What is urinary bladder dysfunction?
Urinary bladder dysfunction is a range of conditions that adversely affect how the bladder stores and empties urine. Dysfunction occurs when problems arise with the muscles or nerves that control bladder function.
What are the symptoms of a dysfunctional bladder?
There are numerous potential symptoms to watch out for, including:
- Frequent urination: Needing to pass urine more than eight times a day or waking up often at night (nocturia).
- Urgency: Sudden, uncontrollable urges to urinate.
- Urinary incontinence: Leaking urine unintentionally (e.g., stress or urge incontinence). You may leak just a few drops of urine or gush a large amount.
- Weak stream or dribbling: Difficulty starting or maintaining urine flow.
- Incomplete emptying: Feeling like the bladder isn’t fully drained, also called urinary retention.
- Pain or burning: Discomfort during urination, signaling possible infection or inflammation.
These problems can result from various causes, including neurological disorders, injuries, infections, aging, or other medical conditions that interfere with everyday communication between the brain and bladder.
Who does urinary bladder dysfunction normally affect?
Urinary bladder dysfunction can affect anyone, but it’s most common in specific groups.
Older adults
Age-related changes in bladder muscles and nerves increase the likelihood of bladder problems in older adults.
Men with prostate issues
Conditions like benign prostatic hyperplasia (BPH) can cause obstructions in the urinary system, which can, in turn, adversely affect bladder function.
Women post-childbirth or post-menopause
Weakening of the pelvic floor muscles or hormonal shifts often plays a role in urinary bladder dysfunction.
People with neurological conditions
Disorders like multiple sclerosis (MS), Parkinson’s disease, spinal cord injuries, or stroke frequently lead to bladder dysfunction.
People with diabetes
Nerve damage from diabetes can impair bladder control.
What causes urinary bladder dysfunction?
Understanding urinary bladder dysfunction’s root causes and risk factors is the first step to effective treatment. Common triggers include:
- Neurological disorders: Damage to the brain, spinal cord, or nerves (e.g., MS, stroke, or spinal injury) can disrupt the signals between the brain and the bladder, leading to problems.
- Obstructions: An enlarged prostate, urethral strictures, or bladder stones can block the flow of urine and are common causes of adverse bladder symptoms.
- Muscle weakness: Overactive or underactive bladder muscles (e.g., from aging or childbirth) can impair bladder function.
- Infections or inflammation: Chronic urinary tract infections (UTIs) or interstitial cystitis can damage the bladder and cause adverse symptoms.
- Medications: Drugs like antihistamines or antidepressants may affect bladder control.
- Diabetes: High blood sugar levels can harm the nerves that control the bladder.
- Lifestyle factors: Obesity, smoking, or excessive caffeine/alcohol intake all heighten the risk of bladder dysfunction.
How does Tower Urology diagnose urinary bladder dysfunction?
Diagnosing urinary bladder dysfunction requires a thorough approach, and at Tower Urology, we leave no stone unturned. When you attend your appointment, we will make the following investigations.
Medical history review
We take a complete medical history, review any past or existing health issues, and assess your symptoms and lifestyle.
Physical exam
An appropriate physical exam is undertaken and may include examinations of your pelvis, prostate, and rectum to check for structural issues.
Urine tests
These detect infections, blood, or other abnormalities in the urine.
Urodynamic testing
This measures bladder pressure, capacity, and urine flow to pinpoint the type of dysfunction.
Imaging
Ultrasound, CT scans, or cystoscopy visualize the bladder and urinary tract, further assisting in diagnosis.
Bladder diary
We may recommend that you keep a bladder diary. Tracking urination patterns helps identify trends, which in turn helps with diagnosis.
How do you treat urinary bladder dysfunction?
Treatment for urinary bladder dysfunction depends on its cause and the severity of the condition. Tower Urology offers a full spectrum of options:
Lifestyle changes
Reducing caffeine intake, managing fluid levels, and practicing pelvic floor exercises (e.g., Kegel exercises) may help alleviate symptoms of bladder dysfunction.
Medications
Some medications available to resolve or ease symptoms include anticholinergics for an overactive bladder, alpha-blockers for obstructions, and antibiotics for infections.
