What are bladder spasms?
Bladder spasm is a condition where the muscles of the bladder wall contract suddenly and often forcefully. This occurs without any warning and happens involuntarily. It may cause a sudden intense urge to pass urine and depending on the force of the contraction it may even result in urine being passed out unwillingly (incontinence). Usually there is not a complete emptying of the bladder but rather a leakage of urine from the bladder.
Bladder spasms are also referred to as overactive bladder (OAB), urge incontinence or urgency urinary incontinence (UUI) . It is typically described as a cramping sensation or burning pain and can vary in intensity. In severe cases, some women may even compare it to the labor pains associated with childbirth. Even when there is no incontinence, people with bladder spasms usually report frequent urination and nighttime urination (nocturia).
Read more on bladder fullness.
Causes of Bladder Spasms
The bladder dysfunction and urinary symptoms seen with bladder spasms may occur in other conditions, such as a bladder infection (cystitis) or other type of bladder disease. While these conditions can cause bladder spasms, it is important not to confuse these conditions with bladder spasms.
Why do bladder spasms occur?
It is important to first understand the normal functioning and control of the urinary bladder in order to understand how bladder spasms may occur.
The bladder is a hollow muscular organ which stores urine. Its walls are made of muscle which can stretch to allow the bladder to fill. When these muscles contract then it forces urine out of the urethra and into the environment. This is known as urination. Normally the muscular bladder wall only contracts when a person desires to do so although there may at times be involuntary contractions if the bladder filled beyond its maximum capacity.
The gradual filling of the bladder and stretching of its muscular walls signals the body that there is urine to be passed out. This sensation increases in intensity as the bladder fills and beckons a person to find a suitable setting to urinate. Most of us do not pass out urine until the sensation becomes strong or if we want to ’empty’ our bladder before it fills up. However, even in these cases most people have control of emptying their bladder.
In bladder spasms the filling of the bladder is normal but for some reason the bladder muscles suddenly contract, and often contract with greater than normal force. This appears to be due to some abnormality with the bladder muscle or the nerves that control these muscles. As mentioned, the disruption is not associated with an infection, enlarged prostate or other bladder conditions that can cause similar symptoms.
Read more on weak bladder.
A number of different bladder problems may cause bladder spasms. This includes a bladder infection (infectious cystitis), interstitial cystitis and urethral catheterization. Interstitial cystitis is also known as painful bladder syndrome and may be triggered or worsened by certain foods. It is important to note that these foods, such as spicy foods, alcohol, caffeinated beverages and acidic foods, do not cause interstitial cystitis.
Nervous System Disorders
Nervous system disorders that cause bladder disturbances are generally referred to as a neurogenic bladder. Causes may include:
- Diabetic neuropathy
- Parkinson disease
- Medullary lesions
- Multiple sclerosis
- Shingles involving the lower spinal nerves.
- Spinal cord injury
- Tumors of the brain
Sometimes bladder spasms occur as a side effect of the drugs being used. These drugs may affect the bladder in various ways. For example, bethanechol (urecholine) may abnormally stimulate the bladder muscles thereby leading to incontinence. Diuretics (“water pills”) increase urine production which may cause the bladder to fill faster and more often. Bladder spasms may also occur with cancer-treating drugs (chemotherapy).
Any lower abdominal or pelvic surgery may cause bladder spasms. This includes:
- Bladder surgery
- Cesarean section
- Prostate removal surgery
Sometimes the cause of bladder spasms occurs for no clearly identifiable reason. This is known as idiopathic bladder spasms. However, it is rare.
Who is at risk of bladder spasms?
Some people are more likely to suffer with bladder spasms than others. The following risk factors have been noted with bladder spasms. This includes:
- Advancing age, particularly over 75 years old
- Diabetics (particularly insulin-dependent)
- Hormone replacement therapy (HRT)
However, it is important to note that bladder spasms can affect people who have none of the risk factors mentioned above.
Pain and Other Symptoms
Bladder spasms are usually painful and the pain can vary in nature and intensity. It is often described as a cramping pain or burning pain. Depending on individual cases, the pain can be very severe and debilitating. The discomfort or pain can be felt in the lower abdomen or pelvic region where the bladder is located. The pain may also occur during urination and does not necessarily ease or resolve after urinating.
A characteristic symptom is the sudden onset of intense urging to pass urine. It is usually so intense and compelling that a person may immediately abandon any other task to urinate. This is a consequence of the spasm and depending on the intensity of the spasm it may also lead to involuntary passing of urine (incontinence). Nighttime urination (nocturia) is another common symptom in bladder spasms.
Bladder Spasms Treatment
There are several treatment options for bladder spasm but the choice of treatment largely depends on the underlying cause. Treatment and management of bladder spasms often involves more than one of these treatment options.
- Dietary restriction of certain foods that trigger bladder spasms as identified on an individual basis.
- Time voiding whereby a person has scheduled trips to to the toilet to urinate irrespective of the urge.
- Pelvic floor exercises such as Kegels to help the muscles relax while also strengthening it.
- Medication such as anticholinergics, antidepressants and alpha-blockers. Sedatives may be used for uretheral catheterization and botulinum toxin shows promising results for reducing spasms.
- Electrotherapies such as transcutaneous electrical nerve stimulation (TENS) or electrical stimulation implants.
- Biofeedback is a tool to assist with bladder training.