stress incontinence

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Related to stress incontinence: urge incontinence, reflex incontinence


1. inability to control excretory functions.
2. immoderation or excess. adj., adj incon´tinent.
bowel incontinence
2. a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a state in which an individual has a change in normal bowel habits, with involuntary bowel movements.
continuous incontinence continuous urinary leakage from a source other than the urethra, such as a fistula.
fecal incontinence (incontinence of the feces) inability to control defecation; both physiologic and psychological conditions can be contributing factors. Called also encopresis and bowel incontinence. See also bowel elimination, altered. Physiologic causes include neurologic sensory and motor defects such as those occurring in stroke and spinal cord injury; pathologic conditions that impair the integrity of the sphincters, such as tumors, lacerations, fistulas, and loss of sensory innervation; altered levels of consciousness; and severe diarrhea. Psychological factors include anxiety, confusion, disorientation, depression, and despair.

There is potential for physical and psychological stress when a person is unable to control his or her bowel movements. Damage to the integrity of the skin and its breakdown into pressure ulcers is always a possibility no matter how hard caregivers might try to keep the patient clean and dry. Psychologically the person is likely to suffer from loss of self-esteem and is certain to experience some alteration in self-image. From the time of toilet training a person is expected to be able to handle the tasks of bowel elimination. An adult who for some reason is no longer able to do this is often embarrassed by and ashamed of the inability to perform this most basic of self-care activities.
Patient Care. Assessment of the problem of fecal incontinence should be extensive and thorough so that a realistic and effective plan of care can be implemented. Sometimes all that is needed is a regularly scheduled time to offer the patient a bedpan or help using a bedside commode or going to the bathroom. If diarrhea is a problem it may be that dietary intake needs changing or tube feedings are not being administered correctly. Dietary changes may also help the patient who has a stoma leading from the intestine. In cases of neurologic or neuromuscular deficit, retraining for bowel elimination is a major part of rehabilitation of the patient. Frequently, it is possible to help a patient achieve control by means of a well-planned and executed bowel training program.

Biofeedback techniques can be helpful in many cases. The person learns to maintain higher tone in the anal sphincter through use of a balloon device that provides feedback information about pressures in the rectum. With practice the person can learn better control and develop a more acute awareness of the need to defecate.
functional incontinence incontinence due to impairment of physical or cognitive functioning.
functional urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as an inability of a usually continent person to reach the toilet in time to avoid the unintentional loss of urine. See also urinary incontinence.
overflow incontinence (paradoxical incontinence) urinary incontinence due to pressure of retained urine in the bladder after the bladder has contracted to its limits; there may be a variety of presentations, including frequent or constant dribbling or symptoms similar to those of stress or urge incontinence.
reflex incontinence the urinary incontinence that accompanies detrusor hyperreflexia.
reflex urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as an involuntary loss of urine at somewhat predictable intervals, whenever a specific bladder volume is reached. See also reflex incontinence.
risk for urge urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as the state of being at risk for involuntary loss of urine associated with a sudden strong sensation of urinary urgency. See also urge urinary incontinence.
severe stress urinary incontinence severe stress incontinence as a result of incompetence of the sphincter mechanism.
stress incontinence urinary incontinence due to strain on the orifice of the bladder, as in coughing or sneezing.
stress urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as loss of urine of less than 50 ml when there is increased abdominal pressure. See also stress incontinence.
total urinary incontinence a nursing diagnosis accepted by the Seventh National Conference on the Classification of Nursing Diagnoses, defined as a state in which an individual has continuous and unpredictable loss of urine; see also urinary incontinence.
urge incontinence (urgency incontinence) urinary or fecal incontinence preceded by a sudden, uncontrollable impulse to evacuate (see also urgency). Urge incontinence of urine is a major complaint of patients with urinary tract infections and is also present in some women two or three days before onset of the menstrual period.
urge urinary incontinence a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as the involuntary passage of urine soon after feeling a strong sense of urgency to urinate; see also urge incontinence.
urinary incontinence (incontinence of urine) loss of control of the passage of urine from the bladder; see also enuresis. It can be caused by pathologic, anatomic, or physiologic factors affecting the urinary tract, as well as by factors entirely outside it. See also urinary elimination, altered.
Patient Care. The Agency for Health Care Policy and Research (AHCPR) convened an interdisciplinary, non-Federal panel of physicians, nurses, allied health care professionals, and health care consumers that has identified and published Clinical Practice Guidelines for Urinary Incontinence in Adults. Identification and documentation of urinary incontinence can be improved with more thorough medical history taking, physical examination, and record keeping. Routine tests of lower urinary tract function should be performed for initial identification of incontinence. There are also situations that require further evaluation by qualified specialists.

