Bladder function is to store the urine that is continuously produced by the kidneys and reaches it through the ureters. When the urine has a certain volume, nerve pathways are activated that give this information to the brain; When we are in an adequate condition to urinate, other nerve pathways are activated that cause a contraction of the bladder muscle and a relaxation of the muscle ring that exists around the urethra (urethral sphincter), allowing urine to escape. Thus, in a normal situation, there is no involuntary leakage of urine . The mechanism of storage and voluntary expulsion of urine by the bladder is due to: The bladder is a hollow organ with a distensible wall, which adapts to the volume of urine received; The urethral sphincter, which remains contracted; The support that the pelvic floor muscles give to the bladder and urethra. What causes incontinence or involuntary loss of urine? Incontinence can have several causes: In stress urinary incontinence , an involuntary loss of urine occurs with efforts that increases intra-abdominal pressure, as with laughing, coughing, sneezing, running, jumping, carrying weights, among others. Stress urinary incontinence may be due to: Problems with the pelvic floor support tissues, giving rise to a hypermobility of the urethra; Urethral sphincter problems. In the case of urgent urinary incontinence , there is a feeling of urgency to urinate and an inability to prevent urine from flowing out. The cause may be a malfunction of the bladder wall muscle. In urgent urinary incontinence, urine leakage occurs even when the bladder has a small urine volume and, therefore, the feeling of needing to urinate is much more frequent: During the day, more than 7 times a day; During the night, more than 1 time per night. Many women have both types of urinary incontinence simultaneously. In these cases, it is a mixed urinary incontinence , with a predominance of the effort or urgency component. Treatment of urinary incontinence Stress urinary incontinence This type of incontinence has two possible treatment approaches: Conservative treatment, with changes in lifestyle and strengthening of the pelvic floor with physiotherapy; Surgery. Urgent urinary incontinence There are several approaches to urinary incontinence: Bladder training and changes in life habits; Medication to relax the bladder muscle; Intravesical injections of botulinum toxin; Neuromodulation. In either case, the decision on the treatment to follow is made with the doctor , based on the severity of complaints and the particularities of each woman. Author : Manuela Costa Meet the gynecology team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
