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Urinary retention and incontinence
The document outlines urinary retention and incontinence, detailing their symptoms, causes, diagnosis, and treatment options. Urinary retention is characterized by the inability to void despite the urge, with causes such as tumors and medication side effects, while incontinence can be classified into types including stress and urge incontinence, each with specific management strategies. Treatments include medications, surgical interventions, pelvic floor exercises, and lifestyle modifications to improve bladder control.
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Urinary retention and incontinence
- 1. GEETA JOSHI STATE COLLEGEOF NURSING
- 2. URINARY RETENTION Inability to voideven when the urge to void is present.
- 3. CAUSES OF RETENTION OTHERCAUSES • tumor • Interference with the sphincter muscles during surgery • side effect of medications
- 4. SYMPTOMS OF RETENTION • frequencyof urination, • voiding small amounts • Pain • Palpation of a distended bladder above the symphysis pubis
- 5. DIAGNOSIS • check forresidual urine- 1.bladder scan (The bladder scan uses ultrasound waves to identify the amount of urine remaining in the bladder. This method is preferred because it is noninvasive, decreasing the risk of urinary tract infection (UTI).) 2. inserting an intermittent straight catheter (can also be used to empty the bladder of the remaining urine increases the client’s chance of contracting a UTI.) The amount of urine left in the bladder, residual urine, should be less than 50 mL.
- 6. TREATMENT • analgesics -tohelp the client relax. • Cholinergic medications - to promote contraction of the bladder muscle, which promotes bladder emptying. • Antispasmodic medications - encourage relaxation of the bladder muscle consequently decreasing the urge to void. • urinary catheter may be used to empty the bladder • surgery may be performed to remove any obstruction (stones, strictures, tumors, etc.).
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- 10. STRESS INCONTINENCE Stress incontinenceoccurs when there is an involuntary leakage of urine due to activities that strain the pelvic floor muscles. Activities such as coughing, laughing, jogging, dancing, sneezing, lifting, and walking can all contribute to stress incontinence.
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- 12. Surgical procedures • PURPOSE-torestore the support of the pelvic floor muscles or to reconstruct the sphincter. 1. internal mesh support of the urethra 2. formation of a urethral sling to elevate and compress the urethra 3. implantation of an artificial sphincter. 4. support prostheses and external barriers
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- 16. cuff is placedaround the urethra when inflated it increases pressure on the urethra and keeps it closed. patient wishes to pass urine, he presses the control pump fluid in the cuff moves into the balloon reservoir releases the pressure around the urethra, allowing the urine to flow out. cuff refills on its own with fluid from the balloon reservoir
- 17. Pelvic floor exercises(Kegel exercises) PURPOSE- to strengthen the muscles, thereby preventing or minimizing stress incontinence.
- 18. BLADDER RETRAINING Bladder retrainingbegins with- • assessing the client’s ability to recognize the urge to void • completion of a 3-day voiding pattern history. Once a voiding pattern has been established, encourage the client to void 30 minutes before the projected time of incontinence.
- 19. URGE INCONTINENCE • occurswhen a person is unable to suppress the sudden urge or need to urinate. • The bladder muscles send strong signals to the brain indicating that it is time to void regardless of the amount of urine in the bladder. • The client is unable to control the strong signals and consequently leaks urine without any warning.
- 20. CAUSES OF URGEINCONTINENCE • irritated bladder • urinary tract infections • Neurologic dysfunction • Uninhibited detrusor contraction
- 21. TREATMENT OF URGEINCONTNENCE • Anticholinergic medications- to relax the smooth muscle and increase bladder capacity. • Treatment of infection • Increasing fluid intake- to prevent infection
- 22. OVERFLOW INCONTINENCE When thebladder becomes so full and distended that urine leaks out, it is called overflow incontinence.
- 23. CAUSES OF OVERFLOW INCONTINENCE • Blockedurethra • Bladder weakness 1. Diabetes 2. alcohol, 3. decreased nerve function • Enlarged prostate
- 24. TREATMENT OF OVERFLOW INCONTINENCE •surgical removal of the prostate • repair of genital prolapse • intermittent self- catheterization
- 25. FUNCTIONAL INCONTINENCE Functional incontinenceoccurs as a result of cognitive, neurological, and behavioral malfunctions.
- 26. MANAGEMENT OF FUNCTIONAL INCONTINENCE •behavior modifications • bladder retraining programs • surgical interventions • absorbent padding and undergarments • Diligent skin care is necessary to prevent skin breakdown • indwelling catheters
- 27. NOCTURNAL ENURESIS • Incontinencethat occurs during sleep is called nocturnal enuresis. • Limiting fluid intake after 6 p.m. helps the client remain continent during the night. • The total fluid intake for 24 hours, however, should remain the same. • The bladder should be emptied immediately before going to bed.
Editor's Notes
- #4 stress benign prostatic hypertrophy (BPH), obstruction of the urethra by calculi (concentration of mineral salts, known as stones), tumor, infection, Interference with the sphincter muscles during surgery side effect of medications trauma.