Urinary incontinence is a disease that affects about twice as many women as men and increases with age. About half of all women and a good quarter of all men suffer from urinary incontinence over the age of 65. The prevalence increases with age and reaches its highest levels towards the end of life.
For patients, the disease usually represents a high psychological burden. Since the urge to urinate cannot be sufficiently restrained, different forms of urine leakage occur, depending on the type of urinary incontinence. This is sometimes not noticed and only becomes noticeable through the distinctive urine smell.
Patients suffer greatly from this, as theater evenings, long journeys, and social occasions in general become a veritable gauntlet. The word incontinence comes from the Latin (“incontinentia”), and means as much as not behaving. Urinary incontinence generally describes the inability to retain urine.
Urinary incontinence can have many different causes. Depending on the mechanism, the therapy also depends on it and the chances of recovery are more or less poor. The different forms are discussed below.
Stress incontinence
According to its name, this form of urinary incontinence leads to urine leakage after or during physical exertion. Physical strain can be climbing stairs in the simplest case, but laughter or coughing can also lead to urine leakage. The mechanism behind this is the following: coughing or laughing tenses the abdominal muscles, which shortens.
As a result, the organs in the abdominal cavity are briefly pressed closer together. In addition, the coughing causes a short-term, strong pressure on the abdomen. In combination, this results in a considerable increase in pressure, which compresses the bladder.
The pelvic floor muscles can no longer withstand this increase in pressure, so that urine is discharged. The pelvic floor muscles are a multi-layered network of muscles that are stretched in the pelvis. Due to its natural basic tension it presses on the urethra and closes it.
However, if it is damaged for various reasons, coughing, laughing or climbing stairs can be enough to express the urethra. Reasons for damage or slackening of the pelvic floor muscles can include: surgical interventions in the pelvis, childbirth – the risk of urinary incontinence increases with the number of births until it falls again after the 4th birth, although the reasons for this are not known. Furthermore, neurological failures, tumors and constant heavy physical strain are considered the main causes of stress or strain incontinence. For a more precise classification, a distinction is made between three degrees of severity: Grade 1: Urine loss when coughing and laughing Grade 2: Urine loss when walking and running Grade 3: Urine loss when lying down without any physical strain
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