Incontinence Flashcards
What is Urinary Incontinence?
Loss of bladder control:
- functional abnormalities of the bladder or urethra
- bladder muscle contractions
- weak pelvic floor and/ sphincter muscles
- blockage in urethral opening
Dual control of urination
- Autonomic Nervous System
- nerve from spinal cord directly to bladder
- when bladder gets full signals sent to brain - CNS
- voluntary control to choose when to void
**Pontine Micturition Center
- located in brain stem
- provides automatic coordinated voiding
- urethra opens before bladder contracts
PONS
hold micturition reflex center which allows bladder to empty when reaching a certain fullness regardless of social situation
Parasympathetic
- comes off at S2-S4
- causes bladder to contract and urethra to relax
- stimulation initiates voiding
Sympathetic
- T10-L2
- causes bladder neck to tighten and contribute to bladder relaxation
- stimulation contributes to urine storage and promotes continence
Trigone
smooth triangular region of the internal urinary bladder formed by two urethral orifices and the internal urethral orifice
Bladder pressure NOT greater than urethral pressure
patients with urge or frequency
Bladder pressure GREATER than urethral pressure
pt with urge incontinence
Stress Incontinence
- urethral hypermobility and intrinsic sphincteric deficiency
- lose urine when they exercise or move in a certain way
- Leak urine when sneeze, cough, laugh, get up from a chair or out of bed, walk
- may go to the bathroom often during the day to avoid accidents
Urge Incontinence
- lose urine as soon as they feel a strong need to go to the bathroom
- May leak when they can’t go to the bathroom quick enough, drink small amount of liquid or when they hear or touch running water, go to bathroom often ( q 2 h during the day), may wet the bed
Urge Incontinence Risk Factors
aging, bladder irritants, neurological lesions, stones, cancer, obstructed flow, idiopathic
Overflow Incontinence
- do not feel the urge to urinate
- incomplete bladder emptying
- small amounts of urine leaked on a near continuous basis
- weak bladder muscles
- most frequent in older men (BPH), spinal cord injuries or nervous system disorders
Overflow Incontinence Symptoms
- feeling as though the bladder is never completely empty
- urge to urinate but not being able to
- dribbling stream of urine
- nocturia
- may leak urine day and night
Functional Incontinence
- intact urinary storage and emptying
- unable to toilet themselves
- voids large amt at regular intervals
- usually related to cognitive status, motivation, mobility issues
- no social continence
