Urinary incontinence: therapy and prevention

Spending on incontinence aids is increasing year by year! Therefore, among other things, it has become an important public health goal not only to treat the "widespread disease" of bladder weakness, but also to prevent it through targeted prevention or to improve the chances of recovery through early detection.

Therapy stress incontinence

If the cause is a weak pelvic floor muscle, in addition to a possibly necessary weight reduction active training of the musculature helps. Daily gymnastics first with professional guidance, later also alone, tightens the pelvic floor muscles, strengthens the sphincter and straightens up the urethra. Supportive is physical therapy. If after a few months no satisfactory treatment success occurs, one will have to think about an operative intervention.

If there is a bladder reduction, pelvic floor training is also the first option of choice. In severe cases, a correction of the position of the bladder is indicated by surgery. If the weakening of the urethral closure is due to the menopause, drug replacement of the missing estrogens (prescription) can eliminate the discomfort; but this should only be done under specialist supervision (gynecologist).

Therapy urge incontinence

In the first place, bladder infection or bladder cancer must be excluded and treated if necessary. If the bladder receptors are over-stimulated, bladder tea and heat or phytotherapy, ie intake of herbal medicines, help in mild cases. These include, for example, extracts of pumpkin seeds, nettle root, goldenrod or nasturtium oil. These drugs are partly pharmacy-dependent, partly also available in drugstores.

Heavier forms necessarily require medical treatment. Effective are anticonvulsant medications from the group of anticholinergics such as oxybutynin, propiverine, tolterodine or trospium chloride (all prescription). They inhibit contraction, the contraction of the bladder muscle, where the strong urinary urgency subsides. The treatment should last at least 6 weeks.

Although some of the medications initially cause dry mouth, you should still continue the therapy. After just a few days, the feeling of dry mouth is. Until then simply suck candies or chew gum to promote salivation. In addition, physiotherapeutic measures must not be missed. Affected themselves can z. B. by toilet training, ie bladder emptying at specified times, preclude the urgency and avoid unwanted urine loss. For mental causes often helps z. B. Autogenic training.

Therapy overflow incontinence

Early forms of prostate-related bladder emptying disorders are favorably influenced by herbal medicines (see also benign prostatic hyperplasia). Effective here are extracts of pumpkin seeds, sabal fruits, nettle roots or beta-sitosterols from vegetable oils (some pharmacy). Furthermore, drugs from the group of alpha-receptor blockers (prescription) come into question. They inhibit, inter alia, the alpha receptors on the bladder neck, which are responsible for a good bladder closure. The bladder closure is loosened and the outlet resistance is reduced.

Even so-called 5-alpha reductase inhibitors (prescription) can lead to an improvement of the bladder emptying by a reduction of the prostate. In advanced stages, removal of the prostate may be necessary. If prostate cancer is suspected, specialist therapy (urologist!) Is indispensable.

Urinary Incontinence: Precaution

First and foremost prophylaxis is a healthy lifestyle, especially normal weight, due to a healthy diet and adequate exercise. A balanced mixed diet, avoiding too much fat and sweets, does not make excess weight, or helps to reduce it if necessary. Sensible nutrition also helps to maintain proper digestion. Constipation leads to excessive stress on the pelvic floor due to excessive pressure during defecation, which in turn promotes incontinence. Exercise consumes calories, helps to reduce weight and helps to improve body awareness. For this all circulation-promoting measures (sauna, Kneippgüsse, change baths etc.) are meaningful.

Mothers are especially affected by stress incontinence. Even during pregnancy her pelvic floor is heavily loaded by the weight of the child. In order to avoid incontinence in later years, a controlled episiotomy helps to prevent muscle tears during delivery. After a childbirth, good pelvic floor training is required for good recovery gymnastics in order to strengthen the overstretched muscles. Pelvic floor training is a prevention of urinary incontinence at any age, even at a young age, especially for people in "sitting occupations".

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