The bladder is a storage organ that sits in your pelvis. Urine is made by your kidneys and stored in the bladder until you are ready to empty it. When you go to the toilet your bladder outlet muscles (urethral sphincter and pelvic floor) relax and your bladder contracts (squeezes) emptying your bladder of urine. Your brain controls your bladder by sending messages to tell it when to hold on and when to empty.BladderEncyclopedia Entry for Bladder :Bladder biopsy. A bladder biopsy can be done as part of a cystoscopy. Cystoscopy is a procedure that is done to see the inside of the bladder using a thin lighted tube called a cystoscope. A small piece of tissue or the entire abnormal area is removed. The tissue is sent to the lab to be tested if: Abnormalities of the bladder are found during this exam A tumor is seen.You must sign an informed consent form before you have a bladder biopsy. In most cases, you are asked to urinate just before the procedure. You may also be asked to take an antibiotic before the procedure. For infants and children, the preparation you can provide for this test depends on your child's age, previous experiences, and level of trust. For general information regarding how you can prepare your child, see the following topics: Infant test or procedure preparation (birth to 1 year) Toddler test or procedure preparation (1 to 3 years) Preschooler test or procedure preparation (3 to 6 years) School age test or procedure preparation (6 to 12 years) Adolescent test or procedure preparation (12 to 18 years).You may have a slight discomfort as the cystoscope is passed through your urethra into your bladder. You will feel discomfort that is similar to a strong urge to urinate when the fluid has filled your bladder. You may feel a pinch during the biopsy. There may be a burning sensation when the blood vessels are sealed to stop bleeding (cauterized). After the cystoscope is removed, your urethra may be sore. You may feel a burning sensation during urination for a day or two. There may be blood in the urine. In most cases, this will go away on its own. In some cases, the biopsy needs to be taken from a large area. In that case, you may need general anesthesia or sedation before the procedure.This test is most often done to check for cancer of the bladder or urethra.The bladder wall is smooth. The bladder is of a normal size, shape, and position. There are no blockages , growths, or stones.The presence of cancer cells indicates bladder cancer. The type of cancer can be determined from the biopsy sample. Other abnormalities may include: Bladder diverticula Cysts Inflammation Infection Ulcers.There is some risk for urinary tract infection. There is a slight risk for excessive bleeding. There may be a rupture of the bladder wall with the cystoscope or during biopsy. There is also a risk that the biopsy will fail to detect a serious condition.You will likely have a small amount of blood in your urine shortly after this procedure. If the bleeding continues after you urinate, contact your health care provider. Also contact your provider if: You have pain, chills, or a fever You are producing less urine than usual ( oliguria ) You cannot urinate despite a strong urge to do so.Biopsy - bladder.Bladder catheterization, female Bladder catheterization, female Bladder catheterization, male Bladder catheterization, male Female urinary tract Female urinary tract Male urinary tract Male urinary tract Bladder biopsy Bladder biopsy.Bent AE, Cundiff GW. Cystourethroscopy.Encyclopedia Entry for Bladder :Bladder cancer. In the United States, bladder cancer often starts from the cells lining the bladder. These cells are called transitional cells. These tumors are classified by the way they grow: Papillary tumors look like warts and are attached to a stalk. Nonpapillary (sessile) tumors are flat. They are much less common. But they are more invasive and have a worse outcome. The exact cause of bladder cancer is not known. But several things may make you more likely to develop it: Cigarette smoking -- Smoking greatly increases the risk of developing bladder cancer. Up to half of all bladder cancers in men and several in women may be caused by cigarette smoke. Chemical exposure at work -- About 1 in 4 cases of bladder cancer is caused by coming into contact with cancer-causing chemicals at work. These chemicals are called carcinogens. Dye workers, rubber workers, aluminum workers, leather workers, truck drivers, and pesticide applicators are at the highest risk. Chemotherapy -- The chemotherapy drug cyclophosphamide may increase the risk for bladder cancer. Radiation treatment -- Women who had radiation therapy to treat cervical cancer have an increased risk of developing bladder cancer. Bladder infection -- A long-term (chronic) bladder infection or irritation may lead to a certain type of bladder cancer. Research has not shown clear evidence that using artificial sweeteners leads to bladder cancer.Symptoms of bladder cancer can include: Abdominal pain Blood in the urine Bone pain or tenderness if the cancer spreads to the bone Fatigue Painful urination Urinary frequency and urgency Urine leakage (incontinence) Weight loss Other diseases and conditions can cause similar symptoms. It is important to see your health care provider to rule out all other possible causes.The provider will perform a physical examination , including a rectal and pelvic