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Transcript of Urinary Incontinence
Urethra -Having a strong urge to urinate even when your bladder isnt full
-Occurs in both men and women
-This urge occurs when the detrusor(the bladder muscle) begins to contract and signal a need to urinate, even when the bladder is not full.
-Causes of Urge Incontinence:
Physical problms such as damage to the brain, spine or nerver extending from the spine to the bladder
Can also be caused by infections Lifestyle Changes Bladder training: Creating a schedule of when to urinate helps teach your bladder to alert your body when it is full.
Fluid management: Eliminating excess fluid intake.
Pelvic floor physical therapy: Exercises to help strengthen the pelvic floor muscle. Men vs. Women Women are affected 32%
Men are affected 5%-15% Urinary System Stress Incontinence Overactive Bladder or
Urge Incontinence Types of Urinary Incontinence 1)the bladder's detrusor muscle can become unstable or overactive, which can cause urge and frequency incontinence;
2)the urinary sphincter that normally opens and closes at your command may become weakened, leading to stress incontinence or;
3)the pelvic muscles may be weakened, which can also cause stress incontinence 1)incontinence can occur when prostate enlargements constricts the urethra, inhibiting the flow of urine, causing difficulty urinating and sometimes cause the bladder to overfill. In addition, prostrate surgeries may cause damage to crucial nerves and cause detrusor muscle over activity.
2)weakened pelvic floor muscles
3)sphincter dysfunction -Occurs when the urethral sphincter, the pelvic floor muscle or both have been weakened or damaged.
- Urine leaks out when any physical exertion increases the abdominal pressure and puts more pressure on the bladder. These stressors can be something as simple as jumping, coughing or laughing.
-Often related to child birth. During vaginal birth, the pelvic floor muscles stretch and possibly become damaged. Mixed Incontinence -Symptoms of both urge incontinence and stress incontinence add up to Mixed incontinence.
-Most women with incontinence problems have mixed incontinence.
-Also occurs in men who have had prostate removal or surgery for and enlarge prostate. Overflow Incontinence -Occurs when the bladder never completely empties, and then leaks.
-Usually caused by something blocking the urine from flowing normally out of the bladder, and the body not feeling the urge to urinate.
-Men are much more likely to get overflow incontinence because it is often caused by prostate related conditions like prostate enlargement.
-Also caused by underactive bladder(not feeling the urge to urinate), urine blocking tumors, bladder stones, and scar tissue.
-Women can get overflow Incontinence if a severe prolapse of the uterus or bladder occurs. This means that the organ has dropped out of its original position, often kinking the urethra.
-Aging of the bladder muscle can prevent it from contracting normally, making you unaware of the urge to urinate. Functional Incontinence -Functional incontinence is when the urinary tract is funtioning properly, but other illnesses or diabilities are preventing you to getting to the bathroom.
-Any illness that renders you unaware or unconcerned about the need to find a toilet is considered the cause of functional Incontinence.
some medications Reflex Incontinence -Occurs when the bladder muscle contracts and urine leaks(often large amounts) with out and urge to urinate.
-Reflex Incontinence occurs with people that have serious neurological impairment from things like multiple scerlosis, spinal cord injuries, or damage from surgery or radiation treatment. Who to see if you suspect urinary incontinence? Dependent on symptoms
Connection to specific medical event
Specialist for women are Urogynecologist
Specialist for men are Urologist How to Diagnose Urinary Incontinence Share all symptoms and medical history.
Past and present medications How to diagnose Urinary Incontinence:Physical Exam During the physical exam, the doctor will focus on your nervous system, abdomen, and genital area.
First they will test your reflexes, access your muscle strength.
The doctor will press on your abdomen to check areas for hernias, tenderness, tumors, infections, scarring or an impacted bowel.
Provide urine sample
Check for urinary tract and bacteria infections.
To test for stress incontinence
Doing a physical activity to test for leakage
Might have to wear a pad and test for leakage
For men, the doctor exams the penis for any signs of constrictions. The strength of the pelvic muscles are also assessed. Surgery -Less Invasive
-Less recovery time Surgery Treatments Medications Lifestyle changes
Surgical Procedures Sling Procedure Artificial Urinary Sphincter Urethral Catheter or Suprapubic Tube Insertion While medical expenses to treat Urinary Incontinence increased dramatically, the amount of missed work by Urinary Incontinence patients decreased due to more effective procedures. Cost of Urinary Incontinence -Sling Procedure
¯Artificial Urinary Sphincter
-Urethral Catheter or Supra pubic tube insertion Rate of inpatient surgical treatment decreased slightly from 1994 to 2000, while ambulatory surgical center visits (same day procedures) more than doubled. Length of Stay Future studies for Urinary Incontinence are looking more at prevention.
delivery of medication directly into the bladder Urinary Incontinence in the Future Sources Chancellor,, M.B. (n.d.). Future Trends in the Treatment of Urinary Incontinence. In US National Library of Medicine. Retrieved November 11, 2012, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476068/
Haight, R., Gayken, J., & Westanmo. A. D. (n .d.). Duloxetine: A balanced and selevtive norepinephrine- and serotonin-reuptake inhibitor. In American Journal of Health-System Pharmacy. Retrieved November 11, 2012, from http://ajhp.org/content/62/23/2481.short
Urinary incontinence. (2011). Better Bladder & Bowel Control, 2-9. Retrieved November 8, 2012, from Health Source - Consumer Edition (71409067).
Urinary Incontinence. (2011). Better Bladder & Bowel, 14-28. Retrieved November 25, 2012, from Health Source - Consumer Edition (71409069).
Urinary Incontinence in Women (n.d.). In National Kidney and Urologic Diseases. Retrieved November 7, 2012, from http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/index.aspx Changes in Urinary Incontinence History: Length of stay after procedures decreased
Ambulatory procedures increased
Medical expenditures increased With new advancements and more awareness to Urinary Incontinence, treatments are easier to obtain, and also allow a faster recovery. Urethral Sling Bulbourethral sling