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Bladder Spasms: Get the Facts on Symptoms and Treatment

Chances are we have all crossed our legs a time or two in hopes of making it
to the closest restroom in time. But there’s a big difference between having to
go, and always feeling like you have to go. For those who live
with bladder spasms, that feeling is
a painful reality that can lead to embarrassing wetting accidents and an
unwanted shift in lifestyle. However, there are a variety of treatment options
available to manage the symptoms. Here’s what you need to know about bladder spasms, from the causes to what you can do to
ease the pain.

What Do Bladder Spasms Feel Like?

Normally, the bladder gently fills with urine and you slowly become aware of
the need to urinate. This feeling is your cue to start looking for a
bathroom.

But in people who have bladder spasms, the sensation occurs suddenly and
often severely. A spasm itself is the sudden, involuntary squeezing of a
muscle. A bladder spasm, or “detrusor contraction,” occurs when the
bladder muscle squeezes suddenly without warning, causing an urgent need to
release urine. The spasm can force urine from the bladder, causing leakage.
When this happens, the condition is called urge incontinence or overactive bladder.

People who have had such spasms describe them as a cramping pain and
sometimes as a burning sensation. Some women with severe bladder spasms
compared the muscle contractions to severe menstrual cramps and even labor
pains experienced during childbirth.

Who Is Most Likely to Develop Bladder Spasms?

Anyone at any age can have bladder spasms. In children, bladder spasms (also
called pediatric unstable bladder or uninhibited bladder) are the leading cause
of daytime incontinence.

However, you are more likely to have bladder spasms with urine leakage if
you:

  • Are elderly
  • Are going through menopause
  • Recently had a baby or are pregnant
  • Have a urinary tract infection
  • Have recently had lower abdominal or pelvic surgery
  • Have nerve or bladder muscle damage caused by disease or injury

What Causes Bladder Spasms?

There are a number of different causes of bladder spasms. The cramping pain
could be due to something as simple as your diet or a medication that you are taking, or it could be
associated with changes in blood supply and function of the nerves controlling
the bladder.

However, bladder spasms may be the result of an infection or a recent
surgery, or they may occur if you have nerve or muscle damage. So it’s
important to see a doctor to determine the cause.

In some cases, your doctor may not be able to identify the cause. When this
happens, the condition is called idiopathic bladder spasms.

Some common causes of bladder spasms are:

  • Urinary tract infection (UTI): Bladder pain and burning are a common symptom of a
    UTI.
  • Interstitial cystitis (IC), also called painful bladder
    syndrome: This condition refers to bladder and urinary pain that is not due to
    other causes, such as a urinary tract infection. Pain is recurring and often
    severe.
  • Catheter use: A catheter is a thin tube used to drain urine from the body,
    often after surgery. It is placed into the urethra and up into your bladder.
    Bladder spasms are a common and sometimes distressing complication of catheter
    usage.

Nervous System Disorders That Lead to Bladder Spasms

The feeling you get when you need to empty your bladder is normally an
involuntary response. The brain signals the bladder muscle when it is time to
tighten (contract) and release urine. However, certain nervous system disorders
cause damage to the nerves that send signals between the brain and the bladder.
When this happens, the bladder does not work properly. “Neurogenic bladder” is
the general term for bladder problems due to nerve damage.

Nervous system disorders and injury that can cause bladder spasms
include:

Surgery That Leads to Bladder Spasms

Surgery to the lower abdominal area may weaken the bladder or pelvic floor
muscles, or cause damage to the nerves that control the bladder. Bladder spasms
may occur following certain surgeries, including:

  • Bladder surgery (a common cause of bladder spasms in both children and
    adults)
  • Cesarean section
  • Hysterectomy (removal of the uterus, or womb, and sometimes the surrounding
    female organs, including the ovaries and fallopian tubes.)
  • Prostatectomy (prostate removal)
  • Other lower abdominal surgery

Other Causes of Bladder Spasms

Some medications may cause bladder spasms as a side effect. Medications that
commonly cause bladder spasms include:

What you eat or drink can sometimes bother a fragile bladder and cause it to
go into a spasm. This is especially true in patients who have a condition
called interstitial cystitis.

