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An irritable bladder, also called an overactive bladder or urge incontinence, results in the involuntary leakage of urine. This form of urinary incontinence suddenly contracts the bladder's muscles. As a result, the patient is struck by an uncontrollable urge to void. There are many possible causes for this condition, including nerve damage and pregnancy. An irritable bladder may be treated with behavioral retraining, medications, or possibly surgery.
Certain medical conditions may result in an irritable bladder, such as an enlarged prostate or benign prostatic hypertrophy (BPH) in men. Women may have this condition due to pregnancy. Neurological conditions, such as multiple sclerosis or Parkinson's disease, as well as nerve damage or poor kidney function can also cause an irritable bladder. In some cases, the cause may be as simple as a high consumption of alcohol or caffeine. At other times, the cause may never be determined.
Medications may sometimes ease an irritable bladder. A doctor may prescribe antibiotics if a bacterial infection is to blame. Some drugs, called antispasmodics, can help relax the bladder muscles. These medications are typically prescribed to complement a form of therapy called bladder training or behavioral techniques.
Under the supervision of a doctor, a patient with an irritable bladder can train the bladder to delay voiding. This program will begin with small time delays and gradually build up to where the patient can urinate no more than every three to four hours. If this technique is impractical for the patient, he may instead use a schedule of voiding, during which he will train the bladder to void at certain times of the day.
Those who have weakened pelvic muscles can benefit from Kegel exercises, which are designed to strengthen the muscles that control the bladder. To perform these exercises, the patient will engage the muscles that stop the flow of urine, hold the contraction for several seconds, and then release the muscles and repeat the exercise. Patients can gradually build up to holding the contractions for longer intervals.
Surgery for an irritable bladder is considered a last resort option, to be tried only when other treatments have failed and the patient suffers from severe symptoms. For this type of urinary incontinence, augmentation cystoplasty is the most commonly used surgical technique. The surgeon will increase the size of the bladder by augmenting it with a section of bowel. This allows patients to void less frequently because they can store more urine. Patients who undergo an augmentation cystoplasty will likely need to use a catheter to empty their bladder off and on throughout their lives.