Irritable bladder

Most of the people may experience an urge to empty the bladder, and this condition is termed as irritable bladder, also known as overactive bladder. Sometimes, the irritable bladder can be embarrassing and inconvenient. However, your doctor would help you by determining the underlying cause that is leading to the symptoms and treating it appropriately.

The irritable bladder may result from an abnormal bladder-storage function that causes an urge to urinate. According to World Health Organization, it is estimated that more than 200 million people suffer from overactive bladder.

About bladder

Urine is formed by your kidneys and then transferred through ureters into the bladder for storage. Then, the urine passed from the bladder into the urethra and excreted through the vagina in women and penis in men. Once your bladder is filled, the nerve impulses from the bladder are sent to the brain that triggers the need for urination. The nerves regulate the contraction and relaxation of the muscle in the urethra.

Causes

When there is an abnormal nerve function, irregular contractions and relaxations may occur in the bladder leading to an urge to urinate. The involuntary contractions of the bladder may occur as result of many underlying conditions that include the following:

  • Tumors or stones in the bladder

  • Neurological disorders, such as Parkinson's disease, dementia, stroke and multiple sclerosis

  • Diabetes

  • Acute urinary tract infections

  • Enlarged prostate gland or constipation

  • Increased intake of caffeine and alcohol

  • Incomplete bladder emptying

  • Poor kidney function

  • Spinal cord injury

  • Disc hernia or degenerative disc disease

Symptoms

The symptoms of irritable bladder include:

  • Frequent urination (more than eight times in 24 hours)

  • Urinary urgency

  • Nocturia

Risk factors

Following are the factors that increase your risk of the irritable bladder.

  • Age: The risk of an urge to urinate increases with increasing age.

  • Underlying conditions: If you’re diagnosed with benign prostate enlargement or diabetes, then there is an increased risk of developing irritable bladder.

  • Cognitive disorders: People with cognitive disorders such as Alzheimer's disease may develop overactive bladder.

Complications

An overactive bladder may affect you physically and emotionally. It can get in the way of your social life, work, exercise, and sleep. You may feel depressed which affects your quality of life. It can disturb your sleep, and too little sleep makes you feel stressed. Additionally, leakage of urine may cause skin infections.

Initially, your doctor performs a physical examination and also inquires you about the symptoms. To confirm the diagnosis, your doctor might suggest the following tests:

  • Urinalysis: A sample of urine is tested for infections, the presence of blood cells, or proteins.

  • Neurological exam: This test helps to identify abnormal reflexes or sensory dysfunction.

  • Ultrasound: This test is used to measure the amount of urine left in your bladder after voiding. It also helps in identifying any abnormality that is causing urinary incontinence. Your doctor might recommend certain tests that measure urine flow rate.

Your doctor might suggest a combination of any of the following treatment strategies.

Behavioral therapies:The behavioral therapies might help you to regain control of your bladder. These therapies include:

  • Bladder training helps you to know how to resist the urinary urgency and also to expand the intervals between urination gradually.

  • Toileting assistance prevents leaking of urine with the use of scheduled toileting and prompted voiding.

Pelvic muscle rehabilitation: This helps to improve your pelvic muscle contractions and relaxations that prevent leakage.

  • Kegel exercises can improve and prevent the urinary urgency. These exercises strengthen your pelvic floor and urethral muscles.

  • Vaginal weight training involves tightening of the vaginal muscles by applying small weights on the vagina.

  • Pelvic floor electrical stimulation involves stimulating the pelvic muscles with electrical impulses.

Medications: Your doctor might prescribe certain medications that relax your bladder and prevents urinary urgency. The medications include tolterodine, oxybutynin as a skin patch, oxybutynin gel, trospium, solifenacin, darifenacin, mirabegron, and fesoterodine. Sometimes, bladder injection called as Botox is prescribed.

Surgery: If you experience severe symptoms, your doctor might suggest a surgery that involves either a procedure to increase the bladder capacity or removal of the bladder.

Overactive bladder can be prevented by adopting the following measures:

  • Maintain a healthy weight

  • Perform the pelvic floor exercises regularly

  • Maintain a schedule for fluid intake

  • Avoid consumption of caffeine and alcohol