THE IRRITABLE BLADDER - OVERACTIVE BLADDER

The irritable bladder is a very troublesome disease that affects millions of people worldwide. NeuroGyn has developed an innovative treatment method for the overactive bladder. This method is based on the placement of a micro-stimulation electrode via abdominal laparoscopy on the bladder nerves to dampen bladder function. The emptying ability of the bladder remains unaffected, only the unpleasant symptoms are treated. This treatment is unique can be performed on an outpatient basis or with only a 1-2-day clinic stay. Such an intervention can be performed by most gynaecologists (uro-gynaecologists).

Definition

The irritable bladder is defined by a series of symptoms: the urge to urinate, with or without urge incontinence, most often and at night. The main symptom is the feeling or urge to "go to the toilet" day and night - the sudden, strong need to urinate, which the patient cannot control. "Frequent urination" is usually defined as more than eight urinations per day. Patients may - but do not have to - lose urine (urge incontinence) both during the day and at night. Everyday life, social activities and leisure activities can thus be severely affected by a lack of bladder control and the sudden urge to urinate. An overactive bladder can cause significant social, psychological, occupational, domestic, physical and sexual problems and can lead to social and workplace exclusion.

Causes

The most common form of the irritable bladder is the "overactive bladder", usually without any cause being found.
In older people, however, it often results from diseases of the nervous system (Parkinson's disease, stroke, diabetes, multiple sclerosis, spina bifida, spinal cord injury, etc.).
However, new studies have shown that diseases of the bladder or pelvic organs can also lead to irritable bladder. Fibroids of the uterus which press on the bladder, endometriosis of the bladder, adhesions between the bladder and the intestines (after operations or infections), but also irritations of the pelvic nerves which control the bladder can all cause irritation of the bladder. In order to identify such causes and treat their consequences, it is necessary to access the pelvic organs by means of a laparoscopy. The treatment of such a cause then leads to the choice of therapy and saves the patient many years of (often unnecessary) treatment.

Frequency

The irritable bladder is a widespread condition that affects millions of people around the world. According to scientific studies, the overactive bladder occurs mainly in 7-27% of men and 9-43% of women, which corresponds to about 33 million Americans, about 15 million Germans and more than one million Swiss. 30% of all men and 40% of all women in the USA live with the symptoms of an overactive bladder. But the real number of people suffering from an overactive bladder is estimated to be much higher. This is because many people who suffer from an overactive bladder often do not ask for help. As the average age of the population in industrialised countries rises, it is expected that the disease could continue to spread in the future.

Aggravating factors

CHRONIC INFLAMMATION OF THE BLADDER AND URETHRA
 DRINKING TOO LITTLE FLUIDS
TOO EARLY EMPTYING OF THE BLADDER
hormone deficiency
PHYSICAL AND MENTAL STRESS 

The information on this website does not replace a personal consultation with your doctor.
Always consult your doctor for diagnosis and treatment.

THE FLACCID BLADDER (URINARY RETENTION)

The flaccid bladder is a condition in which a person has difficulty emptying their bladder. If the patient cannot urinate at all, it is called acute urinary retention. A flaccid bladder must always be treated, otherwise the patient is threatened with repeated bladder and kidney inflammations with serious consequences (kidney failure). NeuroGyn has developed an innovative therapy for the treatment of the flaccid bladder which is based on the "activation" of the bladder nerves.

Definition

In a flaccid bladder, the muscles of the bladder are slackened. The bladder can no longer contract correctly during emptying. The patient is no longer able to determine when and how to empty his bladder. The bladder is filled both by the "newly produced urine" and by the "residual urine". This increases the amount of urine in the bladder and thus also the bladder pressure; three subsequent problems can arise:

  • If residual urine remains in the bladder, germs and bacteria can lead to urinary tract infections.
  • If the sphincter muscle holds the resistance of the bladder pressure, the urine flows back into the kidneys and this all the more if the patient presses to be able to drain more urine. Recurrent kidney infections and reflux of urine into the kidneys lead in the long term to kidney damage and eventually to kidney failure (dialysis).
  • If the sphincter cannot resist this bladder pressure, uncontrolled urine loss occurs (overflow incontinence).

