Causes | Incontinence
Urinary incontinence: these are the causes
Do you struggle with uncontrollable urges to pee? You're not alone. Millions of people suffer from urinary incontinence, and the causes can be diverse - from nerve damage to infections. But have you ever wondered how it all starts?
In this article, we'll dive into the fascinating world of the urinary tract and uncover the root causes of bladder weakness. Get ready to take control of your bathroom breaks. If you are suffering from incontinence then feel free to browse our range of adult pull ups.
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Function of the bladder
The formation and excretion of urine are essential processes for the body and serve the following purposes:
- Elimination of urinary waste products from the blood
- Regulation of the fluid balance in the body
- Maintenance of the acid-base balance in the body
How much urine is formed each day depends not only on the volume of fluids taken in but also on the functionality of the kidneys. Even fluids that are excreted in sweat, breath or the water content of stool affect the volume of urine produced. The average volume of urine according to Apotheken Umschau1 in adults is 1 to 1.5 litres per day.
Check out our new article "Overactive Bladders – What You Need To Know"
The pelvic floor and its importance for incontinence
The pelvic floor can be thought of as an upside‑down umbrella that is stretched between the pelvic bones and supports the bladder and the other organs of the lower abdomen. The pelvic floor muscles is made up of several muscle bundles that form the outer sphincter muscle that can be deliberately relaxed to release urine. Together with the inner sphincter muscle on the neck of the bladder, these muscles ensure that the bladder is closed when tensed.
The lower urinary tract with the bladder, urethra and sphincter system therefore has two functions that it must fulfil:
- the storage of urine and
- the controlled release of urine (miction).
Along with an intact bladder and sphincter muscles, a functioning nerve supply is also required.
Particularly with increasing age and, for example, after pregnancy, the muscles in the pelvic floor become weakened in many people. They can no longer perform their function, leading more and more often to the involuntary loss of urine as a symptom of urinary incontinence. However, weak pelvic floor muscles can be specifically trained, just like many other muscles in our bodies. You can learn more here about pelvic floor training.
Some neurological disorders such as stroke also disrupt the communication along the nerves between the urinary tract and the brain.
What happens when the bladder is emptied
Thanks to the elastic muscles of the bladder wall, we only notice that the bladder is filling above a certain increase in pressure. If the urinary tract is healthy, the sphincter muscle system holds the opening of the urethra firmly closed during this filling phase.
If the bladder continues to be filled, then the bladder sends more and more nerve impulses that travel along the nerve pathways in the spinal cord to the miction centre in the brain stem and from there to the higher brain centres. As soon as these nerve impulses reach a certain intensity, we perceive them as the urge to urinate. In healthy people this usually occurs with a volume of about 130 to 150 ml.2 If the urinary tract is healthy, at this point the urge to urinate can be suppressed for a while until it becomes much stronger or it is possible to go to the toilet.
The emptying of the bladder can now be deliberately started by issuing the appropriate ‘commands’ from the brain to contract the bladder muscles. They force the urine out of the bladder and open the inner sphincter muscle while at the same time the pelvic floor muscles relax. As a result, the outer sphincter muscle also now opens and the urine is released. The control by the miction centre means that it is also possible to initiate the emptying of the bladder even if the bladder only contains a small volume of urine and not when there is a strong urge to urinate.
As a rule, adults must empty their bladder about four to seven times a day, depending on the capacity of their bladder, their age and the volume of liquids taken in. One trip to the toilet over night is also considered normal. Older people have to empty their bladders more often than younger people because of a smaller bladder capacity.3
Different types of incontinence
Based on the various functional disorders, urinary incontinence is classified into different types.
The most common types are
- stress incontinence,
- urge incontinence (which is also commonly referred to as an overactive bladder, we wrote a new article about it. Click here to read more
- overflow incontinence (incontinence with chronic urinary retention)
In old age, a weak bladder is rarely due to only one of the different causes listed above and is therefore also known as mixed incontinence. Several factors play a role here. In addition to urinary incontinence, faecal incontinence can also occur in older people but this is considerably rarer.
Regardless of the type of incontinence, those affected can only be effectively helped if the cause of the problem is known. It is therefore important that a doctor accurately diagnoses the disorder and the type of urinary incontinence and tailors the treatment to the needs of the patient and the severity of the bladder weakness. For this reason a physical examination is essential.
With the appropriate therapy and the use of reliable incontinence products, an active life is still possible even with bladder weakness. Take the first step today and make an appointment with your doctor.