Distended bladder: 13 Causes, Symptoms, Treatments, Complications

Distended bladder can be really troublesome when you are outside your home. So, let’s learn why it occurs and how to get rid of it.

There is an organ in the form of the sac in our body that maintains the urine in it before our body excretes and get rid of it. But not always this bladder or sac keeps its same size or form. In some cases, it gets enlarged more than usual, this is called distended bladder.

What is Distended Bladder?

distended bladder
Distended bladder
Image source: susanhutchinson.com

It is a bladder with a bigger size than usual; its walls are thickened due to overstretching causing its extension and enlargement, a condition called distended bladder or bladder hypertrophy. Distended bladder if not treated and taken seriously is a life-threatening condition.

Sometimes distended bladder could be seen at the time of birth or due to obstructions and diseases later. Distend bladder means that your bladder is filled with urine, but little and inconsistent amount passes out causing pain and unrelieved sensation in the pelvic area, with never an empty bladder feeling.

Symptoms of the distended bladder?

Frequent visits to the bathroom in mildly distended bladder:

  • Leaking urine
  • Urinating difficulty
  • Always the bladder is filled (only there is partial urine release in the distended bladder)
  • Slow, inconsistent urine flow
  • Abdominal and especially pelvic pain recognizing distended bladder, tender when touched
  • Waking up from sleep urging to urinate
  • Abnormal sweating
  • Blood in urine in some cases
  • Pain during urination
  • Kidney failure
  • Fever if there is an infection
  • High blood pressure
  • Feet swelling from fluid retention
  • Sometimes distended bladder is from a neurological disorder, causing a numb feeling in limbs, and maybe the limb muscles get weaker.

What causes a distended bladder?

The passage of urine is obstructed usually in the distended bladder which could be found in certain cases:

Urinary bladder stones:

Urinary bladder stones, cause obstructions based on the size of stones, causing mild to severe pain. Big stones cause urine retention with swelling and high blood pressure and cause the patient to suffer.

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Prostate enlargement:

There is enlargement of the prostate gland which totally or partially blocks the orifice form which the urine is excreted, preventing urine release and causing distended bladder symptoms. It is usually seen in old patients and prostate cancer individuals.

Infections:

Infection or ulceration of the channel which connects the urinary bladder to the urinary outlet can cause severe pain and prevent urine release.

Sphincter spasticity:

The neurological disorder, if associated with distended bladder will cause numb feeling in limbs, and maybe the limb muscles get weaker. The contraction and relaxation of the bladder muscles are controlled by nerves.

If any disease that will affect these nerves is present, it will cause problems in the neural control of the bladder emptying mechanism. Spine rigidity or spine degeneration, spinal injury and spinal tumours are the main types of spinal diseases causing distended bladder.

Urinary obstruction:

Obstruction in the bladder or the urethra is a major cause of distended bladder. This obstruction is usually in the form of stones or tumours, originating from the kidney, this will make the bladder perform extra effort in contraction to assist urination from this obstruction.

This will create elasticity loss in the walls of the urinary bladder. Fast and correct diagnosis of such disorders helps in preventing enlargement of the urinary bladder

Uncontrolled Diabetes:

There are other cases, for example, uncontrolled diabetic patients, who produce large amount of urine, so they never feel empty bladders and are always full, causing enlargement and stretching of the bladder. This prevents the bladders to go back to their original size.

Congenital problems:

Unfortunately, some kids have distended bladder congenitally or at birth due to some genetic or formation problems, but no symptoms are shown or expressed until a few years later when the kids grow up.

If it is accidentally discovered while taking a radiograph or medical screening for any reason, it should be monitored closely and followed up well to prevent over-stretching and enlargement in their bladders.

Obesity:

Obese with overweight patients and diabetic ones are of the most suspected subjects to have distended bladder.

Neurological diseases:

Multiple sclerosis & paralysis, cause hard times to their patients, as they also face difficulty in emptying their bladders.

Tuberculosis:

An infection caused by tuberculosis, called Pott’s disease usually affects the vertebral column and damages the spinal nerves, which are responsible for bladder walls regulation. This leads to contraction and relaxation difficulty of the muscle bladder.

