Symptoms
People who suffer from urge incontinence typically describe a pronounced urge to urinate. In addition, there is a recurrent involuntary loss of urine in the course of the disease. Persons suffering from urge incontinence usually notice a significantly increased frequency of urination.
Depending on the severity of the disease, those affected report having to go to the toilet more than eight times a day.However, only the smallest amounts of urine can be excreted each time you go to the toilet. Frequently, urine is already lost before going to the toilet. Furthermore, it can be observed that people with urge incontinence also often suffer from the nightly urge to urinate.
The classic urge incontinence patient must visit the toilet more than once a night. This phenomenon is generally referred to as “nocturia”. In older patients, the nightly urge to urinate can be particularly problematic. The reason for this is the fact that elderly people often have a limited wakefulness due to the nightly urge to urinate. On the way to the toilet, falls with far-reaching consequences can occur frequently for this reason.
Diagnosis
Due to the different forms of urinary incontinence, appropriate treatment can only be initiated after a detailed medical diagnosis. During the diagnostic process, it must be determined what form of urinary incontinence the person has and how severe the symptoms already are. The fact that most patients do not consult a doctor until the pressure of suffering has become unbearable is particularly problematic.
The fear of being examined and the shyness to describe the symptoms to a specialist mean that suitable treatment can usually only be initiated at a very late stage. The diagnosis of suspected urge incontinence involves several steps. In the majority of cases, urinary incontinence can be diagnosed as such during a detailed doctor-patient consultation (anamnesis).
In particular, the so-called “micturition anamnesis”, which includes various questions regarding urinary behaviour, plays a decisive role in the diagnosis. In addition, the patient’s lifestyle can provide an indication of possible risk factors. For women who may suffer from urge incontinence, the menstrual cycle, menopause, pregnancy and childbirth are also important topics of discussion.
In addition, the recording of toilet visits is an important part of the basic diagnosis of suspected urge incontinence. Affected persons should record the number of times they go to the toilet and the amount of urine they urinate over a period of two to three days. The doctor-patient consultation is followed by a physical examination.
The clinical diagnosis includes an external examination of the abdomen, examination of the external genitals, a rectal examination and the so-called cough test. This test determines whether the affected patient loses urine under stress (i.e. when coughing) when the bladder is filled to medium capacity. This would indicate stress incontinence rather than urge incontinence. If the suspicion of the presence of urge incontinence is confirmed, further diagnostic measures must urgently be initiated. The most important methods for further diagnosis of suspected urge incontinence include
- Bladder examination
- Urodynamics
- Uroflowmetry
- Neurological examinations
- Laboratory tests