exam. Tests that may be done include: Abdominal and pelvic CT scan Abdominal MRI scan Cystoscopy (examining the inside of the bladder with a camera), with biopsy Intravenous pyelogram - IVP Urinalysis Urine cytology If tests confirm you have bladder cancer, additional tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future. The TNM (tumor, nodes, metastatis) staging system is used to stage bladder cancer: Ta -- The cancer is in the lining of the bladder only and has not spread. T1 -- The cancer goes through the bladder lining, but does not reach the bladder muscle. T2 -- The cancer spreads to the bladder muscle. T3 -- The cancer spreads past the bladder into the fatty tissue surrounding it. T4 -- The cancer has spread to nearby structures such as the prostate gland, uterus, vagina, rectum, abdominal wall, or pelvic wall. Tumors are also grouped based on how they appear under a microscope. This is called grading the tumor. A high-grade tumor is fast growing and more likely to spread. Bladder cancer can spread into nearby areas, including the: Lymph nodes in the pelvis Bones Liver Lungs.Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health. Stage 0 and I treatments: Surgery to remove the tumor without removing the rest of the bladder Chemotherapy or immunotherapy placed directly into the bladder Stage II and III treatments: Surgery to remove the entire bladder (radical cystectomy) and nearby lymph nodes Surgery to remove only part of the bladder, followed by radiation and chemotherapy Chemotherapy to shrink the tumor before surgery A combination of chemotherapy and radiation (in people who choose not to have surgery or who cannot have surgery) Most people with stage IV tumors cannot be cured and surgery is not appropriate. In these people, chemotherapy is often considered. CHEMOTHERAPY Chemotherapy may be given to people with stage II and III disease either before or after surgery to help prevent the tumor from returning. For early disease (stages 0 and I), chemotherapy is usually given directly into the bladder. A Foley catheter can be used to deliver the medicine into the bladder in advanced stages (II-IV) of bladder cancer (intravesically). Common side effects include bladder wall irritation and pain when urinating. IMMUNOTHERAPY Bladder cancers are often treated with immunotherapy. In this treatment, a medicine triggers your immune system to attack and kill the cancer cells. Immunotherapy for bladder cancer is often performed using the Bacille Calmette-Guerin vaccine (commonly known as BCG). As with all treatments, side effects are possible. Ask your provider what side effects you might expect, and what to do if they occur. SURGERY Surgery for bladder cancer includes: Transurethral resection of the bladder (TURB) -- Cancerous bladder tissue is removed through the urethra. Partial or complete removal of the bladder -- Many people with stage II or III bladder cancer may need to have their bladder removed (radical cystectomy). Sometimes, only part of the bladder is removed. Chemotherapy may be given before or after this surgery. Surgery may also be done to help your body drain urine after the bladder is removed. This may include: Ileal conduit -- A small urine reservoir is surgically created from a short piece of your small intestine. The ureters that drain urine from the kidneys are attached to one end of this piece. The other end is brought out through an opening in the skin (a stoma). The stoma allows the person to drain the collected urine out of the reservoir. Continent urinary reservoir -- A pouch to collect urine is created inside your body using a piece of your intestine. You will need to insert a tube into an opening in your skin (stoma) into this pouch to drain the urine. Orthotopic neobladder -- This surgery is becoming more common in people who have had their bladder removed. A part of your bowel is folded over to make a pouch that collects urine. It is attached to the place in the body where the urine normally empties from the bladder. This procedure allows you to maintain some normal urinary control.You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.After treatment for bladder cancer, you will be closely monitored by a doctor. This may include: CT scans to check for the spread or return of cancer Monitoring symptoms that might suggest the disease is getting worse, such as fatigue, weight loss, increased pain, decreased bowel and bladder function, and weakness Complete blood count (CBC) to monitor for anemia Bladder exams every 3 to 6 months after treatment Urinalysis if you did not have your bladder removed How well a person with bladder cancer does depends on the initial stage and response to treatment of the bladder cancer. The outlook for stage 0 or I cancers is fairly good. Although the risk for the cancer returning is high, most bladder cancers that return can be surgically removed and cured. The cure rates for people with stage III tumors are less than 50%. People with stage IV bladder cancer are rarely cured.Bladder cancers may spread into the nearby organs. They may also travel through the pelvic lymph nodes and spread to the liver, lungs, and bones. Additional complications of bladder cancer include: Anemia Swelling of the ureters ( hydronephrosis ) Urethral stricture Urinary incontinence.Call your provider if you have blood in your urine or other symptoms of bladder cancer, including: