Patient education: Bladder spasm (The Basics)

What is a bladder spasm? — A bladder spasm is when the muscles in the bladder suddenly contract, or tighten (figure 1). Bladder spasms can be caused by:

●Urinary tract infection ("UTI")

●Urgency incontinence or overactive bladder – "Incontinence" means leaking urine or losing control of your bladder. People with urgency incontinence feel a strong need or "urge" to urinate all of a sudden. "Overactive bladder" is another term for having a sudden, frequent urge to urinate.

●Certain medicines

●Certain foods that irritate the bladder – These might include alcohol, caffeine, artificial sweeteners, or spicy or acidic foods.

●Bladder stones, tumors, or growths called "polyps"

●Neurogenic bladder – This condition causes problems with bladder control. It most often happens in people who have had a spinal cord injury.

●Using a urinary catheter

●An enlarged prostate

What are the symptoms of a bladder spasm? — A bladder spasm feels like a strong, sudden need to urinate. In some cases, you might not be able to control your urine when this happens and might leak urine.

Depending on what is causing your bladder spasms, you might have other symptoms, too. For example, if your bladder spasms are caused by a UTI, you might also have a burning feeling when you urinate.

Will I need tests? — Maybe. Your doctor or nurse will start by asking about your symptoms. They might need to do an exam of your pelvis, genitals, or rectum.

If tests are needed, they might include:

●Urine tests – These can check for signs of infection.

●Imaging tests – Imaging tests create pictures of the inside of the body.

●Urodynamic tests – These check how well your bladder is working. They include tests to measure pressure inside your bladder, how fast your urine flows, and how well your nerves and muscles are working.

●Pad weight test – For this test, you wear a pad inside your underwear while you exercise or do other activities. After, the pad is weighed to see if any urine leaked out, and how much.

●Blood tests

In some cases, your doctor or nurse might want you to keep a "voiding diary" for a few days (form 1). This is a record of when you urinate. It includes information about when you urinate, how much, and whether you had any leaks. You can also write down notes about when you went to bed and got up, what you had to drink, and other information your doctor suggests.

Is there anything I can do on my own to feel better? — Depending on what is causing your bladder spasms, there are some things you can try.

These things might help with your symptoms:

●Avoid foods or drinks that make your symptoms worse – These might include alcohol, caffeine, artificial sweeteners, or spicy or acidic foods.

●Try to drink water throughout the day, instead of drinking a lot of water at once. Avoid drinking anything for about 2 hours before bed.

●Prevent constipation – Constipation is a common problem that makes it hard to have bowel movements. It can make bladder spasms worse.

●Bladder training – Bladder training helps your bladder hold more urine so you can urinate less often. If your doctor or nurse thinks that bladder training would help you, they will teach you what to do.

●Relaxation – This can help manage the urge to go. When you get an urge, stand still or sit down. Take a deep breath, squeeze your pelvic muscles, and let the "wave" of needing to go pass. Then, walk slowly to the bathroom to urinate.

●Pelvic muscle exercises – Pelvic muscle exercises strengthen the muscles that control the flow of urine. Ask your doctor or nurse how to do them correctly. They might suggest working with a physical therapist who has special training in these exercises.

●Lose weight, if you have excess body weight – If your weight is causing your bladder spasms or making them worse, losing weight can help. If you want to try to lose weight, talk to your doctor or nurse about how to do this in a healthy way.

How are bladder spasms treated? — Treatment for bladder spasms depends on what is causing them.

Possible treatments might include:

●Treating the underlying problem – For example, your doctor or nurse might prescribe antibiotics for a UTI. If a medicine is causing your symptoms, they might switch you to a different medicine.

●Medicines to relax the bladder

●Biofeedback – This is a way to retrain the muscles that control the bladder. It is done at the doctor's office, a physical therapist's office, or sometimes at home. It involves using devices called "sensors" that measure muscle activity.

If bladder spasms continue to cause you to leak urine after trying the above, your doctor or nurse might suggest other treatments. These might include:

●Botulinum toxin (Botox) injection – This is a shot into the bladder. It can help the bladder relax. The injection needs to be given about once or twice a year. At first, these injections can cause trouble urinating and UTIs, but these improve with time. There is also a chance that the treatment will not correct the problem.

●Electrical nerve stimulation – For this treatment, a surgeon implants a device under the skin. The device sends mild electrical signals to nerves that control bladder function. The signals do not hurt. This treatment can reduce sudden urges or the need to urinate often. The device is tested before the surgery to check if it will help.

When should I call the doctor? — Call for advice if you have:

●Signs of infection – These include a fever of 100.4°F (38°C) or higher, or chills.

●Blood in your urine

●Pain when urinating

●Very bad belly pain

●Very bad back pain, or pain on the side of your lower back

More on this topic

Patient education: Urinary incontinence in females (The Basics)
Patient education: Treatments for urgency incontinence in females (The Basics)
Patient education: Urinary incontinence in males (The Basics)
Patient education: Urinary tract infections in adults (The Basics)
Patient education: Bladder cancer (The Basics)
Patient education: Bladder training (The Basics)
Patient education: Pelvic floor muscle exercises (The Basics)
Patient education: Surgery to treat stress urinary incontinence in females (The Basics)
Patient education: Neurogenic bladder in adults (The Basics)

Patient education: Urinary incontinence in women (Beyond the Basics)
Patient education: Urinary incontinence treatments for women (Beyond the Basics)
Patient education: Urinary tract infections in adolescents and adults (Beyond the Basics)
Patient education: Bladder cancer diagnosis and staging (Beyond the Basics)
Patient education: Bladder cancer treatment; non-muscle invasive (superficial) cancer (Beyond the Basics)
Patient education: Bladder cancer treatment; muscle invasive cancer (Beyond the Basics)
Patient education: Pelvic floor muscle exercises (Beyond the Basics)