It is an embarrassing situation when you have an urge to pass urine, but you may not be able to void immediately due to various reasons. The result is you have a distended bladder with mild pain in lower abdomen. Often we all come across such situation mostly while traveling. We only feel relieved after emptying our bladder.
However, apart from these normal phenomenon that we sometime face, there are many pathological conditions that may cause distended bladder. There may be an urge to pass urine, but the person may not be able to pass urine or if at all, he may void minimal quantity. This typical presentation is found in retention of urine, which leads to distension of bladder. Distension of bladder is a result of large accumulation of urine.
Causes Of Distended Bladder
Bladder distension can occur primarily due to two main reasons:
- If there is a blockage in the pathway of urine expulsion.
- If there is damage to the nerve or the bladder wall that controls urination.
Following are some important causes:
Urinary tract causes:
- A large sized stone in bladder can block the urine outflow and cause accumulation of urine in bladder.
- Similarly prostate enlargement (Benign prostate hypertrophy, BPH) may obstruct the urethral passage and cause retention of urine with bladder distension. It is usually seen in old males above the age of 55years. The flow of urine may be completely blocked or partially blocked, depending on the size of the growth.
- Problems in urethra such as stricture, spasm, infection or an ulcer may lead to partial or complete blockage of urine. Urethra is a passage through which urine flows out of the body. Urethra is connected to urinary bladder.
Damage to nerves which control bladder contraction and relaxation to empty the collected urine may be a cause for distended bladder. These nerves can get compressed and damaged as a result of spinal cord compression, spinal cord tumor, or injury to spinal cord. Infection of spinal cord such as pott’s disease can also compress the spinal nerves and become a cause for bladder distention.
In females, compression of bladder as a result of ovarian tumor or uterine fibroid or pelvic cyst may also cause distention of bladder.
Certain drugs such as smooth muscle relaxants, antihistamines, anesthetic drugs, can cause bladder enlargement.
Distended Urinary Bladder Symptoms
- Pain in lower abdomen: Most cases of distended bladder come with the first complaint of pain in lower abdomen. The lower abdomen may feel swollen when it is palpated. It feels tensed and tender when toughed. This is particularly felt in a thin person. However, pain may not be elicited in old age people or those who are in coma. If the condition is chronic, then there is less pain as compared to acute state.
- Difficulty to urinate: Patient may find difficulty to pass urine, even though there is an urge to pass it. There may be partial outflow after great straining. The person may feel unsatisfied and there is always a feeling of bladder fullness.
- Prolonged time for urination: the person may find an extended period of time for actual flow of urine to take place after trying to urinate.
In neurological causes there may be associated symptoms such as weakness in muscles, pins and needles in limbs, decreased muscle tone etc.
Treatment Options For Distended Bladder
- In most cases of acute bladder distension, applying hot water bag or sitting in bathtub containing hot water may be effective. It relieves the congestion of bladder and allows easy voiding of urine.
- Reassurance and encouragement to pass urine is also valuable during this period.
- Many times hearing or watching the flow of tap water helps to start the urine flow.
- In case if all the home treatment options fail, the last option is to visit a hospital and consult a doctor. In hospital, they may use catheter (a tube) for removal of accumulated urine in a distended bladder. Full aseptic precautions are taken while introducing the catheter inside the urethra and bladder.
- In case of neurological causes, new implantable devices have come, which stimulate the nerves and muscles of bladder to contract and relax when the need arises.