Causes of Urinary Incontinence

Urinary Incontinence Is Intermittent or complete absence of ability to control excretion of urine.

Incidence: Affects more than 13 million people in the U.S. and twice as many women as men.

Onset: Depending on cause, incontinence may occur at any age.

Etiology: In women, pregnancy, childbirth, and menopause are responsible for the majority of cases. In both men and women, various underlying medical conditions include spinal cord injury, birth defects, strokes, multiple sclerosis, and physical problems associated with aging.

Clinical Findings: Involuntary leakage of urine.

Types of Incontinence
■ Stress: Leakage of small amounts of urine during physical movement (coughing, sneezing, exercising).
■ Urge: Involuntary passage of urine occurring soon after a strong sense of urgency to void.
■ Mixed: Usually the occurrence of stress and urge incontinence together.
■ Overflow: Unexpected leakage of urine because of a full bladder.
■ Functional (Environmental): Untimely urination because of physical disability, external obstacles, or problems in thinking or communicating that prevent a person from reaching a toilet.
■ Transient: Leakage that occurs temporarily because of a condition that will pass (infection, med).

Nursing Focus
■ Provide routine skin care and assessment including fluid intake and output.
■ Encourage Pt to practice Kegel exercises and monitor effectiveness.
■ Offer reassurance and encouragement.
■ Ensure a barrier-free pathway to the bathroom (functional incontinence).

Patient Teaching
■ Provide Pt and family with literature on incontinence.
■ Teach Kegel exercises: Contract the pelvic floor muscles (the same muscles that stop the flow of urine) for 10 seconds, and then relax for 10 seconds. Perform 3 sets of 10 contractions every day.
■ Encourage Pt to quit smoking to reduce coughing and bladder irritation. Smoking also increases risk of bladder cancer.
■ Explain that alcohol and caffeine can overstimulate the bladder and should be avoided.
■ Advise the Pt to avoid foods and drinks that may irritate the bladder such as spicy foods, carbonated beverages, and citrus fruits and juices.
■ Explain the actions, dosages, side effects, and adverse reactions of meds.
■ If surgery is to be performed, provide preoperative teaching to prepare the Pt and family about the procedure, and postoperative care and recovery.