Overactive bladder
The complex interplay of filling the urinary bladder and emptying urine leaves plenty of room for functional disorders of the urinary bladder. Among many other factors, changes in the urinary bladder or prostate, neurological or metabolic disorders or side effects of medication can be the cause. Clarification can be highly complex and can also include instrument-based examinations such as cystoscopy and urodynamics.
An irritable bladder is also referred to as an overactive bladder and is characterised by the symptoms of a strong urge to urinate with or without incontinence, frequent urination and urination at night. No obvious physical causes are found during diagnostics. Treatment is usually with medication.
Diagnostics
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Cystoscopy
How it works
In this video, you will learn everything important about cystoscopy – an endoscopic examination of the urinary bladder in men and women.
- Purpose: Clarification of subtle changes in the bladder wall, e.g. in the case of blood in the urine, suspected tumours, bladder stones or emptying disorders.
- Procedure: Examination under sterile conditions with lubricating gel and local anaesthesia.
- In women: Use of a rigid endoscope – the short, straight urethra allows a simple examination.
- In men: Use of a flexible endoscope that adapts to the natural curves of the urethra – making it low-pain and gentle.
- Technology: Modern video optics ("chip-on-the-tip") provide clear images; if necessary, minor procedures or tissue sampling can be carried out directly.
- Advantages: Reliable diagnostics, precise assessment of the bladder wall, practically painless today.
Surgery
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Incontinence surgery in women
Should only be the last resort
To treat involuntary loss of urine when coughing, sneezing, exercising or during physical exertion, women can undergo sling surgery and have a TVT/TOT tape inserted. However, the procedure carries risks: due to the artificial outflow obstruction, the bladder has to work with higher pressure.
In this video you will learn:
- How does sling surgery with a TVT/TOT tape work for stress incontinence in women?
- Why does narrowing of the urethra lead to increased bladder pressure & thickening of the bladder wall?
- How does this result in an overactive bladder, a strong urge to urinate, residual urine and recurrent cystitis?
- Why should surgery for stress incontinence only be performed after all conservative therapies (e.g. pelvic floor training) have been exhausted?
- Why should a precautionary (prophylactic) operation be strictly rejected?
About this page:
Author
Medical director of the Goldstadt-Privatklinik.
Specialist for Urology, Mini-PCNL and robot-assisted da Vinci procedures.
Member in Scientific Societies and Reviewer of scientific journals.