Catheterization
Intermittent or indwelling catheters can help manage bladder emptying issues in individuals with underactive bladders.
Minimally invasive Botox therapy
At Tower Urology, we are leaders in using Botox (botulinum toxin) to treat an overactive bladder. This treatment provides longer-lasting relief compared to traditional medications and has fewer side effects.
Advanced neuromodulation
Our expertise in sacral and tibial nerve stimulation offers options for patients who are unresponsive to standard care, directly targeting nerve dysfunction.
Comprehensive pelvic floor therapy
Unlike many practices, we integrate specialized physical therapy to strengthen pelvic muscles, reducing reliance on surgery.
Surgery
Surgical procedures like bladder augmentation or sphincter resection are an option for severe cases.
Are there treatment options other practices use to treat urinary bladder dysfunction that Tower Urology doesn’t?
Yes. At Tower Urology, we avoid outdated or overly aggressive treatments:
- Routine open surgery: While some practices opt for invasive procedures, we prioritize minimally invasive techniques to minimize recovery time and risks.
- Long-term catheter use without alternatives: We explore all options (e.g., neuromodulation) before resorting to permanent catheters, preserving your quality of life.
What is the recovery process like after treatment for urinary bladder dysfunction?
Recovery varies by treatment:
Lifestyle/medication
When patients adopt lifestyle changes or are prescribed medication, there is minimal downtime. Results are usually noticed after days or weeks.
Botox or neuromodulation
The patient may experience mild discomfort for a few days following the procedure. Most patients resume normal activities within a week.
Surgery
Immediately after surgery, a period of initial rest is followed by a gradual return to activity. A full recovery may take four to six weeks.
Is urinary bladder dysfunction commonly or occasionally misdiagnosed as another condition?
Yes, urinary bladder dysfunction is sometimes mistaken for other issues.
- Urinary tract infections (UTIs): There is some overlap between symptoms of UTIs and urinary bladder dysfunction, like a strong urge to urinate or a burning sensation. However, infections clear with antibiotics, while dysfunction persists.
- Prostate issues: In men, urinary bladder dysfunction is often confused with BPH, though not all cases of dysfunction involve obstruction.
- Stress incontinence: Leakage might be misattributed to weak pelvic muscles alone. It usually occurs when an action—coughing, sneezing, laughing—puts pressure on the bladder and causes urine to leak.
What makes Tower Urology unique in treating urinary bladder dysfunction in Los Angeles?
At Tower Urology, we take a personalized, evidence-based approach to general urology care. All our professionals are committed to providing you with expert care. We take the time to understand you and personalize your treatment plan to your specific needs.
We invite you to establish care with Tower Urology.
Tower Urology is conveniently located for patients throughout Southern California and the Los Angeles area, including Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Burbank, Glendale, and Downtown Los Angeles.
Our services include treatment for incontinence/overactive bladder (OAB), hematuria, urinary tract infections, nocturia, kidney stones, and urinary bladder dysfunction.
Urinary Bladder Dysfunction FAQs
Yes, with proper management, people with neurogenic bladder and other bladder dysfunction can live long lives. Modern treatments have significantly improved life expectancy for those with this condition.
Without treatment, complications can include kidney damage, urinary tract infections, kidney stones, and, eventually, kidney failure. People who develop kidney failure and require dialysis have a life expectancy of about five to ten years, although many live longer. However, with appropriate treatment and regular follow-up care, it’s possible to maintain kidney function and quality of life.
The level of reversibility depends on early intervention and proper treatment of the underlying condition. Without proper treatment, permanent damage to bladder or kidney function is likely.
Yes, stress can significantly contribute to urinary bladder dysfunction in multiple ways. There is mounting evidence of a relationship between psychological stress and lower urinary tract symptoms (LUTS).
Studies in mice showed moderate stress, decreased bladder capacity, and increased voiding frequency.
Sources
Surgical Management of Neurogenic Sphincter Incompetence in Children
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6448010
Neurogenic Bladder
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3287034
Detrusor sphincter dyssynergia: a review of physiology, diagnosis, and treatment strategies – PMC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739973
