Urge incontinence

Synonyms

Overactive bladder

definition

Urge incontinence is a voiding disorder in which the Bladder muscle involuntarily already at one low capacity contracts.

introduction

The term "Urge incontinence“Describes a complex of symptoms in which those affected with a frequent urge to urinate already with small bladder volumesurinating at night, and involuntary loss of urine.

Each of these symptoms in detail and especially the combination of these complaints represent a major one for the person concerned Endurance test represent.
Due to the urge to urinate, which cannot be suppressed, the affected person often experiences a involuntary leakage of urine.
Depending on the severity of the urge incontinence, even the normal daily routine can no longer be completed.

In general it can be assumed that especially men suffer from urge incontinence. In women, however, other forms of urinary incontinence are much more common.
In the male sex, urge incontinence is the most common form of urinary incontinence at any age.

In women under 50, however, a so-called Stress incontinence observe.
Only after the age of 50 does the likelihood of urge incontinence develop in women increases.
Both urinary incontinence in general and urge incontinence in particular are characterized by a strong taboo in today's society.

Because the ability to control the Bladder muscles A milestone in early childhood development can be a loss of control for those affected psychologically very stressful be. People who lose control of the bladder often begin to isolate themselves out of shame.

Due to the widespread concealment of this topic, it is particularly difficult to give precise information about the frequency of urge incontinence.
However, it can be assumed that in Germany alone approximately six to eight million People who suffer from urinary incontinence.
It can also be observed that the likelihood of the occurrence of urge incontinence with increasing age increases.

Please also read our article on this Bladder weakness.

causes

The causes for the occurrence of urge incontinence can be diverse.
In general, if there is an existing urge incontinence, between the motor and sensory Disease form can be distinguished.

The motor urge incontinence is mainly caused by a uncontrollable contraction of Detrusor vesicae muscle (Synonym: urinary expeller).
This muscle is a roughly bundled network smooth muscle cellsthat are in the Bladder wall are let in.
The contraction of the detrusor muscle leads to an emptying of the urinary bladder (so-called micturition).

The reason for the uncontrolled contractions that occur in mechanical urge incontinence is the failure of the central one inhibition of the bladder muscle.
Motor urge incontinence is by no means based on the fact that the brain receives incorrect impulses regarding the filling level of the urinary bladder.
Motor forms of urge incontinence can mainly be found in people who have neurological diseases suffer, watch.

Typically it mainly occurs at Parkinson's disease, Alzheimer's disease and Polyneuropathies to develop mechanical urge incontinence. There are also several Brain tumors as a cause for the development of urge incontinence.

Sensory urge incontinence, on the other hand, is based on an amplification of the impulses of the urinary bladder wall that rise to the brain. Typically, for this reason, a low bladder volume sends the signal of a completely filled bladder to the brain.

As a result, the affected persons suffer from a pronounced urge to urinate even with small volumes of urine.
An uncontrolled contraction of the detrusor vesicae muscle cannot be observed in sensory urge incontinence.
Common causes for this form of urge incontinence are Tumors, bladder stones or inflammatory processes.

In the case of urge continence, the fact applies that a cause can actually be found in only about 20 percent of affected patients. In most cases, the genesis of urge incontinence remains unclear.

Symptoms

People who suffer from urge incontinence typically describe a severe one Urge to urinate.
In addition, in the course of the disease it comes to recurring involuntary Loss of urine. As a rule, people with urge incontinence notice a significantly increased frequency of urination.

Depending on the severity of the disease, those affected report more than eight times a day Having to go to the bathroom.
However, every time you go to the toilet, only the smallest amounts of urine can be excreted. Urine leakage often occurs before going to the toilet.

Furthermore, it can be observed that people with urge incontinence also often have nocturnal urge to urinate Suffer.
The classic urge incontinence patient has to per night more than once go to the toilet.
This phenomenon is commonly referred to as "Nocturia" designated.
In older patients, the urge to urinate at night can be problematic. The reason for this is the fact that older people often only wake up to a limited extent from the urge to urinate at night.
Because of this, it can accumulate on the way to the toilet Fall come with far-reaching consequences.

diagnosis

Due to the different forms of urinary incontinence, suitable treatment can only be initiated after a detailed medical diagnosis.

