Bladder Hydrodistention
What Is Bladder Hydrodistention?
Bladder hydrodistention is a diagnostic and therapeutic procedure in which the bladder is gently stretched by filling it with sterile fluid under controlled pressure while the patient is under anaesthesia. It is most commonly performed during a cystoscopy to help diagnose and manage bladder conditions, particularly interstitial cystitis/bladder pain syndrome (IC/BPS). Stretching the bladder allows the urologist to inspect the bladder lining more thoroughly, identify abnormalities such as small bleeding points or ulcers, and, in some patients, provide temporary relief from bladder pain and urinary symptoms.
What Are the Benefits of Bladder Hydrodistention?
Bladder hydrodistention offers several potential diagnostic and therapeutic benefits. These include:
- Helps diagnose interstitial cystitis/bladder pain syndrome.
- Allows detailed examination of the bladder lining during cystoscopy.
- Identifies inflammation, ulcers, bleeding points, or other abnormalities.
- May provide temporary relief from bladder pain and urinary urgency.
- Helps rule out other bladder conditions causing similar symptoms.
- Can guide future treatment planning.
- Performed as a minimally invasive procedure.
- Usually completed as a day-case or short hospital stay.
When Is Bladder Hydrodistention Recommended?
A healthcare professional may recommend bladder hydrodistention in the following situations:
- Persistent bladder pain without a clear cause.
- Suspected interstitial cystitis/bladder pain syndrome.
- Frequent or urgent urination that has not responded to conservative treatment.
- Chronic pelvic pain associated with bladder symptoms.
- Ongoing urinary symptoms despite normal imaging or urine tests.
- Evaluation of unexplained bladder discomfort during cystoscopy.
- Assessment before considering additional treatment options for IC/BPS.
What Does Preparation for Bladder Hydrodistention Involve?
Preparation begins with a consultation to review the patient's medical history, symptoms, medications, allergies, and previous investigations. Urine tests are commonly performed beforehand to exclude a urinary tract infection, as the procedure is generally postponed if an infection is present.
Patients receive instructions regarding eating and drinking before the procedure because it is usually performed under general or regional anaesthesia. Certain medications, particularly blood-thinning medicines, may need to be adjusted temporarily under medical supervision. The healthcare team explains the procedure, expected benefits, possible risks, and recovery process before obtaining informed consent.
How Is Bladder Hydrodistention Performed?
Bladder hydrodistention is performed in an operating theatre under general or regional anaesthesia. Once the patient is comfortable, the urologist inserts a cystoscope, a thin tube with a camera, through the urethra into the bladder. The bladder is first inspected in its normal state to assess the lining and identify any visible abnormalities.
The bladder is then slowly filled with sterile fluid under carefully controlled pressure until it reaches a predetermined capacity. The bladder remains distended for a short period before the fluid is drained. Following distention, the urologist re-examines the bladder lining, looking for characteristic findings such as pinpoint bleeding (glomerulations), Hunner lesions, inflammation, or other abnormalities associated with interstitial cystitis.
If necessary, small tissue samples (biopsies) may be taken during the same procedure to exclude other conditions, including bladder cancer or chronic infection. Once the examination is complete, the cystoscope is removed, and the patient is transferred to the recovery area for monitoring before discharge.
What to Expect during Recovery after Bladder Hydrodistention?
Most patients return home on the same day, although some may require an overnight stay. Mild burning during urination, blood-tinged urine, urinary frequency, and pelvic discomfort are common for a few days. Drinking plenty of fluids can help ease these symptoms. Some patients experience temporary improvement in bladder pain and urinary urgency, although symptom relief varies and may last from weeks to several months. Follow-up appointments allow the healthcare team to discuss findings and plan any additional treatment if required.
What Are the Risks and Complications of Bladder Hydrodistention?
Although bladder hydrodistention is generally safe, potential risks and complications include:
- Temporary pain or pelvic discomfort
- Burning during urination
- Blood in the urine
- Urinary tract infection
- Temporary worsening of bladder symptoms
- Difficulty passing urine immediately after the procedure
- Adverse reactions to anaesthesia
- Rare bladder perforation requiring additional treatment
- Temporary urinary retention