Frequent urination Painful urination Urgent need to urinate.If you smoke, quit. Smoking can increase your risk for bladder cancer. Avoid exposure to chemicals linked to bladder cancer.Transitional cell carcinoma of the bladder; Urothelial cancer.Cystoscopy Cystoscopy Female urinary tract Female urinary tract Male urinary tract Male urinary tract.National Cancer Institute website. Bladder cancer treatment (PDQ) - health professional version. www.cancer.gov/cancertopics/pdq/treatment/bladder/healthprofessional. Updated March 9, 2018. Accessed March 26, 2018. National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): Bladder cancer. Version 3.2018. www.nccn.org/professionals/physician_gls/pdf/bladder.pdf. Accessed March 26, 2018. Smith A, Balar AV, Milowsky MI, Chen RC. Bladder cancer.Encyclopedia Entry for Bladder :Bladder exstrophy repair. Bladder exstrophy repair involves two surgeries. The first surgery is to repair the bladder. The second one is to attach the pelvic bones to each other. The first surgery separates the exposed bladder from the abdomen wall. The bladder is then closed. The bladder neck and urethra are repaired. A flexible, hollow tube called a catheter is placed to drain urine from the bladder. This is placed through the abdominal wall. A second catheter is left in the urethra to promote healing. The second surgery, pelvic bone surgery, may be done along with the bladder repair. It may also be delayed for weeks or months. A third surgery may be needed if there is a bowel defect.The surgery is recommended for children who are born with bladder exstrophy. This defect occurs more often in boys and is often linked to other birth defects. Surgery is necessary to: Allow the child to develop normal urinary control Avoid future problems with sexual function Improve the child's physical appearance (genitals will look more normal) Prevent infection that could harm the kidneys Sometimes, the bladder is too small at birth. In this case, the surgery will be delayed until the bladder has grown. These newborns are sent home on antibiotics. The bladder, which is outside the abdomen, must be kept moist. It can take months for the bladder to grow to the right size. The infant will be followed closely by a medical team. The team decides when the surgery should take place.Risks of anesthesia and surgery in general are: Reactions to medicines Breathing problems Bleeding, blood clots Infection Risks with this procedure may include: Chronic urinary tract infections Sexual/erectile dysfunction Kidney problems Need for future surgeries Poor urinary control ( incontinence ).Most bladder exstrophy repairs are done when your child is only a few days old, before leaving the hospital. In this case, the hospital staff will prepare your child for the surgery. If the surgery was not done when your child was a newborn, your child may need the following tests at the time of surgery: Urine test ( urine culture and urinalysis ) to check your child's urine for infection and to test kidney function Blood tests ( complete blood count , electrolytes, and kidney tests) Record of urine output X-ray of your child's lower stomach and bones Ultrasound of your child's kidneys Always tell your child's health care provider what medicines your child is taking. Also let them know about the medicines or herbs you bought without a prescription. Ten days before the surgery, your child may be asked to stop taking aspirin, ibuprofen, warfarin (Coumadin), and any other medicines. These medicines make it hard for the blood to clot. Ask your provider which drugs your child should still take on the day of the surgery. On the day of the surgery: Your child will usually be asked not to drink or eat anything for several hours before the surgery. Give the drugs your child's provider told you to give with a small sip of water. Your child's provider will tell you when to arrive.After pelvic bone surgery, your child will need to be in a lower body cast or sling for 4 to 6 weeks. This helps the bones heal. After the bladder surgery, your child will have a tube that drains the bladder through the stomach wall ( suprapubic catheter ). This will be in place for 3 to 4 weeks. Your child will also need pain management, wound care, and antibiotics. The providers will teach you about these things before you leave the hospital. Due to the high risk of infection, your child will need to have a urinalysis and urine culture at every well-child visit. At the first signs of an illness, these tests may be repeated. Some children take antibiotics on a regular basis to prevent infection.Urinary control most often happens after the neck of the bladder is repaired. This surgery is not always successful. The child may need to repeat the surgery later on. Even with repeat surgery, a few children will not have control of their urine. They may need catheterization.Bladder birth defect repair; Everted bladder repair; Exposed bladder repair; Repair of bladder exstrophy.Surgical wound care - open.Elder JS. Anomalies of the bladder.Encyclopedia Entry for Bladder :Bladder outlet obstruction. This condition is common in aging men. It is often caused by enlarged prostate. Bladder stones and bladder cancer are also more commonly seen in men than women. As a man ages, his chance of getting these diseases increases greatly. Other common causes of BOO include: Pelvic tumors (cervix, prostate, uterus, rectum) Narrowing