Urinary Incontinence: Therapy

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Urinary Incontinence: Therapy
Urinary Incontinence: Therapy
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Urinary Incontinence: Therapy

In principle, there are various forms of treatment and aids available. If possible, we aim to remedy the cause. In addition to drug therapy approaches, regular pelvic floor training plays a central role. If conservative measures are unsuccessful, operative measures should be considered. In addition, aids such as bandages, pads, pads, etc. can make life with incontinence easier.

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  • Continue reading
  • more on the subject
  • Advice, downloads & tools
  • How is incontinence treated?
  • Strengthen the pelvic floor
  • Bladder and toilet training, bladder diary
  • Whom can I ask?
  • How are the costs going to be covered?

Accompanying measures are behavioral approaches such as toilet and bladder training as well as keeping a bladder diary. Explanatory discussions by the doctor on relevant lifestyle factors such as drinking and eating habits are just as important. For example, avoiding diuretic drinks has a positive effect (coffee, black tea, carbonated and alcoholic drinks). A high-fiber diet and adequate hydration reduce the tendency to constipation, which can sometimes have a positive effect on incontinence. Weight reduction is recommended if you are overweight.

How is incontinence treated?

The choice of therapy depends on the type of incontinence present.

  • Stress incontinence: In mild cases, pelvic floor training, possibly with electrical stimulation, is usually successful. Medicines play a rather subordinate role. If conservative methods are unsuccessful, surgery may be required. This is done in a minimally invasive manner, with the urethra being stabilized with a plastic band during loop surgery. An artificial sphincter is only rarely implanted. Expanding measures: weight reduction, stool regulation. Aids: pessaries, special tampons.
  • Urge incontinence: It is important to remedy / treat the cause such as foreign bodies or bladder infections. The focus is on drug treatment with anticholinergics, for example. This should calm the muscles in the bladder and increase the volume. In postmenopausal women, local use of hormones (estrogen) may help in some cases. In severe cases, botulinum toxin injections into the bladder muscle or implantation of a bladder pacemaker may be used. Expanding measures: weight reduction, bladder diary and urination training, pelvic floor training, if necessary electrical stimulation.
  • Mixed incontinence: The therapy is a combination of that for stress and urge incontinence.
  • Overflow incontinence: Here, the urine is first drained off via a urethral or abdominal wall catheter, followed by surgical rehabilitation.

Aids for incontinence

A number of tools are available to maintain the quality of life of those affected and to enable normal everyday life and social contacts. The acceptance of absorbent aids is usually higher with women than with men, because the former are familiar with insoles, etc. Most aids are comfortable and discreet to wear and offer protection.

Aids are (according to the Robert Koch Institute):

  • Absorbent aids: e.g. templates, diaper (s), documents, briefs, drip catchers.
  • Dissipative aids: e.g. condom urinals (urine bag with condom), urinary catheters, abdominal wall catheters.
  • Other incontinence aids: e.g. pessaries (lifting the bladder), special tampons for bridging physical activity / sport, training utensils for the pelvic floor muscles such as vaginal cones (weights to be inserted into the vagina).

Note Do not use penile clamps, straps, or urethral plugs. These utensils lead to permanent damage to the urethra or to infections.

Strengthen the pelvic floor

The strengthening of the pelvic floor muscles shows very good results, especially in stress urinary incontinence, as there is an undesired leakage of urine mainly due to increased pressure in the abdomen. It is advisable to learn how to train the pelvic floor under expert guidance, with the help of, for example, physiotherapists and midwives. Only regular muscle training achieves long-term effects. At the beginning of training, the main difficulty lies in noticing these muscles: Women

can feel the pelvic floor tension on the perineum or in the vagina. Men orientate themselves on the anus and testicles - in order to build up tension, one tries to bring both closer together.

The following exercise examples can be easily integrated into everyday life:

Pelvic floor lift

This exercise is done while standing. Stand hip-width apart, upper body straight. One imagines the pelvic floor as a lift that slowly travels to higher floors. Tense the pelvic floor muscles slowly and pull the "lift" up, so to speak. The tension should be held for a moment, the passengers get out. Then let the “lift” sink slowly, gradually, stick by stick.

Cat hump

It is best to use a soft surface such as a rug or mat for this exercise. You kneel down and support yourself on your hands. The arms are hip-width apart. At the beginning the back is straight. Then take a deep breath, you notice how the chest and stomach expand. When you exhale through your mouth, you consciously make a “cat hump”. In doing so, pull your back upwards and at the same time lower your head between your arms. Then breathe in again and straighten your back at the same time. Alternate several times. Exercises according to the Vienna Social Fund, for incontinence - let's talk about it!

You can find out more about the effectiveness of pelvic floor training at www.medizin-transparent.at.

Bladder and toilet training, bladder diary

Bladder training (also micturition training) helps with some sufferers, in which, for example, the frequency of going to the toilet is systematically reduced. The urge to urinate can be deliberately suppressed by tensing the pelvic floor. Especially with patients in need of care, it can be beneficial to go to the toilet at set times, e.g. every two to three hours. Changes in behavior show particularly good results in the case of urge incontinence.

Keeping a urinary or bladder diary (micturition diary) can provide the doctor with valuable information and can subsequently also be used therapeutically, especially with regard to changing behavior. Relevant information is noted in a bladder diary over a period of several days, such as the amount drunk, the frequency of going to the toilet, the amount of urine, the intensity of the urge to urinate and whether the person has been wetting.

You can find a micturition log on the website of the Medical Continence Society Austria.

Danger! Many sufferers react to incontinence problems by reducing the amount they drink! However, this can lead to complications such as circulatory problems.

Skin care for stressed areas

The skin in the genital area is sometimes exposed to high levels of stress during urinary incontinence. Sucking aids such as insoles etc. should be changed regularly to avoid prolonged urine-skin contact. Suitable skin care products include pH-neutral cleansing products and creams / lotions with a low water content (water-in-oil emulsion, W / O products) to protect the skin from drying out.

Whom can I ask?

The following bodies are responsible for the treatment of urinary incontinence:

  • General practitioner
  • Specialist in urology
  • Specialist in gynecology
  • Incontinence clinic at hospitals

You can also get non-binding and free advice in advance by phone from the Medical Continence Society Austria on 0810/100 455.

How are the costs going to be covered?

All necessary and appropriate therapies are covered by the health insurance carriers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. However, you may have to pay a deductible with certain health insurance providers (BVAEB, SVS, SVS, BVAEB).

However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic. For more information, see Costs and Deductibles.

Medicinal aids such as pads, diapers and Co

For certain incontinence products such as pads and pads or diapers, there is support from the health insurance company. However, a doctor's prescription is required for this. This can be redeemed at contract suppliers such as medical supply stores or pharmacies. You can find out which companies have a contractual relationship with the health insurance providers on the website of your responsible social insurance provider.

If you would like to obtain medical aids / medical aids from a company that is authorized to dispense and has no contractual relationship with health insurance carriers, you must first pay for the medical aids yourself and then apply for reimbursement of costs from your responsible social insurance institution. For medical aids, the insured person will contribute to the costs (deductible).

You can obtain further information from your health insurance company and from The route to medical aids and aids.

Pelvic floor training

Pelvic floor training is offered in certain health insurance institutions. The costs for this are borne by the health insurance carriers.

For more information, please contact your health insurance provider.

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