What is bladder fullness?
Bladder fullness is a sensation that the bladder is filled to capacity and there is a need to urinate. This is also known as urinary or bladder urging. It is normal sensation that every person experiences as the bladder fills close to its maximum capacity. It serves as a signal that a person needs to find the appropriate facility to urinate. Although the sensation can be ignored for a period of time if the situation is not suitable, the sensation gradually intensifies until a person can no longer bear it or a person may end up urinating involuntarily.
However, sometimes the bladder fullness sensation occurs even after passing urine or with there being only small amounts of urine contained within the bladder compared to its normal capacity. In these cases the sensation is abnormal and most likely a symptom of some underlying disease of the bladder. It is more correctly known as urinary or vesical (bladder) tenesmus. Although the causes of this bladder fullness sensation is largely the same for both males and females, there are some conditions which are specific to each gender that results in this abnormal feeling.
Normal Filling of the Bladder
The bladder is constantly filling with urine throughout the day and night. The rate at which it fills depends on the filtration rate of the kidney, total water volume, levels of electrolytes and various hormone levels. Urine produced in the kidneys passes down the ureters and into the bladder where it is stored for a period of time. As the bladder fills its muscular walls are stretched. Special receptors in the walls of can detect the degree of stretching and this is perceived as the sensation of bladder filling.
The adult human bladder has a maximum capacity of about 500 ml (1 pint) but the average full bladder sensation peeks when the urine levels reach about 350 mL (three quarters of a pint). The bladder fullness sensation becomes intense as the bladder fills to capacity. It subsequently relieves after the bladder is emptied during urination. Normally the bladder is emptied out to a sufficient degree to ease the stretching of the bladder walls. However, if the bladder is not completely emptied then the sensation may persist albeit milder than it was initially.
The bladder control mechanism ensures that the bladder fills gradually thereby expanding as it fills, is emptied almost fully during urination and that the sensation arises and subsides in response to filling and emptying.
Abnormal Bladder Fullness Sensation
There are several ways that an abnormal bladder sensation arises.
- The bladder does not empty fully or at all in which case the sensation cannot truly be considered abnormal.
- The bladder wall is irritated and causes abnormal sensations of bladder fullness despite the bladder being empty.
- External pressure on the bladder wall from surrounding organs.
Less commonly, problems with the nerves that carry impulses from the bladder (sensory nerves) may be responsible for an abnormal full bladder sensation.
Other Signs and Symptoms
An abnormal bladder fullness sensation is a symptom of a disease and not a disease on its own. Other symptoms that may also be present includes :
- Painful urination (dysuria)
- Blood in the urine (hematuria)
- Cloudy urine
- Abnormally offensive odor of the urine
- Urinary frequency
- Urinary retention
- Urethral discharge
- Urinary incontinence
- Genital itching
Causes of Bladder Fullness Sensation
The most common causes of an abnormal bladder fullness sensation are :
- Cystitis is inflammation of the urinary bladder. An infection of the bladder as a consequences of an ascending urinary tract infection (UTI) is the most common cause.
- Urethritis is inflammation of the urethra which is mainly due to an infection. It also occurs frequently with sexually transmitted infections (STIs) and trauma.
- Sexually transmitted infections (STIs) such as gonorrhea or chlamydia which are contracted through sexual contact.
- Prostate problems in men.
Other causes that are due to problems with urinary tract may include :
- Bladder cancer – malignant tumor of the bladder.
- Bladder stones – stones within the bladder that either forms here or passes down from the kidney (kidney stone).
- Urethral strictures – narrowing of the urethra.
- Overactive bladder syndrome – involuntary contraction of the bladder muscles.
- Neurogenic bladder – damage of the bladder nerves affecting sensation or control.
- Trauma – injury to the bladder or urethra especially following catheter insertion.
A bladder fullness sensation may also arise in an otherwise healthy bladder with certain diseases affecting the surrounding organs or related structures :
- Rectal tumors
- Fecal impaction
- Spinal injury
- Spinal cord tumors
- Spina bifida
- Abdominal injury
- Colon or rectal surgery
- Foreign objects lodged in the urethra or bladder
Bladder Fullness in Men
Certain conditions with bladder fullness as a symptom may be specific to men. This includes :
- Prostatitis – inflammation of the prostate often due to an infection.
- Benign prostatic hypertrophy – enlargement of the prostate usually associated with advancing age.
- Prostate cancer – malignant tumor in the prostate gland.
Bladder Fullness in Women
Gynecological conditions do not as frequently present with bladder fullness as prostate conditions in men. Nevertheless it should be taken into consideration as possible causes of bladder fullness in women.
- Tumors in the uterus or cervix.
- Following pelvic surgery such as a hysterectomy