Pregnancy and birth
Bladder weakness often occurs also in younger women: about one in three women have difficulties reliably controlling their bladder after the birth of a child1. Pregnancy and birth put a lot of stress on the pelvic floor muscles, causing them to overstretch. This can lead to changes in the bladder position and the functioning of the bladder. The ability of the bladder sphincters to close properly declines and is sometimes not enough to hold the urine in, causing urinary leaks.
The level of oestrogen also affects the bladder and its functioning. This is why dysfunctions of the bladder system can develop during menopause. The falling oestrogen level causes the tissue to weaken, which can have a negative effect on the control of the bladder sphincter muscles. This reduces the ability of the bladder sphincter to close properly as a woman ages.
From the age of 65, the female body no longer produces oestrogen. This oestrogen deficiency leads to a degeneration in the mucous membrane and a weakening of the bladder connective tissue and therefore encourages the development of bladder weakness.
Incontinence is the medical term for the involuntary leakage of urine and is often the result of the bladder sphincters not closing properly. There are different types of incontinence:
The most common type is stress incontinence. Urinary leaks occur when physical stress is put on the pelvic floor muscles, such as when lifting heavy objects, laughing, sneezing, climbing steps or running. Women are more often affected by stress incontinence than men. This is due to the anatomical differences between both genders; more precisely, differences in the pelvic floor muscles. They have a critical function in bladder closure.
Another type of incontinence is urge incontinence, which is characterised by frequent urges to urinate that are difficult to suppress. Frequent, involuntary leakage of urine is also one of the typical symptoms. Many of those affected report that they often do not manage to reach the toilet in time. The cause of urge incontinence is a bladder storage dysfunction: the bladder muscles contract, which cannot be controlled voluntarily, even if there is only a small amount of urine in the bladder. The urge to urinate, which cannot be suppressed, leads to involuntary leakage of urine.
Sometimes both types of incontinence occur at the same time.
1 Wesnes, S.L. et al. (2009). The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study. BJOG, Vol.116, No.5 (Apr 2009), pp. 700-707, ISSN 1471-0528 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2675011/
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