Irritable or overactive bladder is bladder discomfort that manifests as a constant need to urinate, frequent urination, or loss of urine due to a strong urge to urinate.
The causes lie in the bladder itself. On the one hand, the bladder lining can be irritated, inflamed, malignant or very dry as a result of inflammation or hormone deficiency.
On the other hand, there is the motor urge bladder, in which the bladder muscle contracts uninhibitedly. This is caused by inadequate inhibition of bladder activity during the filling phase. Stress and psychological problems can also affect bladder sensation and function.
Symptoms of an irritable bladder are
Frequent urge to urinate
Urgent urge to urinate
Sudden urge to urinate
Involuntary urge to urinate
Small portions of urine
Uncontrolled loss of urine
Pain towards the end of urination
Urge to urinate without the bladder being full
Cramp-like pain in the abdomen
No feeling of relief after urinating
Irritable bladder can be caused by:
Bladder Inflammation
Irritation of the bladder lining by coffee, alcohol, spicy foods
Medication
Hormone deficiency
Age-related changes
Neurogenic disorders with central dysregulation of bladder control
Diabetes, fibromyalgia
Insufficient emptying of the bladder (residual urine)
Lowering of the pelvic floor
Bladder prolapse (cystocele)
Stress, anger and anxiety
What to do about bladder problems?
Bladder problems can manifest as a frequent need to urinate or even leakage of urine.
It is important to take these symptoms seriously and monitor how and when they occur. Women can consult their gynaecologist, urologist or urogynaecologist.
Doctors will take a detailed medical history, including any medication you have been taking, and carry out a urological and gynaecological examination. A prolapse of the pelvic floor can also cause bladder problems and should be ruled out.
How does a bladder specialist examination work?
The doctor will have a confidential discussion with you. A medical history will be taken.
Important information includes Births, previous operations, illnesses, medication, treatments already received. The symptoms are asked about as precisely as possible. A urine sample gives quick information about bacteria or blood in the urine.
The doctor will then carry out an examination. A gynaecologist will mainly examine the genitals and a urologist will do a cystoscopy. Both will also do an ultrasound scan of the bladder and kidneys. This allows the doctor to determine the structure, size and condition of the bladder, as well as the thickness of the bladder wall, and to detect diverticula or bladder stones. It can also detect blockages in the kidneys.
A measurement of bladder pressure (urodynamics) can be used to diagnose irritable bladder and urinary incontinence.
A thin, flexible catheter is painlessly inserted through the urethra into the bladder. A balloon catheter in the rectum is also used to measure pressure in the abdomen. The bladder is then filled with warm water. The increase in pressure in the bladder and the pressure in the urethra are measured. Stress incontinence can be detected by provoking a cough. Irritable bladder is indicated by a low bladder capacity. After a filling of 300-500 ml, the patient is asked to void on a commode chair. A built-in scale measures urine flow (uroflow) and voided volume.
The examination takes only a few minutes and can differentiate between different types of urinary incontinence and diagnose sensory or motor urge bladder.