The primary cause of ansträngningsinkontinens is often a weakening of the pelvic floor muscles. This weakening can result from various factors, including pregnancy and childbirth, particularly vaginal deliveries, which can stretch and damage the pelvic floor muscles and nerves. Menopause is another significant factor, as the decline in estrogen levels can lead to thinning of urethral tissues and reduced muscle tone. Obesity also contributes by increasing pressure on the bladder and pelvic floor. Furthermore, certain surgical procedures, such as prostatectomy in men or hysterectomy in women, can sometimes affect the nerves or muscles that control bladder function. Chronic coughing, often associated with conditions like bronchitis or asthma, can also weaken the pelvic floor over time.
Symptoms of ansträngningsinkontinens typically involve urine leakage directly related to physical exertion. The amount of leakage can vary from a few drops to a more significant volume, depending on the severity of the condition and the intensity of the activity. It is important to distinguish ansträngningsinkontinens from other types of urinary incontinence, such as urge incontinence, which involves a sudden, strong urge to urinate followed by leakage.
Diagnosis usually involves a medical history review, a physical examination, and potentially urodynamic testing to assess bladder function and pressure. Treatment approaches are tailored to the individual and can include conservative methods like pelvic floor muscle training (Kegel exercises) to strengthen the supporting muscles. Lifestyle modifications, such as weight loss and fluid management, can also be beneficial. In some cases, medical devices like pessaries may be used to support the bladder neck. For more severe or persistent cases, surgical options, such as slings or bulking agents, may be considered to provide structural support to the urethra.