Bladder Disorders

From bladder control issues, like urinary incontinence and frequent urination, to the opposite problem — urinary retention — there are many ways your bladder can act up. And a lot of different things can cause this to happen.

Did you know that some foods can irritate your bladder? So can dehydration from not drinking enough water. Urinary tract infections can also cause bladder inflammation (cystitis). You might notice urine changes. It may feel like you have to pee all of the time or need to go right away (urgency). It might also burn or hurt when you pee (dysuria). Or you might have trouble getting pee out. Sometimes, bladder inflammation can be so bad that it can cause bleeding in your bladder lining (hemorrhagic cystitis).

And while you may have heard of kidney stones, you may not know that you can also get bladder stones (bladder calculi). These bladder stones can cause pain, scarring and bladder outlet obstructions (BOO). This means the flow of pee from your bladder and into the urethra (the tube that removes pee from your body) slows down or stops entirely (is blocked).

Other bladder disorders include:

• Acute cystitis.
• Bladder cancer.
• Contracture of the bladder neck.
• Fallen bladder (cystocele).
• Functional incontinence.
• Neurogenic bladder.
• Non-neurogenic voiding dysfunction.
• Overactive bladder.
• Overflow incontinence.
• Painful bladder syndrome (interstitial cystitis).
• Pelvic floor disorders.
• Shy bladder syndrome (paruresis).
• Stress incontinence.
• Urinary tract infections (UTIs).
• Vesicovaginal fistula.

The good news is that most bladder disorders are treatable. And the first step is finding out what’s causing them through testing and making a correct diagnosis.

What to expect at your first visit

It might feel uncomfortable talking about peeing. But our urology providers spend every day helping people do just that. We’ll take the time to help you feel comfortable during your first appointment. We start off by getting to know each other. Your provider will ask you to share your story. And they’ll help you do this by asking a lot of questions, like:

• What kind of symptoms are you having?
• How long have you had symptoms?
• Are your symptoms getting worse?
• How are your symptoms affecting your life?
• On a scale of 1 to 10, how bad is your pain?
• Have you had any testing for this problem?
• Do you have any other health conditions?
• Are you taking any medications?

During your visit, your provider will do a physical exam and order tests to help confirm a diagnosis, like:

• Urinalysis.
• Urine culture.
• Ultrasound.
• Cystoscopy.
• CT scan (computed tomography scan).
• Kidney function tests.
• Post-void residual urine test.
• Urodynamic testing.

You may also need to keep a bladder diary. This tracks how much fluid you drink, how much you pee, how long it takes you to do it and how often you go each day.

Meet Our Bladder Disorders Team

While our urology providers treat most bladder conditions, you may need to see other specialists as part of your treatment. We’re all about team-based care at Cleveland Clinic because it lets us highly personalize your treatments. Depending on your needs and diagnosis, your care team may include:

• Urologists.
• Gynecologists.
• Nephrologists.
• Neurologists.
• Radiologists.
• Pathologists.
• Anesthesiologists.
• Physical therapists.
• Psychologists.
• Nurse practitioners.

There are many different bladder disorders — and they can affect people in different ways. So there isn’t one way to treat them. Your care team will consider a lot of things as they build a treatment plan — your age, your assigned sex, the kind of bladder disorder, your symptoms and your treatment goals.

Medications

Some bladder conditions respond well to medications. If you have a bladder infection like acute cystitis, we may prescribe antibiotics. If you’re looking for relief from urinary incontinence, you may take medications that stabilize the muscle contractions that cause an overactive bladder. Or you might need medications to relax muscles so your bladder can empty fully.

Lifestyle changes

We may be able to help you get relief by guiding you through lifestyle changes. Cutting back on irritants like alcohol or caffeine can be a good start. Exercising is another. Weight loss and stopping tobacco use can also help you find relief.

Physical therapy

Your provider may decide to prescribe physical therapy to strengthen your pelvic floor and abdominal muscles. This may include kegel exercises (pelvic floor contractions), exercises to improve muscle strength and biofeedback.

Bladder retraining

When you do bladder retraining, you only use the bathroom at set times during the day. This resets your bladder muscles by teaching you to resist feelings of urgency and delaying your bathroom visit until the designated time.

Other treatments

There are other ways to correct some bladder disorders, particularly if other, less-invasive methods haven’t worked. Some of these include:

• Botulism toxin (Botox^®).
• Condom catheter for incontinence.
• Continuous bladder irrigation.
• Cystolitholapaxy.
• Nerve stimulation (neuromodulation) devices.
• Self-catheterization (clean intermittent catheterization).
• Sling procedures.
• Surgical mesh.

Bladder surgery

Some bladder disorders, like bladder cancer, cystocele or urinary incontinence, may be treated with surgery. We use minimally invasive laparoscopic or robotic surgery whenever possible. Your provider will go over options with you if they feel surgery is best for you and your diagnosis.

Taking the Next Step

Bladder disorders can be uncomfortable to talk about, but they can cause real anxiety. The good news is that most of these conditions are treatable — and often without invasive surgery. Cleveland Clinic’s experienced and compassionate urology care team is here to help you find out why you’re having bladder problems. And they’ll create a personalized treatment plan to help you get control of your life — and bladder — again.