The urinary bladder is a hollow organ in the lower abdomen responsible for storing urine until it is expelled through excretion. The anatomical difference in the urinary bladder between men and women results in the differentiation of bladder issues at different stages in life.
Depending on one’s risk factors, the likelihood of developing bladder conditions varies. Additionally, dealing with a bladder condition in itself is a challenging feat as one does not just struggle with lowered quality of life but also deteriorating psychological health, which is often associated with humiliation and embarrassment.
Over a lifetime, one may encounter a wide range of bladder conditions. Below are various conditions that can be addressed here at Aare Urocare and our treatment pathways for our patients in Singapore.
1. Bladder Cancer
Bladder cancer is a condition where the cells in the bladder mutate and multiply uncontrollably. Often beginning at the urothelial cells, this form of cancer is diagnosed in its early stages. It is 4 times more likely in men and is prevalent among the older demographic.
Symptoms of bladder cancer
Some common signs that may be indicative of bladder cancer include:
- Blood in urine (haematuria)
- Issues with urination, such as frequent urination, urinary incontinence, and painful urination
- Pelvic pain
- Unexplainable weight loss
Treatment options for neurologic lower tract dysfunction
Depending on the type, grade, and stage of bladder cancer, treatment for bladder cancer may include:
- Transurethral resection of bladder tumour (TURBT): surgical treatment to remove superficial cancers while conducting biopsy for further examination.
- Cystectomy: a procedure that removes all (radical) or part of the bladder (partial) that contains the cancerous tumour. After a radical cystectomy, a urinary diversion procedure is performed to create a new pathway to expel urine.
- Chemotherapy: either systemic chemotherapy (delivered via veins or muscles) or intravesical therapy (chemotherapy delivered directly to the bladder) to shrink tumours and kill cancer cells.
- Radiation therapy: utilises high-energy radiation to kill cancer cells.
- Immunotherapy: amplifies an immune response to fight against cancer cells, delivered directly into the bladder through a catheter and triggers the immune system by interacting with the cancer cells.
2. Neurologic Lower Urinary Tract Dysfunction (NLUTD)
Neurologic lower tract dysfunction (NLUTD), also known as neurogenic bladder, is a condition where patients struggle with bladder control due to the brain, spinal cord, or nerve-related issues. This condition may also occur in patients with cerebrovascular accidents or herniated discs. Patients with NLUTD tend to struggle with issues related to the bladder, muscles in the bladder, bladder neck, and sphincters.
Symptoms of bladder cancer
Some of the symptoms that may manifest from NLUTD include:
- Urinary urgency
- Inability to empty bladder
- Unpurposeful urinary leakage (incontinence)
- Lack of sensation in the bladder
- Bladder spasticity (involuntary contractions)
- Frequent sensation of fullness in the abdomen
- Pelvic pain
Treatment options for neurologic lower tract dysfunction
Depending on the severity of the condition and its impact on quality of life, treatment for neurologic lower tract dysfunction may include:
- Drugs: medications to reduce contractions in the bladder, relax the muscles in the bladder neck and sphincters, and stimulate the bladder to contract and help to empty better.
- Non-invasive treatments: bladder training and pelvic floor exercises can be used to train your body to regain bladder control holistically.
- Medical device: medical devices such as a catheter to help empty the bladder completely.
- Injection: injections such as Neurotoxin A can be used to relax bladder muscles and prevent spasms.
- Nerve stimulation: neuromodulation devices can stimulate the tibial and sacral nerves to help with bladder control.
- Surgical procedures: severe cases may require surgery such as a sphincterotomy, bladder augmentation, and urinary diversion to optimise bladder functions.
3. Urinary Tract Infection (UTI)
Urinary bladder infection (UTI) is when a bacterial infection occurs in the bladder. A fairly common condition, 1 in 3 women in Singapore will face their first challenges with urinary tract infection by 24.
