BLADDER
BLADDER TUMOURS
BLADDER
Ureter
Uterus
Rectum
Bladder
Pelvic
cartilage
Urethra
Vagina
Ureter
Rectum
Bladder
Scrotum
Pelvic
cartilage
Prostate
gland
Penis
Urethra
FEMALE
MALE
B
blad d er The hollow, muscular organ in
the lower abdomen that acts as a reser-
voir for
urine.
It lies within, and is
protected by, the pelvis. An adult blad-
der can hold about 0.5 litres of urine
before the need to pass urine is felt.
The bladder walls consist of muscle
and an inner lining. Two ureters carry
urine to the bladder from the kidneys.
At the lowest point of the bladder is the
opening into the urethra, which is known
as the bladder neck. This is normally
kept tightly closed by a ring of muscle
(the urethral sphincter). The function of
the bladder is to collect and store urine
until it can be expelled. Defective blad-
der function, leading to problems such
as
incontinence
and
urinary retention,
can have a variety of causes. (See also
bladder, disorders of; enuresis).
blad d er can cer See
bladder tumours.
bladder, d isord ers o f A group of dis-
orders affecting the bladder, including
inflammation (
cystitis
) usually caused
by a bacterial infection;
calculi
(stones);
impairment of the nerve supply; and
tumours. In men, obstruction to urine
flow from the bladder by an enlarged
prostate gland may cause
urinary reten-
tion.
Tumours of, or injury to, the spinal
cord may affect the nerves controlling
the bladder, leading either to retention
or
incontinence
. Bladder stones are
caused by the precipitation of substan-
ces that are present in the urine. Injury
to the bladder is uncommon but may
occur if the pelvis is fractured when the
bladder is full.
Disturbed bladder control can
also
result from nerve degeneration in condi-
tions such as
diabetes mellitus
,
multiple
sclerosis,
or
dementia.
An unstable or
irritable bladder
is a common condition
and is sometimes associated with a
uri-
nary tract infection
or prolapse of the
uterus. Tension or anxiety can cause fre-
quent urination. In children, delayed
bladder control (see
enuresis
) most
often results from delayed maturation
of the nervous system.
blad d er tum ours Growths originating
in the inner lining of the bladder. Many
are
papillomas
(small wart-like growths),
which tend to recur and will eventually
become cancerous. Other, more malig-
nant, growths may extend not only into
the bladder cavity but may also spread
through the bladder wall to involve
nearby organs such as the colon, rec-
tum, prostate gland, or uterus.
Bladder cancer is more common in
smokers and workers in the dye and
rubber industries.
Haematuria
(blood in
the urine) is the main symptom of blad-
der cancer. A tumour may obstruct the
entry of a ureter into the bladder, caus-
ing back pressure and pain in the
kidney region, or may obstruct the ure-
thral exit, causing difficulty in passing,
or retention of, urine.
Bladder tumours are diagnosed using
cystoscopy
and biopsy of the abnormal
area. If small, they can be treated by
heat or surgically during cystoscopy.
They tend to recur at the same or other
sites within the bladder, so that regular
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