This is one of the big taboos: when the bubble is no longer "tight". In women aged 40 to 50, 25% are affected. "Many patients are alive, succeed – and despair silently their suffering ", if Teacher. Ricarda Bauer, Specialist in urology and responsible for bladder disorders, urinary incontinence and urogynecology in Klinikum Großhadern. She complains to treat the subject. "Bad, but: Incontinent is still secret, in our meritocracy you must be in control."
This can help most people affected! So what to do in case of weakness of the bladder and pelvic floor? Our experts give answers.
1. Why are women so vulnerable?
Our little bubble does a great job: it can hold up to 500 milliliters and guarantees the elimination of "waste water" from the body in time. But sometimes the system goes out of sync. According to the survey, one in three women at least once in the life of a bladder infection: cystitis with pain and burning sensation at urination.
The reason for this susceptibility is anatomy, says Professor Bauer. "The female urethra is very short (about two to four centimeters), the male has a maximum length of 25 centimeters and is therefore more resistant to germs.In addition, the woman's urethra is near the intestinal exit – an ideal port of entry for bacteria. Then there are the hormonal changes of the woman, such as pregnancy, childbirth and menopause. "
Estrogen strengthens the defense: At menopause z. For example, estrogen is degraded, which is responsible for producing vaginal mucus and contains substances that fight harmful microorganisms. Lack of estrogen is the barrier against pathogens weaker. Therefore, women with low estrogen levels have an increased risk of urinary tract infections. In addition, spiral and contraceptive gels and a pill containing too little estrogen may promote cystitis.
The female urinary tract
Sensory organ: woman's bladder
interaction Muscles and Ligaments: As the bladder fills, the sphincters are stretched, relaxing to urinate. The internal sphincter at the beginning of the urethra is regulated by the autonomic nervous system, an unconscious process. The external sphincter muscle is part of the pelvic floor muscles, which prevents urine from escaping, especially when sneezing or laughing. Cystitis or pregnancy can weaken the muscles, consequence: incontinence. In case of inflammation, the germs enter the bladder through the urethra from the outside and cause irritation of the bladder wall (see "Blinks").
2. When is it an inflammation?
Teacher. Bauer: "An infection of the bladder is always associated with pain – this is what distinguishes it from the stimulating bladder, where the symptoms are similar.Many patients also reported the sudden onset of a violent zie. and convulsive.as of nowhere. " Other symptoms: burning sensation during urination and frequent urination; The urine can smell and be cloudy or slightly bloody. The doctor uses an assay strip to check the urine and, in some cases, sends a urine sample to the lab. In chronic cases, the bladder and kidneys are examined ultrasonically. Teacher. Bauer also sees women with recurring problems in their practice as well as the bladder conversation lesson led by the LMUeven every four to six weeks. In many cases, no microbe can be detected: they suffer from irritable bladder – the bladder is not inflamed, but overactive. Teacher. Bauer: "The irritable bladder is often stealthy.The affected people get used to having to go there more often than before." Until they can not get to the bathroom at time. " This can lead to incontinence.
3. What are the triggers?
Often, the bacteria that trigger the transmission are transmitted during sex, hence the term "honeymoon disease". Bauer's advice: "After the traffic, go to the bathroom, eliminate germs from the vagina and the urethra." Even a false hygiene is risky – quickly catch the germs, mainly the bacterium Escheria coli, after defecation in the vagina. Therefore, always: wipe from the front to the back.
Many women also think that it is too good with care, they clean themselves meticulously with special remedies. Better water and neutral pH soap, so Oliver Reich, Chief Medical Officer, Department of Urology, Klinikum Harlaching: "Otherwise, the good bacteria naturally present in the lactic acid will be destroyed and the acid coat of the mucous membrane attacked, which opens the way for fungi and bacteria." In addition, the cold and weakened immune system promote infection.
Also a genetic susceptibility is often programmed: Professor Bauer recently highlighted another trigger: "The latest research knows the genetic risks, I often have in my office young women who report that the mother also suffers from cystitis.New novelty: the intestinal microbiome significantly affects the inflammation of the bladder."
Those who have more problems after intercourse should also send their partner to a urologist for a checkup. "Men may suffer from an undetected prostate infection and therefore transmit sick germs during sexual intercourse ", then farmer. Last but not least, mental tensions particularly irritate in the partnership – the bladder. A call for indirect help? There are indeed womenin which, after a separation, the complaints disappeared. The help can also bring relaxation exercises or psychological treatment.
What helps with incontinence?
Being unable to hold back urine is synonymous with high pressure Loss of quality of lifeaccording to Professor Oliver Reich, one of the world's largest prostate surgeons. Many are silent by shame and ignorance – we are ten million to be affected. First Aid offers incontinence pads (eg, "Tena"). What else can you do?
To one stress incontinence if you lose cough, sneeze or carry urine droplets; Women often suffer, men more likely to be operated on. Urologist Reich: "Often the closure mechanism of the urethra is weakened, for example due to birth, constipation, too much compliance." Training makes the muscle strong, weight reduction is also important. "Physiotherapy, such as electrical stimulation or bio-feedback, can help, quite recently, a minimally invasive surgery in which a bandage is placed under the urethra."
In addition, a drug improves the closure function. the Urge incontinence ("Overactive Bladder"), however, is characterized by a sudden urinary urgency, the urine is in the flood. "It's very stressful for patients, neurological diseases, tumors, bladder infections are triggers, but it's also a typical age-related incontinence." Pelvic floor training and help taking medication. And: "In a bladder reflex, you can inject Botox, which stabilizes the muscle." This is only limited in some cases. After all: "Most patients can help – without surgery."