Symptoms of urinary tract infection (UTI)
Below are some symptoms that are suggestive of a urinary tract infection (UTI):
- Burning sensation during urination
- Blood in the urine (haematuria)
- Cloudy urine and abnormal discharge
- Incomplete voiding of the bladder
- Frequent, painful urination
- Urinary incontinence
- Pelvic or abdominal pain
- High fever with body aches
- Nausea or vomiting
Treatment options for urinary tract infection (UTI)
Treatment for urinary tract infections would include:
- Medications: a cycle of oral antibiotics or intravenous antibiotic treatment if necessary. You may also be advised to consume probiotics or cranberry extracts as a preventative measure.
- UTI vaccines: a preventative measure which may be recommended for recurring cases of UTI.
- Cream: such as topical oestrogen cream typically reserved for post-menopausal women.
4. Bladder diseases
These are a group of health conditions that impact the function of the urinary bladder. Conditions include nocturia, overactive bladder (OAB), urinary incontinence, voiding dysfunction, and underactive bladder (UAB).
Symptoms of bladder diseases
Depending on the exact diagnosis, symptoms of bladder diseases may include:
- Nocturia: disrupted sleeping pattern from a frequent urge to urinate at night.
- Overactive bladder: sudden and uncontrolled need to urinate.
- Urinary incontinence: involuntary loss of urine (leakage) that commonly affects women.
- Voiding dysfunction: poor coordination between the bladder muscles and the urethra that results in nocturia, overactive bladder, inability to empty bladder, weak urinary stream, dribbling and leaking urine, and urinary hesitancy
Treatment options for bladder diseases
Depending on your diagnosis, a wide array of treatment options for bladder diseases include:
- Drugs: medications that address underlying hormone dysfunction that is subsequently causing urine dysfunction and regulate urinary frequency.
- Injections: such as neurotoxin bladder injections to improve muscle contractions.
- Nerve stimulation: such as neuromodulation and devices (Tensi +) to improve nerve messaging capabilities between the bladder and brain.
- Surgery: to increase bladder volume, prevent leakage, and resist pressure.
- Physical therapy: such as pelvic floor exercises and bladder training.
Contact us and book a consultation today to gauge which treatment module best fits you.
How are common bladder conditions diagnosed in Singapore?
Diagnosing common bladder conditions in Singapore involves a series of medical evaluations and tests. This includes discussing your symptoms, duration, and relevant risk factors.
A physical examination may follow, during which your urologist may check for signs of infection or other physical abnormalities. A urine sample may be required to gather valuable information and detect signs of infection, haematuria (blood in the urine), and other irregularities.
Depending on your symptoms, your urologist may recommend imaging tests such as ultrasound, computed tomography scans (CT scans), and magnetic resonance imaging (MRI). These tests can help identify structural abnormalities in the bladder or surrounding organs.
In some cases, you may be required to undergo a cystoscopy to visually inspect the bladder’s interior for abnormalities or signs of disease. Urodynamic tests may also be performed if you are experiencing urinary incontinence or other functional issues.
For cases where bladder cancer is suspected, a biopsy may be necessary. Other tests may include blood tests to help detect markers associated with bladder conditions, such as Prostate-Specific Antigen (PSA) for prostate issues.
Lastly, your urologist may perform a functional assessment for conditions such as overactive bladder. You may be asked to keep a bladder diary and record when and how often you urinate and fluid intake.
Your urologist will use the information gathered from these diagnostic methods to determine the cause of your bladder condition and develop an appropriate treatment plan.
Summary
Bladder conditions can significantly impact individuals socially and psychologically and severely impact one’s quality of life. Many bladder conditions in Singapore go undiagnosed as patients are veiled with shame and embarrassment, avoiding diagnosis and treatment.
Here at Aare Urocare, we are dedicated to the cause of patients reclaiming their lives with an array of treatment modules. A bladder condition is rarely a life sentence; in the right hands, you can overcome challenges affiliated with your diagnosis.
Frequently asked questions
To maintain good bladder health, you should stay hydrated, practice good hygiene, limit caffeine and alcohol intake, and avoid holding in urine.
You should see a doctor for bladder issues if you experience frequent urination, pain or discomfort, blood in the urine, or any significant change in your urinary habits that persist.
No, bladder tumours are not always cancerous. Some bladder tumours are non-cancerous, while others can be cancerous. A urologist will need to conduct tests to determine the nature of the tumour.
