Bladder Problems: Causes and Symptoms

The urinary tract consists of the kidneys, ureters, bladder, urethra, and in males, the prostate gland as well. The bladder is one of the main components of the urinary tract, and its primary role is to serve as a reservoir for the storage of urine, which is produced by the kidneys and for excretion of the stored urine out of the body at a convenient time.

What are bladder problems?

In the field of urology, many problems can occur with the bladder, and these include infections, cancers, and inflammation.

Common bladder problems in women

In women, common bladder problems include urinary incontinence and urinary tract infections. UTIs are more common in women than in men because the urethra in women is shorter, meaning that bacteria can travel easily through the urethra into the bladder and up into the rest of the urinary tract to cause infection.

Common bladder problems in men

In men, bladder problems may arise due to benign prostatic hyperplasia (BPH). An enlarged prostate results in obstruction of urine flow, and this can lead to bladder dysfunction resulting in urological symptoms such as increased urinary frequency, urgency, slow urine stream, increased straining, and nocturia (passing urine frequently at night).

General issues faced

Urinary tract infection (UTI) that affects the bladder (cystitis)
- UTIs can lead to infection of the bladder. Cystitis can present with symptoms such as lower abdominal pain and discomfort, fever, chills, and pain when urinating. Occasionally, there may be blood or pus in the urine as well.

Urinary incontinence
- Urinary incontinence refers to the involuntary leakage of urine. Broadly, there are several types of incontinence, such as stress incontinence, urge incontinence, overflow incontinence, and neurogenic incontinence.
- In women, stress incontinence is common, especially in those who have had vaginal deliveries before, as birth often causes the pelvic floor muscles to weaken.
Overactive bladder
- Overactive bladder (OAB) refers to when the bladder muscles undergo involuntary contractions, leading to an increased urge to pass urine and increased urinary frequency.
Interstitial cystitis (also known as bladder pain syndrome)
- Interstitial cystitis is a chronic disorder of the bladder that results in the feeling of pain and pressure in the bladder. It results due to inflammation of the bladder and can lead to permanent scarring. IC is not a bladder infection, although its symptoms very much mimic that of a UTI.
Bladder cancer
- Bladder cancer results from excessive and uncontrolled cell growth in the tissues of the bladder. Risk factors include cigarette smoking, previous chemical exposure, and having a family history of bladder cancer.

Common symptoms associated with bladder problems

Common symptoms associated with bladder problems include:

Increased frequency of urination
Increased urge to urinate
Nocturia (waking up at night to pass urine)
Weak urine stream
Intermittent urine flow
Straining to pass urine
Hesitancy to pass urine
End-stream dribbling
Double voiding
The sensation of incomplete voiding
Pelvic pain
Blood in urine
Low-grade fever

If you experience any of these symptoms, please consult a urologist.

When should you be worried about a bladder problem?

You should seek medical attention if you begin to notice any of the symptoms mentioned above. Prompt diagnosis is key in helping to make sure that complications do not arise.

How are bladder problems diagnosed?

Bladder problems are diagnosed through:

Taking a history from you, including a list of your medical conditions, social background, family history
Performing a physical examination from you
Blood tests such as a kidney function test
Testing your urine for bacteria, blood, etc.
Imaging of the urinary tract, such as ultrasounds and CT scans
Biopsies of the kidney, i.e. taking tissue samples to be sent to a lab for further investigation

Depending on clinical suspicion, the list of tests that you may undergo may be different. It is best to speak to a urologist to get a good assessment. Based on your results, Dr Terence Lim will work with you on a personalised treatment plan best suited to your needs.