Bladder Pain: 11 Common Causes (& What To Do)

Bladder pain is generally a sign of a UTI or irritation from cysts or kidney stones. It can also be caused by uterine inflammation or intestinal inflammation. To know what is causing your bladder pain, you should monitor for other symptoms like blood in the urine, pain with urination, fever, or vaginal or penile discharge. 

Treatment should be followed as instructed by your family doctor, although a gynecologist or urologist can also identify the causes of bladder pain and prescribe treatment. 

Imagem ilustrativa número 3

The main causes of bladder pain are: 

1. Urinary tract infection (UTI)

A UTI can affect the bladder, urethra, or in more severe cases, the kidneys. This is the most common cause of bladder pain. Normally, this pain is accompanied by other symptoms like: 

  • Pelvic pain or bladder pain when urinating
  • Frequent urge to urinate with low quantities actually 
  • Presence of blood in the urine
  • Urinary urgency 
  • Urethral or bladder pain during sex 
  • Low grade fever 

Although UTIs are most common in women, they can also occur in men of any age. If you notice any symptoms of a UTI, you should see your doctor promptly. If you are unable to get an appointment quickly, you should proceed to the emergency room for an assessment and testing. Learn more about common UTI symptoms

How to treat: If a UTI has been confirmed, the doctor will likely prescribe antibiotics (like norfloxacin, sulpha or fosfomycin. Analgesic medication, like acetaminophen, and anti-inflammatories, like ibuprofen, can be used to relieve pain and discomfort. In addition, when recovery, it is important to drink at least 2 L of water per day and to maintain good genital hygiene. Cranberry tea is a great home remedy that can help to naturally treat this infection. 

Check out other home remedies for UTIs you can use to complement your medical treatment. 

2. Painful bladder syndrome 

Painful bladder syndrome, or interstitial cystitis, is an inflammation or irritation of the lining of the bladder. The cause is not well-known, and it can happen in both men and women. This syndrome is associated with symptoms like: 

  • Bladder pain 
  • Burning or pain with urination 
  • Difficulty urinating 
  • Pain during sex
  • Urge to urinate several times a day and throughout the night 

These symptoms have periods of worsening and improvement, and they are often confused for a urinary tract infection. Many people are treated with antibiotics as a result, although they are unnecessary and ineffective. This condition should be investigated by doctors should symptoms be persistent and recurring. 

In some people, symptoms can be triggered by consuming substances like cigarettes, coffee, black tea, or acidic foods, as well as by psychological factors.  

How to treat: Analgesic or anti-inflammatory medications can be used to relieve symptoms, although it is important to treat triggers like stress or anxiety with psychotherapy or meditation. You should also avoid any substances that can cause flare-ups. 

3. Neurogenic bladder  

Neurogenic bladder is a dysfunction in relaxing and contacting the bladder and urinary tract caused by neurologic diseases. It can cause urinary incontinence, the feeling of incomplete emptying, and in many cases, bladder pain. 

This condition can be categorized into hypoactive (in which the bladder is unable to contract voluntarily) or hyperactive (in which the bladder is over-sensitive and contacts easily). This can cause urgency to urinate during inappropriate times, and is most commonly seen in women. 

How to treat: Neurogenic bladder is treated depending on the underlying cause the presenting symptoms of each person. Some may benefit from physiotherapy, medications (like oxybutin or tolterodine), catheterization or, in some cases, surgery.

4. Kidney stones

A kidney stones can lodge itself anywhere along the urinary tract, like in the kidneys, ureters, bladder or urethra. It can cause pain as it passes and can block urinary flow. Pain from kidney stones is strong in intensity and is associated with blood in the urine and nausea. Read more about the symptoms of kidney stones and how they can present. 

How to treat: Treatment is prescribed depending on the size and location of the stone. It can be conservative and involve solely monitoring, or it may involve surgery for stone removal. It is important to keep yourself hydrated by drinking around 2 L of water per day. This can help with elimination of the stone and prevent possible kidney complications. Learn more about the treatment of kidney stones and what can cause them. 

5. Endometriosis in the bladder

Endometriosis is a chronic inflammatory condition caused by abnormal growth of endometrial cells outside of the uterus. It most commonly affects the ovaries or fallopian tubes, but endometrial cells can also implant inside or outside the bladder. 

Endometriosis in the bladder can cause bladder pain when the bladder is full, as well as irritation, urinary frequency, urinary urgency, pain, burning with urination or pelvic pain. Learn more about endometriosis symptoms and how they can affect the bladder, bowels or ovaries.

How to treat: Endometriosis should be treated by a gynecologist, who may prescribe birth control, an IUD, anti-inflammatories to relieve cramping, or even surgery for more serious cases. 

6. Bladder stone

A bladder stone can form in the bladder when minerals, like calcium, uric acid, phosphate ammonium, magnesium and/or cystine, are present in the urine. These crystals can start to stick together without causing any symptoms. 

