Urinary Bladder
Function
Pelvic girdle, also called bony pelvis, in human anatomy, a basin-shaped complex of bones that connects the trunk and the legs, supports and balances the trunk, and contains and supports the intestines, the urinary bladder, and the internal sex organs.
The urinary bladder is a hollow muscular organ in humans and some other animals that collects and stores urine from the kidneys before disposal by urination. In the human, the bladder is a hollow muscular, and distensible (or elastic) organ, that sits on the pelvic floor. Urine enters the bladder via the ureters and exits via the urethra. The typical human bladder will hold between 300 and 500 mL (10.14 and 16.91 fl oz) before the urge to empty occurs, but can hold considerably more.
Brain Metastases from Primary Tumors of the Urinary Bladder:
Urothelial carcinoma occurs in the bladder, upper urinary tract, and lower urinary tract, including prostatic urethra. A majority of the reported cases of intracranial metastases from urothelial carcinoma originates from the bladder and upper urinary tract.
Symptoms
Urinary Frequency: Needing to urinate more often than usual. This can be caused by overactive bladder, urinary tract infections (UTIs), interstitial cystitis, or certain medications.
Urinary Urgency: Feeling a sudden and strong need to urinate that is difficult to delay. Overactive bladder is a common cause of urinary urgency.
Dysuria: Pain or discomfort during urination. UTIs, bladder infections, and interstitial cystitis can lead to dysuria.
Hematuria: The presence of blood in the urine. Hematuria originating from the bladder can be due to infections, bladder stones, bladder tumors, or other bladder conditions.
Bladder Pain: Pain or discomfort in the lower abdominal or pelvic area. Conditions like interstitial cystitis, bladder infections, and bladder stones can cause bladder pain.
Urinary Incontinence: Involuntary leakage of urine. Stress incontinence (leakage during activities like coughing or sneezing), urge incontinence (strong sudden urge leading to leakage), and mixed incontinence are common types.
Nocturia: Waking up multiple times during the night to urinate. Overactive bladder, bladder infections, and certain medical conditions can contribute to nocturia.
Incomplete Emptying: Feeling like the bladder hasn't fully emptied after urination. This might be due to weak bladder muscles, urinary retention, or bladder outlet obstruction.
Increased Nighttime Urination: The need to urinate more frequently at night. Nocturia can disrupt sleep patterns and might be indicative of underlying bladder or urinary conditions.
Bladder Spasms: Sudden, involuntary contractions of the bladder muscles causing discomfort or pain. Overactive bladder, urinary tract infections, and interstitial cystitis can lead to bladder spasms.
Frequent Urinary Tract Infections: Recurrent infections in the urinary tract can involve the bladder. Symptoms might include urgency, frequency, and dysuria.
Bladder Stones: Hard mineral deposits that can form in the bladder, causing pain, urinary frequency, and other discomforts.
Examination
Patient History:
Start by obtaining a detailed medical history, including any urinary symptoms, previous bladder or kidney problems, surgeries, medications, and relevant medical conditions. Visual Inspection:
Observe the patient's lower abdomen for any visible abnormalities or signs of distention (enlargement) in the bladder area. Palpation:
Gently palpate the lower abdomen to feel for any tenderness, masses, or areas of discomfort. Bladder distention or an enlarged bladder might be palpable. Percussion:
Percuss (tap) the lower abdomen to assess for dullness, which might indicate an enlarged bladder due to retention or other issues. Bladder Palpation:
For a more detailed assessment, the healthcare provider might perform a suprapubic palpation, gently pressing on the lower abdomen above the pubic bone to feel for the bladder's position, size, and tenderness. Pelvic Examination (Women):
In female patients, a pelvic examination might be conducted to evaluate the bladder's position, any masses, and signs of pelvic floor dysfunction. Digital Rectal Examination (Men):
In male patients, a digital rectal examination might be performed to assess the prostate gland's size, consistency, and any signs of enlargement that could impact bladder function. Assessment of Reflexes:
Bladder function is regulated by nerves. Testing reflexes related to urination, such as the bulbocavernosus reflex, can provide insights into neurological issues. Urinary Catheterization (If Needed):
In certain cases, a urinary catheter might be inserted into the bladder to measure post-void residual volume (the amount of urine left in the bladder after urination) or to collect a urine sample for testing. Urinary Flow Rate Measurement (Uroflowmetry):
Uroflowmetry is a non-invasive test that measures the rate of urine flow during voiding. It can provide information about the bladder's function and the presence of any obstruction. Bladder Ultrasound:
A bladder ultrasound might be performed to visualize the bladder's size, shape, and capacity. It can also be used to measure post-void residual volume. Additional Tests:
Depending on the findings of the physical examination, additional tests like urinalysis, blood tests, imaging studies (such as ultrasound or cystoscopy), and consultations with specialists might be recommended.