urge incontinence

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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.

urge in·con·ti·nence

, urgency incontinence
leakage of urine by unintended detrusor contraction with a strong desire to void.
Farlex Partner Medical Dictionary © Farlex 2012

urge incontinence

Leakage of urine from the bladder that accompanies an insistent need to urinate. Also called urgency incontinence.
The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved.

urge incontinence

Detrusor instability; irritable bladder; spasmodic bladder; unstable bladder; urgency incontinence Urology A condition characterized by a sudden and urgent need to urinate (urinary urgency), frequent urination; abdominal distention or discomfort immediately before an involuntary bladder contraction with a loss of a large amount of urine; a urine storage defect in which the bladder muscle contracts inappropriately regardless of the amount of urine in the bladder Etiology Idiopathic (most), neurologic disease–spinal cord injury, stroke, multiple sclerosis, infection, bladder CA, bladder stones, cystitis, bladder outlet obstruction–eg, BPH; UI is more common in elderly ♀; UI affects ±2% of older ♀ Diagnosis Post void residual–PVR, to measure amount of urine left after urination, urinalysis to exclude UTI, urinary stress test–Pt stands with full bladder, then coughs, pad test–after placing a pre-weighed sanitary pad, Pt exercises after which pad is re-weighed to ID urine loss/spillage, pelvic ultrasound, X-rays with contrast dye, cystoscopy, urodynamic studies–to measure pressure and urine flow, rarely, EMG Management Bladder retraining therapy, medications to relax bladder contractions, surgery; antispasmodics–eg, oxybutynin, Kegel exercises– which strengthen the muscles of the pelvic floor and thus improves the Sx of UI, antibiotics for UTIs, bladder retraining exercises, biofeedback; anticholinergics–propantheline and dicyclomine–which is also a bladder muscle relaxant Adverse effects Dry mouth, dizziness, drowsiness, ↑ heart rate, difficulty urinating, terbutaline–a beta-adrenergic that ↑ bladder capacity–Cons Palpitations, insomnia, HTN, distribution of fluid intake throughout the day; surgery aimed to ↑ bladder storage capacity, while ↓ the pressure in the bladder. See Kegel exercises, Oxybutynin. Cf Dribbling.
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
References in periodicals archive ?
For urge incontinence, a device called an "Interstim" can be implanted in the lower back via a minor surgical procedure.
'Clam' ileocystoplasty for the treatment of refractory urge incontinence. BrJUrol 1985;57:6416.
De novo urge incontinence, which is rarely seen after TOT operations, indicates that the obstructive effect of the surgery is minimal.
* Urge incontinence is caused by hyperactivity of the detrusor muscle, the large pumping muscle of the wall of the bladder.
In postmenopausal women, vaginal estrogen can be considered, and in women with equal parts stress and urge incontinence or urge-predominant mixed incontinence, a trial of anticholinergics or beta-3 agonists is appropriate.
* Urge incontinence (unstable or overactive bladder) is the second commonest cause.
All patients were presenting in gynaecology OPD with the complaint of something coming out of vagina with associated complaints of stress incontinence in 36%, Urge Incontinence in 44% and mixed complaints-Dysuria, difficulty in voiding, Dribbling of urine, and others in 20% and 14% presenting with the burning micturition.
This type is a combination of stress and urge incontinence.
Common types of UI are stress incontinence urge incontinence and mixed incontinence.