During much of my medical career, my understanding of the human bladder was that it was a reservoir for the body’s metabolic waste and that it simply stores #urine until it signals a sense of fullness to motivate volitional voiding. As filling increases tissue distension, intensity of desire to void increases accordingly. Throughout most of the day, the bladder just passively fills. How reassuringly simple! I also understood that bladders, and mostly of females, are very vu

This page from European Urology is enlightening for anyone treating urinary urgency or taking the treatments. The text explains that oral treatments’ beneficial responses are slight, modest and substantially placebo effects at the cost of over twice the risk of inducing cognitive impairments. They also produce symptomatic side effects, most notably dry mouth, that are real and mechanistically well understood as antimuscarinic actions on tissue receptors. The authors explain t