The guidelines provide an informed framework for selecting appropriate behavioral, pharmacologic, and surgical treatment and supportive services that can be used to treat urinary incontinence. The panel concluded that behavioral techniques such as bladder training and pelvic muscle exercises are effective, low cost interventions that can reduce incontinence significantly in varied populations. Surgery, except in very specific cases, should be considered only after behavioral and pharmacologic interventions have been tried. The panel found evidence in the literature that treatment can improve or cure urinary incontinence in most patients. The address of the AHCPR is Agency for Health Care Policy and Research, P.O. Box 8547, Silver Spring, MD 20907. They can also be called toll free at (800) 358-9295.
Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved.

stress incontinence

A sudden, involuntary release of urine caused by muscular strain accompanying laughing, sneezing, coughing, or exercise, seen primarily in older women with weakened pelvic musculature. Also called stress urinary incontinence.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

stress incontinence

Dribbling bladder, fallen bladder; loss of pelvic support; urinary incontinence Urology An involuntary loss of urine linked to ↑ internal abdominal pressure–eg, coughing, sneezing, laughing, physical activity; SI is a storage problem in which the urethral sphincter's strength is ↓, and sphincter reacts to ↑ abdominal pressure by releasing urine Etiology Weak pelvic muscles that support the bladder, or urethral sphincter defect, due to prior trauma to the urethral area, neurologic injury, drugs, prostate or pelvic surgery, multiple pregnancies, pelvic prolapse–protrusion of bladder, urethra, rectal wall into vaginal space, with a cystocele, cystourethrocele, rectocele, ↓ estrogen; SI affects 20% of ♀ ≥ age 75 Risk factors Age, obesity, chronic bronchitis, asthma, childbearing
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
Overall our results are consistent with a recent systematic review of periurethral Polyacrylamide hydrogel, which primarily included patients with mild primary stress incontinence; the included studies reported good clinical success, minimal morbidity, and an approximately 25% reinjection rate (8).
When the individuals with a shorter urethral length (Goh classes 3 and 4), a known risk factor for residual stress incontinence, are compared to those with a normal length, a statistically significant larger proportion have stress incontinence and a heavier pad weight (Table 3).
Surgery can be an option for stress incontinence if Kegels fail to improve the problem.
Some findings suggest that first pregnancy and delivery in particular predispose development of stress incontinence, which is in accordance with a study in a large group of young multiparous women(20).
The authors of the CARE trial recommended to perform a Burch colposuspension in all women without stress incontinence who are undergoing abdominal sacrocolpopexy for prolapse to reduce postoperative symptoms of stress incontinence.
(4) Evidence suggests that the prevalence of both urge and stress incontinence increases proportionately with BMI.
The aim is for women to recover their fitness quickly, and classes include pelvic floor exercises to prevent stress incontinence from developing.
It is safe to proceed to surgery for SUI without urodynamic testing in women who meet all the following criteria: no previous surgery, no prolapse beyond the introitus, presence of predominant SUI complaints, demonstration of stress incontinence on cough stress testing, normal postvoid residual, mobile urethra, and normal urinalysis.
64.9% of the male participants had urge incontinence followed by 26.6% having stress incontinence while only 8.44 % of the males were diagnosed with mixed incontinence.
The ombudsman also found there was no alternatives offered to a married woman who complained after seeing consultants at the Southern General Hospital in Glasgow for prolapse and stress incontinence in 2006.
Objective: To evaluate the utility and efficacy of bulbar urethera sling in the management of sphincter insufficiency that usually occurs after prostate surgery or posterior urethral injuries and may lead to moderate to severe stress incontinence.
Urinary incontinence is very common in women, the most common forms are stress incontinence and urge incontinence.

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