Overactive bladder
The term overactive bladder (also overactive bladder, formerly irritable bladder ) is understood as a functional disorder of bladder function without organic pathology. This results in a heaping urination ( pollakiuria ) with or without involuntary loss of urine ( urinary incontinence). The Irritable bladder most likely to occur in women in the 3rd to 5th decade of life.
Symptoms
Constant urge to urinate and excessively frequent urination ( pollakiuria ) are in the foreground, in some cases ( Urge ) incontinence. A burning sensation when urinating missing, the constant urge to urinate, however, can be perceived as suprasymphysärer pain.
Causes
In addition to estrogen deficiency untraceable chronic infections and psychosomatic causes are discussed. The cause of the symptoms can also be in an over-activity and dysregulation of the bladder muscle ( the so-called detrusor, Latin musculus detrusor vesicae ) lie. The muscle that should be relaxed in the filling phase actually, so that the bladder can expand biases in people who suffer from OAB, in too easily. This means that the detrusor still can in the filling phase, so even small amounts of urine, urinary urgency, and pull together triggers that can not be suppressed by some stakeholders.
Diagnostics
The irritable bladder is ultimately a " diagnosis of exclusion " (no objectively organ pathological findings). Recommended to next anamnesis ( a nocturnal persistent urinary frequency ( excessively frequent urination ), for example, has an organic cause to go ) and physical examination, an analysis of Vaginalfluor and urine, residual urine, urethral wide investigation and smear, supplemented where appropriate urodynamics including flowmetry, urethrogram in double balloon technique and the urethrocystoscopy.
Theses to explain
Under neurophysiological and psychological aspects can be the symptoms of those affected interpreted as a disturbance of the autonomic nervous system, pathophysiological an unhappy combination of bladder and pelvic floor muscles is assumed. Another explanation is a chronic subepithelial inflammation is postulated located in the area of the trigone of the bladder.
Therapy
Symptomatic anticonvulsants, alpha-blockers, tricyclic antidepressants and estrogen containing at estrogen deficiency (eg in senility ) topical medications can be tried. To further therapy may be helpful also a psychosomatic treatment. Antibiotics should be avoided.
Prevalence
In Europe and Canada to 13.9 % of the suffering from the symptoms of irritable bladder over 40 years of age.