I very suddenly developed
urinary urgency (aka: overactive bladder, overactive bladder syndrome, or irritable bladder) almost overnight, one or two weeks after starting a sexual relationship with a new girlfriend, decades ago. I strongly suspect this was due to picking up some type of pathogen through sex that entered the bladder via the urethra, which created a long term (possibly intracellular) infection of the bladder lining or the bladder nerve supply.
I'd never had these bladder problems previously; in fact I had a rather iron bladder, that could last most of the day without going to the toilet. But almost overnight I suddenly found myself with this urinary urgency condition, which arises from nervous spasms of the bladder muscle (detrusor muscle). The fact that this happened to me almost overnight needs an explanation: some factor must explain this sudden change of status, and an infectious agent is my guess.
A related condition is interstitial cystitis (IC), which is similar to overactive bladder, but IC can also involve excruciating bladder pain as well as urgency of urination. IC
has been linked to a Gram-negative bacterial infection of the bladder tissue, and I suspect overactive bladder will in the future also be found to be linked to chronic low level infection.
Overactive bladder is not to be confused with
polyuria. Overactive bladder is where there are almost uncontrollable nervous contractions of the bladder muscle, which create great pressure, and force you to find a toilet pretty fast, else you fear you may wet your pants (and I found this sometimes happens if you cannot get to a toilet in time, but fortunately in my case only very rarely). These nervous contractions of the bladder can occur even if the bladder is only say one third full, so it is not much to do with how full your bladder is.
Polyuria by contrast is where the throughput of liquids in the body is much faster: your kidneys are always dumping water into your bladder, so you find you have to visit the toilet a lot more.
In terms of treatments of overactive bladder and interstitial cystitis, restoring the
glycosaminoglycan layer (GAG layer) in the bladder can improve or cure the symptoms of overactive bladder or interstitial cystitis. The GAG layer is a protective mucous membrane lining that covers the bladder. Refs:
1 2 3
Gepan and
Uracyst are products that can repair the GAG layer in cases of overactive bladder and interstitial cystitis. They contain a sterile solution of chondroitin sulphate which is instilled into the empty bladder. Some other similar products are detailed
here. Some contain hyaluronic acid as well as chondroitin sulphate.
Apparently you can administer Gepan yourself at home if you prefer; see
here.
You can also take a combination of
chondroitin sulphate and
glucosamine sulphate (or
N-acetyl-glucosamine) supplements orally to help repair the GAG layer, but I am not sure how this compares in efficacy to products like Gepan and Uracyst that you squirt into your empty bladder via the urethra.
The oral drug
pentosan polysulfate (Elmiron) is thought to work by restoring a damaged GAG layer. Ref:
1
Other oral drug treatments for overactive bladder include:
Darifenacin,
oxybutynin,
solifenacin,
tolterodine and
trospium. These all work by blocking one or more of the muscarinic acetylcholine receptors, such as the M3 receptor that is mainly responsible for bladder muscle contractions. People with glaucoma, urinary retention, or gastrointestinal disease should avoid using these anticholinergic drugs.
Mirabegron is a adrenergic beta 3 receptor drug that work by activating a receptor in the bladder muscles that relaxes the muscle.
Imipramine (a tricyclic antidepressant drug) also relaxes bladder muscles.
Botox injections can be used to treat overactive bladder.
Effective herbal treatments for overactive bladder include:
pumpkin seed oil, and
gosha-jinki-gan. Refs:
1 2
