Incontinence
Synonyms
Synonyms for "incontinence" are Wetting, enuresis, urinary incontinence
introduction
The term "Incontinence" does not just refer to a single clinical picture. Rather, this term includes a Range of diseases, in which substances of the organism cannot be regularly retained.
In medicine one differentiates between the Stool and urinary incontinence. In addition, this is also uncontrolled Dripping milk from the mammary glands (milk incontinence) and the inability to do that Escape of intestinal gases to prevent (Flatulence), assigned to the umbrella term "incontinence".
Under the term Urinary incontinence one understands in medical terminology the (age-related) loss or that Failure to learn the skill, the Store urine in the urinary bladder without loss.
As a rule, the affected patients cannot decide for themselves when and where the urinary bladder should be emptied. By definition there is one Incontinence ready then, if only tiny drops of urine uncontrolled and unintentionally from the bladder escape.
The term Fecal incontinence on the other hand describes a condition in which the affected patient is unable to cope with his bowel movement and / or its bindweed withhold arbitrarily.
In most cases they are elderly affected by this type of incontinence.
From different pathological reasons however, it can also be young patients fecal incontinence develops. Both in the presence of fecal incontinence and in the development of Urination disorders it can be enormous physical and psychosocial stress of those affected come.
Many patients at the Stool or urinary incontinence suffer, feel in theirs Everyday life severely restricted and for this reason withdraw more and more from their social environment. The inability to hold back urine or stool is a particular problem for young patients enormous stress situation represent.
All Forms of incontinence have in common that the initiation of a suitable form of therapy is a extensive diagnostics should precede. Continence problems of all kinds can be regulated relatively well with many causes.
Some underlying diseases can even be cured and the Incontinence thus completely eliminated become. For this reason, treatment should be urgently addressed to causal disease be adjusted.
Please also read our article on this Bladder weakness.
Forms and causes of urinary incontinence
The inability to fully store urine in the bladder is divided into several forms. The most common types of incontinence are the so-called urge incontinence, stress or stress incontinence and overflow incontinence.
Learn more about the Bladder and rectum disorder.
Urge incontinence
The so-called Urge incontinence is characterized by a sudden occurrence strong urge to urinate out.
In many cases, the affected patients are no longer able to reach a toilet in time. The cause of this form of incontinence are Bladder muscle contractions often caused by local inflammation (for example a Cystitis) caused.
More common reasons for the Development of urge incontinence are Nervous system disorders how Alzheimer's disease, multiple sclerosis and the Parkinson's Syndrome.
Stress incontinence (stress incontinence)
The Stress or stress incontinence is in most cases through a Increase in pressure in the area of the abdomen triggered.
Reasons for an appropriate Pressure increase can Stress, straining, laughing, coughing or sneezing be.
This form of incontinence is clinically in three degrees classified (severity according to Starney). At slight manifestations stress incontinence (Grade 1) Coughing, laughing and sneezing lead to uncontrolled leakage of urine from the bladder.
Patients involved in a 2nd degree urinary incontinence suffer, however, already lose sudden onset of body movements, getting up or sitting down and lifting light weights large amounts of urine.
The Grade 3 stress incontinence is characterized by excessive urine leakage with actually less strenuous movements and / or lying down.
This form of incontinence can be common in women Result of multiple spontaneous births through which it becomes a Overstretching and relaxation of important structures of the pelvic floor come his.
As a result, there is a partly strong Lowering of the organs of the small pelvis and to the development of an inadequate sealing pressure in the area of the urethra. In men, this type of incontinence often arises as a result of one traumatic damage to the bladder occlusive muscles. Usually are Operations on the prostate (radical prostatectomy) or accidents.
Read more about the topic here: Stress incontinence
Mixed incontinence
The so-called Mixed incontinence represents a Combination of stress and urge incontinence represent.
Overflow incontinence
In so-called overflow incontinence, there is usually a drainage disorder. As a result of the reduced urine outflow, a permanently overly filled urinary bladder develops.
Over time, the enormous pressure load on the urinary bladder ensures that the closing pressure of the outer bladder sphincter is exceeded.
An effective retention of the urine is no longer possible at this point.
The direct cause of this form of incontinence is the obstruction of the urinary tract. This relocation, in turn, can be triggered by various factors.
In men, a benign enlargement of the prostate is the main cause. Over time, an enormous increase in prostate tissue leads to constrictions in the area of the urethra (urethral stricture).
Another cause for the development of urinary incontinence or for the development of an obstruction to the drainage of the urinary tract is high-grade stenosis of the urethra itself.
Various neurological diseases that lead to relaxation of the detrusor muscle can also provoke overflow incontinence. Some patients develop this form of incontinence as a result of poorly controlled diabetes mellitus. Since the urine flows back into the ureters due to the permanent, excessive filling of the bladder in some cases, the affected patients are at increased risk of developing renal insufficiency (loss of kidney function). In addition, there is no so-called urine poisoning (uremia) in the course of this form of incontinence.
Also read the article on the topic: Urinary poisoning
Reflex incontinence
Cause of Reflex incontinence is a Disorder of the brain outgoing inhibitory nerve impulses which are sent to the urinary bladder.
As a result, there is one The predominance of activity impulses between Urinary bladder and spinal cord.
This excessive activation triggers at the bladder a knee-jerk contraction of the detrusor muscle and thus the Urination out. Furthermore, an incomplete emptying of the urinary bladder with detectable Residual urine to the typical symptoms of reflex incontinence.
This form of incontinence can be found mainly in patients with Paraplegia above the bladder center observe. Further causes for the development of such incontinence are degenerative diseases of the nervous system (for example multiple sclerosis).
Overactive bladder syndrome
In the case of the syndrome of overactive bladder the affected patients experience a sudden, non-suppressible urge to urinate. In many cases, the patient is hardly able to go to a toilet in time.
Affected people usually have a Micturition frequency (Frequency of going to the toilet) of at least 8 times per 24 hours on. Reasons for the occurrence of this form of incontinence can be inflammatory processes in the Lower urinary tract area (Urinary bladder, urethra), Narrowing of the urethra, benign or malignant changes in the prostate or neurological dysfunction be.
In the majority of patients, however, there can be no exact cause for the development of the Overactive Bladder Syndrome be detected.
Laughing incontinence
The so-called Laughing incontinence Usually affects children between the ages of 5 and 7. Are particularly often affected young girls who are at the beginning of puberty. Laughter incontinence manifests itself through one Loss of bladder control while laughing.
In contrast to the rest Forms of incontinence are both the Urinary bladder apparatus, and the adjacent organs perfectly healthy and functional. The affected children usually do not feel the urge to urinate before wetting.
therapy
The Therapy of incontinence is by no means uniform. For each patient, both the exact form and the exact cause of the incontinence must be determined prior to initiating suitable treatment.
In some cases, affected patients can be treated quite well. In the case of laughing incontinence in childhood, a temporary treatment with Medicines such as methylphenidate be useful. In addition, the implementation is more special Exercises to strengthen the pelvic floor muscles (Pelvic floor training) is particularly helpful. Patients who participate in the Overactive bladder syndrome In most cases, ailments can only be treated symptomatically. A complete cure is usually not possible.
Should be a Enlargement of the prostate If the cause of incontinence in men is, the treatment can be operative.
