In the case of urge incontinence, an uncontrollable, so-called imperative urge to urinate leads to involuntary loss of urine. Doctors find physical causes such as narrowing of the urethra, urinary stones and nervous disorders.
In the vast majority of all cases of incontinence with an imperative urge to urinate, however, no physical causes can be identified. Then experts do not speak of urge incontinence, but of a "wet" overactive bladder.
In the case of urge incontinence, it is sometimes possible to remedy the physical cause. Otherwise, treatment is symptomatic, as for overactive bladder.
Urge incontinence can occur on its own. However, it often appears together with stress incontinence as so-called mixed incontinence.
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Urge Incontinence Causes, Risk Factors And Frequency
Doctors find the most common trigger to be overactivity of the bladder muscle (detrusor overactivity, detrusor overactivity). It occurs in three to five out of ten people affected. The causes for this can lie in the superordinate, controlling nervous system. Experts then speak of a neurogenic bladder. It is based on neurological diseases (e.g. strokes, dementia, multiple sclerosis, Parkinson's disease, brain tumors), on nervous disorders as a result of metabolic diseases (e.g. diabetes) or accidents (e.g. paraplegia). Urge incontinence can thus indicate an unrecognized neurological disease. However, disorders outside of the nervous system are also possible, such as inflammation of the bladder, urethra or vagina and narrowing of the urethra.
In the case of urge incontinence without overactive bladder muscles, bladder sensation is usually disturbed. The bladder itself then perceives filling signals incorrectly or increased. Triggers can be certain inflammations (e.g. interstitial cystitis), stones in the bladder or ureters, tumors of the bladder or urethra and narrowing of the urethra, in men for example due to an enlarged prostate (benign prostatic hyperplasia). Other, less common causes can also be considered.
Urge complaints with or without urinary incontinence are very likely to occur more frequently if there is a family history of the problem. Hard stools and constipation may also promote it. Other factors that promote urge symptoms are:
- Age: The frequency of urge incontinence increases with age.
- Overweight (obesity): Diets can significantly reduce the number of incontinence attacks.
- Coffee and tea consumption: Coffee can trigger urge symptoms. In studies, the symptoms increased with the amount of coffee or tea consumed and decreased when those affected saved or avoided such drinks.
- Nicotine: Smokers more often develop incontinence with urge symptoms.
Certain medications can also promote urge symptoms:
- Cholinergics and cholinesterase inhibitors: Application e.g. in dementia and special neuromuscular diseases
- Beta blockers: Use e.g. for cardiac arrhythmias, high blood pressure, cardiac insufficiency, coronary heart disease (disease of the coronary arteries)
- Digitalis active ingredients, cardiac glycosides: Application mainly for cardiac arrhythmias and cardiac insufficiency
- Prostaglandin E1 and E2: Use to promote blood circulation, for example
At least 1 in 20 people suffer from urinary incontinence with the urge to urinate. Among them is urge incontinence, i.e. urinary incontinence with urge to urinate and physical causes, but comparatively rare. Much more common is urinary incontinence with an urge to urinate without physical causes, i.e. a wet, overactive bladder.
Urge Incontinence Symptoms
Do you often have a very strong, uncontrollable urge to urinate?
Does this imperative urge to urinate lead to involuntary urine leakage?
Then there is almost certainly urge incontinence or a wet overactive bladder, but the symptoms are the same. Typical symptoms include:
- Uncontrollable, imperative urge to urinate: The urge to urinate is very strong and often painful, for example when the muscles in the bladder cramp. The feeling becomes so intense that urination is impossible to delay. This is why we speak of an imperative urge to urinate.
- Unintentional loss of urine: Often the way to the toilet is too far when the urge to urinate is felt. Before those affected reach their destination, an undesired gush of urine escapes.
- Frequent trips to the toilet: Affected people sometimes urinate more with a normal daily total amount of urine (pollakiuria).
- Nocturnal urination: Many sufferers also have to urinate more at night (nocturia).
Since the wet overactive bladder is the far more common clinical picture, more details on treatment options, course and many other points are listed there.
Urge Incontinence Treatment
The symptoms of urinary urgency and incontinence quickly put you on the right track. The doctors still have to find physical causes and rule out the possibility of additional stress symptoms. Otherwise there is a wet overactive bladder or mixed incontinence.
Procedures such as ultrasound scans, bladder pressure measurements and other special tests may be necessary to find the causes. It is worth looking for possible causes by all means. When complicated neurological diseases such as dementia or multiple sclerosis are responsible, the causal therapy often quickly reaches its limits. But many of those affected can improve their symptoms with medication such as anticholinergics and other measures. This treatment is similar to treating the symptoms of an overactive bladder. It can continue with herbal remedies, physical therapy, behavioral therapy, continence training, psychotherapy, nerve stimulation, minor procedures to deliver drugs directly into the bladder, or—as a last resort—major, costly surgeries.
If possible, treatment consists of treating the underlying disease. Urinary stones, narrowing of the urethra and other obstacles that interfere with the flow of urine can often be removed with minor or major interventions. For other causes, especially neurological ones, therapy can be more difficult and less successful.
In addition, diseases that affect urge incontinence must be treated. These include diabetes and urinary tract infections.
Prevention
Targeted prevention is hardly possible. The main thing is to avoid the risk factors that can be influenced. In addition, it is important to ensure that you drink enough water.