The illnesses associated to the urinary incontinence

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The unrests of the miction are not insignificant. In addition to the hindrance, they can be at the origin of other problems, as the cystitises or the vaginal infections. To the inverse, an urinary incontinence can be sometimes the first symptom of another illness.

The urinary incontinence remained again today a taboo topic. Yet, 3 millions of Frenchwomen and 1 million of French are concerned. In rare cases, the unrests mictionnels can be the first signs of a more problematic illness.

When the sphincter is manhandled

The sphincter is a muscular structure situated around the urethra whose closing permits the continence and the opening permits the miction. In some cases, the sphincter doesn't assure its function of control anymore because it undergoes the pressure of other organs. The urinary incontinence is then the sign of another pathology. It is notably the case of the benign hypertrophy of the prostate at the man and the prolapse at the woman.

The benign hypertrophy of the prostate corresponds to the increase natural of the volume of the prostate. Past 50 years, two third of the hommes are concerned by this affection, of which the main symptoms (when they exist) are the urinary unrests. Indeed, the prostate surrounding the urethra, the increase of its volume gene the out-flow of urines and disrupt the miction.

The prolapse, named more fluently the coming down of organs, concern 45% of the women aged of 45 to 85 ans. One speaks of prolapse when the uterus, but also the bladder, the urethra or the rectum are not sustained more by the muscles of the pelvic floor. The urinary unrests are one of the symptoms indirect of this illness.

Affected by the nervous system: a breakdown of the orders

In addition to the dysfunctions bound to a pressure exercised on the muscles, the urinary incontinence can be the first symptom of a neurological affection. Indeed, the sphincter and the bladder are managed by the "autonomous "nervous system. It means that all is controled without we have conscience of it. When the bladder is filled, some nervous messages are transmitted until our brain, it is to this moment that one feels the need to urinate. If the nervous system is reached, the continence is not assured anymore.

It can be the case among the patients affected by neurological illnesses as multiple sclerosis, the illness of Alzheimer or the attacks bound to the diabetes.

Multiple sclerosis provokes lesions of the nervous fibers. Among his numerous symptoms, this illness can provoke two antagonistic symptoms: an imperious desire to urinate and an incontinence, or on the contrary a difficulty to urinate. Other problem: the draining of the bladder is not complete, what encourages the urinary infections.
Of other illnesses of the brain as the illness of Alzheimer or the Parkinson's disease can also disturb the urinary system and can provoke an incontinence. These two illnesses interfere in the control of the bladder. Result: the draining doesn't make itself completely and the desire to urinate comes back precociously: one speaks of pollakiurie. This emergencies mictionnelles affects a big part of the patients. They greatly sound on the quality of life of the patients. She is bound directly to a hyperactivity of the muscle of the bladder called detrusor.
Finally, the attack of the nerves is a frequent complication of the diabetes. The attacks of the nerves controling the bladder generally occur only after 10 years at least of evolution of the illness. They can provoke a loss of the continence and flights urinaires5 then.

Whatever is the illnesses associated to the urinary incontinence, some solutions exist. "If the incontinence is underlying to another illness, it will first be necessary so possible to treat this primary pathology" specifies the Dr Sophie Conquy, Practitioner Hospitalier in the service of urology of the Cochin hospital and member of the French association of urology (AFU). She adds that "if the illness in reason cannot be treated, as hardens in plate or Alzheimer's illness, then the physicians turn toward symptomatic treatments."

2009-05-26