Urinary incontinence (NTM) is, according to the definition of the World Health Organization (WHO) and the International Association for Continuity, the voluntary leakage of urine through the urethra, which in turn is a serious social problem.
According to statistics, NTM affects approx. 10-15 percent. every society and it has been classified as a social disease. In Poland, about 4 million people suffer from this NTM. Everyone is exposed to this ailment, both women and men, regardless of age. It is estimated that women get sick twice as often as men, and after the age of 70, this problem affects 50%. women and men.
NTM is often a symptom or result of diseases of the nervous system (e.g. multiple sclerosis, Parkinson’s and Alzheimer’s disease) or metabolic diseases (e.g. diabetes). In these cases, NTM attacks women and men with equal frequency. The differences in the incidence of SST incidence in men and women depend on the anatomical structure of the human body. Pregnancy and childbirth predispose women at an early age to NTM. Later in age, an additional problem arises that results from hormonal changes during the menopause. In men, NTM is most common in old age due to prostate problems.
In order to understand the cause of NTM and the fact that it affects women more than men, it is worth first to understand how the bladder works.
So how does the bladder work?
When you urinate, the muscles in the bladder wall contract, forcing the fluid to flow into the urinary tract. At the same time, the muscles of the urethra relax and urine can leak out. Urinary incontinence occurs when the muscles of the bladder suddenly contract or when the muscles of the urethra are too weak to hold the urine inside. When the bladder muscles are weakened, the fluid may leak out with less than normal pressure. Muscle weakness also changes the position of the bladder in the abdomen. Obesity makes the situation even worse, because obese people have more intra-abdominal pressure than lean people.
Several systems in the human body must function properly for the bladder to function properly.
- the muscles lining the bladder wall, keeping the bladder in the right position
- the muscles of the urethra that close the urinary system tightly,
- the muscles lining the bladder wall that relax as the bladder fills and contract when the person wants to urinate
- nerves that run to the brain, which tells the brain when the bladder is full
- nerves that run to the brain so the brain knows when to signal the bladder to empty
- hormones that ensure that the bladder and urinary canals are properly lined.
It is often enough that only one part of the problem arises for NTM to appear.
NTM in women
Millions of women experience uncontrolled leakage of urine (NTM). Pregnancy and childbirth, menopause and the structure of the urinary tract strongly predispose women to problems with NTM.
The changes in the body of women during pregnancy and childbirth can damage the entire abdominal ‘scaffolding’ system that helps support the bladder in women. The pelvic floor muscles, vagina and ligaments make up the structure that holds the bladder. If this structure weakens, the bladder may displace, tilting towards the vagina. This prevents the muscles that normally block the flow of urine from tightening as tightly as they normally would. As a consequence, urine flows out uncontrollably in situations where the pressure in the abdominal cavity increases, i.e. when sneezing or exercising.
Additionally, the severity of symptoms may vary with the menstrual cycle, especially in the week before the onset of menstruation. Due to the deficiency of female sex hormones, the pelvic floor muscles can become weaker, which makes women, also around the menopausal age, more vulnerable to this ailment.
An overactive bladder makes itself felt when the nerves that reach the bladder give impulses to contract at the wrong times. As a result, bladder contractions and loss of urine occur unexpectedly.
NTM in men
NTM is less common in men than in women. At the same time, the probability of this ailment increases with age. It has to do with an enlarged prostate: a male gland that belongs to the reproductive system.
A properly functioning prostate is the size and shape of a walnut. The prostate is located just below the bladder and surrounds the urinary tract. Its purpose is to produce a special mucus that allows sperm to be transported and survived.
There are several prostate problems that eventually lead to NTM in men.
BPH (Benign Prostatic Hyperplasia) – i.e. benign prostatic hyperplasia. In men, the prostate grows larger with age. An enlarged prostate can constrict the urinary tract and bladder, and obstruct the flow of urine. Men often complain of an unsteady, intermittent and weak stream, sudden pressure on the bladder and uncontrolled leakage of urine, and a more frequent need to urinate.
In addition, the methods used to treat prostate cancer may also contribute to the development of NTM. Procedures or surgery to remove the prostate can damage the muscles or nerves that go to the bladder and damage the entire system.
NTM treatment
The treatment that NTM uses depends on the type of person suffering from it. However, you almost always need to improve your habits first, min. lose weight if you are overweight, change your diet (eliminate alcohol and caffeine), do not allow your bladder to fill up, make sure you drink the right amount of fluids.
Kegel exercises (i.e. pelvic floor muscles) are often recommended for exercise NTM. By exercising these muscles in a completely non-invasive way, we can help each other a lot. Of course, this is a process that takes quite a long time and does not give immediate results, but consistency and persistence can lead to symptom relief or even getting rid of NTM.
Other treatments include:
- Medicines – which are used in the case of cystitis or urinary tract inflammation, neurological ailments (i.e. hypersensitive bladder) or to shrink the prostate.
- In the treatment of NTM in women, special devices are used to help keep the bladder in place while supporting the urethra.
- Surgical treatment is used in severe cases. Surgical methods are more and more advanced, and the type of surgery performed depends strictly on the patient’s gender and his ailments.