BSN Notes: Common Signs And Symptoms: Urinary Incontinence

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Urinary Incontinence
 Urinary incontinence is any involuntary leakage of urine.
TYPES OF INCONTINENCE:
Stress incontinence
Stress urinary incontinence (SUI), also known as effort incontinence. It is the loss of small amounts of urine associated with coughing, laughing, sneezing, exercising or other movements that increase intraabdominal pressure and thus increase pressure on the bladder. 
Causes: Relaxed pelvic musculature, prostate surgery.
Treatment: Kegel exercises


Urge Incontinence:
Involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate.
Causes
 Idiopathic Detrusor Over activity-  Local or surrounding infection, inflammation or irritation of the bladder.
Neurogenic Detrusor Over activity-  Defective CNS inhibitory response.
Treatment
·         Treatment of the underlying cause
·         Condom catheters


Functional incontinence
Functional incontinence occurs when a person recognizes the need to urinate, but cannot physically make it to the bathroom in time due to limited mobility.
Causes
Confusion, dementia, poor eyesight, poor mobility, unwillingness to toilet because of depression, anxiety or anger.
Treatment
Modification of environment


Overflow incontinence
Sometimes people find that they cannot stop their bladders from constantly dribbling, or continuing to dribble for some time after they have passed urine.
Causes
When the patient's bladder is always full, weak bladder muscles, resulting in incomplete emptying of the bladder or a blocked urethra can cause this type of incontinence.eg: BPH


Reflex Incontinence
Urination is frequent, is moderate in volume and occurs equally during the day & night.
Cause: Spinal cord lesion above S2
Treatment : Treatment of underlying cause, intermittent self-catheterization

Incontinence after trauma or surgery
 Vesicovaginal or urethrovaginal fistula may occur in women  
Causes: as a result of hysterectomy or radiation therapy
Treatment: surgery to correct fistula.

Structural Incontinence
Rarely, structural problems can cause incontinence, usually diagnosed in childhood
Diagnosis
·         History & physical examination
·         Urinalysis -  urine is tested for evidence of infection, urinary stones, or other contributing causes.
·         Ultrasound
·         Cystoscopy
·         Urodynamics - various techniques measure pressure in the bladder and the flow of urine.
Management
·         Use Absorbent products - diapers
·         Exercises
·         Treatment of the cause
·         Bladder training
·         Condom drainage
·         Indwelling urinary catheter



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notes.nursium.com: BSN Notes: Common Signs And Symptoms: Urinary Incontinence
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