A trabeculated bladder is a bladder that has a thickened wall, making it harder for the bladder to contract. Bladder trabeculation can make it difficult to empty the bladder fully.
The main cause of bladder trabeculation is repeated or chronic urethral obstructions. This is when the urethra, which transports urine out of the body, becomes blocked numerous times.
A urethral obstruction can happen to people of any sex or age. It can even occur in fetuses before birth.
This article looks at bladder trabeculation, the signs, symptoms, and causes. It also looks at how doctors diagnose and treat the condition.
Bladder trabeculation is a thickening of the bladder walls. The condition often occurs due to repeated or chronic obstructions in the urethra, which is the tube that drains urine from the bladder.
If the urethra becomes blocked by something, urine cannot get past. This makes it harder for the bladder walls to contract and expel the urine. With repeated obstructions, the bladder walls thicken and lose their elasticity.
Eventually, the muscle walls begin to lose their tone, and the bladder retains urine for longer than it should.
A person with bladder trabeculation
- difficulty urinating
- pain when urinating
- feeling as if the bladder is not fully empty
- recurring urinary tract infections (UTIs)
- kidney pain
The main cause of bladder trabeculation is urethral blockage. Urethral blockages can occur for many reasons, including:
- congenital conditions or structural irregularities that result in a narrow or blocked urethra
- polyps, which are benign growths
- blood clots, which can put pressure on the bladder walls
- fecal impaction, which is when large masses of hard stool accumulate in the digestive tract
- an enlarged prostate gland, which can press on the urethra and block the flow of urine
- tumors
Other potential causes include:
- Nerve disorders: Neurogenic bladder is when the nerves that control the bladder do not operate as they should. People with neurogenic bladder
may experience bladder trabeculation. - Surgical treatment for enlarged prostate: Surgery for an enlarged prostate aims to remove excess prostate tissue. However, it can also cause blood clots to form in the bladder, preventing urination.
- Pelvic organ prolapse: This occurs when one or more organs in the pelvis move from the normal position and bulge into the vagina. The prolapse can cause lower urinary tract problems, which may affect urine flow.
- Hydronephrosis: This refers to swelling of the kidneys due to a buildup of urine. Females can develop this problem during pregnancy as the growing uterus puts pressure on the ureter. Hormonal changes can also contribute to hydronephrosis.
A doctor may suspect bladder trabeculation if an individual has difficulty passing urine, a slow urine stream, or a frequent urge to urinate.
They may use an individual’s symptoms, medical history, and further tests to make a diagnosis. These tests may include:
- physical exam
- ultrasound imaging
- urine tests
- blood tests
- a prostate-specific antigen (PSA) test, if male
- rectal exam
- endoscopy to view the urethra, prostate, and bladder
- voiding cystourethrography to show the size of the bladder and how well it drains
Doctors may diagnose bladder trabeculation if an individual has a bladder wall that measures more than 3 mm when distended or 5 mm when it is not.
People with trabeculated bladder can also develop bladder diverticula, or pouches in the bladder wall. Doctors may grade the severity of bladder trabeculation depending on the appearance of diverticula in radiology findings.
The treatment of bladder trabeculation depends on the underlying cause. For example, if someone has an enlarged prostate, doctors may recommend treatment or medication to reduce the size. If initial treatments do not help, then surgery may be an option.
Likewise, doctors may recommend medications or other medical procedures to treat the obstruction if someone has a tumor, kidney stone, or another blockage in the urethra.
If someone is pregnant and has a trabeculated bladder, they may not require treatment. Following the birth, the parent’s bladder may return to normal.
In cases where doctors suspect a fetus has a urethral obstruction, they may be able to perform intrauterine surgery to correct it.
Diagnosing and treating the underlying cause of bladder trabeculation is important to prevent further complications. Once the bladder wall muscles lose their elasticity, it can be difficult to reverse. Severe UTIs that occur due to blockages can also impact the kidneys.
The success of any treatment may depend on early intervention and the underlying cause. Some people may experience a complete improvement in symptoms, while others may have some lingering symptoms.
Here are some questions to ask a doctor during a consultation:
- What could be causing the bladder trabeculation?
- What treatment options are available?
- What are the benefits and risks of the treatments?
- Is there a chance the bladder will get better on its own?
- Will I have any long-term effects from this condition?
- What can I do to manage or reduce the symptoms?
- Will it be possible to reverse bladder trabeculation?
Bladder trabeculation is a condition where the muscles in the bladder wall become thicker. Blockages to the urethra typically cause the condition. Various conditions can cause a blockage, including an enlarged prostate, polyps, pregnancy, or pelvic organ prolapse.
Doctors may use blood, urine, and imaging tests to diagnose the condition. They then base treatment on the underlying cause.
If someone experiences urinary difficulty, they should seek their doctor’s advice. Early diagnosis and treatment are essential to prevent further damage to the bladder or kidneys.