Definition
An irritable bladder is a disorder of bladder emptying that is manifested by a frequent urge to urinate and sometimes also by the inability to hold the urine. It is important for the diagnosis that none of the numerous other causes of a bladder voiding disorder are present.
Synonyms
- Over- and hyperactive bladder
- Urethral Syndrome
- Frequenca urgency syndrome
Summary
Mostly it is women and men between the ages of 30 and 50 who suffer from an irritable bladder. The urge to go to the toilet frequently and usually to urinate in small amounts is the main symptom of an irritable bladder. In some cases, an inability to hold the urine while urinating is observed (so-called urge incontinence).
A burning sensation when urinating, which would rather indicate an infection of the bladder, is usually absent. However, after frequent visits to the toilet and urination, pressure pains in the bladder area can occur. The urine is usually unconcentrated, i.e. bright and free of blood.
Irritable bladders occur frequently, but the number of unreported cases is very high, as most patients either do not go to the doctor at all or go late. A distinction is made between a primary and a secondary form of the irritable bladder. The primary irritable bladder is the most common form and does not indicate a clear cause of the disease.
If one examines the bladder by printing, one can often see that in patients with a primary irritable bladder, even a small amount of urine is often sufficient to cause the bladder muscles to relax. After frequent cystitis in the past, the bladder can also be sensitized, i.e. even here a small amount of urine is enough to trigger the urge to urinate. The secondary, rarer form of an irritable bladder can have many causes.
For example, cystitis can also be mentioned, but also stone ailments (bladder stones) can lead to an irritable bladder if they remain in the bladder for a long time and are not excreted. Tumours of the bladder are also a rare but very serious cause of an irritable bladder and are often the first sign of the tumour. By lowering the oestrogen level in menopausal women, the condition of the urethral mucosa can change and thus lead to an irritable bladder.
Any further changes or narrowing of the urethra, e.g. adhesions after radiation therapy for cancer, often carried out years in advance, can become noticeable as an irritable bladder. The intake of washout drugs (diuretics), which must be taken regularly because of other diseases, can also cause an irritable bladder as a side effect. A not negligible cause of an irritable bladder, if not the most common one, is a psychological component.
Many patients state that they are afraid of having to go to the toilet all the time, especially when they are on the road and cannot find a toilet. The result: an increase in the urge to urinate. After traumatic events or during emotional conflicts, one should differentiate between incontinence (e.g. wetting during sleep) and irritable bladder. In contrast to patients with an irritable bladder, those affected do not notice their urge to urinate.
