Bladder tenesmus is the medical term for the sensation of incomplete emptying of the bladder after urination, regardless of whether the bladder is actually empty or not. It is worth noting that the term tenesmus, used without further specification, usually refers to rectal tenesmus, or the sensation of incomplete emptying of the bowels after a bowel movement.
Why does bladder tenesmus occur?
The feeling of needing to urinate again, even immediately after a recent urination, is caused by the constant muscular contraction of the urinary tract, which normally responds to the expansion of the bladder due to the presence of a large volume of urine. This explains, for example, tenesmus of the bladder in the presence of objective residual urine, but in other cases it may be due to damage to the nerves responsible for urination.
Overall, there are many causes of bladder tenesmus, but the most common are: cystitis, or bacterial infection of the bladder, which is very common in women; prostate diseases such as prostatitis, cancer, and benign prostatic hypertrophy; urethritis, an inflammation of the urethra; sexually transmitted infections such as gonorrhea or chlamydia ; bladder and kidney stones, which block the passage of urine.
Less common causes in clinical practice include: bladder cancer, urethral stenosis (narrowing of the urethra), the presence of foreign bodies in the bladder or urethra, insufficient bladder activity, and other neurogenic dysfunctions.
Tenesmus of the bladder may also be observed in the case of pathologies not necessarily directly related to the urinary system, such as: abdominal trauma and injuries, spinal trauma, bowel surgery, constipation, rectal tumors. In women, this may be a consequence of pregnancy, endometriosis and vaginitis.
Side effects of medications
It should be borne in mind that tenesmus of the bladder may occur after taking certain medications, which, among other side effects, cause difficulty emptying the bladder with muscular contraction of the sphincter, preventing urination.
These drugs include: amphetamines , a class of nervous system stimulants used to treat narcolepsy; obesity; attention deficit hyperactivity disorder ; antihistamines used to treat allergies; drugs for Parkinson's disease; muscle relaxants ; nonsteroidal anti-inflammatory drugs (NSAIDs, such as over-the-counter pain relievers); some antipsychotics, used, for example, to treat schizophrenia; older-generation antidepressants; opioids .
How does bladder tenesmus manifest itself?
It is important to understand that bladder tenesmus is a symptom, not a disease. It may be accompanied by other symptoms, the most common of which are urination-related disorders. These include:
• difficulty urinating, with a weak and/or intermittent urine stream (dysuria);
• the need to get up at night to urinate ( nocturia );
• pain and/or burning during urination ( strangury );
• the presence of blood in the urine, urine that is cloudy, dark and/or foul-smelling (hematuria).
• frequent urination (pollakiuria).
A thorough analysis of the symptoms accompanying bladder tenesmus is often enough for the urologist at the Bogolyuby Medical Center to diagnose the problem, at least narrowing the range of possible causes. It may be necessary to differentiate between two different cases: the subjective feeling of incomplete emptying of the bladder and the objective presence of a large amount of residual urine in the bladder (measured by ultrasound), which may be caused, for example, by the presence of some form of obstruction or blockage of the urinary passage itself. Therapy should be aimed at eliminating the cause of the problem itself.
