Why is urinary incontinence serious
What is urinary incontinence?
Bladder weakness, also known as urinary incontinence in technical jargon, is a disease that patients often conceal because it is still taboo in many places today. However, incontinence should be taken seriously. Doctors already speak of a weak bladder if only a few drops of urine involuntarily leak out. The severity of the disease can range from a few drops of urine to a permanent loss of urine without the possibility of holding back even the smallest amounts of urine.
Almost 50% of all women over 50 will suffer from bladder weakness at some point in their life. In Germany alone, it is assumed that at least 5 million women and men are affected.
What types of incontinence are there and how do they arise?
Urge incontinence (urge incontinence)
With this type of bladder weakness, patients often feel a very strong urge to urinate, which occurs suddenly. Usually this urge is so great that the patient cannot even go to the toilet. In extreme cases, urge incontinence can even occur several times an hour.
Learn more about urge incontinence
In stress incontinence, the pelvic floor muscles are weakened to such an extent that an unwanted flow of urine occurs when the abdominal cavity is stressed. Heavy physical work, but also lifting heavy objects as well as coughing and sneezing can stimulate the unwanted flow of urine here. Stress incontinence can be so advanced that affected patients inadvertently leak urine with every movement, whether standing or lying down.
Learn more about stress incontinence
Affected patients do not feel their bladder well in this case. Due to neurological damage (paraplegia, Parkinson's disease or multiple sclerosis) cannot tell whether the bladder is filled or emptied. Rather, the bladder empties itself reflexively, the patient usually has no arbitrary influence on it.
As soon as the bladder fills, it involuntarily “overflows” in this form of incontinence. The sphincter muscles do not work properly, mostly due to neurological damage. Overflow incontinence can also be caused by an enlarged prostate (for example in the case of a benign Prostatic hyperplasia ), in which the enlarged prostate forms an obstacle for the bladder so that it cannot empty completely and the bladder therefore always remains overfilled.
The cause of this form lies outside the urinary tract. This disease is often accompanied by a small, pathological connecting canal (so-called fistula duct) that connects to the urinary tract and flows into the intestine or vagina of the woman. The patients therefore have absolutely no influence on the flow of urine, because this channel was created unnaturally.
What treatments are available for incontinence?
Patients who suspect incontinence should consult a doctor, for example with a urologist. Specialized doctors can provide the patient with a clear diagnosis and create an individual therapy plan for it, especially since there are no general therapy recommendations, especially for incontinence. In general, the sooner medical contact is sought, the better the chances of therapy.
Conservative incontinence therapy
The following treatment options can improve urinary incontinence in most cases:
Overview of incontinence surgical methods
The tension-free plastic tape (TVT, tension free vaginal tape)
Involuntary flow of urine in women, which occurs, for example, when laughing, sneezing or coughing, can be treated with a simple band operation. The natural band that holds the urethra in place is stabilized by a one and a half centimeter thick plastic band. To do this, a small incision is made in the vagina and the band is attached in the middle area of the urethra and directly to the pubic bone or it is passed around the pubic bone and fixed there.
It is a very simple and uncomplicated surgical procedure that only takes 20 to 30 minutes, but has a very high success rate. The patient undergoes spinal anesthesia, the anesthesia is usually placed near the lower spinal cord and can leave the clinic after four days, in some cases earlier.
The gel pad
As an alternative to tape surgery, the urethra can be narrowed using a special gel pad. The specialist injects an insoluble hydrogel depot (Bulcamidgel) into the proximal area of the urethra, thereby narrowing the urethral lumen. The result is an improved closure of the urethra and the continence of affected patients improves. This procedure is also quite simple and can take place under local anesthesia.
In some cases where stress incontinence is present, lifting the bladder neck (from a functional point of view, the bladder neck is the most important part for maintaining continence) via a small incision in the lower abdominal area can help - alternatively, keyhole surgery can also be used here. To do this, several sutures are placed in the adjacent tissue of the urethra and the bladder neck can be effectively lifted by pulling it. The retropubic colposuspension is a simple but very promising intervention in the urogenital system that can relieve stress incontinence in those affected.
Incontinence therapy for men
In men who have incontinence due to a benign prostate tumor, transurethral prostate resection can also be used. Here, the prostate is completely or partially removed so that the urinary bladder can work naturally again and continence is restored.
If maintaining continence proves to be very difficult, a catheter - a small tube - can also be used, which has surgical access to the urethra. This has the task of emptying the bladder manually. Permanent or temporary catheters are used for this.
Which specialists and clinics are specialists in urinary incontinence?
Anyone who suffers from urinary incontinence asks themselves: Which doctor is the right contact for my problem. First of all, you should speak to your family doctor or gynecologist. He can decide whether a referral to a urologist or a continence center is necessary. A list of continence and pelvic floor centers and medical advice centers in Germany, Switzerland and Austria can be found at German continence society or on this page.
If you suffer from involuntary loss of urine and have therefore not yet consulted a doctor, do not hesitate to contact one of our experts. With early diagnosis and rapid intervention, urinary incontinence can be treated very well and, as a rule, always improved!
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