Practical Placement at Child and Aged Care Center

Urinary incontinence (UI) is loss of bladder control. Symptoms can range from mild leaking to

uncontrollable wetting

Types of urinary incontinence include:

1. Stress Urinary Incontinence (SUI)

Urine leaks when patient exert pressure on the bladder by coughing, sneezing, laughing,

exercising or lifting something heavy. With SUI, weak pelvic muscles let urine escape. It is

one of the most common types of urinary incontinence. It is common in older women. It is less

common in men.SUI happens when the pelvic floor muscles have stretched. Physical activity

puts pressure on the bladder. Then the bladder leaks. Leaking my happen with exercise,

walking, bending, lifting, or even sneezing and coughing. It can be a few drops of urine to a

tablespoon or more. SUI can be mild, moderate or severe. Ways to manage SUI include

"Kegel" exercises to strengthen the pelvic floor. Lifestyle changes, vaginal and urethral

devices, pads, and even surgery are other ways to manage SUI.

2. Urge incontinence (Overactive Bladder) - (OAB)

Patient may have a sudden, intense urge to urinate followed by an involuntary loss of urine.

Patient may need to urinate often, including throughout the night. Urge incontinence may be

caused by a minor condition, such as infection, or a more severe condition such as neurologic

disorder or diabetes.

With OAB, your brain tells your bladder to empty - even when it isn't full. Or the bladder

muscles are too active. They contract (squeeze) to pass urine before your bladder is full. This

causes the urge (need) to urinate

OAB is more likely in men with prostrate problems and in women after menopause.

The main symptom of OAB is the sudden urge to urinate. You can't control or ignore this

"gotta go" feeling. Another symptom is having to urinate many times during the day and night.

OAB is more likely in men with prostrate problems and in women after menopause. It is

caused by many things. Even diet can affect OAB. There are a number of treatments. They

include life style changes, drugs that relax the bladder muscle, or surgery.

3. Overflow incontinence

Patient experience frequent or constant dribbling of urine due to a bladder that doesn't empty

completely. With overflow incontinence, the body makes more urine than the bladder can hold

or the bladder is full and cannot empty thereby causing it to leak urine. In addition, there may

be something blocking the flow or the bladder muscle may not contract (squeeze) as it should.

One symptom is frequent urinating of a small amount. Another symptom is a constant drip,

called "dribbling."

This type of urinary incontinences is rare in women. It is more common in men who have

prostate problems or have had prostate surgery.

4. Functional incontinence

A physical or mental impairment keeps patient from making it to the toilet in time. For

example, if patient has severe arthritis, he or she may not be able to unbutton pants quickly

enough.

5. Mixed incontinence

Patient may experience more than one type of urinary incontinence.

Temporary urinary incontinence

Certain drinks, foods and medications can cause temporary urinary incontinence

They include:

 Alcohol

 Caffeine

 Decaffeinated tea and coffee

 Carbonated drinks

 Artificial sweeteners

 Corn syrup

 Foods that are high in spice, sugar or acid, especially citrus fruits

 Heart and blood pressure medications, sedatives, and muscle relaxants

 Large doses of vitamins B or C

Urinary incontinence also may be caused by an easily treatable medical conditions, such as:

 Urinary tract infection. 

Infections can irritate the bladder, causing to have strong urges to urinate, and sometimes incontinence.

 Constipation. 

The rectum is located near the bladder and shares many of the same nerves.Hard, compacted stool in the rectum causes these nerves to be overactive and increase urinary frequency.

Persistent urinary incontinence

Urinary incontinence can also be a persistent condition caused by underlying physical problems

or changes, including:

 Pregnancy. Hormonal changes and the increased weight of the uterus can lead to stress

incontinence.

 Childbirth. Vaginal delivery can weaken muscles needed for bladder control and also

damage bladder nerves and supportive tissue, leading to a dropped (prolapsed) pelvic floor.

With prolapse, the bladder, uterus, rectum or small intestine can get pushed down from the

usual position and protrude into the vagina. Such protrusions can be associated with

incontinence.

 Changes with age. Aging of the bladder muscle can decrease the bladder's capacity to store

urine.

 Menopause. After menopause women produce less estrogen that helps keep the lining of

the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.

 Hysterectomy. In women, the bladder and uterus are supported by many of the same

muscles and ligaments. Any surgery that involves a woman's reproductive system, including

removal of the uterus, may damage the supporting pelvic floor muscles, which can lead to

incontinence.

 Enlarged prostate. Especially in older men, incontinence often stems from enlargement of

the prostate gland, a condition known as ben

 Prostate cancer. In men, stress incontinence or urge incontinence can be associated with

untreated prostate cancer. But more often, incontinence is a side effect of treatments for

prostate cancer.

 Obstruction. A tumor anywhere along the urinary tract can block the normal flow of urine,

leading to overflow incontinence. Urinary stones / calculi may also obstruct the urinary

tract.

 Neurological disorders. Multiple sclerosis, Parkinson's disease, stroke, a brain tumor or a

spinal injury can interfere with nerve signals involved in bladder control, causing urinary

incontinence.

Factors that increase risk of developing urinary incontinence include:

 Gender. Women are more likely to have stress incontinence. Pregnancy, childbirth,

menopause and normal female anatomy account for this difference. However, men with

prostate gland problems are at increased risk of urge and overflow incontinence.

 Age. As get older, the muscles in the bladder and urethra lose some of their strength.

Changes with age reduce how much your bladder can hold and increase the chances of

involuntary urine release.

 Being overweight. Extra weight increases pressure on your bladder and surrounding

muscles, which weakens them and allows urine to leak out when intra abdominal pressure

increases.

 Other diseases. Neurological disease or diabetes may increase the risk of incontinence.

Urinary incontinence may

 Indicate an underlying condition

 Restrict activities and limit social interactions

 Increase the risk of falls in older adults

 Increase the risk of infections

 Increase the risk of pressure ulcers on immobile clients