What medications are available for irritable bladder?
Drug therapy for overactive bladder is often prescribed to accompany behavioral adjustment and bladder training.
Anticholinergics against irritable bladder
Because muscarinic receptors of detrusor cells (muscle cells of the bladder wall) are involved, the agents are also called antimuscarinics.
Choosing the right anticholinergic
There are a large number of different preparations from the group of anticholinergics. The treating physician will decide which of these is most appropriate in which dosage in each individual case.
Other anticholinergics suitable for irritable bladder therapy include darifenacin, trospium chloride, and desfesoterodine.
Contraindications
Anticholinergic irritable bladder medications should not be used in certain cases. These contraindications include, for example, untreated glaucoma (cataracts), mechanical narrowing (stenosis) of the gastrointestinal tract, and urinary retention.
Side effects and interactions
Because of such side effects, some patients discontinue anticholinergic irritable bladder medications on their own. However, this is by no means advisable. Instead, patients are advised to seek discussion with their treating physician. It may be possible to adjust the dose or switch to a better-tolerated preparation.
Local estrogen therapy
In some women, irritable bladder symptoms are due to a lack of estrogen, especially after the onset of menopause. In these cases, so-called local estrogen therapy is usually performed. The hormones are applied to the vagina in the form of a cream, for example. This is supposed to strengthen the elasticity of the pelvic floor when applied permanently. A comparison with placebos showed that women with overactive bladders demonstrably benefited from this.
The following substances have shown effects in studies with a small number of patients, which should indicate efficacy:
- Bryophyllum pinnatum (Kalanchoe, a thick-leaf plant)
- Gosh-jinki gan or Weng-li-tong (combinations of different herbs)
- Ganoderma lucium (shiny lacquer fungus, a mushroom)
- Combination of Crataeva nurvala (caper plant), Equisetum arvense (acler horsetail) and Lindera aggregata (feverfew shrub)
- Seeds of the garden squash (Cucurbita pepo)
Herbal medicines have their limitations. If symptoms persist, do not improve, or even get worse, you should always consult a doctor.
Beta-3 receptor agonists
Other medications
When anticholinergics and beta-3 receptor agonists do not help sufficiently, sufferers sometimes wonder what else can be done. Botox injections may then be tried. The nerve toxin acts locally on the nerves of the bladder and helps to suppress the excessive urge to urinate. However, the duration of effect of such an injection is limited to six months. Nevertheless, patients often experience a noticeable improvement in their quality of life as a result.
