Extraurethral urinary incontinence

In addition to the five main forms of urinary incontinence already mentioned, there are a few less frequent special cases that should also be mentioned here. In extraurethral urinary incontinence, women experience short circuits between the bladder and the vagina. Since the bladder and vagina are anatomically adjacent to each other, malformations can lead to a connection between the bladder and vagina.

At a certain filling level of the bladder, urine can overflow into the vagina through this connection and then out of the body through it. Since the vagina does not contain any sphincter muscles that would be sufficient to retain urine, the urine runs out of the body uncontrollably, which is perceived by the affected person as incontinence. However, the actual urinary tract is mostly functionally preserved, but it is usually very difficult for the patient to distinguish between urine “from the urethra” and urine “from the vagina”.

This fact can make it difficult to find the cause. In addition to the connection between the bladder and the vagina, there may also be a short circuit connection between the urethra and the vagina. Symptomatically, this form of extraurethral urinary incontinence does not differ from the above, although there are differences in the therapeutic approach.

In addition to congenital malformations, these short circuit connections can also occur after radiotherapy or surgery.Often they are not noticed for a long time because they are very small or are ignored. Above a certain volume of urine, however, incontinence is perceived as a nuisance, which is why a gynecologist should be consulted at the latest then. A further malformation is the so-called “urethra diverticulum”, in which urine accumulates in the urethra behind the bladder in a sac of the draining urinary tract.

This type of “reservoir” is filled with each micturition and then emptied involuntarily with certain movements. Since no closing muscles can close the urinary tract behind the bladder outlet, the urine flows out of the body undisturbed via the urethra. These bulges can also occur after radiation or surgery for no particular reason, but can usually be removed relatively easily by surgery. The causes and forms of urinary incontinence are therefore varied, but they can usually be treated well.