Diseases

Bladder Spasms Information

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.

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:

• Brain tumor
• Cerebral palsy
• Herpes zoster infection that affects the nerves in the sacrum
• Multiple sclerosis
• Parkinson's disease
• Multiple system atrophy (Shy-Drager syndrome)
• Spinal cord injury
• Stroke that has caused brain damage
• Diabetic neuropathy (when the nerves are damaged by longstanding diabetes)

Other Causes of Bladder Spasms

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

• Bethanechol (urecholine)
• A chemotherapy drug called Valrubicin
• Medicines called diuretics, which help the body remove excess water, such as furosemide (Lasix)

• Alcohol
• Artificial sweeteners
• Caffeinated beverages such as soda, coffee, and tea
• Chocolate
• Citrus fruits and drinks, such as oranges and orange juice
• Pickled foods
• Tomatoes

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

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.

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