From the Guidelines
Sarcoidosis can potentially cause urinary bladder issues, though it is not a common manifestation of the disease, and may lead to significant morbidity due to irreversible organ damage to the kidneys 1. Sarcoidosis primarily affects the lungs and lymph nodes, but it can impact any organ system, including the urinary tract. When sarcoidosis affects the bladder, it may cause symptoms such as:
- Frequent urination
- Urgency to urinate
- Difficulty emptying the bladder
- Pelvic pain or discomfort These symptoms occur because sarcoidosis can lead to the formation of granulomas (small clusters of inflammatory cells) in the bladder wall, which may interfere with normal bladder function. According to the European Respiratory Journal, irreversible organ damage to the brain, eyes, or kidneys can cause significant morbidity 1.
If a patient with sarcoidosis experiences persistent urinary symptoms, they should consult their doctor for evaluation. Diagnosis may involve imaging studies like CT scans or MRI, and possibly a cystoscopy with biopsy to confirm bladder involvement. Treatment typically focuses on managing the underlying sarcoidosis with anti-inflammatory therapy, such as corticosteroids, to prevent progression to irreversible disease 1. In some cases, immunosuppressants like methotrexate or azathioprine may be necessary. Specific bladder symptoms might be managed with medications such as anticholinergics or beta-3 agonists, depending on the nature and severity of the symptoms. It's essential to note that bladder involvement in sarcoidosis is rare, and other more common causes of urinary symptoms should be ruled out before attributing them to sarcoidosis, as stated in the European Respiratory Journal guidelines 1.
From the Research
Sarcoidosis and Urinary Bladder Issues
- Sarcoidosis can cause urinary bladder issues, as evidenced by a case report of bladder sarcoidosis in a woman with known systemic involvement of the disease 2.
- The lesion improved and ureteral obstruction was relieved after transurethral resection and systemic corticosteroid treatment 2.
- Neurosarcoidosis can also cause micturitional disturbance, as shown in a case study where a patient developed urinary urgency, frequency, urge urinary incontinence, and detrusor hyperreflexia 3.
- Urological manifestations of sarcoidosis can include nephrolithiasis, renal function impairment, and obstructive uropathy 4.
- Renal involvement in sarcoidosis is common and can be asymptomatic, emphasizing the need for a diagnostic work-up to detect possible renal involvement 5.
Types of Urinary Bladder Issues
- Detrusor hyperreflexia has been reported in a patient with neurosarcoidosis 3.
- Ureteral obstruction can occur in bladder sarcoidosis 2.
- Nephrolithiasis is a possible urological manifestation of sarcoidosis 4.
Treatment and Management
- Systemic corticosteroid treatment can improve urinary and neurological symptoms in patients with sarcoidosis 3, 2.
- Transurethral resection can relieve ureteral obstruction in bladder sarcoidosis 2.
- Steroid-sparing agents, such as disease-modifying antirheumatic drugs and infliximab, can be used in the treatment of renal sarcoidosis, although the evidence for their efficacy is mostly based on case series and expert opinions 5.