Urge incontinence is characterized by very sudden urge to urinate, empty the bladder, the person must immediately. If not, it comes quickly to involuntary loss of urine. It is estimated that about 30 percent of those over 65 years are affected by urinary incontinence. The disease is more common in women than in men, even in women at a younger age. Urinary incontinence occurs in conjunction with fecal incontinence, it is called by double incontinence.
Anatomy of the urinary tract
Urine is formed in the kidneys and urinary bladder (vesica urinaria) were collected. If a certain fullness of the bladder is reached, the urination occurs. The sphincter muscle (sphincter), which regulates the discharge of urine from the bladder into the urethra opens. The urine is discharged through the urethra, the bladder empties. In addition to the sphincter muscle are other groups involved in the process of urination, especially the pelvic floor muscles surrounding the bladder as an open top hopper. The so-called expeller-muscle (detrusor muscle) contracts and the bladder emptied in this way.
What causes urinary incontinence?
In many cases, the incontinence occurs as a side effect of treatment with medication. Urge incontinence is in most cases to an excessive activity of the detrusor muscle of the bladder due. Rare cause of urinary incontinence are disorders of the central regulation of urination, for example after a stroke or other neurological disorders. Inflammation of the urinary tract or tumors can lead to incontinence.
Causes in women
Especially in young women, a weakness of the pelvic floor muscles lead to urinary incontinence. Pregnancies and births, the pelvic floor muscles are severely stressed. However, even women who have experienced no pregnancies, develop a weakness of the pelvic floor.
In women, a reduction (prolapse) of the uterus is possible. By altered anatomic relationships can protrude bladder or bowel (cysto-or rectocele), so much pressure is exerted on the bladder. This may cause urinary incontinence.
Causes in men
Men can also develop a weakness of the pelvic floor and urinary incontinence will result. A common cause of urinary incontinence in men, the enlargement of the prostate gland (prostatic hyperplasia) is. Almost every man develops in old age a benign enlargement and induration of the prostate. Since the urethra passes through the prostate, they can be concentrated at a prostatic hyperplasia. The urine flow is obstructed, making it over the years can lead to urinary incontinence.
What are the signs of the urinary incontinence?
Urinary incontinence is characterized by the involuntary loss of urine from the bladder.
With stress incontinence of urine takes place mainly at increasing pressure in the abdomen, such as coughing, sneezing or laughing (stress incontinence grade I). If it comes to loss of urine during stress, such as climbing stairs, one speaks of a grade II stress incontinence, the bladder can not be consciously controlled even at rest, there is a third-degree stress incontinence.
When the urge or urge incontinence and urgency felt by the person concerned must be emptied shortly afterwards the bladder. If not, there is an involuntary loss of urine.
How is urinary incontinence diagnosed?
The first step to diagnose urinary incontinence is the detailed medical interview (medical history). This may in particular the possible causes and the type of incontinence can be defined. A urine sample is examined in the laboratory for possible signs of inflammation.
The physical examination includes men in the sampling of the prostate gland (prostate) via the rectum with a finger (digital rectal exploration).
To narrow down possible regularities and trigger for urinary incontinence, can be affected by the leading bubble diary may be helpful.
An ultrasound examination (sonography) of the bladder before and after urination tells you whether the bladder is emptied completely or whether residual urine remains in the bladder. Moreover, the structure of the bladder and kidney are directly assessed.
In the urological examination, the size of the prostate are more accurately determined. Also a reflection of the bladder (cystoscopy) may in certain issues apply.
The investigation at the woman doctor (gynecologist) provides information about the function of the pelvic floor muscles. Nor can this be assessed, for example, whether a reduction (prolapse) of the uterus and a bulging of the bladder (cystocele) or rectum (rectocele) is present.
Special investigations such as X-rays of the kidneys and urinary tract or the so-called urodynamics be performed at specific issues.
How is urinary incontinence treated?
Not in all cases, the treatment of urinary incontinence is necessary. Important are the severity of the symptoms and primarily the suffering of those affected. In many cases, symptomatic treatment is sufficient. This is to contribute to incontinence underwear or in the templates to use in men, condom urinals. In mild cases can also be worn panty liners.
In more severe cases, especially in elderly, bedridden people are recommended to wear diapers.
When the pelvic floor muscles of the pelvic floor muscles will be strengthened specifically, continence can be improved significantly. Other supportive measures are defined emptying times or bladder training.
Stress incontinence can usually be treated by surgery is best.
For example, the original anatomical conditions with a cysto-or rectocele by an operation to be restored (Kolporaphie). Alternatively there is the possibility of treatment by combining medication with pelvic floor exercises.
A relatively new method for the treatment of urinary incontinence is a bladder pacemaker. Here are the nerves that are responsible for the proper function of the bladder sphincter of significance, using an electric pulse generator (pacemaker) is stimulated. Before surgical treatment, which involves implanting a pacemaker, a test phase is performed with an external device.
Urge incontinence is treatable by medication well. Thus, the activity of the detrusor muscle that controls bladder emptying is inhibited. In some cases, surgery is used, for example, in men, the removal of a portion of the prostate through the urethra (transurethral resection of the prostate).
How is urinary incontinence?
The course of urinary incontinence depends significantly on the time of diagnosis and from the beginning of therapy. The treatment starts early, especially stress incontinence can be treated well and cured. Even with surgery, incontinence can be eliminated in many cases.
Many cases of urinary incontinence is a chronic course. Through the various options for treatment can usually at least the quality of life improved.
How can you prevent urinary incontinence?
Are there signs of urinary incontinence, should a doctor be consulted early in order to initiate proper treatment in time.
A preventive measure against urinary incontinence, particularly after a pregnancy and birth is the targeted strengthening the pelvic floor muscles.
Further questions about urinary incontinence can provide you expertise in urology for men or women in the doctor's expertise.
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