Synonyms
Overactive bladder
Definition
Urge incontinence is a bladder voiding disorder in which the bladder muscle involuntarily contracts even at a low level. The term “urge incontinence” describes a complex of symptoms in which those affected suffer from a frequent urge to urinate even at low bladder volumes, nocturnal urination and involuntary loss of urine. Each of these symptoms in detail and especially the combination of these symptoms represent a major stress test for the persons concerned.
Because the urge to urinate cannot be suppressed, involuntary loss of urine often occurs in the affected individuals. Depending on the degree of urge incontinence, even the normal daily routine can no longer be completed. In general, it can be assumed that men in particular suffer from urge incontinence.
In women, however, other forms of urge incontinence are much more common. For men, urge incontinence is the most common form of urinary incontinence at any age. In women under 50, however, so-called stress incontinence is much more common.
Only after the age of 50 does the probability of developing urge incontinence in women increase. Both urinary incontinence in general and urge incontinence in particular are characterized by a strong taboo in today’s society. Since the ability to control the bladder muscles represents a milestone in early childhood development, a loss of control can be very stressful for the person affected.
People who lose control of the bladder often begin by isolating themselves out of shame. Because of the widespread concealment of this issue, it is particularly difficult to make accurate statements about the frequency of urge incontinence. However, it can be assumed that in Germany alone, approximately six to eight million people suffer from urge incontinence. It can also be observed that the probability of the occurrence of urge incontinence increases with increasing age.
Causes
The causes for the occurrence of urge incontinence can be manifold. In general, a distinction must be made between the motor and sensory forms of urge incontinence. Motor urge incontinence is primarily caused by an uncontrollable contraction of the detrusor vesicae muscle (synonym: urinary expeller).
This muscle is a roughly bundled network of smooth muscle cells which are embedded in the bladder wall. The contraction of the detrusor muscle leads to emptying of the bladder (so-called micturition). The reason for the uncontrolled contractions occurring in mechanical urge incontinence is the failure of the central inhibition of the bladder muscle.
Thus, motor urge incontinence is in no way based on the brain receiving false impulses regarding the filling level of the bladder. Motor forms of urge incontinence can be observed especially in people suffering from neurological diseases. Typically, mechanical urge incontinence develops mainly in patients with Parkinson’s disease, Alzheimer’s disease and polyneuropathies.
In addition, various brain tumors are possible causes of urge incontinence. Sensory urge incontinence, on the other hand, is based on an amplification of the impulses of the bladder wall that rise to the brain. For this reason, the signal of a completely filled bladder is typically sent to the brain even with a small bladder volume.
As a result, even small volumes of urine cause the affected persons to suffer from a pronounced urge to urinate. An uncontrolled contraction of the detrusor vesicae muscle cannot be observed in sensory urge incontinence. Common causes of this form of urge incontinence are tumors, bladder stones or inflammatory processes. In the case of urge incontinence, the fact is that a cause can only actually be found in about 20 percent of affected patients. In most cases, the genesis of urge incontinence remains unclear.
