urge urinary incontinence


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Related to urge urinary incontinence: stress urinary incontinence

incontinence

 [in-kon´tĭ-nens]
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.

urge urinary incontinence

Involuntary passage of urine occurring soon after a strong sense of urgency to void. Drugs that inhibit the detrusor muscle of the bladder, such as oxybutynin, can be used as treatment.

Patient care

Healthy older adults may develop urge incontinence, but it also can affect those who have suffered a stroke or who have Alzheimer disease, Parkinson disease, multiple sclerosis, or diabetes mellitus. Bladder retraining and Kegel exercises should be the first therapies for urge incontinence. The patient should maintain a regular toileting schedule, beginning with every 1 to 2 hr, then gradually increasing the time between voiding. Keeping a diary of fluid intake, urine output, and any episodes of incontinence helps the patient and the primary health care provider recognize patterns and revise the regimen as needed. The patient should carry out Kegel exercises when the urge to void starts because these exercises help strengthen perineal muscles, which may provide the patient more time to reach the toilet. Anticholinergic drugs, such as oxybutynin and tolterodine, that inhibit the detrusor muscle of the bladder can be prescribed. Patients should be aware of potential adverse effects, which include confusion, dry mouth, dry eyes, urinary retention, constipation, and blurred vision.

See also: incontinence
References in periodicals archive ?
After 3 months of finishing therapy 4 patients continued to stay "dry", and in 16 women the urge urinary incontinence preserved.
The data stratification into responders and nonresponders was helpful, as were the tables and figures that demonstrated who was helped by BFB for their urge urinary incontinence.
NEW ORLEANS -- Hormone replacement therapy was associated with a greater than twofold increase in risk of urge urinary incontinence and an almost fourfold increase in risk of stress urinary incontinence in postmenopausal women, according to a new analysis of data from the Heart and Estrogen/Progestin Replacement Study.
The medicine is intended for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency and urinary frequency.
Brain activity measured by functional magnetic resonance imaging (fMRI) is related to patient reports and clinical severity of urge urinary incontinence.Presented at the International Continence Society Annual Meeting 2008abstract #214.
Botros, also a fellow at Northwestern's Evanston Continence Center, presented a poster detailing postsurgical resolution rates of detrusor overactivity and subjective urge urinary incontinence (UUI) in 276 subjects with urodynamic stress or mixed urinary incontinence.
A transdermal patch containing oxybutynin for overactive bladder that causes symptoms of urge urinary incontinence, urgency and frequency The first transdermal treatment for this indication.
A contract has been signed that will resolve the parties' patent litigation in connection with Mylan Pharmaceuticals' Abbreviated New Drug Application for Tolterodine Tartrate ER capsules, two mg and four mg, which is the generic version of Pfizer's Detrol(r) LA, indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.
ATLANTA -- Women with postpartum depression are more likely than are nondepressed women to have urge urinary incontinence, according to findings presented in a poster at the annual meeting of the American Urogynecologic Society.
M2 EQUITYBITES-August 6, 2012-Pfizer Inc's phase 4 study of Toviaz reduces urge urinary incontinence in patients with OAB, meeting primary endpoint(C)2012 M2 COMMUNICATIONS http://www.m2.com
M2 PHARMA-August 6, 2012-Pfizer Inc's phase 4 study of Toviaz reduces urge urinary incontinence in patients with OAB, meeting primary endpoint(C)2012 M2 COMMUNICATIONS
In a study published in 2000, investigators examined the effects of combining behavioural treatment and drug treatment for urge incontinence in community-dwelling older women.[sup.11] A total of 197 ambulatory, nondemented, community-dwelling women (age 55 years or older) with persistent urge urinary incontinence were enrolled.