Problem for millions of women
You might also know this: The bladder doesn´t hold the urin any more and a few drops or a whole barrage of urin gets lost unintentionally. While this can be controlled still reasonably by sanitary towels, it becomes very uncomfortable when the urine can not be held any more at all. In the beginning you can still stand it for 10 minutes when you first get the urge to urinate, but then it gets shorter and shorter, until you no longer will eventually reach the toilet in time. Most women feel very uncomfortable with their problem and have difficulties to talk about their situation, it takes a great effort to overcome this. They also have difficulties to take and accept help as they often have made the experience that no one can help them properly. Instead, the everyday life is adjusted to the urinary incontinence and the whole life is set up around this. Accordingly, life must be planned that a toilet is constantly nearby. Social life and spontaneity is suffering a lot.
There are two types of incontinence: stress-and urge urinary incontinence. Stress urinary incontinence defines the uncontrolled loss of urine during stress when coughing, sneezing, climbing stairs or abrupt body movements. This form of incontinence is good treatable, as there are various,effective treatment options for quite some time.
The situation is different for urge urinary incontinence. Women who suffer from it, are not able to hold the urin properly or even hold the urine at all, they need to go immediately to a toilet for urination.
How arises urge urinary incontinence
At most women aged between 40 and 60 years starts a general weakness of the connective tissue. This means that the holding bands in the pelvis, involving uterus, vagina, bladder and intestine, lose their elasticity and also their holding function. A descensus of the pelvic organs is the consequence and this leads to urge incontinence.
For a better understanding the anatomical structures are represented as a bridge. Here, the bony structures pubis and ischium serve as the “pillars of the bridge”. The “roadway” (vagina) hangs on the front and rear holding ropes (PUL + USL).
- S= Ischium
- U =Uterus
- B = Bladder
- R = Rectum
- V = Vagina
- PB = Pubic Bone
- USL = rear holding bands
- PUL = front holding bands
If both ropes are intact, the bridge is fully functional. If a rope is loose however, the roadway becomes slack. The bridge (bladder) can no longer meet it´s function. If a rope is lying on the ground, there is no longer any control over the bladder and the woman loses urine at any opportunity. The clinical symptoms are usually the result of broken ropes – front, rear or in both places. They must be replaced, in order to fully restore the function of the bridge.
Urinary incontinence is not an independent disease, but a symptom of a disease of the bladder or weakness of the connective tissue of the ligaments and muscles in the pelvis.To initiate a successful therapy, the exact cause has to be determined first.
For this purpose, a detailed medical history (anamnesis) is taken. Using a special questionnaire, the individual history and other important factors are collected. These include for example questions about when an urine loss occurs or how long it is still possible to keep the urine in the bladder.
This is followed by a normal gynecological examination, which could be possibly completed by a ultrasound diagnosis. Within 15 to 20 minutes, this gives a reliable diagnosis where the defect – that is the cause of the incontinence – is and how to treat it.