Living with bladder spasms is a painful reality for many. Not only is the condition physically painful, but it can also cause mental and emotional trauma among those dealing with bladder spasms daily.
What are bladder spasms?
Normally, passing urine is a systematic function of the body, wherein the bladder is gently filled up with urine and nerve signals are sent from the bladder to the brain to make one slowly become aware of the need to urinate. Once the brain receives this signal, it interprets it as a sign to start looking for a restroom to empty the bladder. In patients living with bladder incontinence or bladder spasms, this sensation surfaces suddenly with a sense of urgency, giving them little or no time to even look for a restroom.
A bladder spasm, also known as “detrusor contraction”, is known to occur when the bladder muscle involuntarily squeezes, almost suddenly without warning, and with an urgency to release urine. This spasm can result in a leakage as it forces the urine out from the bladder. Medically, this condition is referred to as “urge incontinence” or “overactive bladder”.
What is the feeling like?
Bladder spasms can be very painful in certain instances and are often described by patients as a cramping pain accompanied by a burning sensation. Some women describe their bladder spasm pain as those experienced during menstrual cramping or labor pain during childbirth.
Who can develop bladder spasms?
Bladder spasms can strike anyone and at any age. A bladder spasm among children is also referred to as the “pediatric unstable bladder” or “uninhibited bladder”.
Bladder spasms are commonly found in the following groups of people:
- Elderly persons
- Women going through menopause
- Overweight and obese
- Pregnant women or those who have recently given birth
- Diagnosed with a urinary tract infection
- Those who have undergone a recent lower abdominal or pelvic surgery
- Those who have a bladder muscle impairment as a result of a disease or injury
- People who are suffering from a neurological disease such as stroke
What causes bladder spasms?
There are various causes associated with bladder spasms. The cramping pain or spasms could result due to simple factors such as diet, a medication that is being taken by the patient, or it could arise due to the changes in the supply of blood or function of the bladder-controlling nerves.
Bladder spasms can also arise due to an infection, surgery, or in the case one is suffering from a nerve or muscle damage. To determine the exact cause of the bladder spasms, it is important to see a health practitioner at the earliest. In some instances, the cause remains unidentified even by a doctor. This condition is referred to as “idiopathic bladder spasms.”
Some of the common causes that are associated with the occurrence of bladder spasms are:
- Urinary tract infection (UTI) – its common symptom includes bladder pains that are accompanied by a burning sensation.
- Interstitial cystitis (IC)– is also known as “painful bladder syndrome,” which happens when the bladder or urinary pain is not due to other causes like UTI. In this condition, the pain experienced by the patient is recurrent and often severe.
- Use of catheter - a catheter is a thin tube that is used to drain out urine from the body and is often inserted post-surgery. A catheter is inserted through the urethra and up into the bladder.
Bladder spasms are one of the most common and at times distressing complications of using catheters.
Bladder spasms resulting from nervous system disorders
The sensation to empty out the bladder is normally an involuntary response. The brain sends out nerve signals to the bladder muscles indicating the time to tighten (contract) the muscle and release the urine. Nervous system disorders can sometimes damage the nerves that send out communication signals between the brain and the bladder. When this miscommunication occurs, it results in a bladder dysfunction. This dysfunction resulting from nerve damage is known as the "neurogenic bladder.”
Bladder spasms resulting after a surgery
Some surgeries in the lower abdominal area may weaken the bladder or pelvic muscles, and in some cases, may result in damaging the nerves that control the bladder. Bladder spasms may occur in certain post-surgeries such as:
- Bladder surgeries
- C-section deliveries
- A hysterectomy that could involve the removal of the uterus or other surrounding female organs
- Prostatectomy (prostate removal in men)
- Other forms of surgeries around the lower abdominal area
Other causes of bladder spasms
Some bladder spasms occur as a side effect of certain medications to treat various health reasons. Some of these medicines include:
- Bethanechol (Urecholine)
- Valrubicin (Valstar) - a prominent drug used in chemotherapy
- Furosemide (Lasix) or hydrochlorothiazide - diuretics used to drain out excess water from the body
Spicy, acidic, or foods that are high in citrus content can cause bladder spasms to occur. Foods containing high amounts of chemicals such as preservatives and food additives may also irritate the lining of the bladder causing the spasms. Alcohol, artificial sweeteners, caffeine, pickled foods, and tomatoes are examples of some foods that can trigger bladder spasms.
