Expenditure on incontinence aids is increasing from year to year. Therefore, among other things, it has become an important health policy goal not only to treat the “widespread disease” of bladder weakness, but also to prevent it through targeted prevention or to improve the chances of recovery through early detection.
Therapy for stress incontinence
If the cause of urinary incontinence is weak pelvic floor muscles, active training of the muscles helps in addition to any necessary weight reduction. Daily gymnastics, initially with professional guidance and later on your own, tones the pelvic floor muscles, strengthens the sphincter and straightens the urethra. Physical therapy has a supporting effect. If there is no satisfactory treatment success after a few months, surgical intervention will have to be considered. If the bladder is sagging, pelvic floor training is also the first choice. In severe forms, correction of the position of the bladder by surgery is indicated. If the weakening of the urethral closure is due to menopause, drug replacement of the missing estrogens (prescription) can eliminate the symptoms; however, this should only be done under specialist supervision (gynecologist).
Treatment of urge incontinence
In the first place, cystitis or bladder cancer must be ruled out and treated if necessary. If the bladder receptors are overstimulated, bladder teas and heat or phytotherapy, that is, taking herbal medicines, help in mild cases. These include, for example, extracts from pumpkin seeds, from nettle root, from goldenrod or nasturtium oil. Some of these medications are available in pharmacies, others in drugstores. More severe forms require medical treatment. Effective here are antispasmodic drugs from the group of anticholinergics such as
- Oxybutynin
- Propiverine
- Tolterodine or
- Trospium chloride (all prescription).
They inhibit the contraction, that is, the contraction of the bladder muscle, where the strong urge to urinate subsides. Treatment should last at least six weeks. Some of the medications may cause dry mouth at first, but you should still continue the therapy. After a few days, the feeling of dry mouth will disappear. Until then, simply suck candy or chew gum to promote saliva flow. In addition, physiotherapeutic measures should not be omitted. Those affected themselves can, for example, prevent the urge to urinate by toilet training, i.e. emptying the bladder at set times, and avoid involuntary loss of urine. For psychological causes, autogenic training often helps, for example.
Therapy for overflow incontinence
Early forms of prostate-related bladder voiding disorders can be favorably influenced by herbal medications (see also benign prostatic hyperplasia). Effective here are extracts from pumpkin seeds, from sabal fruit, from stinging nettle roots or beta-sitosterols from vegetable oils (some available only in pharmacies). Drugs from the group of alpha-receptor blockers (available only on prescription) are also used. Among other things, they inhibit the alpha receptors at the bladder neck, which are responsible for good bladder closure. The bladder closure is thus loosened and the outlet resistance is reduced. So-called 5-alpha-reductase inhibitors (available by prescription) can also lead to an improvement in bladder emptying by reducing the size of the prostate. In advanced stages, removal of the prostate may be necessary. If prostate cancer is suspected, specialist therapy (urologist!) is essential.
Urinary incontinence: prevention
In the first place of prophylaxis for urinary incontinence is a healthy lifestyle, especially normal weight, conditioned by a healthy diet and adequate exercise. A balanced mixed diet, avoiding too much fat and sweets, prevents overweight from occurring in the first place, or helps to reduce it if necessary. A sensible diet also helps to regulate digestion. Constipation leads to excessive strain on the pelvic floor due to heavy pressing during defecation, which in turn promotes incontinence. Exercise burns calories, helps reduce weight, and helps improve body awareness. In addition, all measures that promote blood circulation (sauna, Kneipp baths, alternating baths, etc.) are useful. Stress incontinence mainly affects mothers.Even during pregnancy, her pelvic floor is under a lot of strain from the weight of the baby. To avoid incontinence in later years, a controlled perineal incision during childbirth helps prevent muscle tears. After childbirth, good postnatal exercises include intensive pelvic floor training to re-strengthen the overstretched muscles. Pelvic floor training is a preventive measure against urinary incontinence at any age, even at a young age, especially for people in “sitting jobs”. So with targeted prophylaxis and therapy, urinary incontinence can be well managed.
