The urinary bladder is a muscular sac located in the pelvis. The muscular walls of the bladder stretch and expand as it fills with urine. Its primary function is to store urine and then release it in a controlled manner through the urethra when the bladder is full. When the bladder is empty, the walls relax, and it returns to its original smaller size.

The bladder can get affected by various conditions, which can result in pain and discomfort. Millions of women globally have reported experiencing bladder pain due to different reasons. Though it sounds distressing, bladder pain can be managed with proper treatment.

This article will explore the causes and symptoms of bladder pain and how they can be treated effectively.

Causes of Bladder Pain

Urinary Tract infections (UTIs)

Urinary tract infections (UTIs) are infections occurring in the urinary tract, i.e., the kidneys, bladder, ureters, and urethra. These are infections caused by bacteria, usually Escherichia coli (E. coli), that enter the urethra and infect the bladder. The typical symptoms include pain or burning sensation while urinating, frequent and urgent need to urinate, cloudy or bloody urine with a strong odor, along with bladder pain.

Interstitial cystitis

It is one of the most common causes of bladder pain in women. Interstitial cystitis is a chronic condition typically characterized by bladder inflammation and debilitating pain, especially when the bladder is full. Its exact cause is unknown; however, it is believed to be caused by an inflamed bladder lining, trauma to the bladder, spinal cord injury, or other reasons.

Bladder cancer

Bladder cancer is cancerous cell growth in the bladder lining. The most common among bladder cancer is transitional cell carcinoma, characterized by malignant cellular growth in the deepest layer of tissue of the bladder lining. It can cause pain and discomfort in the bladder in addition to blood in the urine and frequent urination.

Bladder stones

A bladder stone is a hard, rock-like mass that forms in the bladder when minerals in urine crystalize and stick together. Bladder stones can cause symptoms like painful urination, frequent urination, pain in the bladder (lower abdomen), and bloody urine.

Bladder inflammation

Bladder inflammation can result from bacterial infection, irritants (such as feminine hygiene products), autoimmune disorders, and even certain medications. It is characterized by painful urination, frequent or urgent need to urinate, lower abdominal pain, and cloudy or strong-smelling urine.

Symptoms of Bladder Pain

Bladder pain can cause various symptoms, which can vary depending on the underlying cause. Some common symptoms of bladder pain include:

• Pain or discomfort in the pelvic area
• Pain or burning sensation during urination
• Frequent or urgent need to urinate
• Difficulty starting or emptying the bladder
• Blood in the urine (hematuria)
• Cloudy or strong-smelling urine
• Pain during sexual intercourse
• Pain or discomfort in the bladder when pressure is applied to the area
• Fatigue and muscle aches (in some cases)
• Nausea and vomiting (in severe cases)

Diagnosis of Bladder Pain

• Physical exams: Your physician will perform a physical exam to assess the abdomen and pelvic area for any signs of tenderness or swelling. 

  They may also perform a pelvic exam to check for any abnormalities in the reproductive organs or the bladder itself.

• Urine tests: Urine tests can help your doctor check for signs of infection, such as the presence of bacteria or white blood cells, as well as other abnormalities, such as blood in the urine,

• Imaging tests:  Your doctor may also ask you to get certain imaging tests done, such as ultrasound, CT scans, or MRI. These tests help your doctor to identify any abnormality by providing detailed images of the bladder and surrounding tissues.

• Cystoscopy: In this test, a thin, flexible tube equipped with a camera will be inserted into the bladder through the urethra. The camera produces detailed images of the inside of the bladder, allowing your doctor to visually look for signs of inflammation, infection, or other abnormalities. This technique is also used to perform biopsies of the bladder lining.

Treatment Options for Bladder Pain

• Medications: Your doctor may prescribe antibiotics to treat bladder pain caused by a urinary tract infection (UTI). He may also prescribe oral pain relievers, bladder wall protectants, and nerve pain medications to help manage pain and other symptoms.
• Bladder training techniques: Other symptoms associated with bladder pain, such as the frequent and urgent need to urinate and urinary incontinence, can be managed by bladder training techniques like timed voiding, pelvic muscle exercises, and relaxation techniques.
• Lifestyle changes: Drinking plenty of water to flush out the urinary tract, avoiding irritants such as caffeine and alcohol, and maintaining a healthy weight can significantly reduce the risk of bladder pain.
• Pelvic floor exercises/physical therapy: Strengthening the muscles that support the bladder and improve bladder control can help reduce bladder pain and discomfort. 
• Surgery/Chemotherapy: Your doctor may suggest surgical therapy in case bladder pain is caused by large bladder stones or cancerous tissue.

Prevention of Bladder Pain

Certain preventive measures can help reduce the risk of developing bladder pain, such as:

• Drinking plenty of water: This helps to flush bacteria and other irritants out of the urinary tract and reduce the risk of UTIs and bladder stones. 

• Practicing good hygiene: Keeping the genital area clean and dry is important to prevent infections that can cause bladder pain. Doctors advise women to wipe from front to back of the genital area after using the toilet to avoid bacterial infection. 

• Avoiding bladder irritants: Laying off the alcohol, caffeine, acidic foods, and artificial sweeteners can prevent bladder pain.

• Regular exercise and pelvic floor training: Moving the body regularly can help prevent urinary incontinence and improve bladder control.

• Manage underlying health conditions: Conditions like diabetes, kidney stones, or overactive bladder can help prevent bladder pain.

Other preventive measures, such as emptying your bladder regularly, especially after sexual intercourse, avoiding using scented hygiene products, and wearing cotton underwear instead of synthetic fabrics, can reduce the risk of developing bladder issues that can cause bladder pain.

Conclusion

Bladder pain can occur due to various medical conditions such as UTIs, interstitial cystitis, bladder cancer, and bladder stones. It can also occur due to dehydration, consumption of acidic foods or drinks, and holding urine for too long.

If you are experiencing bladder pain, it is important to seek medical attention promptly. Early detection and appropriate care increase the chances of successful recovery and prevent complications. Treatment for bladder pain depends on the underlying cause and may include antibiotics for UTIs, medication for interstitial cystitis, surgery or chemotherapy for bladder cancer, and lifestyle modifications to reduce bladder irritation. Your doctor can help you determine the best course of treatment based on your individual needs and medical history.

Supervising Doctor of This Article

Koichi Nagao, MD PhD

Professor, Department of Urology, Toho University Faculty of Medicine
Director of Urinary tract reconstruction center, Toho University Omori Medical Center
Director of Reproduction Center, Toho University Omori Medical Center

Professor Nagao specializes in plastic surgery in the field of reproductive medicine. He completed eight years of plastic surgery training at Showa University before majoring in urology at Toho University. With his meticulous surgical techniques and careful examinations that combines urology and plastic surgery, Professor Nagao became a Board Certified Specialist with multiple associations including the Japanese Urological Association, the Japan Society for Reproductive Medicine, and the Japanese Society for Sexual Medicine.

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