Bladder problem in women: symptoms, causes and treatments

Bladder problems in women are varied and can have various origins. From urinary infection, commonly called cystitis, to an overactive bladder, including urinary retention or incontinence, these disorders can affect daily life and require appropriate care. Knowing the symptoms is essential for early detection.

Understanding the bladder and how it works

The bladder is an essential organ of the urinary system whose main function is to store urine produced by the kidneys before its evacuation . It is designed to hold up to 600ml of urine, although most people feel the need to urinate when it reaches around 250ml.

This organ is made up of a muscle, the detrusor, and several layers of epithelial lining . The kidneys filter the blood and produce urine which is then carried to the bladder through the ureters. As the bladder fills, the sphincters remain closed to prevent urine leakage.

During urination, the detrusor muscle contracts and the sphincters relax, allowing urine to pass through the urethra. In women, the urethra is relatively short (about 4 cm) and is located between the vagina and the clitoris.

Finally, the bladder is a very expandable organ, capable of containing 200 to 500 milliliters of fluid in adults . It is located at the very bottom of the abdomen, in the pelvis.

Urination problems in women

Difficulty urinating: causes and solutions

Dysuria , the medical term for difficulty urinating, can be caused by a variety of factors. The most common causes are:

• Urinary infections such as cystitis or genital infections such as vulvovaginitis. In these cases, drug treatment is usually sufficient.
• The presence of an obstacle under the bladder preventing the evacuation of urine, often due to a hormonal imbalance .
• Mechanical causes such as a cyst on the ovaries or a fibroid of the uterus which compresses the bladder.
• An abnormal descent of the bladder into the pelvic cavity ( prolapse ), often following childbirth or uterine surgery.

For these situations, drainage by urinary catheter or suprapubic puncture is sometimes necessary.

Finally, certain lifestyle changes, including reducing caffeine and alcohol consumption, as well as regular exercises to strengthen the pelvic muscles, can help improve urinary symptoms.

Urinary incontinence: what does it consist of?

Urinary incontinence is a condition characterized by involuntary leaking of urine . This loss of control can manifest itself in different ways:

• Stress incontinence : Occurs during activities that increase abdominal pressure such as coughing, laughing, exercising, or lifting heavy objects.
• Urge incontinence : Also known as overactive bladder, it is characterized by a sudden, irrepressible urge to urinate.
• Mixed incontinence : a combination of the two previous types.
• Overflow incontinence : occurs when the bladder is too full and urine spills (also called overflow urination )

The causes of urinary incontinence can vary, from hormonal changes and age to physical factors such as obesity, vaginal births, pelvic surgeries, or even certain medications. Urinary leakage can also be temporarily caused by certain foods and drinks.

Urinary retention: symptoms and treatment

Urinary retention is a condition characterized by an inability to completely empty the bladder . Common symptoms include a persistent feeling of a full bladder, pain in the lower abdomen, and difficulty starting to urinate or maintaining a steady flow of urine.

Several factors can contribute to urinary retention in women, including:

• nerve damage
• muscle problems
• obstructions in the urinary tract
• or certain medications.

Causes specific to women may include tumors of the uterus or weakening of the pelvic muscles following childbirth.

Treatment for urinary retention depends on its underlying cause. In acute cases, immediate drainage of the bladder is necessary, usually by catheterization. For chronic cases, medication, pelvic rehabilitation exercises, or surgery may be necessary.

Cystitis, a common inflammation of the bladder

What is cystitis?

Cystitis is an inflammation, generally of infectious origin, which is located in the bladder. Very common in women, it is mainly caused by the bacteria Escherichia Coli. It is characterized by various symptoms, including a burning sensation when urinating and an increase in the frequency of urination, often for small amounts of urine.

In some cases, cystitis may be linked to other factors, such as menopause, diabetes or pregnancy. There are different types of cystitis, including interstitial cystitis, an inflammation of the bladder without an infectious cause, which causes pain above the bladder and a frequent need to urinate.

Symptoms of cystitis

Cystitis, often of bacterial origin, can manifest itself in different ways. The most common symptoms are:

• Burning or pain when urinating
• A feeling of weight in the lower abdomen
• Urgent needs to urinate

In some cases, a slight fever or blood in the urine may be observed. Cystitis can also be the manifestation of an abnormal reaction of the bladder and reveal other pathologies such as the presence of a stone in the bladder.

It is therefore important to consult a healthcare professional quickly as soon as symptoms appear.

How to treat cystitis?

To treat cystitis, the first step is to consult a doctor who will prescribe appropriate antibiotic treatment . The most common is single-dose fosfomycin-trometamol.

