Urinary incontinence characterizes an uncontrolled loss of urine. For feeling of shame it is often kept in secrecy and this may lead to a substantial burden on quality of life. Worldwide, the International Continence Society (ICS) assumes that 30% of women and 15% of men over 60 years of age suffer from the symptoms of urinary incontinence.
In the main forms a distinction is made between:
Stress incontinence = loss of urine during physical strain without noticeable urinary urge
Urge urinary incontinence = an involuntary loss of urine, accompanying or following a suddenly onset, not suppressible urge to urinate.
Mixed incontinence = a mixed form of stress and urge incontinence In addition there are special types of incontinence, such as enuresis, nocturnal bedwetting of the child.
For an overactive bladder the urge complaints are in the foreground, a loss of urine does not have to occur here.
Because many factors, such as neurological, psychiatric or cardiac diseases, metabolic diseases such as diabetes mellitus (diabetes), surgery on the pelvic organs, but also medication can have influence on bladder emptying, an accurate investigation of complaints is for us a priority. Through a detailed and thorough diagnostics an individual therapy can be adjusted.
A detailed survey of medical history is at the beginning of the diagnostics. In addition to physical examination and urinalysis the voiding diary (see information) provides an essential component in the diagnosis.
The gold standard of diagnostic apparatus presents the video-urodynamic measurement. This includes:
Pressure of the bladder measured continuously by slowly filling the bladder. Even the smallest changes in bladder activity can be registered.
The activity of the pelvic floor muscles simultaneously recorded over a pelvic floor EMG.
The closure pressure of the urethral sphincter measured.
The strength of the urinary stream measured.
An X-ray examination of the bladder during the filling and the emptying carried out (so-called MCU - see at the right)
Depending on the question separate examination steps can also be selected. Moreover In some cases a cysto-urethroscopy is necessary.
Thanks to modern equipment, these examinations not very stressful for our patients and can be performed on outpatients.
Miction cystourethrogram (MCU) by bladder Voiding dysfunction.