complete detail about urinary incontinence

1. URINARY
INCONTINENCE
PRESENTED BY: SONIA DAGAR

2. INTRODUCTION:
 Incontinence is the inability to control the passage of
urine.
 Urinary incontinence, the involuntary loss of bladder
control and general bladder weakness.
 This can range from an occasional leakage of urine to a
complete inability to hold any urine.
 Incontinence is most common among elderly.
 Women are more likely than man to have urinary
incontinence.
 Children and infant are not considered incontinent, but
merely untrained.

3. CAUSES AND RISK FACTORS:
 Bed rest – e.g. recovering from surgery
 Increased urine amounts, like with poorly controlled
diabetes
 Alcohol
 Overactive bladder
 Mental confusion
 Pregnancy
 Prostate infection or inflammation
 Stool impaction from sever constipation, causing
pressure on the bladder

4. CONT…
 Urinary tract infection or inflammation
 Weight gain
 Polyuria (excessive urine production)
 Caffeine or coca beverages also stimulate the bladder.
 Certain medicines such as diuretics, antidepressants,
tranquilizers, antihistamines for allergy etc.
 Alzheimer’s disease
 Multiple sclerosis
 Parkinson’s disease
 Stroke and spinal cord injury

5. CONT…
 Bladder cancer
 Bladder spasms
 Depression
 Large prostate in men
 Nerve or muscle damage after pelvic radiation
 Pelvic prolapse in women
 Problems with the structure of the urinary tract
 Weakness of the sphincter

6. TYPES OF INCONTINENCE
1) Stress incontinence
2) Urge incontinence
3) Overflow incontinence
4) Functional incontinence
5) Gross total incontinence

7. 1) STRESS INCONTINENCE:
 It is involuntary lose of urine during actions – such as
coughing, sneezing and lifting that put abdominal
pressure on the bladder.
 It occurs when the sphincter muscle of the bladder is
weakened.
 In women, physical changes resulting from pregnancy,
childbirth and menopause can cause stress incontinence.
 In men, removal of the prostate gland can lead to stress
incontinence.

8. 2) URGE INCONTINENCE:
 It occurs in patients who have a strong,
uncontrollable, involuntary urge to urinate that leads
to uncontrollable voiding of urine.
 It may be caused by urinary tract infections, bladder
irritants, bowel problems, Parkinson’s disease,
Alzheimer’s disease, stroke, injury or nervous
system damage associate with multiple sclerosis.
 if there is no known case, it also called overactive
bladder.

9. 3) OVERFLOW INCONTINENCE:
 It is the constant dribbling of urine usually associated
with urinating frequently and in small amounts.
 Overflow incontinence is occurring after urinary
retention.
 This type of incontinence may occur in people with a
damaged bladder, blocked urethra and nerve damage
from diabetes and in men with prostate gland problems.

10. 4) FUNCTIONAL INCONTINENCE:
 Many older adults, especially people in nursing homes,
experience incontinence simply because a physical or
mental impairment keeps them from making it to the
toilet in time.
 For example, a person with severe arthritis may not be
able to unbutton his or her pants quickly enough.

11. 5) GROSS TOTAL INCONTINENCE:
 It is described as continuous leaking of urine, day and
night, or the periodic uncontrollable leaking of large
volumes of urine.
 In this the bladder has no storage capacity.
 Some people have this because of anatomical defect.
 This can cause by injuries to the spinal cord or urinary
system or by an abnormal opening called fistula between
the bladder and an adjacent structure, such as the vagina.

12. CLINICAL MANIFESTATIONS:
1. SENSORY SIGN:
 Odor of urine or feces in the room
 Soiling of undergarments or bed linens
 Irritation of perineal area
 Accidents while engaged in physical activity,
sneezing, laughing.
2. EMOTIONAL SIGN:
 Anger
 Decline in Social Activity
 Desire for Attention

13. DIAGNOSTIC EVALUATIONS:
 Urinalysis and urine culture
 Residual urine measurement
 Vaginal and anal examination
 Urodynamic studies
 Serum electrolytes, calcium levels and BUN/creatinine levels
 Spinal MRI
 Ultrasonography
 Cystourethrography
 Interavenous pyelograpgy (IVP)
 Fleuroscopy and video urodynamics
 Uroflowmetery, cystometer and urethral pressure
profilometery(UPP)
 Electromyography (EMG)

14. MANAGEMENT:
1.BEHAVIORAL
TECHNIQUES.
2. DRUG THERAPY
3. MEDICAL DEVICES
4. INTERVENTIONAL
THERAPIES
5. SURGERY
6) ABSORBENT PADS
& CATHETERS

15. 1) BEHAVIORAL TECHNIQUES:
 Bladder control training
 Scheduled toilet trips
 Biofeedback
 Pelvic floor muscle exercises
 Vaginal cone therapy
 Fluid and diet management
2) DRUG THERAPY:
 Anticholinergic agent
 Antispasmodics
 Topical estrogen
 Tricyclic antidepressants
 Alpha- adrenergic blockers
 Alpha – adrenergic agonists

16. 3) MEDICAL DEVICES:
 Urethral inserts
 Pessaries
 Catheters
 Clamps and compression rings for man
 Electrical stimulation devices
4) INTERVENTIONAL THERAPIES:
 Radiofrequency therapy
 Botulinum toxin type A
 Bulking material injections
 Sacral nerve stimulator

17. 5) SURGERY:
 Artificial urinary sphincter
 Sling procedures
 Bladder neck suspention
 Laproscopic bladder suspension procedure
 Retropubic colposuspension
 Bladder augmentation
 Neuromodulation
6) ABSORBENT PADS AND CATHETERS:
 Pads and protective garments
 catheters

18. KEGEL EXERCISE