Irritable Bladder

Contrary to popular belief that only women after vaginal delivery or people of older age can be affected by the condition known as irritable bladder, this problem affects men and women of all ages. However, women generally suffer from irritable bladder more often.

It is often the case that those affected do not tell anyone about their symptoms out of shame and also do not see a doctor. In severe cases, the sufferers may even avoid the public because of their irritable bladder. It is possible to treat an irritable bladder.

Irritable bladder is a condition associated with incontinence, the origin of which is unknown. In the case of irritable bladder, the incontinence is caused by a cramping of the bladder muscles. This can result either from the bladder falsely reporting to the central nervous system that it is full too early, triggering emptying, or from a contraction of the bladder muscles triggered by the nervous system at even the smallest amount of filling. Unlike many other diseases that can also cause incontinence, no physical changes are found in irritable bladder.

Typical for the symptoms of an irritable bladder is that they occur mainly in stressful moments, such as stress, exertion or cold. As a result of the fear of a renewed sudden urge to urinate with involuntary urination, those affected find themselves in stressful situations more and more often, which increases the symptoms of irritable bladder and they can occur more frequently. Furthermore, it is known that excessive consumption of caffeine, nicotine and alcohol has a negative effect on the course of the disease. The main symptom of irritable bladder is an increased urge to urinate, the intensity of which can vary greatly. In some people, the urge to urinate can be so strong that normal everyday life is no longer possible. It is very typical for those affected to have to urinate very frequently, but only to pass very small amounts of urine. Furthermore, urination can also be painful in some cases.

When diagnosing an irritable bladder, it is important to exclude an infection of the urinary tract, as a urinary tract infection can lead to similar symptoms as an irritable bladder. In the case of a urinary tract infection, however, this can be diagnosed by the presence of pathogens in the urine. Furthermore, in women a prolapsed uterus and in men changes in the prostate should be looked for.

In the case of complaints that indicate an irritable bladder, it is best to consult a urologist for clarification. For basic diagnostics, a urine sample is usually obtained and the urinary tract is examined by ultrasound. A urodynamic examination can also be carried out, in which the storage capacity of the bladder and the function of the bladder muscles are examined. In addition, it is checked whether the sphincter and the muscles of the pelvic floor can close the urethra sufficiently. In some cases, additional examinations, such as imaging procedures, are necessary to make a definitive diagnosis.

Furthermore, it is of great importance to find out which factors trigger the increased urge to urinate. It is therefore advisable to keep a diary in which it is stated what and at what time the affected person consumes food and drink and under what circumstances the urge to urinate occurs. By keeping such a diary, connections between certain situations and increased urination can often be found and avoided in the future.

In terms of therapy, the combination of medication, pelvic floor training to promote continence and psychotherapy is the most successful.

Medication: Medications are used here that relax the muscles of the bladder, such as anticholinergics or spasmolytics. The latter have the advantage that, unlike anticholinergics, they have no effect on the nervous system. Both substance classes have in common that they reduce the excitability of the bladder muscles.

Psychotherapy: The symptoms of irritable bladder mainly occur in stressful moments or during stress. Psychotherapy can help to cope better with such stressful situations and thus alleviate the urge to urinate. A micturition diary is particularly helpful here, which can be used to identify triggering factors together with a therapist. The aim of psychotherapy is to learn to deal with these factors and to find a coping strategy.

Another treatment option is to train the bladder using behavioural therapy. For example, it is advisable to set fixed, regular times for urination and to keep increasing the time intervals between voiding.

In addition, there are a number of other techniques and treatment options that can be useful as support in the therapy of irritable bladder. These include various relaxation techniques, for example autogenic training. However, each patient should find out for themselves which technique is best for them. However, the underlying principle is that you try to relax the entire musculature of the body, which may also have an influence on the bladder muscles.

Continence training: The aim of continence training is to reduce or eliminate involuntary urination. Many affected persons suffer so much from the incontinence of an irritable bladder that they are very much affected in their everyday life because they always fear that they will not be able to go to the toilet in time if they suddenly have to urinate.

Continence training consists of special exercises to strengthen the pelvic floor muscles. The training sessions take place partly together with doctors, but also partly as self-training at home.

When the urge to urinate sets in, a few minutes should be allowed to pass before emptying the bladder, even if small amounts of urine are released. Suppressing the urge to urinate will be very difficult and strenuous at first, but over time you will be able to suppress the urge to urinate for longer and longer periods of time. It is advisable to keep a diary and to compare the periods in order to see the progress. Gradually, refraining from emptying the bladder will also not require as much concentration as it did in the beginning.

Other methods: For some sufferers, electrostimulation therapy may also be considered. On the one hand, this can strengthen the pelvic floor muscles, but on the other hand it can also reduce the over-excitability of the bladder.

Furthermore, it is possible to strengthen the pelvic floor muscles by means of special, small weights which are inserted into the vagina and thus bring the incontinence under control.