Stress incontinence (formerly stress incontinence) is a symptom of involuntary urination during physical exertion. Coughing, climbing stairs or even standing up can be enough to cause this. The cause is considered to be an insufficient bladder outlet, a weakness of the urethral sphincter. There are various options for treating stress incontinence.
Below you will find further information and selected stress incontinence specialists.
Incontinence, also known as bladder weakness, is the involuntary loss of urine. Those affected are unable to hold their urine safely and pass it at the desired place and time.
In principle, a distinction must be made between urinary storage disorders and bladder emptying disorders.
A urinary storage disorder is defined as the inability of the bladder to store a certain volume of urine over a certain period of time.
The classification of urinary storage disorders includes
The degree of stress incontinence is categorized according to severity or the activity during which the incontinence occurs.
The condition is more common in older people, but younger people also frequently suffer from stress incontinence. This form of bladder weakness mainly affects women.
Bladder incontinence is more common in people with the following risk factors:
The diagnosis is usually based on the medical history. However, there are also other methods for diagnosing stress incontinence:
Behavioral modifications primarily include prevention, weight loss and reducing the amount of water drunk in the evening.
With targeted pelvic floor training, around half of all those affected can avoid a planned operation. This training has been proven to improve the symptoms of stress incontinence if it is carried out regularly and on an ongoing basis.
As this form of incontinence mainly affects women, we will focus on the female anatomy in the following text.
The pelvic floor muscles are located on the inside of the pelvis. They surround the urethra, vagina and bowel opening and, together with the sphincter muscles, control the openings. They also ensure the correct position of the urethra.
If these muscles are too slack, the urethra can descend when straining, resulting in uncontrolled urine leakage.
Recognized the right muscle area? Then you're ready to go:
There is little data available on pessary or cone therapy. To date, no advantage has been proven for any particular type of pessary. Moreover, pessaries only treat the symptoms and not the cause of the incontinence.
Vaginal cones and biofeedback can reinforce the positive effects of pelvic floor training. Electrostimulation or magnetic stimulation (ExMi) have the same effect.
There are several studies that show that electrostimulation leads to an improvement in stress incontinence. However, there is no higher level of evidence or recommendation for this.
Only one approved serotonin reuptake inhibitor (duloxetine) is currently available for drug therapy. It can also be used "off-label" for male stress incontinence. A positive therapeutic effect has been demonstrated for duloxetine. However, only 10 % of patients became completely continent in large studies.
Minimally invasive surgical methods (TVT and TOT) achieve continence rates of 80 % - 90 %. These rates correspond to those of more invasive surgical methods such as colposuspension according to Burch or fascioplasty.
However, surgery should only be performed after all conservative options have been exhausted.
There are various forms of treatment for stress incontinence. A combination of pelvic floor training with
usually leads to a significant improvement in symptoms.
Even after surgical treatment, supportive conservative measures are still necessary. These therapy cascades should therefore be recommended and adhered to as part of a holistic approach.