Causes

These are the best known causes:

  • In men, prostate enlargement is the most common cause. The prostate presses against the urethra, which impedes normal urine flow.
  • Damage to the pelvic nerves can be the result of pelvic interventions (cancer surgery, endometriosis surgery, back surgery, etc.) or diseases of the nervous system (diabetes, multiple sclerosis, polyneuropathy, etc.).
  • Damage to the bladder muscle
  • Tumours of the bladder or urethra
  • Bladder stones or kidney stones that jam in the urethra
  • bladder surgery
  • Urethral injuries
  • Nerve drugs and psychotropic drugs
  • „Lazy Bladder“: such a flaccid bladder is trained over the years, by visiting the toilet too rarely, or by the fact that the intervals between visits are too long (e.g. due to work).

Symptoms

The following symptoms may indicate a flaccid bladder:

  • Weak urinary flow with frequent interruptions
  • Difficulty urinating (abdominal press)
  • Sensation of incomplete bladder emptying
  • Significant delay between the attempt to urinate and the actual onset of urinary flow
  • Complete retention (urinary retention)
  • Recurrent cystitis
  • kidney pain

The information on this website does not replace a personal consultation with your doctor. Always consult your doctor for diagnosis and treatment.

URINARY INCONTINENCE

Urinary incontinence (bladder incontinence) is the loss of the ability to retain urine and determine the time and place for emptying the bladder. The causes vary due to the different anatomical characteristics of women, men and children. 

Definition

The term urinary incontinence refers to the unwanted discharge of urine between toilet visits.

  • Stress incontinence is the most common form of urinary incontinence. The loss of urine occurs during physical exertion such as climbing stairs, sneezing, laughing, coughing or during physical activity. In severe cases, urine loss can be triggered by merely walking, getting up or even without any strain at all. The reason for such incontinence is a weakness of the sphincter and pelvic floor muscles, which very often correlates with a prolapse of the uterus or vagina in women. 
  • Urge incontinence manifests itself in a sudden, frequent and strong urge to urinate. This form of incontinence is the second most frequently diagnosed. Many patients only experience such an urge when they are particularly under stress. The most common form of urge incontinence is the overactive bladder (see "Irritable bladder"), usually without a cause being found. In older people, however, it often develops as a result of diseases of the nervous system (Parkinson's disease, stroke, diabetes). 
  • Overflow incontinence (see "flaccid bladder") is accompanied by overstretching of the bladder. Here the warning urge to urinate is missing. This form of incontinence inevitably leads to an overstretching of the bladder and usually to a backflow of urine into the kidneys with risks of kidney damage. Such urinary incontinence can also be trained over the years if the toilet visits are too rare or the intervals between them are too long ("lazy bladder").

Mixed urinary incontinence is the combination of simultaneous stress and urge incontinence.

Frequency

Urinary incontinence in women 
Every fifth woman who comes to the gynaecologist's practice complains of a "weak" bladder. It is estimated that 40% of women over the age of 60 suffer from bladder weakness. About 25% of all women between the ages of 25 and 35 suffer temporarily from bladder weakness as a result of childbirth. In Germany there are about six million people whose bladder function is impaired. Due to anatomical and hormonal differences, women are twice as often affected as men at an early age. Urinary incontinence affects all age groups, but increases with age. It usually leads to changes in personal activities and severely affects the quality of life of the affected women. Last but not least, it represents a great psycho-social challenge with changes in self-esteem and often leads to social isolation. Women who suffer from a weak bladder are particularly often affected by stress incontinence. The cause is a weakness of the pelvic floor muscles, which means that the urethra's closing mechanism no longer works reliably. Births, frequent abdominal surgeries, overweight or physical strain can permanently weaken the pelvic floor. This in turn can lead to a prolapse of the uterus and other pelvic organs and affect the bladder closure mechanism. Women with weak connective tissue are particularly at risk. 

Urinary incontinence in men
In men, however, there is little data on urinary incontinence, both in terms of frequency and treatment. However, the frequency of urinary incontinence in men seems to increase with age. Urge incontinence is the most common form of urinary incontinence in men and occurs between 40-80% of cases (stress incontinence only in 10%!). With the increase in prostate and bladder surgery, the frequency of male stress incontinence has increased.

Diagnosis

Urinary incontinence can already be established during a question and answer session with the doctor.
 The search for a possible cause and the determination of the type of urinary incontinence requires a professional uro(gynaecological)logical examination. This includes a gynaecological/urological examination, an ultrasound of the kidneys and the bladder and a bladder pressure measurement, also called urodynamic testing.

The information on this website does not replace a personal consultation with your doctor.
Always consult your doctor for diagnosis and treatment.