The Inner Workings of Incontinence in Women
When trying to understand incontinence in women, it is important to understand the underlying anatomy of the female urinary system. It consists of four main organs, which include the kidneys, the ureters, the bladder and the urethra. These organs filter out excess fluid from the bloodstream and excrete it from the body in the form of urine.
The process starts when kidneys produce urine and deliver it to the bladder by way of the ureter. Once the bladder fills, it signals the brain to release the urine through the urethra. The body uses urine to slough off excesses, which include vitamins, minerals and blood corpuscles. The urinary system keeps the body’s bloodstream from becoming toxic, and the kidneys, in particular, are instrumental in maintaining the bloodstream’s proper salt to water and acid base balances. The kidneys are at the forefront of keeping the body’s internal systems stable, so they are, in essence, a very sophisticated filtering system for the body. While conserving electrolytes, salts and water, the kidneys also extract toxins and waste from the bloodstream. One kidney is essential to life itself, but the kidneys are so important that the human body has two; so the second kidney is might be considered nature’s backup system.
Each kidney has a tube that allows urine to flow into the bladder from the kidneys. Known as ureters, these tubes are about 25 cm long, and they are highly muscled, which helps to continuously move small amounts of urine into the bladder. Upon entering the bladder, urine is moved along the inner surface of the bladder wall until the bladder becomes almost full. At this point nerve sensors trigger the muscles at the outlet of the bladder to begin releasing the urine. These muscles are called the urethral sphincter, and while some of the muscles are involuntary, some can be trained to relax voluntarily to release urine. As the urine is released it enters the urethra and begins the final journey to the exterior of the body.
The bladder is a very elastic muscle, and it rests on the pelvic floor muscles. It is nestled in between the pubic bone and the vagina in women, and it holds approximately 500 ml of fluid on average. Once there is about 200 ml of urine in the bladder, nerve endings trigger the signal to relax the sphincter muscles to allow urine to flow into the urethra. In a woman the urethra is anywhere from two and a half to five cm long. Since the urethra is much shorter in a woman than a man, it is very common for harmful bacteria to make their way into her bladder and cause a bladder infection, explaining why women are so much more susceptible to urinary tract and bladder infections than men.
When everything is functioning correctly a woman’s urinary excretory system is a marvel, and when any portion of it is not functioning properly or simply out of sync, the result is incontinence in women.
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