The Bladder

The bladder is located in the pelvic area just in front of the rectum, and is part of the urinary tract system. The bladder has two primary functions: to store urine, and to void urine. In simple terms, kidneys empty their contents through the ureter into the bladder where the urine is stored before emptying. The bladder plays a key role, in that it keeps urine flowing in the proper direction, not allowing urine to flow backwards into the kidneys. This outward flow ensures that the urinary tract is periodically emptied of waste contents. If the bladder does not function properly, due to infection, bladder stones, or tumors, a urologist is often asked to treat these conditions.

Bladder infections are very common among women because the urethra, a conduit for urine to leave the body, is short and can allow easy access for bacteria to enter the bladder from outside sources. Normally bacteria is washed out of the bladder during voiding, but occasionally, bacteria remains causing infection and symptoms. In males, bladder infections are less common since the urethra is longer and the bladder is further away from the outside of the male body.

Interstitial Cystitis (IC), also known as chronic pelvic pain, is a chronic bladder disorder that affects both men and women. IC occurs more often in females, usually between the ages of 20-65. In the beginning, symptoms closely resemble recurrent or chronic bladder infection. With this disorder, the bladder wall can become inflamed and irritated. This inflammation can lead to scarring and stiffening of the bladder, decreased bladder capacity, pinpoint bleeding and in rare cases, ulcers in the bladder lining. It seems most probable that the cause of IC may be an autoimmune reaction in which the body's defense system targets normal bladder tissue. 

Bladder stones develop when the minerals found in urine bind together and crystallize. If bladder stones are small enough, they can pass out of the system without causing problems. However, if they are undetected and begin to grow, they can become very large oftentimes requiring surgical removal. Small or large, they can cause infections and other bladder problems.

Bladder cancers arise on the inside of the bladder wall. The fragile cancerous tissue often bleeds a bit causing a redness of the urine. Unfortunately the bleeding often stops by itself and the urine may be clear for several weeks or months as the tumor continues to grow. The cancer often stays confined to the inside of the bladder wall and can be removed surgically. These cancers were at one time found much more often in men than women, but they are becoming more common in women because more women are smoking. Unlike kidney tumors, cigarette smoking or chemical exposure often causes bladder tumors.

When asked to examine a patient with bladder problems, the urologist will often use the same studies that he or she uses to evaluate the kidneys, for example, a urinalysis and x-rays. It is not uncommon for a urologist to recommend direct inspection of the bladder with a cystoscope to rule-out tumors, stones or other potential problems.