The Stimulus Bubble: Cause, Diagnosis and Therapy of Permanent Urination
Permanent urge to urinate, pain during urination and a small amount of urine? The symptoms of a stimulus bladder resemble those of a cystitis. However, with a hyperactive bladder, bacteria are not the trigger: Emotional stress, physical overload and various basic diseases can cause a stimulus bubble. The therapy? Behavioral training for the bladder.
The urge to urinate suddenly comes. From one moment to another, the urge to go to the bathroom is unacceptable. Up to 20 times, sufferers have to go to the toilet every day – without having a full bladder. About 10 to 20 percent of the adults suffer from the so-called stimulus bubble. The symptoms are similar to those of a cystitis . But here there are no bacteria in the game: The causes for a permanently stressed or irritated bladder are manifold.
In a stimulant bladder the function of the urinary bladder is disturbed. In a healthy adult, the bladder holds about half a liter of urine. The urine is filtered in the kidneys and then collected in the bladder before excretion. From an amount of approximately 300 milliliters, receptors in the bladder report to the brain that an early emptying is due – urine urge.
Stimulus: disturbed impulse forwarding causes urination
This mechanism is disturbed by a stimulus bubble. The cause of the hyperactive bladder is still not completely clarified. There is no physical change that causes permanent urination. It is thought that there is a faulty transmission of nervous impulses and thus mistakenly conveys the feeling of a full bladder to the brain. As a result, the bubble muscle changes its perception and the alarm sounds faster – a devil’s circle arises. Medics also describe this disease as a primary stimulus.
Doctors talk of a secondary stimulus bubble when another disease causes the stimulus bubble. Tumors in the bladder, multiple sclerosis , a stroke or Parkinson’s can lead to a hyperactive bladder. Also diseases of the nervous system and damage of the spinal cord can cause urological suffering.
The symptoms of a stimulus bubble: permanent urination, little urine
Anyone can be affected by the disease of the stimulant, but most patients are female and between the ages of 30 and 60 years. It is assumed that a change in the estrogen level during the menopause (climacteric) is a risk factor for a hyperactive bladder. But even men are affected.
At first urinary urgency (pollakisuria) occurs. The pressure on the bubble grows faster, the phases between the toilets become shorter. The permanent and, above all, very sudden urge to go to the toilet is very unpleasant for those affected. In addition, it may be that the urine can no longer be (completely) held in the bladder with increased urine urine. First, a pair of droplets in acute situations such as sneezing, laughing or lifting heavy objects go into their pants, later the urine can not be held any longer. A urinary incontinence occurs.
The situation is very stressful for those affected and can lead to social retreat and isolation. Psychological problems can also follow.
Diagnosis of irritation bladder by exclusion procedure
If the abovementioned symptoms occur, the doctor should first be consulted. He can use a detailed patient questionnaire (anamnesis) to provide the suspicious diagnosis bladder. Since there is no test that confirms the disease, some other diseases must first be excluded. This mainly includes cystitis. A urine sample provides information on whether the disease is caused by pathogens.
The physician will refer the patient to a urologist and a gynecologist for a more detailed explanation of the symptoms and for further tests. There, the urogenital tract is precisely examined. An ultrasound examination can show whether the bladder on the toilet can be completely emptied or whether urine residues remain behind and thus rob volume. With the aid of probe electrodes, the physician can check the bladder pressure and the muscular function. A bladder mirror serves the medical practitioner to recognize or even exclude a tumor in the bladder.
In women, the gynecologist will take a smear from the urethra and examine the estrogen content. In many patients the local estrogen content in urinary bladder and vagina is diminished. The uterus is also examined for changes.
In men, the prostate is additionally examined. Often a benign enlargement of the prostate is the cause of the irritated bladder.
Also mental trauma or mental stress can cause a stimulus bubble. Therefore, the investigation should also address the patient’s current life situation and his emotional state. If necessary, a conversation with a therapist is appropriate.
Treatment of the stimulant: Training of the muscle possible
As the quality of life decreases significantly for many patients with a stimulant, it is important to recognize the disease and treat it accordingly. Many patients are afraid of the doctor’s visit – the stimulant can be treated. A “cure” is unlikely, but with the correct methodology the symptoms can be significantly reduced and a piece of life quality can be recovered.
The training of the bladder muscle is an effective way to minimize the discomfort. In doing so, the intervals between the jaw lengths are to be increased and the emptying of the bubble retarded. Pelvic bodyscene training combined with electrostimulation of the muscles has in many cases been strengthened. In the initial phase of the therapy, a so-called micturition book can help the body to understand better. Here, drinking amounts, urination and bladder emptying are recorded daily.
In the course of the training, the patient will suppress the urge to urinate and go to the toilet at predetermined times. By the continuous emptying, the bladder has shrunk and no longer holds the original amount of fluid. By holding the urine, the bladder is again stretched and gradually acquires the initial size. The training of the bladder muscle is exhausting, but worthwhile for the patient.
Relaxation techniques against urinary urge
Bladder training can be complemented by relaxation exercises like autogenic training and muscle relaxation according to Jacobsen . If the urge to urinate is unpleasant and omnipresent, the exercises can help to soothe the body and suppress the urge to go to the toilet.
In this way, the effectiveness of the bladder training can usually be increased because physical rest and relaxation is beneficial.
Drug treatment of the stimulant: not a permanent solution
The doctor can also prescribe medication for the stimulant. Anticholinergics or spasmolytics are mainly used here. These remedies help to relax the bubble muscle and soothe the nervous system. Estrogen-containing ointments or suppositories are also used – naturally only in women.
The anticholinergics usually have significant side effects and can not be taken by each patient. Therefore, the treating physician will presumably attack these remedies in the initial phase of the therapy, but they will gradually reduce them and finally settle again. It is not advisable to change the medication independently or to discontinue the preparations on your own – there may be significant side effects. Constipation, mouth dryness, perceptual disturbances and impairment of the eyes can result.
The medication is therefore individually and is individually adapted to each patient. If side effects occur, the doctor should be looked for an alternative to the preparation used.
Stimulation of nerves: stimulus current against stimulus
If both the bladder training and the drugs administered are not as desired, a therapy with stimulus current can be used. The bubble muscles of the affected person are stimulated several times a week with a light stimulus current over half a year. This is to improve the muscle function and so the symptoms are softened.
The increase in therapy is the electrical stimulation of the sacral nerve plexus, also called neuromodulation. The bladder is thereby to be inhibited.
In cases with pronounced symptoms and a great limitation of everyday life, surgery can be attempted as the last therapy. The bladder is lifted or completely removed. A new derivative of the urine must be placed.
Complement the therapy meaningfully: Understanding of the disease is important
If a psychological cause of the stimulus bubble is the basis, this trauma must be treated by a specialist. Only if the mental symptoms are solved, the therapy can achieve success. When patients understand their illness, the therapy usually suggests better and there are less frustrating setbacks. Because the therapy of a stimulus is exhausting and takes time.
An important means of improving the situation is a good intimate care . This reduces the incidence of infections and prevents a deterioration of the unpleasant and embarrassing symptoms. Changes in daily routines can also produce small successes. Before sleeping, do not drink large quantities of liquid, so that urine does not take too much time at night. Even diuretic drinks such as coffee or black tea should be dispensed with. In many patients an alcohol detriment has a positive effect on the symptoms.
If there is another underlying disease causing the irritable bladder, the symptoms often disappear when this disease is successfully treated.
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