Definition
Stress incontinence is one of the most common forms of incontinence. It occurs unconsciously and involuntarily during light to heavy strain. Through strain and tension of muscles in the body, the sphincter muscle of the urethra becomes permeable for a short moment and urine is expelled. Women are affected by this problem far more often than men.
Causes
The cause of stress incontinence in both women and men is weakness in the lower bladder muscles. As soon as there is increased pressure on the bladder, the sphincter muscle gives way and can no longer completely close off access to the urethra. As a result, urine flows out of the bladder.
Increased pressure on the bladder can occur, for example, when the bladder fills up strongly or when the pressure in the abdomen changes. Triggers for such pressure changes can be heavy lifting, coughing, laughing and movements such as getting up or walking. In severe cases, the muscle can also relax without any apparent cause when distracted by thoughts or lying down.
The causes of such advanced bladder weakness are numerous. Stress incontinence is significantly less common in men than in women. The pelvic floor muscles remain largely untouched and intact in men throughout their lives.
Only operations in the pelvic area can lead to unintentional injuries to the muscles. Prostate surgery, for example for cancer, is a typical cause of stress incontinence in men. The muscles of the pelvic floor are stressed much more in women than in men.
An important factor for stress incontinence in women is pregnancy. Pregnancy itself expands the uterus in the pelvis and exerts pressure on the surrounding organs – especially the bladder and pelvic floor muscles. A subsequent vaginal birth leads to a dilation of the muscles, which can largely regenerate, but in some cases leaves permanent damage.
In addition, many births require emergency surgery to dilate and cut the pelvic floor muscles to facilitate delivery. At an advanced age, women may experience possible organ subsidence of the organs of the pelvis and abdomen (see: pelvic floor subsidence) as well as gynaecological interventions. Anatomically, women are also generally affected by weakness of the bladder neck muscles in old age.
Particularly affected are women who perform additional strenuous physical work, are overweight and are not muscular or athletic. Pregnancy is probably the most common reason for stress incontinence. The growth of the child itself creates increased pressure on the bladder and even at this stage, stress-related incontinence can occur.
However, the birth process in particular can cause damage to the pelvic floor muscles. The muscles are stretched considerably during vaginal birth. In some cases they tear or an incision must be made by an obstetrician. Usually the pelvic floor muscles recover from a birth, but in rare cases permanent damage may occur. Through targeted training after birth, rapid healing can be promoted and accelerated.
