Reports & expert advice
Urge incontinence - when the bladder is under constant pressure
You're out and about, feel fine, then suddenly it strikes: a bladder pressure so strong that you almost - or actually - can't hold it in. Unlike stress incontinence, the problem here is not that the pelvic floor is too weak, but that the bladder muscle, the so-called detrusor, is too strong. Read on to learn about urge incontinence and what you can do about it.
Urge incontinence can be very troublesome. Fortunately, there are many things you can do about it.
What is urge incontinence?
Urge incontinence (also called urinary incontinence) is a bladder storage disorder. It is an involuntary leakage of urine caused by an urge in the bladder that is simply too great to contain. This usually happens even though the bladder is not yet completely full. The bladder muscle suddenly contracts so strongly that even the strongest sphincter muscle can no longer withstand this pressure, gives way and urine leaks out. The good news is that often there are things you can do to alleviate the symptoms.
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Causes of urge incontinence
There are many reasons why this type of incontinence can occur. And they are not always directly related to the bladder:
Sensory urge incontinence:
This is where incontinence occurs because the receptors in the bladder are not working properly. In order for your bladder to function properly - to know when it is full and to transmit that information to the brain - there are small sensors located on the bladder wall. They measure exactly how full your bladder is and communicate this value to your brain via nerve fibres in the spinal column. If these sensors are incorrectly polarised or no longer function properly, they send incorrect information that the bladder is full when in reality it isn’t. Reasons for a malfunction of these sensors can be bladder infections, bladder stones, tumours in the bladder, or a narrowed urethra or a lack of oestrogen in women.1
Motor urge incontinence:
In motor urge incontinence, the problem is not in the bladder itself, but in the nerve fibres that transmit the impulses sent by the sensors to the brain. If these nerves do not function properly and send the signals to the brain too early or incorrectly, it can appear that the bladder is full and there is a sudden urge to urinate. Causes for damaged nerve cords include problems in the intervertebral disc, pinched nerves or diseases such as Parkinson's or multiple sclerosis.
Psychological causes of urge incontinence:
Urge incontinence can be psychosomatic. This means that no physical cause is found. It is common to have to go to the toilet more often when we are excited or anxious, for example, before a lecture or a job interview. It is said that the bladder is a mirror of the soul. Alternative practitioners see it as reflecting the passage of emotions through our bodies. If we don't give our emotions free rein, this can be reflected physically as a bladder problem. Urge incontinence, which puts pressure on the body, can be a sign that we are putting too much pressure on ourselves and setting ourselves goals that we cannot achieve or can only achieve with difficulty. If no physical causes for the incontinence are found, it makes perfect sense to take a closer look at your mental health.
Urge incontinence in men
Urge incontinence in men is often due to the prostate. A benign or malignant disease or enlargement can cause the development of an overactive bladder with urge symptoms. If the prostate is enlarged, this can lead to several problems. It can narrow the urethra, which in turn has a negative effect on bladder function. This disorder can lead to the bladder no longer emptying completely, resulting in so-called overflow incontinence. In addition, the residual urine can cause infections or bladder stones, which in turn can promote urge incontinence.
Urge incontinence in women
With increasing age, urge incontinence occurs more frequently in women. Urge incontinence is often due to hormonal changes during pregnancy or the menopause. When oestrogen levels drop, your bladder may respond more strongly to certain substances in the urine, sending you to the toilet more frequently and urgently. This in turn makes the bladder more susceptible to inflammation. A lack of oestrogen can also weaken the pelvic floor and connective tissue, leading to a sagging bladder or uterus. This can also lead to an overactive bladder.
What can be done about urge incontinence?
The good news is that there are a few things you can do about the sudden and urgent need to urinate:
Medicine
If no explanation for urge incontinence is found, i.e. no urinary stones or inflammation, there are various medications for treatment that can provide relief. So-called anticholinergics are often used in the treatment of urge incontinence. These act on the receptors in the bladder and prevent the bladder muscle from contracting too quickly and too strongly. If the urge incontinence in women is due to a lack of oestrogen, oestrogen-containing suppositories or creams can be effective. These are inserted locally into the vagina and are supposed to improve blood circulation and thus increase the capacity of the bladder.2
I highly encourage you to seek for professional medical advice.
Botox
The nerve toxin Botox is no longer only used to eliminate wrinkles. It is now used to treat migraines and hyperhidrosis, i.e. excessive sweating. It blocks the interface between nerves and muscles so that the muscles can no longer tense and cramp. And that is exactly why it is now increasingly used for urge incontinence. Botox is injected directly into the bladder wall. The full effect occurs after about ten days and lasts between three and nine months.
Natural treatment of urge incontinence
Natural treatment of urge incontinence
In addition to prescription tablets, there are a number of things that you can do yourself to support your bladder.
Toilet training
Toilet training involves learning to lengthen the time between emptying the bladder. The idea is to re-educate the bladder by delaying going to the toilet when you get the urge. The best way is to gradually lengthen the time between toilet visits. Start by delaying the urge to go to the toilet for five minutes. After a period of getting used to it, slowly increase the time to ten minutes, and so on. In this way, you can gradually regain control over your bladder.
Quality products make everyday life easier
Using solutions specifically designed for incontinence can help you manage bladder weakness and feel secure during the day and night. With the right pads or incontinence pants, you can manage your incontinence securely and discreetly, with no unpleasant odours or leaks.
For example, the MoliCare lady pads. These are available from 0.5 drops for very light to 5 drops for moderate urinary incontinence. These offer a high level of discretion thanks to a breathable, textile-like backsheet no unpleasant rustling or sweating. The absorbent core quickly absorbs fluid, transports it safely inside and leaves the skin feeling dry all over, odours are also neutralised. The antibacterial material and its fast absorption of liquid preserve the skin's protective acid mantle and is particularly gentle on the skin, as the pH balance is maintained.
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About the author - Birgit Bulla
As the “owner of an incredibly annoying bladder” herself, Birgit knows from personal experience what it means to live with bladder weakness: In her mid-twenties, out of nowhere, she suddenly got an irritable bladder. After many years of struggling with this condition she finally started her own blog “Pinkelbelle” in 2018 to offer emotional support, inform about new research and – most importantly – show her readers that they are not alone with this problem.
Almost two years ago Birgit also published her first book “Everything you need to know about your bladder”, which has been translated into more than four languages. She now lives in Munich, where she works as an online editor and author. Over the years Birgit has become a real expert in the field of bladder health. It seems almost too fitting that her surname “Bulla” also translates from Latin as bladder.
1https://www.pflege.de/krankheiten/inkontinenz/harninkontinenz/dranginkontinenz/
2Dranginkontinenz - eine Form der Inkontinenz | Stiftung Gesundheitswissen (stiftung-gesundheitswissen.de)
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