Irritable bladder: all about symptoms, causes and treatment

As we get older, more and more people - especially women - experience this: The bladder pinches, a toilet is urgently needed, but little urine comes out. And within a very short time, often after just an hour, the urge to urinate returns. In such cases, doctors speak of an irritable bladder or overactive bladder, a malfunction of the organ that can have various causes. Doctors assume that around 10 to 20 percent of young people suffer from an irritable bladder. For older people, the estimate is around half, although the number of unreported cases is likely to be higher, as the subject is taboo for many. In our article, we explain what an overactive bladder is and what treatment options are available. Because there is help for those affected, and therefore also the chance to regain a better quality of life.

Table of contents

• What is an irritable bladder? Symptoms
• Where does irritable bladder come from? Causes
• Diagnosis of an irritable bladder
• Therapy options

What is an irritable bladder? Symptoms

In a healthy person, urine normally collects in the bladder for hours and the urge to go to the toilet increases gradually and can also be delayed under certain circumstances. In people with an irritable bladder, the urge to urinate occurs much more frequently, often even at hourly intervals - even at night -, very suddenly and cannot be controlled. Despite the urge to urinate, the bladder is usually as good as empty - when the bladder is emptied, little or no urine is released and sometimes urination is accompanied by pain. Sometimes there is also a loss of urine because those affected do not make it to the toilet in time (urge incontinence).

Anyone with an irritable bladder quickly loses quality of life, and the condition also causes psychological stress. Those affected no longer have the confidence to spend long periods of time in places where there may not be a toilet available, they scan their surroundings for toilets in every new place and can no longer relax, but unfortunately suffer from anxiety and nervousness. This in turn can also affect bladder function - a vicious circle that requires treatment to make the patient's everyday life more pleasant again.

Irritable bladder is often also referred to as bladder weakness. However, this is a different condition. You can find information on bladder weakness in this article. [[VERLINKUNG SETZEN]]

Where does irritable bladder come from? Causes

The exact cause of irritable bladder syndrome has not yet been determined. It is assumed that the function of the bladder muscle is disturbed to such an extent that the bladder contracts and thus triggers the urge to urinate, even though it is not completely full.

There are many causes that can lead to an irritable bladder. In both sexes, it can be changes in the urinary tract that trigger the dysfunction, for example tumors in the urethra or bladder, or ureteral or bladder stones. Frequent bladder infections can also lead to a weakened bladder and thus to an irritable bladder, as can years of frequent or infrequent urination, constipation and obesity. Parkinson's, stroke, Alzheimer's, brain tumors or other neurological diseases can also cause an irritable bladder.

In women, it is usually a weakened pelvic floor that impairs bladder function. Childbirth, obesity, abdominal surgery or excessive strain can be responsible for the bladder, vagina or uterus descending and causing the dysfunction. The number of women affected increases with age, as a lack of oestrogen after the menopause can also lead to an irritable bladder.

Men with benign prostate enlargement or prostate cancer can also develop an irritable bladder.

However, it is not uncommon for irritable bladder to have psychological causes that are stress-related. This is why the condition is also known as stress bladder. For example, it can be caused exclusively by negative circumstances at work.

Diagnosis of an irritable bladder

Irritable bladder requires a so-called exclusion diagnosis: the doctor carries out various examinations to first rule out other diseases, for example acute bladder inflammation, neurological diseases such as multiple sclerosis, Parkinson's disease or herniated discs, metabolic diseases such as diabetes mellitus or tumors or stones in the urinary tract and bladder, and in men also prostate tumors.

Patients with suspected irritable bladder also keep a so-called micturition log, which is included in the diagnosis. They record the amount they drink, the amount they urinate and the times they go to the toilet.

Once all other possibilities have been ruled out, the treating doctor can then make the diagnosis of “irritable bladder”.
 

Therapy options

Irritable bladder develops gradually - the intervals between visits to the toilet become shorter and shorter, the urge to urinate becomes more and more sudden, while the amount of urine decreases. The earlier patients have their irritable bladder diagnosed, the faster treatment can begin and stop the progression of the disease or alleviate the symptoms. There are various ways to treat an irritable bladder. With all of them, patients should bear in mind that it takes time for the measures to take effect, even up to several months. Patience is therefore required here, coupled with a positive attitude towards the therapy.

Without medication

Depending on the type and intensity of the symptoms, but also the causes, the first step is usually to try to provide patients with relief without medication. Based on the micturition protocol, the attending physician draws up a plan for bladder training, which includes pelvic floor exercises as well as behavioral therapy. The training includes, for example, exercises to strengthen the pelvic floor, but also consciously delaying the urge to urinate. Biofeedback - the measurement of muscle tension in the perineal area using special electrodes - is used to monitor success. Reducing stress factors - for example, changing the circumstances at work - is also part of this type of treatment.
 

Drug treatment

If herbal preparations or bladder training do not help sufficiently, patients are often prescribed medication known as anticholinergics. Their active ingredients - darifenacin, tolterodine or trospium chloride - inhibit the transmission of nerve impulses and can therefore alleviate the symptoms of irritable bladder. There are also beta-3 agonists, which can reduce urge incontinence in particular, as they relax the bladder muscle. However, some of these medications have severe side effects and should therefore only be taken in emergencies and strictly in accordance with the doctor's instructions.

Women who suffer from an irritable bladder for hormonal reasons are often given oestrogen preparations in the form of vaginal suppositories.
 

Surgery on the bladder

Botox injections are another form of medical treatment for irritable bladder syndrome. The active ingredient botulinum toxin is injected into the bladder wall, which can relax and calm the bladder and thus alleviate the symptoms.

If all these treatment methods do not help, there are surgical options as a last resort, such as bladder replacement or bladder augmentation.
 

Tips for irritable bladder

In addition to the treatment options, there are also some tips that can help to reduce the urge to urinate and thus support the treatment.

• Avoiding alcohol and nicotine consumption
• Change your diet so that irritating foods are not eaten or are eaten less often. These include citrus fruits, tomatoes, preservatives, sweeteners and flavorings.
• Diet/weight loss if the irritable bladder is caused by being overweight.
• Consistent drinking behavior during the day
• Sufficient amounts to drink - too little fluid also irritates the bladder.
• No more drinks at least two hours before going to bed