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 NL
REHAB/THETA/PHYSIO
. Incontinentie
In dit gedeelte wordt de behandeling van incontinentie bij vrouwen besproken. Er wordt een beschrijving
gegeven van de praktische behandelmethode die is vastgesteld op basis van de volgende publicaties:
Fall M, Lindström S,
Electrical Stimulation: A Physiologic Approach to the Treatment of Urinary Incontinence. Urologic Clinics of
North America :  - , 
Plevnik S, Vodusek DB, Vracnik P,
Optimization of pulse duration for electrical stimulation in treatment of urinary incontinence. World J Urol
:  - , 
Lindström S, Fall M, Carlsson CA,
The neurophysiological basis of bladder inhibition in response to intravaginal electrical stimulation.
J Urol :  - , 
Fall M, Erlandson BE, Sundin T,
Intravaginal electrical stimulation: Clinical experiments on bladder inhibition. Scand J Urol Nephrol Suppl
: , 
Amaro JL, Gameiro MOO, Padovani CR,

physiotherapy. Int. Urogynecol. Journal :  - , 
Er kunnen twee fasen worden onderscheiden in het urinesysteem: fasen met korte vrijwillige urinelozing
die worden afgewisseld door langere verzamelingsfasen waarin de blaas geleidelijk vult.
Continentie, dat wil zeggen het ontbreken van urineverlies tijdens de verzamelfase, vereist in de eerste
plaats een ontspannen blaas en in de tweede plaats permanente sluiting van de sluitspier van het
urinekanaal. Als een van deze twee elementen niet goed functioneert, leidt dat tot incontinentie van de
urinewegen. Klinisch kunnen drie soorten incontinentie worden onderscheiden.
Drangincontinentie:
De blaas trekt abnormaal samen (overactieve detrusor) en drukt op de urine waardoor de druk in de blaas
te groot wordt.
Stress-incontinentie:
De sluitspier van het urinekanaal is onvoldoende krachtig en kan niet gesloten worden gehouden bij
plotselinge optredende en aanzienlijke vergroting van de druk in het abdomen, bijvoorbeeld bij inspanning,
hoesten, enz.
Gemengde incontinentie (drang- en stress-incontinentie):
Een combinatie van drang- en stress-incontinentie in meer of mindere mate.


260


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