Urinary incontinence

The strain urine incontinency is a result of a constrictor deficiency of the bladder. Contrary to men whose complaints often caused by operations with a nearness to the constrictor, with women many reasons take effect: so the age, the number of child births and the body weight play an important part. Often a weakness of the whole floor of the pelvis can be found. The drive incontinence is expression of an increased stimulation of the sensitive (responsible for the sensitivity) or the motor nerves (responsible for activating the muscles). The reason for the manifold and reach from inflammations of the bladder, respectively, urethral mucosa up to mucosal tumors, nerve diseases, prostatic hyperplasia (BPH) with men up to bladder and uterus sinking with women.

Strain urine incontinency: uncontrolled loss of urine that is occurring due to physical strains like (coughing, laughing, sneezing, walking and so on) without a respective desire to void.
Drive incontinency: uncontrolled loss of urine after an uncontrollable desire to void.

The basic diagnostic contains taking an anamnesis (number of child births, frequency and conspicuities during urination, time of occurrence for the urine loss, other diseases), the examination of the body (signs for the bladder and/or uterus lowering as well as oestrogen deficiency in the vulva of women, size and character of the men’s prostate), an urine screening (exclusion of an urinary tract infection), an ultrasound examination of the urine bladder (conspicuity of the bladder wall, voidance disorders) as well as filing a 24-hours protocol showing the drinking habits, urination frequency as well as the time of occurrence of the uncontrolled urine loss.

In the course of a special medical diagnostic the function of the bladder and the sensitivity when it comes to filling and voidance is examined (urodynamic assessment). If necessary, a contrast media is used for outlining the urethra and the bladder or also a cystoscopy.

Depending on the degree of severity when it comes to a strain urine incontinency a medication therapy and an operative procedure are both deployed. Latter reaches from a tension-free urethral (vaginal) tape (TVT) over an endoscopic undersplashing of the compressor up to a complex reconstruction of the pelvic base. A very effective procedure is the implantation of an artificial urethral sphincter.
If the drive incontinency is a consequence of an organic disorder it can be treated operable. This can be treated for example by a resection or laser treatment of the benign prostatic hyperplasie (BPH), a tumor resection of the bladder mucosa, the minimal-invasive slashing of an urethral stenosis as well as a reconstruction of the female pelvic base by the use of mesh implants. Alternatively medications are brought into action that shall slake the bladder activity. In severe cases the insertion of special substances into the bladder or a targeted palsy of the bladder muscle become necessary and are achieved by injecting botulinum toxins (botulinum A) into the bladder wall in the course of a minimal-invasive endoscopic procedure.