Urinary incontinence: the key questions and answers

Urinary incontinence is not a diagnosis, but a symptom, namely an involuntary urination. The causes can be quite different. The topic is still not talked about. However, it has been present on television and other public media for some time now through the advertising of manufacturers of their incontinence products. If this should contribute to the destigmatization of those affected, that would be a good thing. Because feelings of shame and fears of exclusion or social disadvantages probably prevent many people from getting professional help. The chances are very good that the problem can be remedied with the appropriate measures or at least satisfactorily controlled.

Fainting pelvic floor tends to stress incontinence

Urinary continence is widespread. Women are likely to be affected two to three times as often as men. This is mainly because the female pelvis must be much more flexible than the male, in order to allow the pregnancy and birth events. Also, the higher number of organ passages through the pelvic floor muscles at the expense of stability.

The pelvic floor consists of three layers of muscle and connective tissue. Like a hammock that closes the abdomen down, it holds the uterus, bladder, vagina, and rectum in place. Especially at birth, the pelvic floor is heavily loaded. The tissue is greatly stretched during delivery, fine cracks can arise.

Stress incontinence is one of the typical symptoms of a damaged pelvic floor: every time, when, for example, when coughing, sneezing, climbing stairs or heavy lifting the pressure in the abdomen increases, urine involuntarily goes off. Therefore, not only the recovery course as such is so important, but also the continuation of the learned training of the pelvic floor muscles as a preventive measure on their own initiative.

Menopause and enlarged prostate major causes in advanced age

With advancing age, the proportions of urge incontinence and mixed incontinence increase. During and after menopause, estrogen deficiency is often responsible for decreased pelvic and bladder tone tension and uncontrolled urine leakage. Overall, about half of incontinent women are affected by stress urinary incontinence, one third by mixed incontinence and one sixth by urge incontinence.

In contrast, overactive bladder and urge incontinence dominate as male manifestations. At a young age it is a rather rare phenomenon, caused mainly by neurological diseases, bladder and urethral strictures, urinary calculi or bladder infections. In older age, the incidence in men then increases, mainly caused by a benign enlarged prostate. In this case, one also speaks of an overflow incontinence.

Health hazards due to increased residual urine

Urinary incontinence is often more than a nuisance. It can become a real social and / or psychological problem for those affected. The increased residual urine due to the bladder weakness is also a breeding ground for infectious bacteria and thus source of possible bladder infections. If the bladder muscles are too weak to urinate, it also leads to backwater in the kidneys. This will impair their filtering function and possibly damage kidney tissue, which can have very serious consequences.

Medical diagnostics for permanent complaints announced

Overactive bladder and urinary incontinence are dynamic processes that can disappear on their own. But you can not rely on that. In order to avoid the consequences mentioned above, it is advisable to visit the doctor in the event of a long-term problem. With a bubble pressure measurement (cystometry), the pressure conditions in the bladder and urethra as well as the bladder capacity can be recorded and evaluated. This also applies to the functioning of the bladder muscles and possibly to the cause of the incontinence. The latter, however, often remains in the dark. The inside of the bladder can be explored with a cystoscopy. With the flexible cytoscope, which is introduced through the urethra, minor interventions are possible if required.

First and foremost physiotherapeutic treatment

The treatment of bladder weakness naturally depends on its cause and form. The focus is on non-pharmacological procedures, especially pelvic floor exercises in stress incontinence and bladder training in urge incontinence. A holistic complement to these physical actions are relaxation techniques (such as autogenic training, Jacobson Progressive Muscle Relaxation). The further range of non-pharmaceutical products is extensive and includes i.a. Biofeedback, electrostimulation, reflexology, hypnosis, acupuncture and homeopathy.

Wide range of medical offers and aids

There are also aids, as partially known from advertising, some: such as specially designed incontinence pads, vaginal tampons, pessaries to change the position of the urinary bladder and urethra and drip and condom urinal for men. Careful skin care in the genital area is self-evident, more frequent washing should only be done with soap-free cleansing products. The medical device industry has a pacemaker that uses the pacemaker principle to send electrical impulses to the nerves that regulate the bladder muscles and urinary emptying.

Among the drugs antibiotics are announced when there is a need for treatment bladder infection. Otherwise dominate the so-called anticholinergics or antimuscarinics, which are mainly used in urge incontinence. The prescribed substances more or less all reduce the hyperactivity of the bladder muscles, which increases bladder capacity.

In the case of an enlarged prostate, especially 5-alpha-reductase inhibitors or alpha-receptor blockers are on the doctor's prescription list. Herbal remedies (such as bearberry leaves, pumpkin seed extract or goldenrod) may also be helpful in the event of problems with the urinary tract, whether in the form of medications or bladder tea. An operation is usually considered as a last resort. Of the various, nowadays especially vaginal surgical methods, the so-called DVT procedure (tension free vaginal tape) is currently practiced most frequently.

Keep diary and drink enough!

Of course, your own behavior has a relevant impact on the disease. Especially in urge incontinence, it is recommended to keep a voiding diary (micturition = urination). This will record your drinking and urinary output. This allows you to recognize unfavorable drinking and toilet habits and to control the success of therapy. With careful recording, the sometimes distorted self-perception can be corrected.

Even if one might not expect it on this topic: sufficient drinking is important! Because a reduced fluid intake leads to an increased concentration of urine, which not only increases urinary frequency, but also the risk of cystitis. And otherwise, drinking (preferably water or herbal tea) has some health benefits.

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