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Ovarian tumour:

In females, one of the important causes of the distended bladder is an ovarian tumour, uterine cystic fibrosis (very common) or even a pelvic cyst.

Drugs:

Anti-histaminic drugs, in some case anaesthetics and usually muscle relaxants, causes uncontrolled activity of the bladder wall. This difficulty in control causes some enlargement and stretching that leads to the distended bladder.

Pregnancy:

Pregnancy will surely cause some difficulty in bladder control in a normal female patient even if the size of her urinary bladder is normal, due to the high pressure over the bladder by the uterus. But, those pregnant women with already enlarged bladders will find it so difficult to control the emptying of the bladder, and it’s more severe than other women.

Diagnosis of the distended bladder:

Proper examination and correct diagnosis are vital for the treatment of the distended bladder.

  • Inflamed lower pelvic and abdomen area is felt upon palpation.
  • Tightening of the muscles of the lower abdomen and patient will complain of pain and strain depending on the severity of the case.
  • High blood pressure with no significant reason due to fluid retention and the increase of electrolytes.
  • Using Uroflowmetry, there is an abdominal strain obvious.
  • Inconsistent urination
  • In some cases with severe progression, there is blood in urine.

Treatment options for a distended bladder:

Removing the source of disease is the key of distended bladder treatment.

Fast and accurate diagnosis is very important because once there is damage to the walls of the bladder and they are overstretched, they won’t be fixed and returned to the original size. Treatment will only limit the condition and mild symptoms will be observed.

Surgery:

If Obstruction is the source of the distended bladder, then go for surgery as a means of treatment to remove the obstruction and blockage. There different types of invasive surgery, the surgeon decides which one to use depending on the size of obstruction and severity of the case.

Home remedies that would help in treating enlarged bladder:

If you begin to see any difference in the way you urinate and are concerned you have distended bladder, speak with your physician for early diagnosis & treatment.

  • Massaging with a hot bottle over the lower abdomen area helps to release the urine and relieve the pain and strain felt.
  • Open the water tap during urination to psychologically stimulate the bladder to release its content.
  • Catheterization, under the supervision of a doctor or nurse, is one of the remedies to empty the bladder. Usually, it is used in severe cases and disabled patients. Aseptic techniques are very important to avoid any urinary tract infection that will worsen the case.
  • There are over the counter medications that have to be prescribed by your physician first depending on your case diagnosis, which simulates parasympathetic nerves to regulate the normal contraction and relaxation of the bladder during urination.
  • Pott’s disease which is an infection from tuberculosis, when treated, there is symptomatic relief
  • Another treatment method is the biofeedback; it gives guidance through computer monitor on how to control bladder contraction and relaxation.
  • Botulinum toxin injection type A that causes temporarily strain in muscle increasing the control over the bladder, can efficiently treat sphincter spasticity. But unfortunately, its action is only temporarily and has to be reinjected.
  • Did you know that physical activity and some exercises, can help in emptying the bladder?
  • A warm bath at least twice a day will enhance urination.
  • There is a medical device which is inserted into the body, in patients with neurological problems, which targets the nerves of the bladder, for muscle regulation.
  • Distended bladder if caused by an infection, primary treatment will revolve around treating the infection.
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Medical interventions of the distended bladder (in case of failure of home remedies):
  • Bladder drainage in hospital.
  • Urethral Dilation
  • Urethral stents for urethral support from the bladder till the ejection of urine as it helps in getting control over teh muscle.
  • Prostate surgery for men with prostate disease or tumours

Complications from a distended bladder:

  • Urinary tract infections from retained urine and electrolytes, causing severe pain and burning sensation during urination.
  • Hypertension (high blood pressure)
  • The most common complication of the distended bladder is that the bladder retains urine for longer than it should. This can lead to kidney damage and chronic kidney disease. Unfortunately, kidney damage will require dialysis or kidney transplant.
References:
  1. Bemarrahealth
  2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3398309/
  3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472851/

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