Irritable bladder

definition

Under one Irritable bladder one understands a disturbance of the emptying of the bladder, which by frequent Urge to urinate and partly also through the inability to urine to keep uttering. It is important for the diagnosis that none of the numerous other causes of a voiding disorder are present.

Read more about the topic here: Frequent urination

Synonyms

• Overactive and hyperactive bladder
• Urethral syndrome
• Frequenca urgency syndrome

Summary

It is mostly women and men between the ages of 30 and 50 who suffer from irritable bladder. The urge to go to the toilet frequently and usually to urinate small amounts of water is that Main symptom an irritable bladder. Sometimes one also observes an inability to urinate at the same time Urge to urinate to keep (the so-called Urge incontinence). A Burning sensation when urinating, which would suggest an infection of the bladder, is usually missing.However, after frequent visits to the toilet and urination, pressure pain in the bladder area can occur. The urine is mostly not concentrated, i.e. bright and free from blood. Irritable blisters are common, but the number of unreported cases is very high as most patients either do not go to the doctor at all or go to the doctor late.

Forms / causes of irritable bladder

One distinguishes one primary and a secondary Form of irritable bladder. The primary irritable bladder is the most common form and does not reveal any clear cause of the suffering. If one examines the bladder by printing technique, one can often see that in patients with a primary irritable bladder, a small amount of urine is often enough to relax the bladder muscles. After frequent Cystitis in the past the bladder can also be sensitized, i.e. Here, too, a small amount of urine is enough to trigger the urge to urinate.

The secondary, rarer form of irritable bladder can have many causes. So are they too Cystitis but also stone problems (bladder stones) can lead to irritable bladder if they remain in the bladder for a long time and are not excreted. Tumors of the bladder are also a rare but very serious cause of irritable bladder and are often the first sign of the tumor.

By lowering estrogen levels in women in the Menopause The texture of the urethral mucosa can change and lead to an irritable bladder. Any further changes or narrowing of the urethra such as. Adhesions, often after years of radiation treatment for cancer, can manifest as irritable bladder. The use of flushing drugs (diuretics), which have to be taken regularly because of other illnesses, can also cause an irritable bladder as a side effect.

A non-negligible cause of irritable bladder, if not the most common, is one psychological component Many patients state that they are afraid of having to go to the toilet all the time, especially when they are out and about and there is no toilet. The result: an increase in the urge to urinate. After traumatic events or during emotional conflicts, one should distinguish the incontinence caused by it (e.g. wetting while sleeping) from the irritable bladder. In contrast to patients with irritable bladder, those affected do not notice their need to urinate.

frequency

Mostly women and men between the ages of 30 and 50 are affected. Before the age of 30, more women are affected. After that, men can experience irritable bladder symptoms as well. Irritable bladder is relatively rare in children. Urination disorders in them usually have other causes (e.g. excitement, emotional conflicts, etc.). It is estimated that around 3-5 million people in Germany suffer from irritable bladder. As mentioned above, however, there is a high number of unreported cases, as those affected do not go to the doctor out of shame or confide in others.

Symptoms

Frequent need to urinate and passing small amounts of urine (so-called Pollakiuria). Those affected often go to the toilet 20-30 times a day, during which only a few ml of urine can be passed. The urine is not concentrated (pale) and without blood. Painful urination may occur. However, a feeling of pressure may occur due to frequent evacuation.

More information on the topic: Frequent urination

diagnosis

An irritable bladder is not actually an independent clinical picture, 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 irritable bladder.

One of the most important diagnostic tools is taking anamnesis, i.e. questioning the patient. In this conversation, the doctor should already be able to see whether the problem is more organic or an irritable bladder. He will ask questions like: "Since when does this problem exist? Do you have blood in your urine? How often do you have to go to the bathroom? Are there any comorbidities? Did the family have this problem too? Do you have Painful urination? 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 addition, possibly blood) or whether a suspicion of a bladder tumor needs to be investigated (blood often only visible under a microscope). Then he will like an ultrasound scan of the bladder and urinary tract ureter and Kidneys to see changes such as inflammation or narrowing and congestion or urinary and bladder stones. Furthermore, an ultrasound examination enables the doctor to determine the amount of urine that remains in the bladder after urination. He can thus assess the volume at which a urge to urinate is triggered (a few ml is often sufficient for irritable blisters). This examination is usually carried out by a urologist during the Urinalysis can already be carried out by a general practitioner. A complementary diagnostic measure is the cystoscopy, in which an optical instrument is inserted into the urethra and urinary bladder. This procedure is performed under local anesthesia and can also provide evidence of a tumorous disease.

A Bladder pressure measurement or Cystomanometry called gives information about the capacity of the bladder. This is a complex test procedure in which electrodes in the bladder and anus can be used to measure the pressure when the bladder is filled and when it is emptied.

In the diagnosis of the irritable bladder, which can then only be carried out by a urologist, the methods that are most inexpensive and the most gentle for the patient are used first.