If this option is not possible, another antibiotic, pivmecillinam, can be used for 3 days. It is also possible to take an antispasmodic such as Spasfon® to relieve pain. If conventional antibiotics are not suitable, nitrofurantoin may be prescribed for 5 to 7 days.

In milder cases, natural remedies can be used to ease the pain. For example, a mixture of baking soda and lemon can be prepared in a glass of water. However, these methods are not a substitute for appropriate medical treatment and should only be used as a supplement.

It is essential to note that self-medication is not recommended in cases of cystitis . Indeed, antibiotics are not available without a prescription and inappropriate treatment can worsen the situation.

Urinary tract infection in women: symptoms and treatments

Recognizing a UTI

A urinary tract infection , often caused by the bacteria Escherichia Coli, is characterized by several symptoms . Among them :

• a burning sensation when urinating
• frequent urination
• often for small amounts of urine
• and a feeling of weight in the lower abdomen.

In some cases, the infection may manifest as a fever with chills, pain in the back or side. If you experience these symptoms, it is possible that the infection has affected a kidney (pyelonephritis) and you should urgently see a doctor.

It is also possible to present cloudy urine with an unusual odor, sometimes with traces of blood . Note that the presence of blood in the urine does not necessarily mean that the infection is serious, but it should prompt you to seek medical help quickly.

Causes of a urinary infection

A urinary infection, also called cystitis, can occur due to the proliferation of bacteria in the urinary system, usually Escherichia Coli (E.Coli) . Several factors can promote their appearance:

• Anatomical factors : in women, the urethra is shorter, making it easier for bacteria to move up to the bladder.
• Hygiene : Poor hygiene can facilitate the transfer of bacteria from the anal area to the urethra.
• Sexual intercourse : It can allow bacteria to enter the urethra.
• Menopause : Low estrogen can make the tissues of the urethra more susceptible to infection.
• Kidney stones : they can block the flow of urine, promoting bacterial growth.
• Lack of hydration : insufficient hydration can prevent the elimination of bacteria present in the bladder.

It is essential to know these risk factors to put in place appropriate preventive measures.

Treatment of a urinary infection

Treatment for a urinary tract infection can vary depending on the severity of the infection, but generally involves the use of antibiotics. Fosfomycin-trometamol is often prescribed as first-line treatment, as a single dose.

As a second line, pivmecillinam is another possible option for a duration of 3 days. In addition to medical treatment, it is recommended to:

• Drink plenty of water to help eliminate bacteria through urine
• Urinate as often as necessary, without holding back

Finally, certain natural remedies such as cranberry , thyme or lemon can help relieve symptoms.

Overactive bladder: what is it?

Overactive bladder: causes and symptoms

Overactive bladder is a clinical syndrome manifested by sudden, repeated and irrepressible urges to urinate, day or night, sometimes accompanied by urinary incontinence. It affects approximately 9 to 43% of women.

The causes of overactive bladder are multiple , and can include factors such as:

• Nervous system disorders
• Prostate enlargement in men
• Menopause in women
• Nerve damage
• Hormonal changes
• The use of certain medications
• High caffeine consumption

Characteristic symptoms of overactive bladder include:

• Sudden, irrepressible urges to urinate
• Frequent urination, day and night (pollakiuria)
• Frequently waking up at night to urinate (nocturia)
• Involuntary urinary leakage due to inability to hold urine (urge incontinence)

Treatment of overactive bladder

The treatment of overactive bladder involves several stages. It is first recommended to change your lifestyle habits . This includes staying adequately hydrated, reducing alcohol and caffeine intake, and adopting a healthy diet.

Specific exercises , like Kegel exercises, can also help strengthen the pelvic muscles and control the urge to urinate.

At the same time, medications may be prescribed to relax the bladder muscle and reduce symptoms. These include antimuscarinics and β3-adrenergic receptor agonists.

In certain cases, bladder rehabilitation may be considered. This aims to relearn the patient to control their bladder and to delay the urge to urinate.

Finally, for cases of overactive bladder refractory to first-line treatments, exploration of the bladder using an endoscope can be carried out to eliminate an underlying pathology.

Bladder pain in women: causes and solutions

Identifying bladder pain

Bladder pain generally manifests itself as a feeling of discomfort or pressure related to the bladder. They can be caused by several conditions, including:

• Bladder pain syndrome or interstitial cystitis , a chronic condition that causes a persistent and strong urge to urinate, sometimes accompanied by pelvic pain.
• Urinary tract infections (UTIs) , causing pain felt in the middle of the pelvis or lower abdomen.
• Bladder cancer , which can also cause bladder pain.

Pain may also be related to inflammation of a pelvic organ near the bladder or local inflammation in the bladder.

Treating Bladder Pain

To treat bladder pain, several options are available. Antibiotics are often used in cases of urinary infections, a common cause of pain. Analgesic and anti-inflammatory medications can reduce inflammation and relieve pain.

