Urinary Tract Infection (UTI)
Although both men and women can get a UTI, it’s much more common among women. But what actually is a UTI? It’s an infection of your urinary tract (the body’s drainage system for removing urine) that’s caused by bacteria entering your urinary system via your urethra. The urethra is the hollow tube that provides an exit route for urine. If a UTI remains untreated, the unwanted bacteria can make its way up your urinary tract all the way to your kidneys where they cause can cause a kidney infection.
How do you know if you’re suffering from a UTI?
You’ll likely experience one or more of the following symptoms:
- A burning feeling when weeing
- An increased need to wee
- needing to wee suddenly or more urgently than usual
- Unusual changes in your urine, like cloudiness or traces of blood
- pain in your back or in your lower tummy
- a high temperature, or feeling hot and shivery
- a very low temperature below 36C
To diagnose a UTI, your healthcare professional will likely check your urine for white and red blood cells as well as bacteria. This is called a urinalysis. Your GP might also perform a urine culture which will determine which bacteria is causing your infection. If your UTIs are frequent, further testing might be needed to make sure there are no abnormalities in your urinary tract. These tests can include a CT scan, an ultrasound, or a cystoscopy.
To treat your UTI your healthcare professional may prescribe a short course of oral antibiotics and, if it’s very painful, you’ll likely also get some pain relief. If your UTI is stubborn or severe you might have to take a longer course of antibiotics or stay in hospital for IV antibiotics.
Interstitial Cystitis (IC) or Painful Bladder Syndrome (PBS)
IC, also known as bladder pain syndrome, is a chronic condition that mostly affects women and causes urinary pain. It is currently not known what causes IC, but it is thought that it is caused by a problem with the lining of your bladder wall. What is known is that certain factors like stress, medication, or your diet can trigger symptoms.
The most common symptom of IC is pain as your bladder fills up. This will generally improve again when your bladder is empty. Symptoms can range anywhere from mild to severe and can be very different from person to person. Possible symptoms include:
- Pain between your genitals & anus
- Pain in your bladder, pelvis, or abdomen
- Having to wee more frequently than usual and waking up several times in the night to wee
- Strong urge to wee
- Burning pain when going for a wee
- Pain when having sex
To diagnose IC, your healthcare professional might ask you to keep a bladder diary for a few days ahead of your first consultation. At your first consultation with your GP, they will have a chat with you about all your symptoms, as there is no single test to diagnose interstitial cystitis you will likely have to undergo one or more of the following tests:
- Urinary function tests
- Prostate exam for people with a prostate
- Urinalysis to check your symptoms aren’t caused by an infection
- Pelvic exam if you’re a woman
- Cystoscopy to take a look at the lining of your bladder
- Potassium sensitivity test
At the moment, there’s unfortunately no medication to treat IC and your individual treatment will be based on your symptoms. Treatment can include one or more of the following options:
Bladder stretching: Your bladder is filled with liquid in order to stretch it. You’ll be given medication as the stretching can be quite painful without it.
Physical therapy: A physical therapist might be able to help you stretch your pelvic floor muscles and teach you how you can keep them relaxed. This can relieve some of your symptoms and is especially good if you’re suffering from pelvic floor muscle spasms.
Medication: Over the counter and prescription medication can be used to ease bladder pain and to help the bladder relax.
Lifestyle changes: These will be recommended by your healthcare professional based on what you feel triggers your symptoms. Examples are not drinking alcohol, exercising gently, changing parts of your diet, or quitting smoking.
Bladder retaining: With bladder retaining, you can teach your bladder how to hold more urine so that you need fewer visits to the toilet. It involves taking note of how often you go for a wee and then gradually increase the times between your bathroom trips.
Bladder instillation: A liquid containing medication to reduce any irritation is inserted into your bladder where it will stay for around 15 minutes before being released. If effective, this treatment can be repeated every one to two weeks for about one to two months.
Surgery: Having surgery for IC is only recommended if your symptoms are severe and other treatments before haven’t provided any relief. Surgical treatment can involve bladder augmentation or enlargement, a cystectomy to remove your bladder, or a urinary diversion that will reroute the way your urine exits your body.
Bladder Cancer
Bladder cancer most often occurs after the age of 55 and is known to affect smokers up to three times more.
The most common symptom of bladder cancer is having blood in your urine without any associated pain. Most people will not have any other symptoms but, if other symptoms are present, they can include the following:
- Having trouble weeing
- Pain or a burning sensation when weeing
- Having to wee more frequently
- Urgency to wee even when your bladder isn’t full
- A weak urinary stream
If your bladder cancer is more advanced, it can spread and affect other organs in your body. Symptoms can include:
- Pain in your pelvis or abdomen
- Not being able to wee
- Loss of appetite
- Bone pain
- One-sided pain in your lower back
- General weakness or fatigue
If you’re experiencing any of these symptoms, your healthcare professional will likely run tests to determine whether you are suffering from bladder cancer. These tests can include:
- Imaging tests
- Urine culture
- Urinalysis
- Cystoscopy
- Urine cytology
- Urine tumour marker tests
- Biopsy
How your bladder cancer is treated fully depends on which type of bladder cancer you’re suffering from and how advanced it is, but it usually involves one or more of the following treatments:
Radiation: This can be used to treat early-stage bladder cancer and is usually done if, for any reason, you can’t have surgery in these stages. In combination with chemotherapy, it can also be used treat advanced bladder cancer.
Chemotherapy: This is used to kill cancer cells in your body, and you can either get it in tablet form or via IV. There is also something called intravesical chemotherapy which means that the chemotherapy drugs are administered directly into the bladder. This is generally used for bladder cancer in the very early stages.
Surgery: The type of surgery fully depends on the stage of your cancer. It might include removing a tumour, part of the bladder, or the whole bladder.
Immunotherapy: This means that you will get medication that helps your immune system to recognise and kill cancer cells as they appear.
Key Takeaways
Although most of the time bladder pain isn't a sign of anything serious, that doesn’t mean it should be ignored. While conditions like UTIs and interstitial cystitis are more common and generally more manageable, you should always listen to your body. If you experience any form of bladder discomfort or pain, always speak to your healthcare professional.
References
1.https://www.nhs.uk/conditions/bladder-cancer/
2.https://www.nhs.uk/conditions/urinary-tract-infections-utis/
3.https://www.nhs.uk/conditions/kidney-infection/