Conditions that are related to bladder spasms
There are some diseases which are often associated with bladder spasms. Their symptoms may be caused by bladder spasms and if not, they may require immediate medical attention. They include:
Urinary tract infections (UTIs)
The kidneys, urethra, ureters and bladder are affected when it comes to urinary tract infections. These organs are involved in the passing of urine.
Kidneys lie on the waist. They are extremely vital as they are used in waste removal including excess water from blood in the form of urine. They are essential in blood pressure regulation, blood sugar content and electrolyte balance. Damage to the kidneys can be caused by conditions such as high blood pressure.
Ureters drain urine into the bladder and measure about 10 inches long. The bladder provisionally amasses formed urine. When it attains a certain minimum volume, nervous system sensations cause us to feel the urge to urinate and voluntary control of the bladder muscles can expel the urine. The urethra is a tube for expelling urine from the body. The urinary sphincter at its proximal end relaxes to allow expulsion of urine.
Any of the above parts can be infected, and as it has become accepted that the further up the infection is, the more severe it becomes.
Recommended treatment for controlling bladder spasms
The line of treatment chosen to provide relief from bladder spasms largely depends on what triggers the symptoms. The following are the common measures to bring about relief in patients suffering from bladder spasms:
- Dietary modifications - dietary changes are likely to help manage and prevent bladder spasms if the spasms are triggered by certain foods and beverages. As part of the dietary management, the doctor may advise the patient to refrain from eating certain foods that are naturally spicy, acidic, or citric. Apart from these foods, patients are also advised to curb their alcohol and caffeine consumption.
- Exercises - pelvic floor exercises such as kegels and physiotherapy can help in strengthening and relaxing the bladder and other related muscles. These exercises are recommended for an effective management of the condition. Exercises are a great way to help reduce bladder spasms in adults and children. While performing any form of bladder-related exercises, there should be expert guidance involved as putting pressure on the wrong muscles can worsen the symptoms.
- Medications - bladder spasms are treated with medications in most cases. Drugs called “anticholinergics” are commonly prescribed to help relax the bladder muscles and to prevent the occurrence of spasms. The common side effect resulting from this line of medication is dryness of the mouth. Antidepressants are also administered to patients suffering from extreme bladder spasms. These medications can also aid in relaxing the bladder, thereby, helping in spasm management. In the case of children suffering from bladder spasms, “alpha-blockers” are prescribed, which work by relaxing the bladder as well as allowing it to empty completely.
Bladder spasm medication
Tolterodine, the active ingredient in Detrol, causes the bladder to hold urine by preventing detrusor muscles from contracting and forcing out urine. Detrol is not advised for patients with gastric and urinary retention or uncontrolled narrow-angle glaucoma. Desiccated mouth, belly discomfort, stultification and neuralgia are some of the most common side effects of this drug.
This drug increases bladder volume and lessens detrusor muscle contraction by influencing the bladder’s smooth muscles and also delaying the urge to urinate. It satisfactorily treats the inability to hold urine, frequency and urgency. It is not proposed for people distressed with urine retention and extreme decreased movement in the gut. It is used under constant monitoring for people with renal dysfunction. Common side effects include nausea, diarrhea, loose bowels, constipation and dry mouth.
Certain alternative therapies can complement the main line of treatment, thus, making the patient’s recovery faster. Some of these therapies include:
- Acupuncture - research suggests that bladder-related acupuncture may largely help in reducing bladder muscle contractions and in controlling the constant urge of urinating.
- Biofeedback - is a highly effective method used in the treatment of bladder spasms. This method teaches the mind to control the normally automated functions of the body. Most medical practitioners believe that the biofeedback methodology of treatment works better than medicines as there are no side effects involved and the mind trains the body against incontinence. However, in most cases, a combination of incontinence and medication works in the most effective manner to treat the condition.
When nervous impulses or signals are not efficiently relayed, received and responded to by the bladder muscles, there can be uncontrolled urine retention. This is a condition known as neurogenic bladder.
This condition causes you to lose bladder control and you can urinate too much or little, which is hazardous.