Bladder stones may cause bladder irritation, however, or even block urinary flow. These situations can lead to bladder pain, difficulty or inability to urinate and increased urinary frequency. 

How to treat: Treatment should be oriented by a urologist, who may recommend increased water intake to eliminate small bladder stones. Larger stones may require surgical procedures to remove them, like a c cystolitholapaxy or cystolithotripsy. 

7. Bladder cancer

Bladder cancer is associated with a malignant tumor that can affect the inner layer of the bladder or the bladder muscles. Initial symptoms usually include blood in the urine, or red to orange colored urine. 

As the cancer develops, other symptoms may start to emerge, like a weak urine stream, bladder pain, difficulty or inability to urinate, lower back pain, weakness and weight loss for no apparent reason. 

How to treat: You should see an oncologist to start treatment, which may involve catheter placement, surgery, chemotherapy or radiation therapy. 

8. Prostate abnormalities

Bladder pain in men can be a sign of prostate abnormalities, like inflammation (ie. prostatitis), infections, enlarged prostate or prostate cancer. 

Other symptoms that can occur with prostate problems include testicular or penis pain, pain between the scrotum and anus, pain with urination, weak urine stream, blood in the urine and/or blood in the sperm. 

How to treat: Treatment for prostate abnormalities should be oriented by a urologist and will vary depending on the underlying cause. The doctor may prescribe analgesics and anti-inflammatories to relieve symptoms, as well as antibiotics if an infection is present. With prostate cancer, treatment may involve radiation therapy, hormonal replacement therapy or chemotherapy. 

9. Use of medications

Some medications, especially chemotherapy used for cancer (like ifosfamide, cyclophosphamide or BCG) can cause bladder tissue irritation, cystitis or UTIs. This can lead to pain or discomfort in the bladder, burning with urination, bleeding with urination, fever or chills

In addition, chemotherapy can reduce the body's overall defense mechanisms, which increases the risk for UTI. 

How to treat: You should consult the oncologist responsible for your treatment, who may prescribe analgesics to relieve symptoms and antibiotics to combat an infection.  

10. Bladder catheterization

A bladder catheter is a flexible tube that is inserted through the urethra to the bladder to drain urine. It is usually indicated to relieve acute or chronic urinary retention, although it may also be indicated to drain the bladder before or after surgery, to administer bladder medications or to monitor precise urine output. 

Prolonged use of catheters can increase the risk for complications, however, like a UTI. This can lead to bladder pain, general malaise or fever.

How to treat: Treatment for a UTI caused by a catheter should be monitored by a family doctor or urologist. The doctor may prescribe antibiotics to combat the infection, analgesics or anti-inflammatories to help relieve pain and reduce fever, or even a catheter change or removal, depending on the assessment. 

11. Organ inflammation in the pelvic area

Inflammation of some of the organs in the pelvis can cause abdominal pain that radiates to other areas. This can lead to a sensation of bladder pain.

The main inflammatory conditions that can cause this feeling include pelvic inflammatory disease, IBS or inflammation of the muscles or joints in the pelvis. 

How to treat: You should consult a urologist or gynecologist to identify the underlying cause of bladder cancer and to start specific treatment, depending on the underlying cause.

Can bladder pain be pregnancy? 

Generally, bladder pain does not indicate pregnancy. Nonetheless, pregnant women are at a higher risk for developing a UT which causes bladder pain and therefore people commonly associate the two. Urine tends to be higher in protein concentration during pregnancy, making women more prone to developing UTIs during this phase. 

Bladder pain felt by pregnancy is normally a result of normal pregnancy-related body changes, particularly during the third trimester. Pain is felt due to increased pressure on the uterus due to the pelvic organs. 

In addition, due to increased progesterone production, the bladder becomes more relaxed. Together with the increased pressure on the bladder, this can cause bladder discomfort or pain when urinating or throughout the day. 

How to treat: To reduce or prevent bladder pain during pregnancy, ensure you drink plenty of water and use comfortable, cotton-based clothing. You should maintain adequate genital hygiene and rest throughout the day to prevent stress. 

Other causes of bladder pain 

Inflammation in the pelvic organs can cause abdominal pain that radiates to other areas, including the bladder. Some main causes of this phenomenon include>

  • Pelvic inflammatory disease, caused by uterine or vaginal infections 
  • Endometriosis in other pelvic organs, like the fallopian tubes, ovaries, intestines and peritoneum 
  • Intestinal illnesses, like inflammatory bowel disease and irritable bowel syndrome
  • Abdominal cramping caused by menstruation or pregnancy 
  • Muscular or joint inflammation within the pelvis 

These causes should be considered if other, more likely conditions (like a UTI or kidney stones) have been ruled out. Your family doctor should refer you to a urologist or gynecologist for further investigation.