From the Guidelines
Urinary tenesmus is a symptom characterized by a feeling of incomplete bladder emptying, often accompanied by pain or discomfort in the lower abdomen or urethral area, and can be a hallmark of interstitial cystitis/bladder pain syndrome (IC/BPS) as described in the 2011 AUA guideline 1. The sensation of urinary tenesmus occurs due to irritation or inflammation of the bladder or urethra, causing spasms that mimic the need to urinate despite having little to no urine present. Key characteristics of urinary tenesmus include:
- Persistent feeling of needing to urinate even after emptying the bladder
- Pain or discomfort in the lower abdomen or urethral area
- Possible causes such as urinary tract infections, interstitial cystitis, bladder stones, prostate issues in men, or pelvic floor dysfunction Treatment for urinary tenesmus depends on the underlying cause, but may include:
- Antibiotics for infections
- Anti-inflammatory medications
- Alpha-blockers to relax the bladder neck
- Pelvic floor physical therapy For immediate relief, patients can try:
- Warm compresses on the lower abdomen
- Staying well-hydrated
- Avoiding bladder irritants like caffeine and alcohol
- Practicing timed voiding techniques It is essential to seek medical evaluation if experiencing urinary tenesmus, as it may indicate a condition requiring specific treatment, such as IC/BPS, which is characterized by symptoms including suprapubic pain, pressure, and discomfort related to bladder filling, as well as pain in the urethra, vulva, vagina, rectum, and lower abdomen and back 1.
From the Research
Definition of Urinary Tenesmus
Urinary tenesmus refers to a feeling of incomplete bladder emptying. This symptom is often associated with other lower urinary tract symptoms, such as hesitancy, straining to void, and diminished stream 2.
Characteristics of Urinary Tenesmus
Urinary tenesmus is a symptom that can occur in both men and women, and its etiology is often multifactorial 2. It can be a symptom of underactive bladder (UAB), a condition characterized by a slow urinary stream, hesitancy, and straining to void, with or without a feeling of incomplete bladder emptying 3, 4.
Key Features of Underactive Bladder
The key features of underactive bladder include:
- Slow urinary stream
- Hesitancy
- Straining to void
- Feeling of incomplete bladder emptying
- Storage symptoms, such as nocturia and urinary frequency 3, 4
Diagnosis and Management of Urinary Tenesmus
The diagnosis of urinary tenesmus is often based on patient symptoms and medical history 5. Management options for underactive bladder, which can include urinary tenesmus as a symptom, are limited and may include clean intermittent catheterization, neuromodulation, and other therapies 4. However, more research is needed to develop targeted therapeutic interventions and validated diagnostic questionnaires for underactive bladder and urinary tenesmus 4.