In cases of bladder pain syndrome, therapeutic approaches may include:

• behavioral therapy
• physiotherapy
• bladder retraining
• psychological therapy
• and transcutaneous electrical nerve stimulation (TENS).

Relaxing and antispasmodic medications such as anticonvulsants, antidepressants and antihistamines may also be prescribed. For chronic pain, pentosan, a medication taken by mouth, may provide relief.

Neurogenic bladder: understanding this genitourinary disorder

Symptoms of neurogenic bladder

Neurogenic bladder is characterized by bladder dysfunction due to damage to the nervous system. This disorder can cause various symptoms, which vary depending on the severity and nature of the neurological damage.

Symptoms may include:

• Overflow incontinence , which is loss of urine due to an overfull bladder.
• Pollakiuria , or frequent need to urinate, even if the bladder is not full.
• Urgent urination , which is a pressing and uncontrollable urge to urinate.
• Urge incontinence , which is a sudden loss of urine accompanied by an urge to urinate.
• Urinary retention , which is difficulty or inability to urinate.

Other symptoms may also be present, such as inability to completely empty the bladder, a weak urine stream, or straining during urination. An increase in urinary infections may also be observed, due to poor bladder emptying or poor urination control . Finally, difficulty determining when the bladder is full may also occur.

Treatment of neurogenic bladder

Treatment of neurogenic bladder depends mainly on the origin of the neurological lesion and the severity of the symptoms. Several support options can be considered:

• Medications : Certain medications can help improve bladder muscle contractions, making it easier to empty the urinary tract.

• Bladder retraining : Specific exercises may be recommended to improve bladder control and reduce symptoms.

• Surgery : In some cases, surgical treatment may be necessary, especially when the bladder cannot empty completely.

It should be noted that the treatment plan is personalized and defined according to the patient's general health, their medical history, and the type of symptoms presented.

Bladder cancer in women: symptoms and diagnosis

The first symptoms of bladder cancer

The first warning sign of bladder cancer is often blood in the urine, also called hematuria . However, hematuria does not always indicate bladder cancer. In fact, in 95% of cases, blood in the urine is not linked to bladder cancer.

Other symptoms may include:

• pain during urination (dysuria)
• a burning or tingling sensation
• and a frequent need to urinate.

It is crucial to consult a healthcare professional as soon as these symptoms appear for an accurate diagnosis.

Diagnosis and treatment of bladder cancer

To diagnose bladder cancer, several tests are necessary. Abdominopelvic ultrasound allows you to visualize the bladder, kidneys and urinary tract.

1. Cystoscopy, carried out under local anesthesia, allows the bladder to be inspected using a camera inserted into the urethra.
2. Biopsy, consisting of taking a fragment of tumor, is essential to confirm the diagnosis and determine the type of tumor.

In terms of treatment, doctors offer options adapted to each situation, depending on the nature and extent of the tumor . Treatments may include:

• Instillations into the bladder
• Surgery to remove the bladder
• General treatment with chemotherapy
• Radiotherapy treatment

In cases where the cancer has spread to the lymph nodes, adjuvant treatments, such as radiotherapy and chemotherapy, may be started to eliminate the remaining cancer cells.

Preventing bladder problems in women

Healthy lifestyle and prevention of bladder disorders

To prevent bladder problems, adopting certain healthy habits is essential.

• Hydration : Good hydration promotes optimal bladder function. It is recommended to drink at least 1.5 liters of water per day.
• Diet : A balanced diet can help prevent the formation of bladder stones. Avoid foods and drinks that may irritate the bladder such as coffee, alcohol or strong spices.
• Intimate hygiene : Good intimate hygiene can prevent urinary infections. It is advisable to wipe yourself from front to back after using the toilet and to wear cotton underwear.
• Physical activity : Regular exercises, especially those that strengthen the pelvic muscles, can help maintain good bladder health.

Finally, it is recommended not to hold back the need to urinate because emptying the bladder too rarely encourages the proliferation of micro-organisms.

When to consult a doctor ?

Consultation with a doctor is necessary as soon as certain unusual symptoms appear. Among these warning signs, we can cite:

• Unusual pain or sensations in the lower abdomen;
• Changes in urinary habits, such as a sudden and frequent urge to urinate;
• Presence of blood in the urine (hematuria);
• Difficulty urinating (dysuria) or inability to completely empty the bladder (urinary retention).

In the event of these symptoms, a general practitioner may be consulted first. Depending on the case, he may redirect to a specialist, such as a urologist or a gynecologist. Bladder problems can have multiple origins, so it is essential not to neglect them and to seek medical advice for an accurate diagnosis and appropriate treatment.