bladder size versus bladder capacity

[youngin]

I'm trying to get a good understanding of these terms, because I think they are different. Some people have frequency because their bladders are literally shruken and cannot hold a normal amount of urine. There is an actual physical limitation as to how much urine can fit into their bladder. But then there are those people who have normal size bladders but still have terrible frequency. Their bladders may be able to physically hold a normal amount of urine (for instance, with a hydrodistension, the bladder stretches as large as it should), but the URGE to urinate occurs when only a small amount of urine has entered the bladder, eventually forcing the person to urinate long before they should have to. Thus the fact that they have a normal size bladder is rendered meaningless - practically speaking, it is the same as having a shrunken bladder; the full size of their bladder cannot be utilized because the urination urge always forces them to void long before a normal amount of urine has time to collect in the bladder. Does anyone get what I'm driving at here? I just want to have a better understanding of this - because it sounds to me like there is a difference. I hear the term "bladder capacity" used a lot, but have never known whether people are referring to those with actual shruken bladders or those who just cannot hold a normal amount of urine before urinating. Please comment. Thanks.

[ICNDonna]

Frequency is not always related to bladder size. Urine can be an irritant, especially if we've ingested a "problem" food. So the minute any urine hits the bladder, it creates the need to urinate. I know this is what happens to me. And if I take something that makes the urine less irritating, I can go longer before the need to urinate hits.

Donna

[Trishann]

I do have a shunken bladder, but I know people with normal bladder size still have to urinate frequently too. I think that is part of IC, because the bladder is damage. I would not even begin to think that you are in less pain than I am. IC is painful. I am glad we can share with others that have IC, because maybe we can learn and be able to find answers. For instance, I did not know normal bladder size can have low urine output. But that is common sense, because if you are urinating more that means less output at a time. Thanks for sharing your post with us.

[yvette]

Youngin: I think you're on the right track, I do agree with Donna--its more of an irritant things with some people (like myself).

My capacity is fairly normal....but my inclination "to go" is frequent. Also despite the capacity being somewhat normal....the bladder is a big enough size....

BUT

even under anesthesia it has been seen that the muscle itself gets irritated upon filling...the last C&H I had done: the uro had to pinch my urethra shut just to check capacity. The muscle involuntarily was starting to spasm, trying to push out the liquid.

So my bladder volume wise-should be able to hold enough.
However, its so easily irritated, it gets angry and revolts

Do that help you any?

[~*~Christine~*~]

I do have a shunken bladder, but I know people with normal bladder size still have to urinate frequently too.

When the bladder "shrinks" it can still be dilated to that of a regular bladder (500-600cc's).
My old uro once explained this to me after a hyrdo/cysto that our [ICers] bladders can frequently "shrink" since we rarely, if ever, hold enough cc's to retain its regular size. It's like if a balloon starts to lose air, it shrinks, but when air is put back into it returns to its regular size.
So, the size of our bladders, for those of us with IC, doesn't seem to make much of an impact on our symptoms since we're not using most of the bladders storage capacity anyways

[sweetangel2080]

I used to think I had a small bladder too but recently experienced a week long remission after ayurvedic medication and realised I could up to 300ml - nowadays back to 50ml and urgency!

[Trishann]

You all talking about bladder size, do you know if there is a difference between a shruken bladder and a stiff bladder.

[~*~Christine~*~]

You all talking about bladder size, do you know if there is a difference between a shruken bladder and a stiff bladder.

I did a Yahoo! Search for "Stiff+Bladder" and it said that an IC bladder can become 'stiff' due to scaring of the bladder wall (GAG layer).
That would make sense, it's like if you expose your feet to the elements of the ground without shoes for protection you will eventually develop callus's

This probably explains why I and many others bleed bedpans full of blood after hydros, since it's like having really dry lips and than smiling, your lips will crack all over

[Trishann]

Thank you for explaining about the bladder. The doctor said I had a stiff bladder and it will not stretch. He said if I don't have surgery, the bladder will keep getting stiffer to the point the bladder will not hold no more. There are days I think I will keep my bladder and then there are days, I am really to take it out. I guess I wonder sometimes is there any possibilities that the bladder can become unstiff or is it to late. If there is a possibility the bladder can heal, I will want to wait but if not, I can not keep living like this, something needs to be done. Again, thank you for the information.

