Bladder Care

Bladder problems are common in women. The bladder is a muscular, hollow organ where urine is stored after it leaves the kidneys. Bladder problems can be merely annoying or get in the way of everyday activities. The most common bladder problems include urinary tract or bladder infections, urinary incontinence, cystitis (bladder pain), and blood in the urine.

Bladder problems are common in women. They can be merely annoying or get in the way of your everyday activities. This article describes common bladder problems, how to manage them, and when to see a doctor for treatment.

About the bladder

The bladder is a muscular, hollow organ where urine is stored after it leaves the kidneys. It has an opening at the bottom called the urethra (u-REE-thra) where urine leaves the body when you go to the bathroom.

Urinary Tract Infection (UTI)

Any part of your urinary tract can become infected, including your kidneys, ureters (tubes that go from the kidneys to the bladder), bladder, and urethra. Bladder infection is the most common UTI. It’s important to treat a bladder infection as soon as you can so the infection does not spread to your kidneys.

Urinary tract infections are caused by bacteria that get into the urethra. Women are more likely than men to get bladder infections because a woman’s urethra is so close to the anus, where the bacteria are. Also, a woman’s urethra is short and the bacteria don’t have far to travel to cause an infection. Some other factors can increase your risk of a bladder infection:

• Being sexually active
• Using certain types of birth control that are inserted into the vagina, like a diaphragm
• Having gone through menopause
• Having diabetes
• Having a problem with your immune system that makes it hard to fight infections
• Recent use of a catheter

Symptoms of a bladder infection:

• A burning pain when you urinate
• Feeling the urge to urinate even when you don’t have to empty your bladder

See a doctor if you have these symptoms. Get the infection treated quickly so it doesn’t spread to your kidneys. The doctor will take a urine sample to find out if you have a bacterial infection. If you do, the doctor will prescribe antibiotics.

Drinking plenty of water can help prevent bladder infections or help them get better faster.

If you keep getting bladder infections, the doctor may do other tests, like an CT scan or MRI, to find out what might be causing them.

Urinary Incontinence

Urinary incontinence means leaking urine because of losing bladder control. Women can have one or both of the two main types of urinary incontinence:

• Stress incontinence. This is when you leak urine when you cough, sneeze, laugh, or do physical activities like running. The leaking stops when the activity stops. Most people leak urine from time to time. It’s common immediately after vaginal childbirth or after a surgery involving the pelvic organs (the internal organs in the hip area). It can become an ongoing problem, for example, when the bladder drops into the vagina (prolapse).
• Urgency incontinence. This is when you leak urine because you have a strong urge to urinate. This happens because the muscles in your bladder contract to empty your bladder before you are ready. The cause can be anything that damages the nerves that tell your bladder muscles what to do, like a stroke or multiple sclerosis.

If you leak urine often or in large amounts — and if leakage gets in the way of normal activities — talk to your doctor. You may have urinary incontinence, and treatment will likely help. Your doctor will talk to you about the problem and take a urine sample. The doctor may also do other tests to see how much urine your bladder can hold, and how well your bladder releases urine.

Treatment for stress incontinence focuses on strengthening and re-training the pelvic floor muscles. In some cases, the doctor may recommend using a pessary, a device that fits in the vagina to support the pelvic organs. Or the doctor may suggest injecting a bulking agent — for example, collagen or another material — into the tissues around the urethra and lower part of the bladder. The bulking agent can thicken the tissues to help close the bladder opening.

For urgency incontinence, the doctor may give you medicines to calm the bladder muscles.

Cystitis (Bladder Pain Syndrome)

Cystitis (sis-TIE-tis) is when the bladder is irritated and inflamed. It is a chronic problem (goes on for a long time). Some people with cystitis have just irritating pressure or soreness in the pelvis near the bladder. Others have strong pain and feelings of having to urinate often or urgently.

We don’t yet know why people get cystitis. Women are more likely to have cystitis than men. Women who have autoimmune problems that cause inflammation are more likely to have cystitis. These problems include conditions like fibromyalgia and chronic fatigue syndrome.

The doctor will work with you to find treatment to ease your pain and other symptoms. The doctor may try any of these treatments:

• Changes to what you eat and drink, and when
• Quitting smoking
• Exercises like walking or gentle stretching
• Bladder training—for example, stretching the time between urinating
• Physical therapy to help pelvic floor muscles
• Medicines like acetaminophen (Tylenol) or ibuprofen (Advil) to help with pain
• Bladder wash (medicine put into the bladder to relieve discomfort) or bladder stretching (filling the bladder with liquid)

Blood in the Urine (Hematuria)

Sometimes you can see the blood in the urine and sometimes it is found when you have a urine test. Blood changes the color of the urine, which may look browner, pinker, or redder than usual. If there is a lot of blood, you may also see blood clots and have some pain.

Blood in the urine can have a number of different causes, including:

• Urinary tract infection
• Injury
• Extreme exercise
• Sexual activity
• Endometriosis (en-doh-me-tree-OH-sis), when the tissue that is usually in the uterus grows in another place, like the bladder
• An illness like hepatitis that causes liver inflammation
• Cancer of the bladder or kidneys
• Kidney disease
• Problems with blood clotting (as with hemophilia)

The doctor will do a urine test to see if there is blood in the urine. The doctor may follow up with other tests:

• Blood test
• Imaging, like a CT scan or MRI
• Cystoscopy, when the doctor inserts a thin instrument through a catheter in the urethra to look inside the bladder

• Intermoutain Fact Sheet, "Stress Urinary Incontinence"
• National Institute of Diabetes and Digestive and Kidney Disorders, "Urologic Diseases"