4. Do I still have to go to the doctor?
Not with every shot of light, calm Professor Bauer. At first, home remedies often help prevent the worst: a hot water bottle, plus lots of liquids, such as special bladder teas. Even an analgesic (ibuprofen) is fine and is sufficient in mild cases, supported by a lot of fluidconsumption, often even on the outside. Teacher. Bauer: "Rinse the urethra and bladder is important! Those who correctly interpret the early signs can often prevent the worst by drinking a lot." At least a liter and a half of urine a day should be produced and used to eliminate the symptoms. harmful bacteria. " Unfortunately, many often do the opposite: they drinkEnig. According to Professor Reich, a well-diluted urine stimulates the bladder less. Another tip: always go straight to the bathroom, if you have to (but only then!).
Teacher. Reich: "A bad urination behavior, so how and when you emptied your bladder, can cause problems." Bad is a delay or even the advised often to stop the jet while urinating. It does not form the bubble, but, according to Professor Reich: "It promotes an irritable bladder that emits urine when it is empty."
Men should consult a doctor because they are rarely infected with urinary tract infections. In addition, children and all those who suffer from complicated cystitis: pregnant women, diabetics and people whose immune system is weakened. If there is no improvement after two or three days, if fever is present or if inflammation reappears, a visit to the doctor is important. Because untreated cystitis can increase and lead to dangerous inflammation of the renal pelvis.
5. Are antibiotics still needed?
In bacterial cystitis, antibiotics help to quickly clear the symptoms. But: Frequent antibiotics allow bacteria to develop insensitivity. Therefore, it is recommended to create an Urinkultur for recurrent urinary tract infections. It is determined which antibiotics help the best against the pathogen.
Teacher. Bauer: "Often, this can not be done without it, especially with serious infections. But: the trend is going in a different direction. " Because antibiotics destroy the intestinal and vaginal flora. Therefore, the latest research agrees to reduce the role of antibiotics. The focus is now on the knowledge of the important role that the microbiome plays in inflammation and how to strengthen it, for example with probiotics acting on the intestinal and vaginal flora. "It's about solving the fundamental problem: susceptibility to inflammation – and this can be antibiotics no. The goal is clear: reduce as much as possible the number of antibiotics! "
Self-medication of nature and other tips
What can natural medicine do?
A lot! Teacher. Ricarda Bauer: "There are good herbal products that help exceptional!"This also concerns the general and naturopath Dr. med. Jessica Hinteregger-Männel in her Düsseldorf office. Especially in the lightest cases can herbal remedies help strengthen the walls of the bladder and prevent bacteria from settling. The ideal is to take medicinal herbs in the form of tea – so combines increased hydration with the therapeutic effect. "In the morning, you rinse, the urine is disinfected from late in the morning"she explains. This means that affected people must first drink at least one liter of tea with diuretic herbs.
In the pharmacy, there are ready-to-use combinations, such as horsetail, dandelion or orthosiphon (eg, Bad Heilbrunner). But there are also medicinal plant extracts for oral use, such as tablets with goldenrod, toe and Orthosiphon (eg "Aqualibra"). Plants that antibiotic agents contain, disinfect, such as horseradish and nasturtium, both with germicidal mustard oils. They are available in combination as a tablet (eg, "Angocin").
The bearberry is also suitable, whether in tea or dragees (for example, "acute cystinol"). Those who want to prevent over a longer period, is well advised with a mixture of rosemary, lovage and centaury.
Very useful: products with D-mannose (eg, "Klosterfrau Mannose plus") – a simple sugar that stays in the blood and enters the bladder through the kidneys. The bacteria bind to the sugar, which prevents them from sticking to the mucous membranes with the feet. D-Mannose comes u. at. in peaches and cranberries.
Anyway, Cranberrys, finally criticized as unfair, a significant prophylaxis, said Professor Bauer. L & # 39; mind. However, 40 mg of proanthocyanidins (PAC, cranberry ingredients) per day are important even as a combined preparation (eg with D-mannose). Dr. Hinteregger-Männel recommends special at first signs bladder globules (eg "Cantharis" from Wala), which inhibit inflammation.
And: "Acidic urine inhibits the growth of many germs, which is why, especially during recurrences, urine can be easily acidified with methionine." In addition, hibiscus and propolis relieve symptoms and acidify the urine,In this way, bacterial growth can be avoided (for example, "Utipro plus").
And one micturition journal can help evaluate problems; a book in which one notes the attendance of the toilets, what one eats and drinks or if one is stressed. If you eat a lot of poor fiber in the form of white flour products, this promotes constipation – pressing during the stool increases the pressure in the abdominal area and weighs down the fabric.
Ideal: a intestinal cleansing with lactic acid bacteria (eg "SymbioLact"). Lactobacilli are also useful for vaginal flora (for example, in "OmniBiotic Flora").
Attention: also Shapewear exerts tremendous pressure on the bladder. If you delay urination, this can lead to stress incontinence.
6. What can be done preventively?
A useful vaccine against cystitis is already longer on the market – in the form of tablets or syringes. Teacher. Bauer: "This is where germs are used to improve the immune situation." The costs, about 150 euros, are not usually covered by health insurance. It also helps to strengthen the pelvic floor, for example during class. A high birth load or years of constipation can weaken muscles and tissues and promote inflammation and incontinence.
Often, small tips on cleaning and cleanliness decide: It is also important to quickly change wet swimsuits. Likewise, women who freeze quickly must keep their feet and legs warm. And there is something else, according to the expert, simple but important: "Unfortunately, it closes often saved: deposits and cleanliness. "Automatic translation from the German of the customer notice. She finds in patients that the laundry is not washed enough hot (at 60 degrees) or that Deposits can be used multiple times or "enriched" with paper towels. This not only stimulates the skin, but also promotes the formation of bacteria.