[~*~Christine~*~]

If by surgery you mean a hydrodistention that prbably would not help unstiffen the bladder, if anything, it would probably make it stiffer since every time it is streched it breaks open wounds causing the bladder to develop thick gag layer, like a callus.
There are certain instils, like silver nitrate, that are supposed to "burn" off the bad tissue and allow healthy tissue to grow from underneath. Though, they don't seem to be used anymore, probably since they are extremly painful (or so I've heard)

Besides that, I don't think there is anything that can be done to remove the tough tissue, unless the bladder, for some reason, goes into remmision allowing the bad skin to disinegrate and allowing the healthy tissue to grow

[Trishann]

The surgery the doctor is talking about is removing the whole bladder. This is why I wonder if there is any hope for the bladder to become unstiff. Sometimes it is even hard to walk around. Maybe I'm just hitting my head against the wall hoping I don't need surgery. Maybe I need to look at it a different way, the surgery might give me a better life. But hearing about the complication of the surgery, wow, scary.

[~*~Christine~*~]

ahhh okay. My uro actually refered me to one of the best bladder removal surgeons in Canada, located in downtown Toronto, since I'm through with this as well.
If you feel that it can't get any worse and nothing is helping it can be an option for you as well, but like you said, we all don't want to let go of the hope of a cure that might save our bladders, though waiting can be a gamble since that cure may never come, or may take many years/decades to be found

[Judith56]

Okay after reading the original question I want to clarify the answer to what I think you are asking. Bladder size and capacity are pretty much one and the same. BUT as I see it tehre are two types of capapcity. One is what you bladder will hold under anesthesia, the other is functionalcapacity- the amount that you can hold while you are awake- these two measurments are usually very different whehn it comes to people with IC. In an IC [patient while under anesthseia they can get your bladder ot hold more than if you were awake. When you are awake you are sensitve to feelings of needing to go urinate and that amount that you can hold while awake is your functional capacity. I did end up having my bladder out and when I did at the time my functional capacity was 30 cc's or 3 ounces. I forget what it was under anesthesia I do know it was not very much at all. When the bladder gets stiff what is happening is that all the scar tissue constricts the bladder making it unable to stretch as the bladder fills with urine. Hope this helps to clarify things. Judith

[Mimilopez]

1st post!

I have been reading posts on this network for a couple of months. The size of my bladder is exactly what has me confused....or, it seems my urologist confused.

After half a dozen UTIs in the last 5 months, and three different antibiotics, my regular doctor said I was resistant to the antibiotics. I saw my urologist (have been seeing him for a year due to stress incontinence....have had that for about 4 years and seen another urologists prior. I have been taking Detrol for the past year....didn't help tremendously with the stress incontinence, but a little.)

My current urologist listened to my symptoms and then said he suspected IC. He told me to start taking tremendous amount of Vitamin C.(???)vWhen I told him about painful intercourse, he said that has nothing to do with IC! (That's when I started researching IC). He scheduled an ultrasound and for one month, he had me go in each week for four weeks, to leave a urine specimen. When I met with him after the month, he said I had a UTI again, but my ultrasound showed my bladder to be of normal size and capacity, so he said I didn't have IC. When I asked about my symtoms, he didn't seem to know about anything I had learned about IC! He is older, but he is the head of USC Transplant Center. He was so weird about it.

Anyway, He just prescribed twenty days of Cipro. I was stunned and went back to my reg doctor. By then, I began having worse bladder spasms, frequency, back ache and low grade fevers. My reg doctor prescribed Levaquin (sp?) and scheduled a CT scan of my stomache and pelvic. One week later, I still feel awful, pain, fever,etc. but she said the CT showed all is normal.

Does this mean a CT scan and/or ultra sound don't show IC?
Does this mean ALL those who have IC have "small, shrivled bladers" like the uro said?

One thing I really wonder about is two years ago, the first urologist, who after a cystoscpy (sp?) showed no reason for stress incontinence performed silver nitrate instillations for a month to help with stress incontinence...could that have caused this condition??

I am waiting for a referral to a new urologist and in the meantime, elimiating lots of stuff from my diet.

I am in pain, and frustrated because all of these health professionals seem to be stumped or guessing about what the heck is wrong with me.

Feedback?

[ICNDonna]

Some people with IC have very small bladders, others have bladders of normal or even larger than normal size. A CT scan or ultrasound will not diagnose IC.

No, all people with IC do not have "small, shriveled bladders."

I hope you get to see a different urologist soon.

Donna