Diagnostics

Bladder pain in women, what to do?

Throughout her life, a woman can be prone to recurrent urinary tract infections. One of the most common, which affects women 50 times more than men, is cystitis. This inflammation of the bladder affects nearly 50% of women on more than one occasion. It usually manifests itself by a more or less intense pain in the bladder. What causes this disease? How can it be treated? Cliniques Marois provides you with all the information you need about bladder pain in women and suggests the best possible treatments.

What is bladder inflammation?

Cystitis is an inflammation of the bladder that can be bacterial or non-bacterial in origin. When it is non-bacterial, it is called non-bacterial interstitial cystitis or painful bladder syndrome. This chronic, noninfectious inflammation of the bladder is quite rare and affects five to ten times more women than men. It can occur in women from the age of 18.

Bacterial cystine or acute cystitis is the most common form and is a urinary tract infection that is localized in the bladder. It is of bacterial origin and can be cured quickly with appropriate treatment.

Causes of bladder pain in women

The causes of cystitis can vary depending on the form the patient is suffering from.

Causes of interstitial cystitis
To date, the causes of interstitial cystitis are unknown. Some scientists link it to radiation to a pelvic organ or damage to the bladder wall. This damage to the bladder wall can make the bladder more vulnerable to various substances in the urine. These substances, often harmful, can easily cause irritation to the bladder.

Interstitial cystine may also be due to:
- the ineffectiveness of the intravesical protective layer,
- inflammation of a pelvic organ near the bladder,
- local inflammation in the bladder (autoimmune reaction in the bladder wall)
Other researchers also link the onset of non-bacterial cystitis to childbirth or surgery. It is a multifactorial disease that could be caused by genetic, allergic or environmental factors.
Causes of acute cystitis

Acute cystitis is usually caused by a bacterial infection. In about 90% of cases, it is caused by Escherichia coli and in the remaining 10% by microorganisms or other bacteria. Escherichia coli is a bacterium that occurs naturally in the digestive tract. It causes cystitis when it enters the urethra and travels up the bladder to multiply.

Certain factors, such as the size of the urethra in women, can also contribute to the development of acute cystitis. Indeed, being generally small, the urethra facilitates the introduction of certain micro-organisms into the bladder. Urinary and genital prolapse in women is also a risk factor for this condition. The patient with this condition is unable to empty her bladder completely, which puts her at risk of a urinary tract infection.

Spermicides used during sex can also increase the risk of cystitis. This infectious inflammation of the bladder can be caused by estrogen deficiency, especially during menopause, or by bladder compression and hormonal changes during pregnancy. These generally favor a bad evacuation of urine by the bladder or a urinary stasis at the level of this organ.

The symptoms of bladder inflammation in women

One of the main manifestations of cystitis is of course bladder pain. Some women experience moderate bladder pain, while others experience very severe pain. Here are some common symptoms of bladder inflammation, both infectious and non-bacterial:

a sensation of burning or pain at the end of urination in the patient,
pain in the lower abdomen,
a feeling of heaviness, especially in the bladder area,
Urinary urgency with a feeling of not being able to hold it (urinary incontinence),
frequent and persistent need to urinate without being able to really evacuate a significant amount of urine (pollakiuria),
dyspareunia.

Dyspareunia is characterized by pain felt by the woman before, during or after penetration.

The symptoms of cystitis most often worsen as the bladder fills. In the most severe cases, women affected by this condition may sit for hours with a few continuous drops of urine. Inflammation of the bladder can also be manifested by cloudy urine that has an unusual odor. This urine may contain traces of blood.

Symptoms of the condition in women can worsen during menstruation or ovulation. They can also be aggravated by physical stress, seasonal allergies, consumption of foods rich in potassium, but also alcohol and tobacco.

When to consult?

Some people who have non-bacterial bladder inflammation do not have symptoms of the disease. Therefore, it may be silent and appear all at once. In most cases, clinical signs appear gradually and become more intense as the lining is affected.

At the first signs of bladder inflammation, it is important to drink enough water and to consult your doctor. While waiting for your doctor’s appointment, it is not advisable to hold back the need to urinate. Go to the bathroom as soon as you feel the need. It is also safer to avoid sexual intercourse until the symptoms have completely disappeared.

Once the symptoms have appeared, a visit to a doctor within the same day is essential to :

pregnant women, because of the high risk of urinary tract infection during this period,
people with immune deficiencies or chronic illnesses (diabetes or chronic kidney disease)
Patients who are prone to urinary tract problems,
seniors over 75 years old.

Consultation also becomes urgent in cases where the patient has a fever or localized pain in the back. If the pain in the lower abdomen becomes intense, it is essential to consult a doctor urgently.

