Frequency
Mostly women and men between the ages of 30 and 50 are affected. More women are affected before the age of 30. After that, men can also have the symptoms of an irritable bladder.
An irritable bladder occurs relatively rarely in children. Urination disorders in them usually have other causes (e.g. excitement, emotional conflicts, etc.). It is estimated that about 3-5 million people in Germany suffer from an irritable bladder. As mentioned above, however, there is a high number of unreported cases, as the affected people do not go to the doctor or confide in others out of shame.
Symptoms
Frequent urge to urinate and the excretion of small amounts of urine (so-called pollakiuria). Those affected often go to the toilet 20-30 times a day, where only a few ml of urine can be passed. The urine is not concentrated (light) and without blood admixture.
Pain when urinating can occur. However, a feeling of pressure may occur due to frequent emptying. More information on this topic: Frequent urinationAn irritable bladder is not an independent clinical picture in the true sense of the word, but a diagnosis of exclusion.
Due to the numerous causes of increased urination, the absence of concomitant diseases (see above) is often the reason for the diagnosis of an irritable bladder.One of the most important diagnostic instruments is the taking of medical history, i.e. the questioning of patients. During this interview, the doctor should be able to determine whether the problem is more of an organic nature or an irritable bladder. He will ask questions such as: “When did the problem start?
Do you have blood in your urine? How often do you have to go to the toilet? Are there any concomitant diseases?
Did this problem also occur in the family? Do you have pain when you urinate? Are you currently under stress?”
The doctor will ask the patient to give a urine sample to find out whether it is an infection of the bladder (nitrite admixture, possibly blood), or whether the suspicion of a bladder tumor must be investigated (blood often only visible under a microscope). Then he will perform an ultrasound examination of the bladder and the urinary tract, such as the ureters and kidneys, to see changes such as inflammation or constriction and congestion or urinary and bladder stones. Furthermore, an ultrasound examination enables the doctor to determine the amount of urine remaining in the bladder after urination.
He can thus estimate the volume at which an urge to urinate is already triggered (in the case of irritable bladders, a few ml are often sufficient). This examination is usually performed by a urologist, while the urine examination can already be performed by a general practitioner. A supplementary diagnostic measure is the cystoscopy, in which an optical instrument is inserted into the urethra and bladder.
This procedure is performed under local anesthesia and may also provide evidence of tumorous disease. A measurement of the bladder pressure or also called cystomanometry provides information about the capacity of the bladder. This is a complex test procedure in which electrodes in the bladder and anus measure the pressure when the bladder is filled and emptied. In the diagnosis of the irritable bladder, which can only be carried out by a urologist, the methods that are least complicated and least stressful for the patient are used first.