Incontinence is the inability to control urination or defecation. There are several types of incontinence including stress, urge, overflow, mixed, structural, functional, bedwetting, and giggle incontinence. Causes can include neurological disorders, an enlarged prostate, caffeine, and polyuria. Symptoms include urinary tract infections and irritation. Diagnosis involves tests like cystoscopy to identify any abnormalities causing incontinence. Treatment options include lifestyle changes like pelvic floor exercises, bladder training, and medication.
2. Definition:-
Inability of body to control the
evacuative functions of urination or
defecation is called Incontinence. It may
be of following types:
Urinary incontinence: Involuntary
excretion of urine.
Faecal incontinence: Involuntary
excretion of bowel contents.
3. Types of incontinence:-
Stress incontinence: also known as effort incontinence, is due essentially
to insufficient strength of the pelvic floor muscles.
Urge incontinence: is involuntary loss of urine occurring for no apparent
reason while suddenly feeling the need or urge to urinate.
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. It is as if their bladders were constantly
overflowing, hence the general name overflow incontinence.
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Mixed incontinence:is common in the elderly female population and can
sometimes be complicated by urinary retention, which makes it a treatment
challenge requiring staged multimodal treatment.
Structural incontinence: Rarely, structural problems can cause
incontinence, usually diagnosed in childhood (for example, an ectopic
ureter). Fistulas caused by obstetric and gynecologic trauma or injury can
lead to incontinence.
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functional incontinence :occurs when a person recognizes the need to
urinate but cannot make it to the bathroom. The urine loss may be large.
Causes of functional incontinence include confusion, dementia, poor eyesight,
poor mobility, poor dexterity, unwillingness to toilet because of depression,
anxiety or anger, drunkenness.
Bedwetting : is episodic UI while asleep. It is normal in young chiidren.
Giggle incontinence: is an involuntary response to laughter. It usually
affects children.
6. Causes of incontinence:-
Polyuria (excessive urine production).
Caffeine or cola beverages.
Enlarged prostate.
Neurological disorders also interfere with nerve
function of bladder, e.g., multiplesclerosis, spinal
bifida, parkinson's disease, strokes, spinal cord injury.
Unconscious
8. Pathophysiology:-
The pathophysiology of stress incontinence is due
to pelvic floor weakness or prolapse and/or loss of
the normal urethra vesical angle. The
pathophysiology of urge incontinence is uninhibited
bladder contractions caused by irritation or loss of
neurologic control of bladder contractions.
9. Diagnostic finding:-
Acystoscopyinvolves using a thin tube
with a camera attached to it (endoscope) to
look inside your bladder and urinary tract. A
cystoscopy can identify abnormalities that may
be causing incontinence.
10. Nursing diagnosis:-
Problem-Focused In effective Breathing Pattern related to decreased
lung expansion as evidenced by dyspnea, coughing, difficulty of
breathing.
RiskRisk for Ineffective Airway Clearance as evidenced by
accumulation of secretions in lungs.
Health Promotion:- Readiness for Enhanced
Family Coping as evidenced by verbalization of desire to
information that will enhance health choices.
Possible :- Possible Chronic Low Self-Esteem
11. Treatment:-
increased fluid intake of up to two litres a day.
high-fibre diet.
pelvic floor exercises.
bladder training.
training in good toilet habits.
medications, such as a short-term course of laxatives to treat
constipation.
aids such as incontinence pads.
12. Bibliography:-
K.Barbara,E Nancy. Introductory Medical-SurgicalNursing.9th ed.USA.
Lippincott Williams andWilkins.2007.p.380-3.
Lewis S,Collier L.Medical-Surgical Nursing Assessmentand Management of
ClinicalProblems.3nded.USA.Mosby. 1992.p.512-7>
K Park. Preventive and Social Medicine.20thed.India.Banarsidas
Bhanot.2009.p. 159-74.
Suzanne C,Branda G.Textbook of Medical SurgicalNursing. 10th ed.USA.
Lippincott Williams andVilkins.2004.p.532-8
