end) to view the stone inside the bladder while the patient is under local or general anesthesia. A urologist breaks the stone apart and flushes it from the bladder.
Blood in urine
Blood in urine can be alarming, but frequently it indicates only a passing infection or other issue. Sometimes, however, blood in urine is a warning sign of a more serious condition, so people should always have a physician evaluate this symptom.
- Blood in urine can look pink, brown (cola-colored) or red, or it might not be visible at all
- Sometimes blood cells are diagnosed during urinalysis
- Blood can appear in urine due to an accident, illness or injury, an infection (kidney stones, bladder stones or kidney infection, tumors within the urinary tract, or leaky blood vessels within the urinary tract.
A physician may order diagnostic tests to determine what is causing the blood’s presence in the urine. If a cause is found, the doctor will work to treat that underlying condition. If no cause is clear, treatment may not be needed. In this case, the physician might ask the patient to return later to ensure the situation has cleared up. Frequently, no treatment will be necessary.
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Dysfunctional elimination syndrome
Dysfunctional elimination syndrome is a condition where patients (usually children) may have trouble with bladder control, suffer from constipation and experience repeated UTIs. Children who urinate infrequently or incompletely, which puts them at risk for UTIs and kidney infections, often have this condition.
When children experience a UTI, a physician might refer them for additional testing and imaging to look at the appearance and function of the urinary tract. It is important to identify early any anatomic abnormalities in the urinary tract to minimize the chance that repeated infection will damage a child’s kidneys.
Some children are born with physical blockages to urine flow. Others may have a condition called vesicoureteral reflux (VUR), where a malfunctioning valve in the urinary system allows urine to flow backwards, from the bladder up to the kidneysThis condition appears in up to 10 percent of children, and frequently resolves itself by age 5 or 6. Other children need surgery to correct the condition.
Having an overactive bladder is another term for having bladder control problems, or difficulty controlling when and how much a person urinates. This condition affects many people at some point in life. Symptoms of an overactive bladder may include feeling an urgent need to use the bathroom, needing to urinate frequently, experiencing large or small leaks of urine, or feeling unable to empty the bladder completely.
There are numerous causes for these symptoms including changes in hormone levels and an enlarged prostate. Other factors that might contribute to the problem include:
- Pregnancy and childbirth
- Prostate cancer
- Neurologic disorders
- Bladder cancer or bladder stones
- A UTI.
Evaluation of this condition includes taking a complete history, performing a physical exam, laboratory studies including a urinalysis, and possibly imaging studies of the urinary tract. Once the cause of the problem is found, a physician also can suggest ways a person can improve his or her symptoms with behavioral changes, physical therapy and possibly the use of medication.
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Incontinence is a term for leaking urine involuntarily. As many as 1 in 12 people experience urinary incontinence. Incontinence is more common in people as they get older.
Urinary incontinence sometimes is a symptom of another condition, such as a UTI or constipation. It also can be caused by pregnancy, childbirth, hysterectomy, prostate cancer, enlarged prostate, bladder stones or other urinary stones, neurologic disorders, menopause and aging.
Women are more likely to experience urinary incontinence initially, but men who have prostate conditions have a higher risk of some types of incontinence.
The following are types of urinary incontinence.
- Urge incontinence is the feeling of being unable to “hold it,” and can be related to overactive bladder.
- Stress incontinence is urine that leaks during activity (running, laughing, sneezing).
- Functional incontinence is when a mental or physical impairment prevents a person from making it to the toilet in time.
- Overflow incontinence is a steady or frequent dribble of urine because the bladder doesn’t empty completely.
- Mixed incontinence is when several types of incontinence combine.
People who experience incontinence should see their doctor. A physician will do a full examination to determine the cause of the incontinence. Treatments range from bladder training to medication to surgery.
Interstitial cystitis (painful bladder syndrome)
Interstitial cystitis is a condition in which the walls of the bladder become inflamed and may cause frequent or painful urination, bladder pressure, pain in the bladder area and sometimes pelvic pain.
Interstitial cystitis affects women more often than men. People with severe interstitial cystitis may feel the need to urinate as often as 60 times in a day. Other symptoms may be similar to those of a chronic UTI, but urinalysis may not reveal bacteria that are present in a UTI. The condition can cause significant discomfort and interfere with quality of life.
Doctors are unsure of the specific cause of interstitial cystitis. To diagnose it, physicians may do a pelvic exam (for women), a cystoscopy or a test of bladder sensitivity. Treatments include:
- Physical therapy
- Nerve stimulation techniques
- Bladder distention
- Surgery (rarely).
Frequent or painful urination
Frequent or painful urination can be a symptom of a variety of issues affecting the urinary tract. Most people urinate four to eight times per day and do not need to wake up at night to urinate. Doctors consider it a worrisome symptom if a person urinates much more often, must awaken to urinate or has pain when urinating (called dysuria).
Neurogenic bladder occurs when a person has a spinal cord injury or other neurological disorder (such as spina bifida, Parkinson’s disease or multiple sclerosis) that interrupts the messages the body sends to the bladder to direct its function. The result can be incontinence, overactive bladder, frequent urination, UTIs or an inability to empty the bladder fully.
Several options now are available for neurogenic bladder management. The goal of treatment is to control a person’s symptoms and prevent damage to the kidneys. The treatment approach depends on a person’s situation, symptoms and the cause of the problem. Treatments include medications, catheter drainage (either as-needed or on an ongoing basis) and surgical intervention.
Urinary retention is the medical term for when a person is unable to empty the bladder completely. Urinary retention is classified as either acute or chronic.
Acute urinary retention means the person cannot urinate at all, even though he or she has a full bladder. This comes on suddenly but does not last a long time. This condition can be very painful and requires immediate medical care to avoid becoming a life-threatening situation.
With chronic urinary retention, which is an ongoing condition that has existed for a long time, people can urinate some (typically more frequently than usual) but cannot fully empty their bladder. Sometimes, people do not know they have this condition until they develop another urinary problem such as a UTI, incontinence or bladder stones.
Urinary retention is somewhat more common in men than in women. This is partly because of how common prostate problems are. It is important to talk to a physician about treatment options for urinary retention to avoid kidney damage.
Causes of urinary retention:
- Something obstructing the flow of urine through the urethra (due to prostate conditions in men)
- A urethral stricture
- Kidney stones
- Bladder stones
- Bulging of the bladder into the vagina
- Nerve problems
- Weakened bladder muscles (due to aging).
Urethral cancer is a rare cancer that occurs when abnormal cells grow in the urethra. It is most common among older women and people who previously have had bladder cancer. It also might be related to having the human papillomavirus (HPV) or previous sexually transmitted infections (STIs). Urethral cancer usually creates symptoms similar to many other urinary tract conditions.
A urethral stricture is a scar that narrows the urethra, the tube that carries urine out of the body. A stricture of the urethra can prevent urine from flowing freely out of the bladder.
- Frequent urination
- Urinary tract infections
- Kidney stones
- Blood in urine
- Decreased urinary stream
- Pain in the lower abdomen or pelvis.
Urethral strictures may occur due to injury to the urethra and pelvis, inflammation from sexually transmitted diseases (STDs) such as chlamydia or gonorrhea, or injury from urethral instrumentation. It also sometimes occurs in men and boys who have previously had surgery for hypospadias.
Treatment options include:
- Stretching the stricture
- Cutting the stricture with laser or scalpel
- Surgically removing the stricture and reconnecting the urethra.