BLADDER CONDITIONS
 

OVERACTIVE BLADDER

 

This is a common condition caused by an overactive detrusor muscle (the smooth muscle of the bladder) which tenses up without any control before the bladder becomes full. The cause of overactive bladder is often unknown, however in some cases it can develop due to a nerve or brain condition such as a stroke, Parkinson’s disease, multiple sclerosis or a spinal cord injury.   

The symptoms of an overactive bladder can be distressing and embarrassing. They include having a sudden urge to pass urine which is difficult to postpone and may be associated with urinary leakage and needing to urinate more often than usual both during the day and at night.

It is important that before the start of any treatment, other conditions that may cause similar symptoms are ruled out such as benign prostatic hyperplasia (BPH) in men, urinary tract infection, bladder cancer, interstitial cystitis and bladder stones.  

Treatment options include lifestyle changes, medications such as anticholinergics and a beta adrenergic agonist and rarely a Botox injection into the bladder muscles. 

 

INTERSTITIAL CYSTITIS (IC)

Also known as painful bladder syndrome, is a long-term condition that causes pain or discomfort in the bladder area with the need to pass urine more frequently and with urgency. The severity of these symptoms can vary and maybe triggered by certain situations such as stress or certain emotions, sexual intercourse, specific food or drink and some other lifestyle behaviours.   

 

IC is more common in patients aged 30 or above and affects more women than men. The exact cause is still unknown but probably related to thinning of the lining of the bladder leading to urine leaking into the bladder muscles causing pain. Other possible theories include allergic reaction, abnormal immune response or pelvic floor muscles problems. 

There is no single test to diagnose IC and assessment should include ruling out other conditions such as urinary tract infection, bladder cancer, endometriosis in women and overactive bladder. IC cannot be cured and treatment is aimed at relieving symptoms which often involves lifestyle changes, oral medications, bladder instillations and bladder surgery.

 

BLADDER CANCER

This is a common cancer affecting around 10,000 people every year in the UK and is more common in men than women. The cancer commonly develops from the lining cells of the bladder (the urothelium).

 

Risk factors 

There are certain risk factors that increase the possibility of developing bladder cancer and these include:

  • Age: more common after the age of 60

  • Smoking

  • Chemicals: exposure to certain chemicals such as in rubber, dye, leather, textiles, printing and other industries.

  • Past history of radiotherapy (to the Bladder area) or certain chemotherapy treatment.

  • Repeated urinary tract infections or infection with Schistosomiasis (Bilharziasis).

  • Untreated bladder stones

Symptoms

  • Blood in the urine (haematuria) is the most common symptom.

  • Other symptoms: pain when passing urine or pain in the bladder area, needing to pass urine more often or with more urgency, feeling tired or unexplained weight loss.

Treatment of bladder cancer

The initial treatment of bladder cancer often involves surgery to remove the cancer or part of it via a telescope (TURBT). Further treatment maybe required in some patients depending on the cancer features and individual circumstances. These additional treatments may include bladder instillations, surgery to remove the bladder, radiotherapy or chemotherapy.