Incontinence is the involuntary loss of urine. This is a common and sometimes very disturbing problem. There are two types of incontinence that work through different mechanisms:

• Urgency incontinence: the urgent nature is in the foreground. There is too little 'warning time': especially when you become aware that you have to urinate, it is often too late to get to the toilet in time, resulting in urine leakage.

• Stress incontinence: here 'stress' refers to pressure in the abdomen. Stress incontinence is caused by a loss of urethra support. This is a result of damage to the pelvic floor, such as can happen during childbirth. In stress incontinence, urine leakage occurs when the pressure in the abdomen increases, such as during sneezing, lifting and lifting.

If both problems are present at the same time, it is called mixed incontinence.

The following things can play a role in involuntary leakage of urine:

• Consuming large amounts of caffeinated drinks can worsen urgency incontinence as caffeine stimulates the bladder.

• In men, an enlarged prostate can play a role in the development of incontinence.

• Some neurological disorders typically involve leakage of urine (eg multiple sclerosis, spina bifida, Parkinson's disease, spinal cord injury).

 

During the development of an incontinence problem, the following examinations are carried out:

• Urinalysis: to rule out urinary infection

• Ultrasound of bladder and kidneys

• Urodymanic examination (UDO) to measure bladder pressures

Stress or urgency incontinence is treated through:

1. PSYSIOTHERAPY

   • strengthening the pelvic floor muscles can reduce or eliminate the symptoms of urine leakage

2. MEDICATION

   • Anticholinergic medications: these make the bladder less irritable and are therefore used as a treatment for urgency incontinence.

3. SURGERY

   • Urethral suspension or mid-urethral sling (TVT, TVT-O, TOT): A mid-urethral sling or mesh bag acts as a support for the urethra at times of pressure increase such as coughing, sneezing and shaking. This prevents the urethra from sagging and prevents urine leakage. This surgery is a solution for stress urinary leakage.

   • Bladder injections with Botulinum toxin (Botox): For certain types of urgency incontinence, Botox can be injected into the bladder. These injections relax the bladder muscle, resulting in less urgency and less urine leakage.