The bladder lies in the anterior half of the PELVIS, bordered in front by the pubis bone and laterally by the side wall of the pelvis. Superiorly the bladder is covered by the peritoneal lining of the abdomen. The bottom or base of the bladder lies against the PROSTATE GLAND in the male and the UTERUS and VAGINA in the female.... urinary bladder
Cystitis Most cases of cystitis are caused by bacteria which have spread from the bowel, especially Escherichia coli, and entered the bladder via the urethra. Females are more prone to cystitis than are males, owing to their shorter urethra which allows easier entry for bacteria. Chronic or recurrent cystitis may result in infection spreading up the ureter to the kidney (see KIDNEY, DISEASES OF).
Symptoms Typically there is frequency and urgency of MICTURITION, with stinging and burning on passing urine (dysuria), which is often smelly or bloodstained. In severe infection patients develop fever and rigors, or loin pain. Before starting treatment a urine sample should be obtained for laboratory testing, including identi?cation of the invading bacteria.
Treatment This includes an increased ?uid intake, ANALGESICS, doses of potassium citrate to make the urine alkaline to discourage bacterial growth, and an appropriate course of ANTIBIOTICS once a urine sample has been ana-lysed in the laboratory to con?rm the diagnosis and determine what antibiotics the causative organism is likely to respond to.
Stone or calculus The usual reason for the formation of a bladder stone is an obstruction to the bladder out?ow, which results in stagnant residual urine – ideal conditions for the crystallisation of the chemicals that form stones – or from long-term indwelling CATHETERS which weaken the natural mechanical protection against bacterial entry and, by bruising the lining tissues, encourage infection.
Symptoms The classic symptom is a stoppage in the ?ow of urine during urination, associated with severe pain and the passage of blood.
Treatment This involves surgical removal of the stone either endoscopically (litholapaxy); by passing a cystoscope into the bladder via the urethra and breaking the stone; or by LITHOTRIPSY in which the stone (or stones) is destroyed by applying ultrasonic shock waves. If the stone cannot be destroyed by these methods, the bladder is opened and the stone removed (cystolithotomy).
Cancer Cancer of the bladder accounts for 7 per cent of all cancers in men and 2·5 per cent in women. The incidence increases with age, with smoking and with exposure to the industrial chemicals, beta-napththylamine and benzidine. In 2003, 2,884 men and 1,507 women died of bladder cancer in England and Wales.
Symptoms The classical presenting symptom of a bladder cancer is the painless passing of blood in the urine – haematuria. All patients with haematuria must be investigated with an X-ray of their kidneys, an INTRAVENOUS PYELOGRAM (UROGRAM) and a cystoscopy.
Treatment Super?cial bladder tumours on the lining of the bladder can be treated by local removal via the cystoscope using DIATHERMY (cystodiathermy). Invasive cancers into the bladder muscle are usually treated with RADIOTHERAPY, systemic CHEMOTHERAPY or surgical removal of the bladder (cystectomy). Local chemotherapy may be useful in some patients with multiple small tumours.... urinary bladder, diseases of
Most urinary tract stones are composed of calcium oxalate or other salts crystallized from the urine. These may be associated with a diet rich in oxalic acid (found in leafy vegetables and coffee); high levels of calcium in the blood as a result of hyperparathyroidism; or chronic dehydration. Other types of stone are associated with gout and some cancers. An infective stone is usually a result of chronic urinary tract infection.
In developing countries, bladder stones usually occur as a result of dietary deficiencies. In developed countries, they are usually caused by an obstruction to urine flow from the bladder and/or a longstanding urinary tract infection.
The most common symptom of a stone in the kidney or ureter is renal colic (a severe pain in the loin) that may cause nausea and vomiting. There may be haematuria (blood in the urine). A bladder stone is usually indicated by difficulty in passing urine. The site of the stone can usually be confirmed by intravenous or retrograde urography.
Renal colic is treated with bed rest and an opioid analgesic (painkiller).
With an adequate fluid intake, small stones are usually passed in the urine without problems.
The first line of treatment for larger stones is lithotripsy, which uses ultrasonic or shock waves to disintegrate the stones.
Alternatively, cytoscopy can be used to crush and remove stones in the bladder and lower ureter.
In some cases, surgery may be needed.... calculus, urinary tract
If weak pelvic muscles are causing stress incontinence, pelvic floor exercises may help. Sometimes, surgery may be needed to tighten the pelvic muscles or correct a prolapse. Anticholinergic drugs may be used to relax the bladder muscle if irritable bladder is the cause.
If normal bladder function cannot be restored, incontinence pants can be worn; men can wear a penile sheath leading into a tube connected to a urine bag. Some people can avoid incontinence by self-catheterization (see catheterization, urinary). Permanent catheterization is necessary in some cases.... incontinence, urinary
Complete retention causes discomfort and lower abdominal pain, except when nerve pathways are defective. The full bladder can be felt above the pubic bone. However, chronic or partial retention may not cause any serious symptoms. Retention can lead to kidney damage and, often, a urinary tract infection.Treatment of retention is by catheterization (see catheterization, urinary).
