Distended Bladder

What is distended bladder?

A distended bladder is when the pouch that holds your pee (urine) is enlarged. This happens when it stretches to hold more fluid because you’re not peeing enough (urinary retention). Not everyone with urinary retention has bladder distention.

Your kidneys remove excess fluids and substances that your body doesn’t need and turn them into pee. Your kidneys are constantly making pee, so your bladder stores it until it’s time to go. When your bladder is full, it tells you that it’s time to empty it.

Urinary retention is when your bladder is full and you can’t empty it. When your bladder can’t empty well, it stretches to hold more urine and becomes enlarged, or distended.

Is a distended bladder a medical emergency?

A distended bladder isn’t an emergency on its own. But acute urinary retention — when you’re barely peeing or not peeing at all — is. If you can’t pee and you’re in pain, seek medical attention immediately.

What are the symptoms of a distended bladder?

Symptoms of a distended bladder include:

• Leaking pee (urinary incontinence).
• Urgent need to pee.
• Pain, pressure or tenderness in your pelvis or abdomen.
• You may also have other symptoms of urinary retention, like peeing very little or with a weak stream, or feeling the need to pee right after you’ve gone.

Some people don’t have noticeable symptoms.

What causes distended bladder?

Pee building up in your bladder, or urinary retention, causes distention. Pee can build up for many reasons, including:

• Blockages. Bladder stones, a tumor, an enlarged prostate or constipation can block pee from getting out of your bladder. Lower urinary tract obstructions (LUTOs) are the most common cause of distended bladder in a fetus (fetal megacystis).
• Inflammation. Swelling in your bladder or urethra (the tube that your pee goes through to get from your bladder to the outside of your body) can prevent you from being able to empty your bladder. Injury or urinary tract infections can cause inflammation.
• Neurological conditions. Medical conditions and medications (like opioids) can affect the nerves that tell your brain that your bladder is full. This means you might not empty it when you need to. Some conditions that could cause this include multiple sclerosis (MS), Parkinson’s disease, Alzheimer’s disease and stroke.
• Surgery. Anesthesia (medication that keeps you from feeling pain during surgery) can interfere with your ability to empty your bladder. Pelvic surgery can also cause scarring or swelling that can block your bladder or urethra.

What are the complications of a distended bladder?

A distended bladder can sometimes cause problems going to the bathroom (bladder dysfunction), even after treatment. You might:

• Leak pee.
• Have the urge to go to the bathroom when you don’t.
• Not be able to fully empty your bladder.

How is distended bladder diagnosed?

A provider will listen to your symptoms and examine you. They might feel your abdomen and ask if it hurts to press on it. If they think your bladder is distended, they might order imaging, like an ultrasound.

A pregnancy care provider may diagnose a distended bladder in a fetus during a prenatal ultrasound.

What tests will be done to diagnose distended bladder?

Providers can look at your bladder using an ultrasound to diagnose a distended bladder. Specifically, they might use a post-void residual urine test to see how well you’re emptying your bladder. They’ll use an ultrasound machine to look at your bladder after you’ve emptied it (peed out as much as you can). They can also use it to determine what’s causing any issues they see.

They might order or perform additional tests to find out what’s causing urinary retention.

How is distended bladder treated?

Providers can treat a distended bladder by draining the excess pee from it. If you can’t pee at all, your provider will do this before looking for the cause or making any other diagnoses.

Then they’ll diagnose and treat the underlying cause (usually whatever is causing urinary retention). They might treat the cause with medications, surgery or other procedures.

Fetal megacystis can sometimes go away on its own as the fetus continues to grow.

Specific procedures used to treat distended bladder

The most common way providers treat a distended bladder is with transurethral bladder catheterization. A provider inserts a thin tube into the opening you pee out of (urethral opening). They move it through your urethra to your bladder to drain the pee. Your provider may use this tube to empty your bladder once, or they might leave it in place for days or weeks.

Fetal megacystis may or may not be treated. Treatment options might include:

• Vesicocentesis. A provider uses a needle to remove fluid from a fetus’s bladder.
• Vesicoamniotic shunt. A provider inserts a tube into a fetus’s bladder that drains fluid from it.

Side effects of treatment

After a catheter is removed, you might experience:

• Blood in your pee (hematuria).
• Increased need to pee.
• Low blood pressure (hypotension).

Most of the time, these side effects are temporary.

How soon after treatment for distended bladder will I feel better?

You should feel some relief right away when a provider drains your bladder. How long additional treatments take depends on what’s causing urinary retention.

Can distended bladder be prevented?

Managing any chronic illnesses that can lead to urinary retention can help prevent a distended bladder. In some cases, like distended bladder after surgery or fetal megacystis, it can’t be prevented.

What can I expect if I have a distended bladder?

A distended bladder can be painful and mean that you’re not peeing enough. It can be treated with a catheter to empty your bladder. You may need ongoing treatment for any underlying causes.

Talk to your pregnancy care provider about what to expect if you’re pregnant and the fetus has a distended bladder.

When should I go to the ER?

If you’re unable to pee and are in pain, go to the nearest ER or seek medical attention right away. Acute urinary retention is a medical emergency.

What questions should I ask my doctor?

It might be helpful to ask your provider:

• What caused this?
• How can I prevent it from happening again?
• What are my treatment options?
• Do I need ongoing treatment?

A note from Cleveland Clinic

A provider can usually treat a distended bladder by draining it. It’s important to treat any underlying causes of urinary retention. Let your provider know if you’re having trouble peeing or have abdominal or pelvic pain, especially if you’ve recently had surgery. Distended bladder isn’t an emergency, but not being able to empty your bladder at all can be.