Spicy, acidic, or citrusy foods and the chemicals in certain preservatives
and food additives can irritate the lining of the bladder. Such products
include:

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Treatment of Bladder Spasms

How your doctor treats your bladder spasms depends on what exactly is
causing your painful symptoms. But in general, therapy may involve one or more
of the following treatments. A combination of treatments often works best.

Change in diet. This may help prevent bladder pain if certain foods
and beverages are the culprit behind your spasms. Avoid spicy, acidic, or
citrusy foods, as well as alcohol and caffeine. Keeping a food diary,
which tracks your meals and your symptoms, can be helpful.

Timed voiding. This involves timed trips to the bathroom to urinate,
usually every 1.5 to 2 hours. Timed voiding is especially helpful for children.
As the bladder spasms get better and fewer wetting accidents occur, you can
extend the time between trips to the bathroom.

Pelvic floor exercises (“Kegels”). Kegels and other forms of physical
therapy help strengthen and relax the bladder and other muscles that help the
body hold in urine. Kegels, combined with biofeedback, are a good way to help
reduce bladder spasms in children. To tighten your pelvic muscles, squeeze your
muscles in the same way as if you were trying to stop the flow of urine or
prevent yourself from passing gas. Kegel exercises take practice, and tightening the wrong
muscles can put more pressure on your bladder. Ask your doctor for specific
instructions.

Medicines to relax the bladder. The most commonly prescribed drugs to
relax the bladder and prevent spasms are called anticholinergics. They include
oxybutynin chloride, tolterodine and others. A common
side effect is dry mouth.

An antidepressant called imipramine hydrochloride (Tofranil) also helps relax the bladder and reduces
bladder spasms.

Medicines called alpha-blockers (such as terazosin or doxazosin) may be
given to children to help the bladder relax and allow the bladder to empty
completely.

TENS. Electrical stimulation through the skin (transcutaneous
electrical nerve stimulation, or TENS) sends mild electrical pulses to the
bladder through patches applied to the skin. It’s believed the electric signals
help you feel better by increasing blood flow and releasing hormones that block
pain. TENS is often used to relieve muscle or back
pain. In the case of bladder spasms, doctors think the increased blood flow
makes the bladder muscle stronger, which reduces spasms and leakage.

Electrical stimulation implant (Inter-Stim). This is placed under the
skin to deliver gentle electrical pulses to the bladder at regularly timed
intervals. Your doctor may recommend this therapy if you have severe bladder
spasms and urge incontinence that does not get better with other
treatments.

Pain medicines and sedatives. These may be given to patients who have
catheter-related bladder spasms after surgery. But they don’t always take away
all the discomfort. Some research suggests that a prescription
anti-inflammatory medicine called ketorolac may help relieve or prevent catheter- or
surgery-related bladder spasms in children.




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Bladder Spasms
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Complementary and Alternative Therapies

Acupuncture. Some
research has suggested that bladder-specific acupuncture may significantly
reduce bladder muscle contractions and the urge to use the bathroom.

Biofeedback. Biofeedback is a method that teaches the mind how to
control normally automated body functions. Bladder training is a type of
biofeedback. Some doctors believe biofeedback and behavioral changes work
better than medicines for treating urge incontinence. A combination of
biofeedback and medications may work best.

Botox. In studies, botulinum-A toxin has
been shown to reduce nerve-related bladder spasms in children and adults. Botox
prevents nerves from releasing chemicals that tell muscles to contract. The
Botox is injected directly into the bladder muscle wall.

When to See a Doctor

Call your doctor for an appointment if you have:

  • Pain or cramping in your pelvic or lower abdominal area
  • Pain or burning while urinating
  • Urgent or frequent need to use the bathroom

If you have or think you are having bladder spasms, it is important that you
see a doctor for a proper diagnosis. Your symptoms may be due to an infection
that can be treated. In rare cases, bladder spasms may be a sign of a serious
underlying condition.

WebMD Medical Reference

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