Diagnoses of bladder inflammation

The diagnosis is an essential step that allows the patient to distinguish the type of cystitis she has. The specialist will then be able to propose the appropriate and effective treatment plan to eradicate the disease.

Depending on the patient’s symptoms, the specialist may perform a urinalysis, a urine cytobacteriological examination (UCE), a cystoscopy of the bladder or a biopsy.

First, the doctor may perform a urine test using a urine dipstick. The purpose of this test is to detect the presence of nitrites and white blood cells (leukocytes) that are usually produced during a urinary tract infection.

The ECBU is performed to complete the strip analysis or systematically on the patient after admission. Carried out in a laboratory, this analysis makes it possible to confirm a cystitis and especially to identify the germ that is responsible for the contamination. It is usually done in the morning, because the urine sample must be taken at least 4 hours after the previous urination. The urine will then have stayed in the bladder long enough to collect many bacteria in case of a urinary infection.

If this test is negative, the specialist may then order a cystoscopy of the bladder. It consists of exploring the inner wall of the urethra and/or bladder in order to diagnose a lesion. It is performed with an endoscope that is inserted into the urinary tract.

Bladder biopsy is often indicated for the diagnosis of interstitial cystitis.

Diagnostics de l'inflammation de la vessie

Treatment options for bladder inflammation

Treatments may vary depending on the type of cystitis the patient has.

Treatments for bacterial cystitis

After confirming the diagnosis of infectious cystitis related to the presence of bacteria or leukocytes in the urine, the doctor may prescribe immediate treatment with antibiotics and anti-inflammatory drugs. The patient is usually cured within a few days.

If the patient does not get treatment as soon as possible, the bacteria that causes the infection can colonize the urinary tract and migrate to the kidneys. This increases the risk of pyelonephritis.
Treatments for non-bacterial cystitis
There is no specific treatment to completely eradicate interstitial cystitis. In most cases, treatment is used to relieve the symptoms of the disease.

The urologist can therefore prescribe relief medications that vary according to the patient’s symptoms:
- analgesics or anti-inflammatory drugs to relieve pain and reduce inflammation
- relaxant and antispasmodic drugs (anticonvulsants, antidepressants, antihistamines)
- Pentosan (the only medication taken orally) for the relief of bladder pain.
The effectiveness of these medications can vary from person to person. It is also possible to use other solutions such as bladder injections and TENS.
Bladder injections

Botulina injections are generally used to control bladder contractions that cause too frequent or too urgent urges, common symptoms of cystitis. They act on the nerve endings in the bladder wall. These bladder injections are often offered in cases where oral medications are ineffective or poorly tolerated.

The patient feels the effect of Botulina within two to ten days after the injection. The duration of its action varies from patient to patient, and can range from six to nine months. Bladder injections are offered at Les Cliniques Marois.
TENS, the reference in perineal rehabilitation

Transcutaneous Electrical Neurostimulation (TENS) treatment is particularly suggested when symptoms become intense during the night. TENS can be used to reduce the frequency of urination and pain in some patients.

This perineal rehabilitation treatment offered at Les Cliniques Marois is performed with the help of a device that emits a low-intensity electric current. This device is connected to certain electrodes in the perineal area.

Cystitis, whether bacterial or non-bacterial in origin, must be treated by a specialist. The Cliniques Marois, which specializes in urology and sexual health, places its qualified physicians and health professionals at your disposal for the management of urinary disorders. Thanks to a perfect mastery of new innovative treatments, our specialists will provide you with the best treatment adapted to your disease. Do not hesitate to contact us now for all your sexual health concerns.

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Dr. Marois is a urologist who is not a member of the Régie d’Assurance Maladie du Québec (RAMQ). As such, the clinic can not claim the RAMQ for the payment of his services. If you consult Dr Marois, you must pay for the services rendered.

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Dr. Marois is a urologist who is not a member of the Régie de l’Assurance Maladie du Québec (RAMQ). As such, if you require his professional services, you will have to pay directly the Cliniques Marois for the services rendered.

Cancellation Policy:

To ensure the smooth running of the clinics aa well as a minimum of courtesy towards other patients and staff members, we ask you to notify us 48 hours in advance for cancelling an appointment, 5 working days for cancelling a minor surgery in the office and 21 working days for major surgery at the CMC. If these deadlines are not respected, a cancellation fee of 50% of the service will be charged.

Change of appointment:

We understand that events occur and schedules change, so we ask patients to give us at least a 24-hour notice for any changes of appointment. We will be happy to reschedule another one for you. Failure to provide such notice within this timeframe will result in a $ 100 fee.

Thank you for your understanding.

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