Trabeculation

Medically reviewed by Cynthia Cobb, DNP, APRN on February 12, 2018Written by Becky Young on February 12, 2018

Overview

Trabeculation of the bladder occurs from repeated obstructions in the urethra. When an obstruction occurs, the muscles walls of the bladder have to work too hard to move urine past the blockage. This leads to a thickening of the muscle walls and a loss of elasticity. When the muscle walls of the bladder lose their tone, the bladder holds onto urine for longer than it should. In these instances, the urine may flow back towards the kidneys, which can lead to infection.

What are the symptoms?

Normally our bladders expand when filled with urine, and return to their original size when they are emptied of urine. Trabeculation of the bladder affects the amount of urine that your bladder can hold and the way that it’s emptied. A trabeculated bladder is no longer able to expand when filled with urine and contract when emptied. This cycle can lead to urinary incontinence, infection, and kidney damage.

How is it caused?

The leading cause of a trabeculated bladder is a chronic blocked urethra. There are many possible reasons that a urethra may become blocked. These include:

  • blood clots
  • kidney stones
  • tumors
  • diseases of the digestive tract
  • injuries to the pelvis, such as fracture
  • disorders of the nervous system
  • enlarged prostate (in men)

Children can be at the most risk of developing this condition, largely due to birth defects of the urinary tract. Men, particularly those over 60, are also at increased risk due to the tendency of the prostate to enlarge after this age which potentially causes a blockage.

How is it treated?

Treatment is aimed at addressing the cause of the trabeculated bladder. A trabeculated bladder is usually a symptom of a blockage. The blockage must be removed to prevent the condition from worsening, and to allow the muscles walls to regain their elasticity. Although, once the elasticity of the bladder wall muscles is lost, it can be difficult to regain.

If the blockage is caused by kidney stones, they usually pass on their own with increased fluid intake. If, however, they are too large to pass, there are several methods available for treatment. The most common of these is extracorporeal shock wave lithotripsy (ESWL). This procedure pinpoints the position of the stone, then uses ultrasound shock waves to break the stone into smaller pieces, which can then be passed.

If the blockage is caused by a tumor, treatment will vary depending on its size and whether the tumor is malignant or benign. Sometimes, medications can be prescribed to dissolve the tumors. Other times, you may need to have it removed surgically. If the tumor is malignant it might be treated with radiotherapy (radiation) or chemotherapy.

Enlarged prostates can be treated with medication, minimally invasive therapies, or surgery. The treatment path will depend upon what symptoms you have and how severe they are; whether or not you have other medical conditions; your overall health; and your age.

How is it diagnosed?

You might suspect a blockage in your urethra if you experience difficulty passing urine, a slowed stream, or a frequent urge to urinate. Some also report a feeling that their bladder isn’t empty. If you see your doctor with these symptoms, they will likely order an ultrasound which can diagnose both the blockage and a trabeculated bladder.

Outlook

Once the elasticity of the bladder wall muscles is lost, it can be difficult to regain. If the condition is caught and treated early, it can be prevented from getting any worse and your symptoms may remain mild.

A severe reduction in the elasticity of the bladder wall muscles can mean that your bladder holds onto the urine for too long before expelling it. This can cause the urine to flow back up to the kidneys, causing infections. Ultimately, this can lead to extensive kidney damage. Kidney damage is an extremely serious condition that could result in the need for dialysis or transplant.

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