of the tube that carries urine out of the body from the bladder (urethra), due to scar tissue or certain birth defects Less common causes include: Cystocele (when the bladder falls into the vagina) Foreign objects Urethral spasms Inguinal (groin) hernia.The symptoms of BOO may vary, but can include: Abdominal pain Continuous feeling of a full bladder Frequent urination Pain during urination ( dysuria ) Problems starting urination (urinary hesitancy) Slow, uneven urine flow, at times being unable to urinate Urinary tract infection Waking up at night to urinate ( nocturia ).Your health care provider will ask about your symptoms and medical history. You will undergo a physical exam. One or more of the following problems may be found: Abdominal growth Cystocele (women) Enlarged bladder Enlarged prostate (men) Tests may include: Blood chemistries to look for signs of kidney damage Cystoscopy and retrograde urethrogram (x-ray) to look for narrowing of the urethra Tests to determine how fast urine flows out of the body ( uroflowmetry ) Tests to see how much the urine flow is blocked and how well the bladder contracts (urodynamic testing) Ultrasound to locate the blockage of urine and find out how well the bladder empties Urinalysis to look for blood or signs of infection in the urine Urine culture to check for an infection.Treatment of BOO depends on its cause. A tube, called a catheter, is inserted into the bladder. The insertion is done through the urethra to relieve the blockage. Sometimes, a catheter placed through the belly area into the bladder is needed to drain the bladder. Most often, you will need surgery for long-term cure of BOO. However, many of the diseases that cause this problem can be treated with medicines. Talk to your provider about possible treatments.Most causes of BOO can be cured if diagnosed early. However, permanent damage to the bladder or kidneys can result if the diagnosis is delayed.Call your provider if you have symptoms of BOO. Early diagnosis can often lead to a simple and effective cure.BOO; Lower urinary tract obstruction; Prostatism; Urinary retention - BOO.Kidney anatomy Kidney anatomy Female urinary tract Female urinary tract Male urinary tract Male urinary tract Kidney - blood and urine flow Kidney - blood and urine flow.Andersson K, Wein AJ. Pharmacologic management of lower urinary tract storage and emptying failure.Encyclopedia Entry for Bladder :Bladder stones. Bladder stones are most often caused by another urinary system problem, such as: Bladder diverticulum Blockage at the base of the bladder Enlarged prostate (BPH) Neurogenic bladder Urinary tract infection (UTI) Incomplete emptying of bladder Foreign objects in the bladder Almost all bladder stones occur in men. Bladder stones are much less common than kidney stones. Bladder stones may occur when urine in the bladder is concentrated. Materials in the urine form crystals. These may also result from foreign objects in the bladder.Symptoms occur when the stone irritates the lining of the bladder. The stones may also block the flow of urine from the bladder. Symptoms can include: Abdominal pain , pressure Abnormally colored or dark-colored urine Blood in the urine Difficulty urinating Frequent urge to urinate Inability to urinate except in certain positions Interruption of the urine stream Pain, discomfort in the penis Signs of UTI (such as fever, pain when urinating, and need to urinate often) Loss of urine control may also occur with bladder stones.The health care provider will perform a physical exam. This will also include a rectal exam. The exam may reveal an enlarged prostate or other problems. The following tests may be done: Bladder or pelvic x-ray Cystoscopy Urinalysis Urine culture (clean catch) Abdominal ultrasound or CT scan.You may be able to help small stones pass on their own. Drinking 6 to 8 glasses of water or more per day will increase urination. Your provider may remove stones that do not pass using a cystoscope. A small telescope will be passed through the urethra into the bladder. A laser or other device will be used to break up the stones and the pieces will be removed. Some stones may need to be removed using open surgery. Drugs are rarely used to dissolve the stones. Causes of bladder stones should be treated. Most commonly, bladder stones are seen with BPH or blockage at the base of the bladder. You may need surgery to remove the inside part of the prostate or to repair the bladder.Most bladder stones pass on their own or can be removed. They do not cause permanent damage to the bladder. They may come back if the cause is not corrected. Left untreated, stones may cause repeated UTI. This can also cause permanent damage to the bladder or kidneys.Call your provider if you have symptoms of bladder stones.Prompt treatment of UTI or other urinary tract conditions may help prevent bladder stones.Stones - bladder; Urinary tract stones; Bladder calculi.Kidney stones and lithotripsy - discharge Kidney stones - self-care Percutaneous urinary procedures - discharge.Female urinary tract Female urinary tract Male urinary tract Male urinary tract.Benway BM, Bhayani SB. Lower urinary tract calculi.Encyclopedia Entry for Bladder :Bladder Infection. May be caused by Proteus Vulgaris, P. Mirabilis, and P. Penneri includes pathogens responsible for many human urinary tract infections.Information from Marcello Allegretti.