What is bladder spasm?

The ability of the bladder to store urine requires a relaxed bladder muscle. The bladder normally fills gently and does not contract (squeeze) until a person urinates. With bladder instability (spasms), the bladder randomly contracts. As the bladder begins to squeeze, most people can sense the need to urinate (urgency).  If a person does not urinate, the contraction strengthens and forces urine out of the bladder (urge incontinence).  Urine may leak in large or small amounts, and the flow may not be stoppable.  Although urge incontinence can occur at any age, in women older than 65, the most common cause of incontinence involves these spasms.  Urge incontinence which results from these random bladder contractions has alternative names including: overactive bladder, irritable bladder, spasmodic bladder, unstable bladder and detrusor instability.

What causes it?

Although the cause of bladder spasms is not completely understood, some women who have had strokes or other neurological diseases may have bladder spasms.  Bladder infection and irritation from certain foods can also produce these spasms.  CLICK HERE for more information about dietary irritants.

What can be done?

Surgery is generally not helpful for controlling bladder spasms.  For most patients, a combination of treatments is usually recommended to improve bladder control: 

• Bladder training - A pattern of urination based on time, rather than on desire, can help retrain the bladder. Each patient follows a urination schedule that allows a brief interval between urinations, for example, one hour. The time between urinations is gradually increased until a urination interval is reached that results in the fewest urinary accidents. The urinating routine must be followed to retrain the bladder.  CLICK HERE for more information about bladder training.
  
  
• Medication - Various drugs help relax the bladder. Unfortunately, this family of medications also has side effects, most commonly dry mouth and constipation.  Sometimes these side effects can limit the amount of medication that a patient can take.
  
  
• Electrical Stimulation - The nerves which supply the bladder may be overactive, causing bladder spasms. Electrical stimulation blunts the effect of these nerves and relaxes the bladder. A vaginal device delivers the weak, painless current.  CLICK HERE for more information about electrical stimulation.
  
  
• Pelvic Floor Exercises - The pelvic floor muscles stretch from the pubic bone to the lower back.  These muscles support the pelvic organs, including the bladder.  Urinary incontinence can be improved in some patients by exercising and strengthening these muscles.  Learning to squeeze them when the urge to urinate becomes strong is an important way to control leaking urine. Biofeedback may be used to help a woman identify her pelvic muscles and improve the ability to contract them to control urgency.   CLICK HERE for more information about pelvic floor muscle exercises.

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