Bladder Pain: Causes, Symptoms, and Treatment Options

Bladder pain

Hello Doctor: Two years ago, my frequent urination improved, but I have been experiencing a hard and distended feeling in my lower abdomen and bladder.
I previously took medication to relax the bladder.
I feel pressure in my bladder and occasionally experience a sense of heaviness and the urge to urinate (this discomfort worsens a few days after my menstrual period, accompanied by nausea, a feeling of heat throughout my body, and bladder pain when I hold my urine).
Sometimes, I feel a strong urge to urinate that causes pain and I struggle to hold it, while at other times I can hold up to 500 ml.
However, I do not go to the bathroom more than 8 times a day (I drink 1000 ml to 1500 ml of water daily).
I have undergone multiple urine tests (some showed bacteria) and abdominal ultrasounds, and all urinary tract examinations were normal.
I have taken PARAN for pain relief and medication for overactive bladder, as well as laxatives for constipation, but I feel they have not been effective, and my lower abdomen and bladder still feel distended and painful.
Could this be due to hypersensitivity of the bladder nerves? How can I improve this condition?

Chen, 20~29 year old female. Ask Date: 2018/09/13

Dr. Xu Wencang reply Urology

You can consult a gynecologist to check for any other issues.
For overactive bladder, in addition to medication and symptomatic treatment, you may try physical therapy such as Kegel exercises.
Please return for a follow-up examination and consult your physician for further inquiries.

Reply Date: 2018/09/13

More Info

Bladder pain can be a complex and distressing symptom that may arise from various underlying conditions. Based on your description, it seems that you have been experiencing persistent bladder discomfort, pressure, and urgency, which have not improved despite various treatments and investigations. Understanding the potential causes, symptoms, and treatment options for bladder pain is crucial for effective management.

Causes of Bladder Pain
1. Bladder Infections (Cystitis): One of the most common causes of bladder pain is a urinary tract infection (UTI). Symptoms typically include a burning sensation during urination, frequent urges to urinate, and sometimes blood in the urine. Although you mentioned multiple urine tests, it’s important to ensure that any infections are adequately treated.

2. Interstitial Cystitis (IC): This is a chronic condition characterized by bladder pressure, bladder pain, and sometimes pelvic pain. It can lead to increased urinary frequency and urgency. The exact cause of IC is not well understood, but it may involve inflammation of the bladder wall.

3. Bladder Overactivity: Overactive bladder (OAB) can cause symptoms such as urgency, frequency, and in some cases, pain. This condition can be triggered by various factors, including nerve issues or bladder muscle dysfunction.

4. Bladder Stones: Although you have undergone imaging studies, bladder stones can sometimes be overlooked. They can cause irritation and pain, especially when the bladder is full.

5. Neurological Conditions: Conditions that affect the nerves controlling the bladder can lead to symptoms of urgency and pain. This includes conditions like multiple sclerosis or spinal cord injuries.

6. Pelvic Floor Dysfunction: Issues with the pelvic floor muscles can lead to bladder pain and discomfort. This may be exacerbated by stress, anxiety, or physical strain.

Symptoms to Monitor
- Pain Location: Note where the pain is located (e.g., lower abdomen, pelvic area) and whether it radiates to other areas.

- Urinary Symptoms: Keep track of any changes in urinary frequency, urgency, or the presence of blood in urine.

- Associated Symptoms: Pay attention to any other symptoms such as nausea, vomiting, or changes in bowel habits.

Treatment Options
1. Medications: Depending on the underlying cause, medications may include:
- Antibiotics for infections.

- Anticholinergics or beta-3 agonists for overactive bladder.

- Pain relievers like acetaminophen or NSAIDs for symptomatic relief.

- Antidepressants may also be prescribed for chronic pain management.

2. Bladder Training: This involves scheduled voiding to help retrain the bladder and reduce urgency.

3. Physical Therapy: Pelvic floor physical therapy can be beneficial for those with pelvic floor dysfunction.

4. Dietary Modifications: Some foods and beverages can irritate the bladder. Keeping a food diary to identify potential triggers may help.

5. Hydration: While you are drinking a reasonable amount of water, ensure that you are not over-hydrating, which can sometimes exacerbate symptoms.

6. Surgical Options: In severe cases of interstitial cystitis or bladder dysfunction, surgical interventions may be considered.

Next Steps
Given your ongoing symptoms and the complexity of your case, it is advisable to have a thorough discussion with your healthcare provider about:
- The possibility of interstitial cystitis or bladder overactivity.

- Further diagnostic tests, such as cystoscopy, to visualize the bladder and rule out other conditions.

- Referral to a specialist, such as a urologist or a pelvic pain specialist, for a more comprehensive evaluation and tailored treatment plan.

When discussing your symptoms with your doctor, be clear about the frequency and intensity of your pain, how it affects your daily life, and any treatments you have tried. This information will help guide your physician in determining the best course of action for your bladder pain.

Similar Q&A

Understanding Bladder Pain: Causes and Treatment Options

Hello Doctor: The day before yesterday, I accidentally pressed lightly on the right side of my bladder (the area covered by pubic hair) and experienced significant pain, while the left side was unaffected. Normally, I do not feel any pain while walking, sitting, or lying down. Ho...

Dr. Xu Weikai reply Urology
Richard: Hello, it could possibly be one of the following conditions: 1. Cystitis 2. Localized neuropathy 3. Myositis 4. Nephrolithiasis. The simplest way to differentiate these is to conduct a urinalysis and an ultrasound examination for initial assessment. If the pain persists,...

Understanding Bladder Pain: Symptoms, Causes, and Treatment Options

Yesterday afternoon, after holding my urine (I urinated more frequently in the afternoon, about every half hour to an hour, with a volume greater than 100ml), I started experiencing pain in my lower abdomen. This morning, I went to the hospital to see a urologist. After the consu...

Dr. Du Shixi reply Urology
Hello: Q1: Is this a bladder infection? Typically, doesn't the infection start from the urethra? Or are there already some bacteria in the bladder that can cause an infection if the bladder is injured? If the urine test is sterile, does that mean the inflammation is just d...

Understanding Urinary Difficulties: Causes and Treatment Options

Hello, doctor. I apologize for bothering you again! I know that my bladder is full of urine and I want to urinate, but I always feel very tense and can't seem to do it. Additionally, I find it easier to urinate when I have a bowel movement, but sometimes I have to apply pres...

Dr. Lai Ronghao reply Urology
Hello: Your issue requires scheduling urodynamic testing, cystoscopy, medical history review, physical examination, and urinalysis to determine the cause and to provide further treatment based on the findings. Please visit our Urology outpatient clinic for further examination and...

Understanding Bladder Pain and Frequent Urination: Causes and Solutions

I have been experiencing frequent urination for over a month. I have seen several doctors, but there has been no improvement. I have been taking antibiotics for almost a month, but I feel the urge to urinate every half hour and often experience discomfort and a burning sensation ...

Dr. Zhang Chengye reply Urology
Hello: It may be cystitis. Please be patient and take your medication while following up with the urology clinic to monitor your condition. Thank you!