The cause is then investigated.
Obstruction can usually be treated; if nerve damage is the cause, permanent or intermittent catheterization is sometimes necessary.... urinary retention
In both sexes, causes of urinary tract infections include stones (see calculus, urinary tract), bladder tumours, congenital abnormalities of the urinary tract, or defective bladder emptying as a result of spina bifida or a spinal injury. The risks of developing a urinary tract infection can be reduced by strict personal hygiene, drinking lots of fluids, and regularly emptying the bladder.
Urethritis can lead to the formation of a urethral stricture. Cystitis usually only causes complications if the infection spreads to the kidneys. Pyelonephritis, if it is left untreated, can lead to permanent kidney damage, septicaemia, and septic shock.
The infection is diagnosed by the examination of a urine culture. Further investigations using urography or ultrasound scanning may be necessary. Most infections of the urinary tract are treated with antibiotic drugs.... urinary tract infection
Amenorrhoea/lack of menstruation (M,B):
French basil, carrot seed, celery seed, cinnamon leaf, dill, sweet fennel, hops, hyssop, juniper, laurel, lovage, sweet marjoram, myrrh, parsley, rose (cabbage & damask), sage (clary & Spanish), tarragon, yarrow.
Dysmenorrhoea/cramp, painful or difficult menstruation (M,C,B):
Melissa, French basil, carrot seed, chamomile (German & Roman), cypress, frankincense, hops, jasmine, juniper, lavandin, lavender (spike & true), lovage, sweet marjoram, rose (cabbage & damask), rosemary, sage (clary & Spanish), tarragon, yarrow.
Cystitis (C,B,D):
Canadian balsam, copaiba balsam, bergamot, cedarwood (Atlas, Texas & Virginian), celery seed, chamomile (German & Roman), cubebs, eucalyptus blue gum, frankincense, juniper, lavandin, lavender (spike & true), lovage, mastic, niaouli, parsley, Scotch pine, sandalwood, tea tree, thyme, turpentine, yarrow.
Frigidity (M,S,B,V):
Cassie, cinnamon leaf, jasmine, neroli, nutmeg, parsley, patchouli, black pepper, cabbage rose, rosewood, clary sage, sandalwood, ylang ylang.
Lack of nursing milk (M):
Celery seed, dill, sweet fennel, hops.
Labour pain & childbirth aid (M,C,B):
Cinnamon leaf, jasmine, true lavender, nutmeg, parsley, rose (cabbage & damask), clary sage.
Leucorrhoea/white discharge from the vagina (B,D):
Bergamot, cedarwood (Atlas, Texas & Virginian), cinnamon leaf, cubebs, eucalyptus blue gum, frankincense, hyssop, lavandin, lavender (spike & true), sweet marjoram, mastic, myrrh, rosemary, clary sage, sandalwood, tea tree, turpentine.
Menopausal problems (M,B,V):
Cypress, sweet fennel, geranium, jasmine, rose (cabbage & damask).
Menorrhagia/excessive menstruation (M,B):
Chamomile (German & Roman), cypress, rose (cabbage & damask).
Premenstrual tension/PMT (M,B,V):
Carrot seed, chamomile (German & Roman), geranium, true lavender, sweet marjoram, neroli, tarragon.
Pruritis/itching (D):
Bergamot, Atlas cedarwood, juniper, lavender, myrrh, tea tree.
Sexual overactivity (M,B):
Hops, sweet marjoram.
Thrush/candida (B,D):
Bergamot, geranium, myrrh, tea tree.
Urethritis (B,D):
Bergamot, cubebs, mastic, tea tree, turpentine.
Immune System
Chickenpox (C,S,B):
Bergamot, chamomile (German & Roman), eucalyptus (blue gum & lemon), true lavender, tea tree.
Colds/’flu (M,B,V,I):
Angelica, star anise, aniseed, copaiba balsam, Peru balsam, French basil, West Indian bay, bergamot, borneol, cabreuva, cajeput, camphor (white), caraway, cinnamon leaf, citronella, clove bud, coriander, eucalyptus (blue gum, lemon & peppermint), silver fir, frankincense, ginger, grapefruit, immortelle, juniper, laurel, lemon, lime, sweet marjoram, mastic, mint (peppermint & spearmint), myrtle, niaouli, orange (bitter & sweet), pine (longleaf & Scotch), rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, turpentine, yarrow.
Fever (C,B):
French basil, bergamot, borneol, camphor (white), eucalyptus (blue gum, lemon & peppermint), silver fir, ginger, immortelle, juniper, lemon, lemongrass, lime, mint (peppermint & spearmint), myrtle, niaouli, rosemary, rosewood, Spanish sage, hemlock spruce, tea tree, thyme, yarrow.
Measles (S,B,I,V):
Bergamot, eucalyptus blue gum, lavender (spike & true), tea tree.... genito-urinary and endocrine systems
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