THE BLADDER

The Bladder

The bladder is the organ that collects urine excreted by the kidneys prior to disposal by urination. Urine drains from your kidneys to your bladder through tubes called ureters, Urine enters the bladder via the ureters and exits via the urethra. Your bladder is the hollow muscular organ that stores your urine. It’s like a balloon - as your bladder fills, it expands to store the urine.

In males, the base of the bladder lies between the rectum and the pubic symphysis. It is superior to the prostate, and separated from the rectum by the rectovesical excavation. In females, the bladder sits inferior to the uterus and anterior to the vagina. It is separated from the uterus by the vesicouterine excavation. In infants and young children, the urinary bladder is in the abdomen even when empty.

On average, your bladder can hold 400-600ml of urine for up to five hours. The muscle in your bladder wall is called the detrusor muscle. The detrusor muscle relaxes to allow your bladder to fill. When you go to the toilet, it contracts to squeeze out urine. The detrusor muscle is a layer of the urinary bladder wall made of smooth muscle fibers arranged in spiral, longitudinal, and circular bundles. When the bladder is stretched, this signals the nervous system to contract the detrusor muscle. This encourages the bladder to expel urine through the urethra.

At the bottom of your bladder is the urethra. This is a tube about 4cm long that runs from the neck of your bladder to the outside of your body, just in front of the vagina. The urethra has two outlet valves called sphincters. For the urine to exit the bladder, both the autonomically controlled internal sphincter and the voluntarily controlled external sphincter must be opened. Problems with these muscles can lead to incontinence and urethritis. If the amount of urine reaches 100% of the urinary bladder's capacity, the voluntary sphincter becomes involuntary and the urine will be ejected instantly.

There are two sphincter mechanisms.

  • The internal sphincter is a ring of muscle that holds the neck of the bladder in place. Your body opens and shuts it automatically without you thinking about it.
  • The external sphincter acts like a tap and keeps urine in the bladder. It is controlled by the pudendal nerve, which is controlled by the voluntary nervous system. This means it’s under your control - you decide when to let it open. The external sphincter is also called the distal sphincter.

The desire to urinate usually starts when the bladder reaches around 125% of its working volume. At this stage it is easy for the subject, if desired, to resist the urge to urinate. As the bladder continues to fill, the desire to urinate becomes stronger and harder to ignore. Eventually, the bladder will fill to the point where the urge to urinate becomes overwhelming, and the subject will no longer be able to ignore it.

The micturition reflex tells you when you need to empty your bladder. This happens on average four to eight times a day. The reflex is controlled by your central nervous system. When your bladder is about half full, the stretch receptors in the walls of your bladder become active and send signals along your pelvic nerves to your spinal cord. A reflex signal is sent back to your bladder, which makes the detrusor muscle in the bladder wall contract. The contraction increases the pressure in your bladder, and this is what makes you want to pass urine. Because the external sphincter is under voluntary control, you don’t urinate until you decide to relax this muscle.

People who have bladder control problems have trouble stopping the flow of urine from the bladder. They are said to have urinary incontinence. Incontinence is uncontrollable leaking of urine from the bladder. Although urinary incontinence is a common problem, it is never normal. Incontinence is both a health problem and a social problem.

Incontinence is both a health problem and a social problem. Most people with incontinence suffer social embarrassment, many become depressed and limit their activities away from home, often becoming socially isolated and lonely. Physical conditions linked to incontinence include skin irritations and infections, falls, fractures, and sleep disturbances. Many people with incontinence are too embarrassed to talk to their health-care provider about it. They "cope" or "just learn to live with it." This is changing gradually as people realize that help is available. Approximately 15%-30% of elderly people who live at home are affected by urinary incontinence. Another 40% of elderly people who live in nursing homes are affected. Incontinence is a major reason for people going into nursing homes. However, it is not an inevitable consequence of aging.

Symptoms include: Voiding inefficiency, continual dribbling, weak flow, hesitancy, incomplete emptying, intermittent stream, straining to void, Enuresis - bed-wetting.

Aromatherapy can help to alleviate the symptoms of Bladder Problems. See our article on Cystitis for more information. Several essential oils can come to the rescue. Juniper, Sandalwood, Camomile, Pine, Tea Tree, and Bergamot are especially effective treatments. However, Juniper is so strong that it could irritate the kidneys if the bladder infection has spread into them. If that is the case, stick to the other oils. In fact, if there is any chance that you have a kidney infection, be sure to seek a doctor's opinion, as it can have serious consequences.

Apply a massage oil or a compress containing the essential oils listed below over the bladder, which is located under the lower abdomen, once or twice daily as an adjunct to herbal, nutritional, or even drug treatments.

Added to a bath, these same essential oils can be used during an active infection and will help prevent future infections. If taking a full bath isn't practical, then try a sitz bath. As the name implies, you simply sit in a large tub of warm water.

Bladder Infection Oil

  • 8 drops juniper berry or cypress oil
  • 6 drops tea tree oil
  • 6 drops bergamot oil
  • 2 drops fennel oil
  • 2 ounces vegetable oil

Combine the ingredients. Massage over the bladder area once daily. For a preventive treatment, add a tablespoon of this same oil to your bath.

Sitz Bath

  • 5 drops rosemary oil
  • 5 drops lavender oil

Add the essential oils to the hot bath only. Sit in a tub with the hot water up to your waist for five to ten minutes. Then switch to a tub of cold water for at least one minute. The large plastic tubs sold at hardware stores work well for this. Continue for two to five rounds. Do this treatment every day, if possible, or at least twice a week.

Herbs can be used to fight infection, soothe the inflamed urinary tract, and encourage urination (which flushes bacteria out of the system). Uva ursi (also known as bearberry and upland cranberry) can be effective in clearing infections from the urinary tract and triggering urination. Its leaves are often taken as a tincture or tea. Because it can be toxic, only small doses of this herb should be used.

Echinacea (or purple coneflower) and goldenseal are commonly prescribed to boost the immune system and as a natural antibiotic. They can be taken in tincture or capsule form.

Marshmallow root and couch grass can relieve the inflamed lining of the urinary tract. For example, marshmallow root teas may be used. Other herbs that are helpful in treating bladder infection include:

  • alfalfa
  • buchu
  • celery
  • juniper berries
  • yarrow
  • parsley

Nutritional therapy offers several ways to treat and prevent bladder infections. Cranberries are often prescribed to increase the acid content of urine, making it unfriendly to bacteria. It's also thought that certain substances in cranberries may prevent bacteria from attaching to the walls of the urinary tract. Research has confirmed that cranberry juice can effectively treat bladder infections. The juice should not contain added sugar, though, which may weaken the immune system. The fruit also can be taken in capsule form; this method can be desirable as it avoids the excess sugar in most cranberry juice formulas, but the patient must remember to maintain their fluid levels, especially their water intake.

Vitamin C (ascorbic acid) supplements may be used for the same antibacterial functions as cranberries. Other supplements that can aid in the treatment of recurrent infections include:

If antibiotics are included in the treatment program, then the body's "good" bacteria should be reestablished with Lactobacillus acidophilus supplements or yogurt with live cultures.

Finally, good eating habits can contribute to a healthy immune system and lessen susceptibility to bladder infection. Many practitioners of nutritional therapy recommend eating a diet high in fresh vegetables, whole grains, and organic foods and low in sugars, refined carbohydrates, saturated oils, and animal products. Any food allergies should be ruled out with the help of an elimination diet. A naturopathic physician may recommend drinking unsweetened cranberry juice daily as soon as the symptoms of bladder infection begin.

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