THE FEELING OF SECURITY RETURNS.

Incontinence: breaking the taboo and regaining quality of life.

Incontinence: breaking the taboo and regaining quality of life.

In Germany, approximately 9 to 15 million women – meaning every third to fourth woman – are affected. And more and more women are shedding the sense of shame that has long surrounded the topic of incontinence. It is a condition that can be resolved, just like any other.

You have already taken the first step toward addressing it by reading this information. Now find out which concrete steps are available to you and how Asst. Prof. Dr. Resmiye Ermis will support and guide you.

Brief overview: understanding incontinence.

Did you know that around 80% of all affected women suffer from stress or exertional incontinence? In these cases, pressure on the bladder plays the decisive role. In addition, there are also overflow incontinence and urge incontinence.

Involuntary loss of urine can, incidentally, occur at any age. Stress incontinence is most common between the ages of 45 and 49.

First and foremost, incontinence naturally takes a toll on quality of life: insecure, stressed, and anxious behavior places a heavy burden on mental well-being. Well-being and self-confidence suffer, which in the long term can in turn lead to further health problems.

Symptoms are usually easy to recognize: constant urge to urinate, frequent – sometimes partially uncontrolled- urination, or involuntary urine leakage when sneezing, coughing, or during physical exertion. Is it sometimes just a few drops? That, too, can be an indication of incontinence. As can pain during urination, unintended urine leakage during sleep, and even blood in the urine.

There are three different degrees of stress incontinence:

Grade I: urine leakage with a marked increase in abdominal pressure, e.g., coughing, laughing, sneezing, or physical exertion.

Grade II: urine leakage with a moderate increase in abdominal pressure, e.g., standing up, sitting down, walking, or climbing stairs.

Grade III: urine leakage with a slight increase in abdominal pressure while sitting, standing, or lying down.

The functional causes lie in hypermobility of the urethra and a sphincter that no longer functions at full strength. When this is the case, even laughing, coughing, sneezing, or physical exertion such as lifting a crate of beverages can be enough to overwhelm the sphincter due to the increased pressure.

Prolapse of the female pelvic organs can also be a cause. In a healthy state, muscles and ligaments keep the bladder, uterus, and vagina in their natural positions. In cases of stress incontinence, these muscles are no longer strong enough, causing the organs to descend, which in turn makes proper closure more difficult.

If the bladder is in a persistent state of fullness, this is a clear sign of overflow incontinence. The underlying cause is usually an obstruction to urine outflow, resulting in continuous dribbling of urine.

If the bladder is overactive or irritated, this is referred to as urge incontinence. In this case, the bladder muscle is overexcitable and builds up increased pressure. If this pressure exceeds the capacity of the sphincter, uncontrolled urine leakage occurs.

In general, urinary tract infections, chronic illnesses, changes in the mucous membranes, or a reduced bladder capacity can be contributing factors – for example due to bladder stones, tumors, or cysts. Incidentally, the risk of being affected also increases with the number of childbirths.

What indications may emerge from the patient’s medical history to date? Asst. Prof. Dr. Ermis explores these and performs a gynecological examination. Ultrasound imaging can also provide valuable information at this stage.

Strengthening the pelvic floor muscles may already help in cases of mild incontinence. If this and all other conservative options have been exhausted, it is time to evaluate the possibilities of minimally invasive surgery, for example by laparoscopy or vaginal procedures. In principle – and if desired – every effort is made to preserve the uterus. The CESA method is ideally suited for this purpose, even in cases of pronounced uterine prolapse. The aim of the CESA method is to return the pelvic floor organs to their original position. Scientific studies and medical experience via laparotomy show a success rate of 75%.

A well-established method, particularly for moderate stress incontinence, is minimally invasive Burch colposuspension. The goal here is to reposition the bladder neck so that it can once again withstand the pressure exerted by the bladder.

Finally, in urethral bulking therapy, a synthetic gel is injected from within into the wall of the urethra, either under local anesthesia of the urethra or under general anesthesia. This narrows the outflow tract and supports the urethra’s closure function.

Free from uncertainty, fear, and the stress that “something might go wrong” – how would this sense of relief positively affect all areas of your life?

And it is not only the patients themselves who gain a new quality of life: women who became pain-free after their incontinence surgery actually have happier partners. This is demonstrated by a study.

Do not hesitate any longer—there is no taboo. Take control of a life free of symptoms and schedule your appointment with Asst. Prof. Dr. Ermis now at 069-407 15 50. Or send a message to gynaekologie@rotkreuzkliniken.de.

Vaginal prolapse:

How can it be recognized, and what is the best course of action?

Vaginal prolapse:

How can it be recognized, and what is the best course of action?