As part of the diagnosis, it must be determined what shape urinary incontinence is present in the person affected and how severe the symptoms are.
Particularly problematic is the fact that most patients do not see a doctor until he has The suffering is unbearable has become.
The fear of examinations and the reluctance to describe the existing complaints to a specialist lead to that in most cases very late Appropriate treatment can be initiated.

The diagnosis of a suspected presence of urge incontinence comprises several steps.
In the majority of cases, the urinary incontinence disease can already be extensive during one Doctor-patient conversation (anamnese) can be diagnosed as such.

Especially the so-called "Micturition history“, The various questions regarding the Urinary behavior includes, plays a crucial role in diagnostics. In addition, the Habits give the patient an indication of possible risk factors.

In women who may suffer from urge incontinence, are also the Menstrual cycle, the Menopause or the insertion of the menopause, Pregnancies and Births important content of the conversation.

In addition, logging of the Going to the toilet an important part of the basic diagnosis of suspected urge incontinence. Affected persons should use the toilet and the number of times over a period of two to three days Amount of urine note.

The doctor-patient conversation is followed by one physical examination.
The clinical diagnosis includes an external assessment of the abdomen, the examination of the external genital organs, one rectal exam and the so-called Cough test.

This test determines whether the affected patient is under stress with moderate bladder filling (so when coughing) Leaks urine. This would be less of a urge incontinence than a Stress incontinence Clues.

If the suspicion of urge incontinence is confirmed, further diagnostic measures must urgently be initiated.

To the main methods count in the further diagnostics of suspected urge incontinence

• Cystoscopy
• Urodynamics
• Uroflowmetry
• neurological examinations
• Laboratory tests

therapy

The treatment of urge incontinence depends largely on the underlying disease. Treatment of the disease that leads to urge incontinence is therefore mandatory.

If no direct cause for the development of urge incontinence can be found, one should medical therapy be initiated.
Urge incontinence is usually treated with drugs that have the parasympathetic innervation of the detrusor vesicae muscle or apply directly to the bladder muscle.

For this reason, the intake of so-called Parasympatholytics, Beta sympathomimetics or tricyclic antidepressants.
In cases where there is a purely sensory urge incontinence without involuntary contractions of the urinary muscle, the treatment can be more complicated.

Urge incontinence occurs in women in combination with diseases of the internal female genital organs without an overactivity of the detrusor vesicae muscle can be detected, the local application of Estrogens may relieve the symptoms.

In addition, the drug therapy of urge incontinence should always be carried out by a Bladder training or one psychotherapy can be added.

prevention

Whether the development of urge incontinence can actually be prevented has so far been rather controversial. Nevertheless, certain measures should be taken early on when people are at risk.

Since every form of urinary incontinence is often caused by a weak pelvic floor provoked should already young women start making the To strengthen muscles.
The earlier the Pelvic floor muscles the less the damage is trained.
In this context, both targeted gymnastics, as well as regular riding effectively train the pelvic floor muscles.

It also increased chronic cough constant pressure on the pelvic floor and the muscles of the bladder wall. There Smoker suffer from chronic cough particularly often, people at risk should stop smoking early.

Furthermore can excessive body weight strain the pelvic floor.
For this reason, obese people have been shown to be significantly more at risk of developing urge incontinence. In addition, it can often be observed that many people with urinary incontinence deliberately drink far too little.
In this way they try to reduce the urge incontinence. It can actually be permanent too small amount of drink make urinary incontinence worse.

Only the regular filling of the bladder can train the bladder muscles. However, if the bladder is only slightly filled, it can Capacity decrease significantly over time.

In addition, the reduction in the daily amount of drinking has been shown to increase the risk of developing Infections. The reason for this is the fact that bacterial pathogens are no longer flushed out and settle in the bladder and urethra can settle.

forecast

Both the course and the prognosis of urge incontinence depend to a large extent on the causal disease from.
Since the treatment of the underlying disease is an important pillar in the treatment of urge incontinence, the prognosis of this form of urinary incontinence is much better if the cause is known.
In addition, that also plays Age of the affected person plays a crucial role.

Urge incontinence can only be treated to a limited extent, especially in people who have reached the age of 70.For this reason, it is important for the affected patients that the nocturnal urination can be made possible in a short way.

A so-called Commode chairthat should be positioned near the bed can often help.