Irritable bladder is a general term for any persistent condition that provokes the muscles in the bladder to contract involuntarily, resulting in a sudden, urgent, uncontrollable need to urinate (urge incontinence). Numerous stimuli can intermittently irritate the bladder and override conscious attempts to inhibit the voiding reflex, sometimes resulting in large-volume accidents that may occur either during the day or while sleeping. The mechanisms that trigger irritable bladder are sometimes difficult to determine; identifying an underlying cause often leads to effective treatment. Irritable bladder is fairly common, especially among women.

What Causes Irritable Bladder?

  • Urinary tract infections (UTIs)
  • Nervous tension
  • Food sensitivities
  • Bladder stones
  • Pregnancy
  • Damage to the nerves that control bladder function, which causes excessive contraction of the bladder.
  • Obstruction of the outflow of urine, for example, because of a tumor, urethral stricture, or an enlarged prostate.
  • A reaction to the use of a urinary catheter
  • In many cases the cause is unknown.

Symptoms of Irritable Bladder

  • Uncomfortable feeling in abdomen and distention
  • Sudden, urgent need to urinate
  • Accidental voiding of urine, sometimes in large volumes
  • Frequent urination, both during the day and at night

Prevention of Irritable Bladder

  • Because it is difficult to identify its underlying cause, irritable bladder is difficult to prevent.

Diagnosis of Irritable Bladder

  • Patient history and physical examination
  • A “voiding diary,” or record of the time, amount, and circumstances of urination
  • Catheterization of the bladder to measure the amount of urine remaining after urination, and to document bladder pressure during filling of the bladder (cystometry).
  • Microscopic examination and culture of urine, to determine if a urinary tract infection underlies the problem.
  • Q-tip test (evaluates the change in the angle of the urethra at rest and when straining)
  • Cytoscopy (use of a lighted scope to view the bladder)
  • Voiding cystogram (an x-ray taken while the patient urinates)

How to Treat Irritable Bladder

  • When irritable bladder is due to bacterial infection, antibiotics are given.
  • In some cases bladder control can be regained or improved with a technique known as bladder training. The technique begins by scheduling a bathroom visit every two hours, whether the patient needs to urinate or not. The interval is gradually increased by a half hour at a time, toward a goal of four-hour intervals. In many cases the body adapts to this schedule, eliminating incontinence.
  • Antispasmodics and other drugs may be prescribed to relax bladder muscles and so prevent uncontrolled contractions of the bladder.
  • Although adult diapers and pads are widely advocated by advertisers, they may actually promote complications, so they are not recommended for anything but very short-term use unless otherwise advised by a doctor.

When to Call a Doctor

  • Consult a doctor for any repeated episodes of urinary incontinence.

Sources:

Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference

Simeon Margolis, M.D., Ph.D., Medical Editor

Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50

Updated by Remedy Health Media

Publication Review By:

Published: 25 Aug 2011

Last Modified: 17 Nov 2011