Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosisPrevention

Table of ContentsView All

View All

Table of Contents

Symptoms

Causes

Diagnosis

Treatment

Prognosis

Prevention

Atrabeculatedbladder is abladderwith a stiff, thickened wall. It mainly occurs when the repeated or prolonged blockage of urine flow (called abladder outlet obstruction) forces the bladder to work harder to push urine past the blockage.

Over time, the increased pressure causes the formation of scar tissues and other changes that reduce the bladder’s elasticity.This loss of elasticity can increase the amount of urine left in the bladder, causing it to backflow into the kidney and causing akidney infection.

Treatment is focused on removing the blockage and improving urine flow with medications, urinary catheters, or surgery.

A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “male” and “female” as the sources use them.

A Note on Gender and Sex Terminology

Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “male” and “female” as the sources use them.

Signs and Symptoms

The symptoms of bladder trabeculation are mainly due to bladder outlet obstruction (BOO). BOO is the blockage of the muscular passageway (called the bladder neck) that connects the bladder to theurethra(the tube through which urine exits the body).

Signs and symptoms of a trabeculated bladder include:

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What Causes Bladder Trabeculation?

Bladder trabeculation occurs when urine does not flow from the bladder as it is meant to and is instead retained in the bladder. The retention causes the bladder to swell, placing excessive stress on the bladder wall and, most specifically, the muscle that contracts the bladder (called the detrusor muscle).

Over time, the stress not only causes the buildup of scar tissue, calledfibrosis, but also an increase in muscle mass, calledhypertrophy. (This is not unlike what happens when skeletal muscles grow when placed under stress from exercise.)

However, with trabeculation, the sustained pressure can cause tiny pockets (known asdiverticula) to spontaneously bulge out of weakened spots in the bladder wall.

The tissues of the bladder itself will start to change, becoming not only thicker but less pliable. Blood vessels will also start to shrink, reducing blood flow and causing the progressive loss of muscle mass even as the bladder wall becomes thicker.

Without the means to push urine out of the bladder, urine can start to reflux (backflow) to the kidneys, causing kidney damage.

Bladder Outlet Obstruction

The main cause of trabeculated bladder is BOO, which may be the result of:

What Is Ureterovesical Junction Obstruction?

Neurogenic Bladder

BOO is not the only cause of a trabeculated bladder. Less commonly, it can occur with a condition calledneurogenic bladder, in which the nerves that control urination are damaged. It can either lead to anoveractive bladderor an underactive bladder.

With an underactive bladder, the loss of detrusor muscle function can cause the bladder to overfill, resulting inurinary retention(the inability to fully empty the bladder).This can place the same level of stress on the bladder as BOO, leading to the thickening and scarring of the bladder wall.

Causes of neurogenic bladder include:

How Is It Diagnosed?

Bladder trabeculation is commonly investigated in people with BOO and neurogenic bladder. As a consequence of these conditions—rather than its own free-standing condition—bladder trabeculation is diagnosed based on the thickness of the bladder wall and the proportion of the bladder affected.

Two tests are commonly used for this:

Together, these tests help grade the severity of bladder trabeculation and direct the appropriate course of treatment. Trabeculation is graded on a scale of 0 to 3, as follows:

Aurodynamic studycan help determine the diagnosis. This series of tests measures bladder function, using uroflowmetry to measure how fast and forcefully you pee and post-void residual (PVR) to measure how much urine is left in the bladder after you pee.

How Is It Treated?

The treatment of a trabeculated bladder is focused on treating or managing the underlying condition. This may involve clearing an obstruction and using medications or surgery to normalize urine flow and prevent kidney damage.

Treating Bladder Outlet Obstruction

BOO treatment can vary and will depend on the cause. Some are treated with drugs, while others require specialist procedures or surgery.

Examples include:

Treating Neurogenic Bladder

Treating trabeculation with a neurogenic bladder can be challenging because the underlying cause is often incurable. Therefore, treatment is mainly aimed at normalizing urine flow and preventing complications.

Among the possible tools and techniques are:

Types of Doctors Who Treat Bladder Problems

Long-Term Outlook

The outlook of bladder trabeculation varies depending on the amount of tissue remodeling that has occurred. Under normal circumstances, remodeling is the process in which injured tissues are repaired using a structural protein calledcollagen.

However, if the injury is persistent, the normal cellular framework—called the collagen matrix—can start to fall apart as more and more collagen piles up. The disorganized remodeling is what causes fibrosis.

With bladder trabeculation, the outlook is based largely on the duration and severity of urinary retention. With some conditions, such as hydronephrosis in pregnancy, the damage may be low-grade and fully reversible.With others, such as a spinal cord injury, the damage may be high-grade and permanent.

Complications of Bladder Trabeculation

The appropriate treatment of a trabeculated bladder can help protect the kidneys and prevent disease complications. This includes a condition calledvesicoureteral reflux(VUR), in which urine backflows from the bladder to the kidneys. '

Left untreated, VUR can increase the risk of potentially severe conditions like:

How to Avoid Complications

If you are diagnosed with bladder trabeculation, there are things you can do to avoid disease progression. Chief among these is fully emptying the bladder; doing so reduces stress on the bladder wall and prevents further scarring.

There are a couple of techniques that can help:

When Is a Kidney Infection an Emergency?

Can You Prevent a Trabeculated Bladder?

It is not always possible to avoid a trabeculated bladder, particularly with conditions like neurogenic bladder or congenital malformations. However, there are five simple lifestyle changes that may help reduce your risk:

How to Keep Your Urinary System Healthy

Summary

A trabeculated bladder occurs when the bladder wall thickens due to a bladder outlet obstruction or a neurogenic bladder. This makes the bladder less elastic, leading to urinary problems, pelvic pain, and an increased risk of urinary tract infections (UTIs). Left untreated, bladder trabeculation can lead to high blood pressure, urinary incontinence, and kidney damage.

Bladder trabeculation is mainly diagnosed with a voiding cystourethrogram (VCUG) which can measure the thickness of the bladder wall. Treatment differs based on the underlying cause but may include medications like Flomax, urinary catheters or stents, and different surgeries to unblock obstructions or help widen the urethra.

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