Distended Bladder: Causes, Risks, Prevention

A sensation of fullness or pressure is experienced when the bladder is full, but will disappear once the person urinates. However, some people experience this pressure persistently, and sometimes accompanied by an ache or pain. This is not normal and may be signs of an overly distended bladder.

The urinary bladder, or simply, the bladder, is a pear-shaped muscular sac where urine is collected and stored. It is located just above and behind the pubic bone. The size and shape of the bladder depends on how much urine it contains. It can also be affected by the pressure it sustains from surrounding organs.

When urine is stored in the urinary bladder, it allows urination to be controlled and timed. During urination, the urine exits the bladder and flows into the urethra, which allows urine to flow out of the body. The normal capacity of the bladder is 400-600 ml of urine.

Overly Distended Bladder

Normally, the bladder expands as it is filled with urine, much like a water balloon. After a person relieves themselves, the bladder returns to its unfilled size. However, it can become overly filled, leading to a distended bladder. 

A distended bladder generally occurs when there is a loss of tone in the bladder muscles resulting in failure  to detect the elevated pressure exerted by the urine. In some cases, there is an obstruction that does not allow urine to flow into the urethra. This may cause pain, a feeling of fullness, and the urge to urinate frequently.

Urinary Retention 

The urinary bladder helps control urination so we don’t need to relieve ourselves constantly. As the bladder is filled with urine produced by the kidneys, pressure builds up within the bladder and expands. The expansion or distention of the bladder sends signals to the brain once it’s full. This triggers the urge to void the bladder or take a trip to the restroom.

But what if the bladder is unable to empty completely?

Under normal conditions, urine is considered sterile or free from pathogens. However, if urine sits in the bladder for too long or there is leftover urine after voiding, it can become a breeding ground for bacteria. Urinary retention or leftover urine  may lead to an infection in the bladder, ureters, and even kidneys.

There are wherein  the bladder is not able to contract and empty completely. The urinary bladder may become too full or overly distended. The urine may back up into the kidney and the pressure may cause damage to the blood vessels of the kidney. A buildup of urine and pressure worsens a distended bladder.

What causes an overly distended bladder?

Urine is made up of waste substances filtered by the kidney from your blood. If the patient’s bladder is not completely emptied when they urinate, it may be a sign of urinary retention.

Urinary retention is a health condition where the bladder does not empty all the way or doesn’t empty at all when you urinate. The causes for urinary retention may include:

• An infection or swelling that prevent urine from leaving your body
• Damage to the nerve that innervates the bladder
• Using certain medications, including anesthesia
• Obstruction or blockage of the urethra (e.g. enlarged prostate)

There are two types of urinary retention, namely:

• Acute urinary retention. This means the condition is sudden and is escalating rapidly. It could be a severe case of urinary retention and is considered a medical emergency.
• Chronic urinary retention. It means that you’ve had the condition for several months. This type of urinary retention is more gradual or slow and may even be asymptomatic. Diseases that can cause chronic urinary retention include benign prostatic hyperplasia (enlarged prostate) and spinal cord injuries.

Risks and complications of a distended bladder

An overly distended bladder generally causes pelvic or abdominal discomfort and the feeling of fullness. Other symptoms include:

• Intense suprapubic pain. The ache or pressure happens in your lower abdomen, where organs such as the intestines, bladder and genitals are located.
• More frequent urges to urinate
• Nausea and vomiting

If a case of overly distended bladder remains untreated, complications may occur, including:

• Urinary tract infection (UTI). When urine does not completely flow out of the body, bacteria also remains inside and could multiply and infect the upper urinary tract. Severe cases of infections can spread up to the kidneys and present with back pain and fever.
• Bladder damage. When the bladder is not emptying normally, it becomes full and stretched for a long period of time. It could cause overdistention which leads to muscle damage and the bladder may not return to its normal size.
• Kidney damage. When you have a distended bladder, it becomes full and will cause urine to flow back up to the kidney, damaging its little nerves. Your kidneys will be full of urine as well and will also become distended and swollen. This may lead to chronic kidney disease and kidney failure.
• Urinary incontinence. Urinary or overflow incontinence is when the bladder is full and does not empty which leads to leaking urine.

How to prevent distended bladder

Distended bladder may lead to severe complications. You can take these preventive steps to lower your chances of developing this condition:

• Change your bathroom habits. Holding in urine frequently may wear out your bladder muscles and can lead to UTI and urinary retention.
• Pay attention to your body. Note every change in your urination habits, whether you have the urge to urinate frequently or you are feeling dull aches or pressure in your lower abdomen.
• Do Kegel exercises. Pelvic floor exercises can improve bladder and bowel function in both men and women.
• Improve your diet and lifestyle. Drink plenty of water and fluids and engage in physical activities.
• Take prescribed medicines and seek help from your doctor when symptoms persist.

In severe cases, treatment aims to remove the cause of bladder distention. Early diagnosis is important because there is no way to repair the bladder muscle if it is stretched past its limit. Proper medication will help in helping the bladder function normally again. In cases where an enlarged bladder is caused by an obstruction or congestion, surgical procedure is the best option. Once the blockage is removed, the bladder may function normally again depending on how much damage it sustained.

Key Takeaways

Distended bladder is an uncomfortable condition and can potentially lead to long-term complications. The overall health of the urinary system relies heavily on your diet, lifestyle and bathroom habits. Your body has a way of telling you that you should make healthier choices so be vigilant. Sometimes simple stomachaches may be signs of serious health conditions.

Always consult your doctor if you suspect problems in your bladder or overall urological function.

Learn more about bladder disease, here.