Bladder spasm
Encyclopedia
A bladder spasm is a contraction of the bladder which generates an urge to urinate, sometimes accompanied by extreme pain. Incontinence
Incontinence
Incontinence or Incontinent may refer to:*Fecal incontinence, the inability to control one's bowels*Incontinence *Incontinent , a 1981 album by Fad Gadget*Urinary incontinence, the involuntary excretion of urine...

 may occur if the bladder spasm continues, as the contraction will force urine out. Any resulting stream of urine may be impossible to stop, as the patient does not have control over his or her bladder.

A number of conditions can lead to bladder spasm; all should be addressed by a doctor.

When a bladder spasm occurs, the bladder randomly contracts, as though the patient is about to urinate. The patient feels like he or she needs to urinate, and some leakage may occur. One of the most common causes of incontinence in the elderly is bladder spasms, which can also occur in young children and pregnant women as well as animals. The spasms may be violent, with patients comparing them to cramps.

In spite of ordinarily-adequate post-operative analgesia, such as an epidural or an opioid infusion, bladder spasms remain a problem for some surgical patients. When bladder spasms occur in children, they can be traumatic for the child and a cause of frustration for hospital staff and anxious parents who find it difficult to deal with the fact that a child is in excruciating pain in spite of being on strong analgesia.

Causes

Causes include diet, medication, urinary tract infection, irritation from catheters, recent surgery, and changes in the blood supply and nerves controlling the bladder.

Weak muscles

Weak pelvic muscles may let the bladder sag out of position, which can stretch the urethral opening, leading to bladder spasm.

Nerve damage

Nerve damage may result in mistimed or erroneous signals, and the bladder may react with spasms. (Nerve damage may also prevent fullness signals from reaching the brain.) Nerve damage may be caused by diabetes, Parkinson's Disease, Multiple Sclerosis, and stroke; by trauma; by pelvic or back surgery; by a herniated disc; or by radiation
Radiation
In physics, radiation is a process in which energetic particles or energetic waves travel through a medium or space. There are two distinct types of radiation; ionizing and non-ionizing...

.

Interstitial cystitis

Interstitial cystitis
Interstitial cystitis
Interstitial cystitis or bladder pain syndrome is a chronic, oftentimes severely debilitating disease of the urinary bladder...

, the cause of which is unknown, may in turn cause bladder spasm.

Urinary tract infection

The most common cause of bladder spasm is urinary tract infection
Urinary tract infection
A urinary tract infection is a bacterial infection that affects any part of the urinary tract. Symptoms include frequent feeling and/or need to urinate, pain during urination, and cloudy urine. The main causal agent is Escherichia coli...

 (UTI), which is characterized by a burning sensation during urination and cloudy, foul-smelling urine. UTI may result in chills, vomiting, fever, and flank pain.

Catheter-related irritation

If bladder spasms occur or there is no urine in the drainage bag when a catheter is in place, the catheter may be blocked by blood, thick sediment, or a kink in the catheter or drainage tubing. Sometimes spasms are caused by the catheter irritating the bladder, prostate
Prostate
The prostate is a compound tubuloalveolar exocrine gland of the male reproductive system in most mammals....

 or penis
Penis
The penis is a biological feature of male animals including both vertebrates and invertebrates...

. Such spasms can be controlled with medication such as butylscopolamine, although most patients eventually adjust to the irritation and the spasms go away.

Treatment

Sometimes medication causes bladder spasm. Medicines that include bethanechol
Bethanechol
Bethanechol is a parasympathomimetic choline carbamate that selectively stimulates muscarinic receptors without any effect on nicotinic receptors. Unlike acetylcholine, bethanechol is not hydrolyzed by cholinesterase and will therefore have a long duration of action. Bethanechol does not involve...

 or valrubicin
Valrubicin
Valrubicin is a chemotherapy drug used to treat bladder cancer. Valrubicin is a semisynthetic analog of the anthracycline doxorubicin, and is administered by infusion directly into the bladder.It was originally launched as Valstar in the U.S...

(a chemotherapy drug) can cause bladder spasm because they help force water from the body.

Treatment includes bladder training, anticholinergic medication, electrical stimulation, pelvic floor exercises and surgery. Surgery is rarely helpful in controlling bladder spasms.

External links

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