Symptoms can be:
- A trickling stream when urinating
- Loss of the ability to completely empty the bladder
- Trying hard to urinate
- Lost control of the bladder
- More cases of urinary tract infections
- Escape and seeping of urine
- Inability to tell when the bladder is full
Seek medical attention if these symptoms persist.
Causes of neurogenic bladder
Neurogenic bladder is caused by defects in the nervous pathway between the brain and bladder. This can be nerve damage in the brain or bladder.
Examples of conditions which can cause brain damage include:
- Alzheimer’s disease
- Spinal cord and brain tumors
- Multiple sclerosis
- Parkinson’s disease
- Spinal cord injuries
- Congenital defects on the spinal cord
Conditions affecting the bladder muscles are:
- Diabetes causing nerve damage
- Long-term use of alcohol
- Improperly done pelvic surgery can cause nerve damage
- Spinal nerve damage
Tests are conducted on bladder muscles to diagnose neurogenic bladder. Medication can help relieve and ease some of the neurogenic bladder symptoms.
Complications due to neurogenic bladder
There can be urine retention with neurogenic bladder. This is where the bladder can fill beyond capacity and leak, but it might also not be able to completely eliminate all urine.
If urine is retained for a long time, it increases the chance of developing urinary tract infections.
If infected with urinary tract and kidney infections regularly, there can be organ failure which can be lethal.
Neurogenic bladder diagnosis
The doctor will check on your medical history and conduct some physical tests and do some neurologic tests to examine your bladder response. These may include:
- Cystometrogram to check bladder function and capacity
- Electromyography to test muscle coordination and tone
- Imaging studies of the brain and spinal cord
- Kidney and bladder imaging studies
Treatment of neurogenic bladder
Your doctor will recommend that you keep urinating frequently to prevent the bladder from exceeding its maximum capacity. The doctor may also note instances when urine leaked and this can be the basis of formulating the most suitable urinating intervals. Some therapies such as kegel therapies may be advised.
Electrical stimulation by placing electrodes on the bladder may be done to send impulses on the brain to initiate the urination reflex.
- Use of medication: There still is no scientifically proven medicine to treat this condition, but some medicine can improve bladder muscle tone. This will aid in retention and expulsion of urine.
- Catheterization: In extreme cases, catheterization may be applied for complete bladder emptying. Insertion of a thin tube made of plastic ensures all urine is removed. Antibiotics may be used alongside this method to avoid bacterial infection.
- Performance of surgeries: Insertion of artificial sphincters can be done to control urination. Other implants can be urethral stents, which function in the same manner as a catheter.
Other medical inventions, such as a bladder sling, are used to alleviate some of the symptoms. The doctor is consulted to ascertain which surgical treatment is suitable.
Bladder stones occur when there is less water and more salts and waste products in urine, causing it to crystallize. This most commonly occurs when urine is concentrated; when it is dark yellow in color indicating high percentages of dissolved substances. Its color is influenced by the type of mineral salts that are dissolved in it.
Dehydration or the inability to completely empty the bladder is the main cause of concentrated urine. This can be due to an enlarged prostate, bladder malfunctions and urinary tract infections. If bladder stones are not treated early enough, it can lead to other long-lasting complications.
Symptoms of bladder stones
- An increased urge to urinate, especially at night
- Pain on the lower abdomen
- A burning or itchy feel when passing out urine
- Blood stained urine or cloudy urine
- An uncontrolled urination reflex
People at risk of developing bladder stones
The larger percentage (more than 95% of cases) is majorly seen in men, especially those with prostate problems. Elderly men in their 80s are more prone to develop bladder stones than youthful ones. Nonetheless, men in their 30s living in urban countries are also at risk since such regions have food with more fat and sugar.
The difference between bladder infections and bladder spasms
The term ‘urinary tract infection’ may also be used interchangeably with bladder infections. The most common entry of bacteria is through the urethra. After entry, bacteria may multiply and colonize any of the parts situated between the kidney and urethra. This will result in an infection in the bladder with really irritating symptoms such as an increased urge to urinate, itchiness when urinating, and abdominal pain or cramps. A combination of home and medical interventions can be used when healing. These include:
Staying hydrated: Drinking more water will lead to formation of more urine. This means that when urinating, colonies of bacteria can be swept out of the system much more easily. Urine is also diluted of its salt content and will become less painful when urinating. Dilute urine is light yellow and does not irritate as much.
