Therapy

The forms of therapy vary greatly depending on the form of urinary incontinence. In the case of stress incontinence, an attempt must be made to strengthen the pelvic floor muscles. This is achieved by pelvic floor training.

Weight reduction can also help to reduce intra-abdominal pressure. Oestrogens can be given as medication, such as “Duloxetine” to improve the strength of the occlusive muscle. If a conservative therapy by training the pelvic floor muscles is not sufficient, a so-called tension-free tape (TVT) can be surgically inserted into the pelvic floor, which artificially supports the pelvic floor muscles and the urethra.

This procedure usually takes no longer than half an hour. In cases of urge or urge incontinence, an attempt is made to reduce the hyperactivity of the bladder wall musculature by means of spasmolytics. As these are relatively associated with side effects (dry mouth, tachycardia, glaucoma), botulinum toxin can also be injected into the bladder wall as a second-choice remedy.

In this way a relaxation of the bladder muscles is achieved. However, this procedure must be repeated at regular intervals. In the case of neurologically caused reflex incontinence, a bladder pacemaker can be implanted, among other things, to rebalance the interaction between the bladder wall muscles and bladder occlusion muscles.

It is also possible to drain the urine from the bladder prematurely by means of self-catheterization. However, many patients find this procedure unpleasant. For all forms of urinary incontinence, the option of a surgical procedure is also available. Especially in the case of malformations or tumorous processes, surgery is usually unavoidable. In many cases, however, a freedom from symptoms can be achieved.

Risk factors and prophylaxis

Risk factors for urinary incontinence include permanent, heavy, physical work, surgical interventions in the pelvis and radiation therapy. However, these can often not be avoided, so that urinary incontinence remains a “lesser evil”. With every birth, the risk of suffering from urinary incontinence later increases.

After the fourth birth, this risk decreases slightly for unknown reasons. The entire pelvis is stretched severely with each birth and the muscles in this area become increasingly slack. Therefore, the urethra can no longer close sufficiently.

Simply exercises for home prevent this: Pelvic floor training does not necessarily have to be done in a gym or with elaborate equipment. Although special courses are offered and usually covered by health insurance companies, training can also be done at home. All that is important is a certain regularity and intensity of the training intervals, as the muscles have to be built up specifically. If the training is carried out consistently, there is a significant improvement within a few weeks. The pelvic floor training can be supportive for several types of incontinence, but for incontinence types such as overflow incontinence, further therapy is always necessary.