Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentComplicationsDiagnosisWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Complications
Diagnosis
When to See a Provider
Bladder pain has several possible causes, the most common of which includeurinary tract infections (UTIs),interstitial cystitis(also known as bladder pain syndrome), andbladder cancer. The pain is felt in the middle of the pelvis or lower abdomen, where thebladderis situated.
This article describes the symptoms and causes of bladder pain, including how the condition is diagnosed and treated. It also explains when it is time to see a healthcare provider, including a specialist in urinary tract diseases known as aurologist.
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Symptoms of Bladder Pain
The bladder is a hollow, muscular organ roughly the size of large grapefruit. It functions as a reservoir for urine. Thekidneyspass urine to the bladder through narrow tubes (ureters). The bladder is flexible and expands and contracts as it is filled and emptied.
When it is time to urinate, a muscular passageway called the bladder neck will widen, releasing urine into a tube called theurethra, through which urine exits the body. Smooth (involuntary, not consciously controlled) muscles in the bladder wall will simultaneously contract to clear the bladder fully.
The combination of symptoms you experience may offer clues as to the underlying cause.
Why Does It Hurt When I Pee?
Causes of Bladder Pain
Bladder pain can sometimes be linked to a specific disease or infection. At other times, the cause may be ambiguous oridiopathic(meaning of unknown origin).
When you have bladder pain, three common causes a healthcare provider will likely investigate are urinary tract infections (UTIs), interstitial cystitis (IC), and bladder cancer.
Urinary Tract Infections
UTIs are those that affect any part of the urinary tract, including the urethra, bladder, ureters, and kidneys. When the bladder is affected, it is known ascystitis.
The vast majority of cases in younger females are related to sexual intercourse. In fact, the term “honeymoon cystitis” was coined to describe the frequency of UTIs in this population.
What Is a UTI (Urinary Tract Infection)?
Interstitial Cystitis
IC may be diagnosed if a cause cannot be found and symptoms persist.
IC commonly occurs alongside other conditions that cause chronic pain, such as:
Bladder Cancer
In addition to urinary symptoms, bladder cancer can cause persistent fatigue, bone pain, loss of appetite, swollen feet, one-sided lower back pain, and unintended weight loss when the disease is advanced.
While the underlying cause of bladder cancer is poorly understood, there are several factors that place a person at increased risk, including:
Bladder Cancer or Bladder Infection?
How to Treat Bladder Pain
Urinary Tract Infection
Common antibiotics used to treat urinary tract infections include:
Antibiotics are tailored to bacterial sensitivities seen in a urine culture. If your infection is more complex, has migrated up to the kidney (pyelonephritis), or you have compounding medical problems (like diabetes) you may be on antibiotics for longer.
As a condition with an unclear cause, IC treatment is largely tailored to treat urinary symptoms associated with chronic bladder pain.This may involvea combination of lifestyle changes, over-the-counter (OTC) and prescription medications, and specialist-driven procedures, including:
Bladder cancer treatmenthas a relatively high success rate. According to the National Cancer Institute, bladder cancer has afive-year survival rateof 77.1%—meaning that nearly 4 of every 5 people diagnosed will live forat leastfive years. Many go on to live for years longer.
If the cancer stage is early and the tumor has not metastasized, the treatment will typically involve:
For cancer that is advanced and has breached the bladder wall, the treatment may involve:
Comparing Bladder Cancer Treatment Options
Complications of Bladder Pain
Ignoring persistent or severe bladder pain places you at risk of complications—mainly because there is no way to know the underlying cause is without a proper diagnosis. This is true whether a UTI, IC, or cancer is involved.
Urosepsis and MortalityUrosepsis is the most severe complication of UTIs. It carries a high risk of death due toshockand multiple-organ failure. Studies suggest that the mortality (death) rate for severe urosepsis is between 20% and 42%.
Urosepsis and Mortality
Urosepsis is the most severe complication of UTIs. It carries a high risk of death due toshockand multiple-organ failure. Studies suggest that the mortality (death) rate for severe urosepsis is between 20% and 42%.
One major complication of untreated bladder pain isfibrosis, or the scarring of tissues due to ongoing irritation and inflammation. The scarring can lead to the contraction and hardening of the bladder wall as well as a reduction in the size of the bladder. These changes can further perpetuate IC symptoms.
Because the internal volume of the bladder is decreased, even smaller amounts of urine can place extreme pressure on the bladder wall, triggering pain.
If bladder cancer metastasizes, the five-year survival rate drops from 77.1% to 7.7%.
Are There Tests to Diagnose the Cause of Bladder Pain?
The diagnosis of bladder pain typically starts with a review of your symptoms, medical history, and family history. The physical exam would involvepalpation(touch) to feel for any abnormalities or areas of pain in the lower abdomen. A stethoscope may be used to listen forbowel sounds.
Apelvic examor adigital rectal exam (DRE)might also be involved in the initial workup.
Based on the initial findings, your healthcare provider will order additional tests and procedures to narrow the possible causes, including:
If there are indications of bladder cancer, other tests may be ordered, including:
How Is Interstitial Cystitis Diagnosed?
Because there are no tests available to diagnose interstitial cystitis, the diagnosis is made if the following three criteria are met:
When to See a Healthcare Provider
As an isolated symptom, bladder pain cannot signal if you have a serious or nonserious condition. Even if you have no other symptom but pain, it is still worth having if looked at—in part because it could be something entirely unrelated to the bladder (such as aninguinal hernia,bowel obstruction, or even the early stages ofacute appendicitis).
It is important to see a healthcare provider immediately if:
When to Call 911If you are unable to urinate despite having a full bladder, seek immediate emergency care. The condition, known as acute urinary retention, can also cause severe bladder pain and lower abdominal swelling.If left untreated, acute urinary retention can overstretch the bladder, causing potentially irreparable damage to the urinary tract. It might even cause the bladder to rupture, a potentially life-threatening event.
When to Call 911
If you are unable to urinate despite having a full bladder, seek immediate emergency care. The condition, known as acute urinary retention, can also cause severe bladder pain and lower abdominal swelling.If left untreated, acute urinary retention can overstretch the bladder, causing potentially irreparable damage to the urinary tract. It might even cause the bladder to rupture, a potentially life-threatening event.
If you are unable to urinate despite having a full bladder, seek immediate emergency care. The condition, known as acute urinary retention, can also cause severe bladder pain and lower abdominal swelling.
If left untreated, acute urinary retention can overstretch the bladder, causing potentially irreparable damage to the urinary tract. It might even cause the bladder to rupture, a potentially life-threatening event.
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