Regular urination: This helps by constantly pushing bacteria out of the bladder. Holding urine back for long durations may cause accumulation of bacteria and their multiplication. Sexual activity also pushes bacteria further into the urethra. Urinating after intercourse will wash accumulated bacteria from your urethra preventing an infection.
Treatment using antibiotics: Minor bladder infections heal on their own. In more difficult cases, your doctor will prescribe antibiotics to kill the bacteria causing the infection. Antibiotics may not always be needed but when symptoms persist, seek medical advice. The duration of treatment will vary depending on the severity and duration of symptoms. Take the whole dose of medicine even after you are healed and some medicine is left, to completely rid your system of bacteria.
Taking pain relievers: After a severe infection, there may be extremely horrendous pain. Although antibiotics do help, it takes one to two days before their effect is felt. Thus, pain relievers are a good solution to abdominal pain and distress when urinating. Consult with your doctor to find out suitable over-the-counter medication for pain.
Using heating pads: If medicine does not bring out positive feedback, a heating pad placed on the abdominal area or on the back, will ease mild pain caused by the bacterial infection. Buy a heating pad from your local drugstore and follow the manufacturer's instructions to avoid burning yourself. You can improvise by soaking a towel in warm water and laying it above the abdomen.
Dressing appropriately: Wearing tight clothing will hold moisture on delicate body parts. With such conditions, bacteria will thrive and you will be very vulnerable to develop bacterial infections. Wear loosely fitting clothing which will allow the skin to breathe and to keep bacteria from getting stuck in your urinary tract.
Drinking cranberry juice: Cranberry is a natural remedy for bladder infections. It has been scientifically proven to aid women who had been affected by bladder infections heal completely. Nonetheless, it is not known if cranberry juice has this healing effect on all people with urinary tract infections. Consult with your doctor if you are not entirely sure cranberry juice will work, so that you get some medications against the infection. Drinking cranberry juice may help, but it is not as effective as expected in some people.
Getting treatment for bladder infection: If you find it impossible to cure yourself of urinary tract infections, it is important to seek medical help immediately to avoid worsening the situation. Consult your doctor to come up with a treatment plan that suits you.
Preventive measures for bladder infections and bladder spasms
Adapting the following in your daily routine will help prevent future infections and also relieve bladder spasms:
- Drinking plenty of water
- Regularly urinating as soon as you feel the urge to
- Frequently taking showers instead of baths
- Regularly changing undergarments
- Front to back wiping after urinating (females)
- Avoid use of douches or feminine hygiene sprays
- Use sanitary pads
- Minimize use of diaphragm or spermicide as birth control
- Use non-spermicidal lubricated condoms
- Urinating before and after sexual activity
Your doctor will recommend the best treatment for recurrent infections. This may include some antibiotics in small doses.
Outlook for bladder infections
Bladder infections, although some may recur, are not life-threatening and don’t influence your health that much. There are also efforts to come up with vaccines against bladder infections, but until then, you can also use home remedies.
Urinary catheterization risks
Catheterization can provide an avenue for bacteria to enter into the body causing urinary tract infections (UTIs). These infections commonly affect the kidneys, bladder and urethra.
Similar risks involved include:
- Bladders spasms which feel similar to stomach cramps often occur. These come as an effort of the bladder to push out the catheter. Bladder spasm medication can be given to reduce the frequency or severity of spasms.
- By-passing or leaking around the catheter is common, and can occur if there are bladder spasms or if the catheter becomes blocked. It is very important to check if the catheter is draining well to avoid the risk of getting infected.
- Blockage can be caused by the presence of blood or other debris, and drainage of the catheter should be checked to ensure it is well functioning.
- Medical attention should be sought if there is a suspected case of a blocked catheter or if increased amounts of fragment waste are passed.
Less frequent risks involved are:
- Insertion of the catheter which leads to urethral injury.
- Scar tissue, which causes a decrease in diameter of the urethra, due to repeated use.
- Incorrect insertion of the catheter which damages the bladder or rectum.
- After using the catheter for a prolonged duration, bladder stones may develop.