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Urinary Incontinence
The inability to control the passage of urine. This can range from an occasional leakage of urine, to a complete inability to hold any urine.
The Impact of Urinary Incontinence in African American Women
Urinary incontinence is a major health problem for many individuals, especially older women. Research on urinary incontinence is common in Caucasians, but scarce in women of diverse cultures. Using data from a previous (parent) descriptive correlational study on risk factors for urinary incontinence in African American women (N = 233), a descriptive study of the impact of urinary incontinence was conducted among 85 college-educated African American women who were members of a prestigious African American organization and reported symptoms of urinary incontinence. Information about frequency and duration of incontinence, activities affected by urinary incontinence, and ratings of how much they were bothered by their urinary incontinence was obtained. Mean age of the study group was 51.94 years (range 20 to 80 years). Fifty-four of the participants (64%) reported one or more vaginal delivery, 33% had undergone a hysterectomy, and symptoms of urinary incontinence had been present from 3 months to 30 years. Stress, urge, and mixed incontinence were reported. Eleven women (13%) had sought treatment for their urinary incontinence, 20% said urinary incontinence bothered them a great deal, 8.5% reported behavioral modifications, and a portion of the women said they had to spend extra money on incontinence supplies. In this group of African American women, urinary incontinence rates were similar to those reported in Caucasian women. Research to increase clinician knowledge base and improve the care of African American women is needed.
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Using Epidemiology in Patient Education for Post-Prostatectomy Urinary Incontinence
This article reviews and discusses the prevalence and incidence of and risk factors for urinary incontinence after prostate cancer surgery. The reported prevalence rates of urinary incontinence in men vary among studies due to different definitions and methodologies; however, it is agreed that urinary incontinence is a common condition, especially immediately after surgery. Although few risk factors have been identified, damage to the sphincter or its nerves is an accepted underlying pathology. Urinary incontinence can be devastating to men and sensitivity to emotional and educational needs is critical. Ostomy/Wound Management 2001;47(12):20?25
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The State of the Science on Urinary Incontinence. A look at the proceedings of the conference, "Urinary Incontinence: Research, Practice, and Policy Issues"
This article is excerpted from the executive summary of the full report of the symposium and also appears in the American Journal of Nursing, March 2003 (reprinted with permission). The report is available at www.nursingcenter.com/ui. Ostomy/Wound Management is grateful to the collaborators, sponsors, and publishers involved in this project for allowing us to bring this information to our readers.
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Urinary Incontinence, Catheters, and Urinary Tract Infections: An Overview of CMS Tag F 315
The majority of nursing home residents experience some type of urinary incontinence. Other bladder-related disorders (eg, urinary retention and urinary tract infection) also are common in long-term care facilities. Efforts to manage urological conditions such as the use of indwelling catheters and absorbent products, perineal hygiene and care, toileting, and bladder rehabilitation are areas of concern and have become the subject of revised regulations. The intent of recent changes to the Centers for Medicare and Medicaid Services surveyor guidance for incontinence and urinary catheters is to ensure that: 1) incontinent residents are identified, assessed, and provided appropriate treatment, 2) indwelling catheters are not used without medical justification and removed as soon as clinically warranted, and 3) residents receive appropriate care to prevent urinary tract infections. Nursing homes must implement policies, procedures, and programs to help restore bladder function and continence in order to improve quality-of-life for nursing home residents. KEYWORDS: urinary incontinence, catheters, urinary tract infection, long-term care, CMS
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Modern Management of Women with Stress Urinary Incontinence: Part 2
Incontinence Surgery Retropubic suspensions. Bulking agents. Procedure.
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A Nursing Analysis of the Causes of and Approaches for Urinary Incontinence among Elderly Women in Nursing Homes (PART 2)
Urinary incontinence is a widespread but often ignored problem among elderly women residing in nursing homes. Despite numerous research studies performed within this setting, few have been able to demonstrate lasting change in the care of and enduring outcomes in this population. However, neither the most commonly used definitions of incontinence nor current management approaches are meeting the needs of institutionalized frail elderly, particularly women, who are twice as likely as men to demonstrate symptoms of the condition. Costs in terms of quality of life and expense of care are staggering. Because many believe that a holistic approach may provide direction for management of urinary incontinence, and because nursing is a holistic profession, a solution to the challenges involved in treating incontinence among the elderly potentially lies in utilizing a nursing as opposed to medical framework for the analysis of factors and care. Specifically, the complexities of testing necessary to differentiate current diagnoses might be simplified by classifying incontinence in a different way, such as using nurse-identified levels of need as opposed to physiologically-based factors. The use of nursing theory to guide patient assessment and an evaluation of systems of care provides a fresh approach to this long-standing problem. Keywords: urinary incontinence, nursing home population, women, diagnosis, treatment
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A Nursing Analysis of the Causes of and Approaches for Urinary Incontinence among Elderly Women in Nursing Homes (PART 1)
Urinary incontinence is a widespread but often ignored problem among elderly women residing in nursing homes. Despite numerous research studies performed within this setting, few have been able to demonstrate lasting change in the care of and enduring outcomes in this population. However, neither the most commonly used definitions of incontinence nor current management approaches are meeting the needs of institutionalized frail elderly, particularly women, who are twice as likely as men to demonstrate symptoms of the condition. Costs in terms of quality of life and expense of care are staggering. Because many believe that a holistic approach may provide direction for management of urinary incontinence, and because nursing is a holistic profession, a solution to the challenges involved in treating incontinence among the elderly potentially lies in utilizing a nursing as opposed to medical framework for the analysis of factors and care. Specifically, the complexities of testing necessary to differentiate current diagnoses might be simplified by classifying incontinence in a different way, such as using nurse-identified levels of need as opposed to physiologically-based factors. The use of nursing theory to guide patient assessment and an evaluation of systems of care provides a fresh approach to this long-standing problem. Keywords: urinary incontinence, nursing home population, women, diagnosis, treatment
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Identifying and Treating Reversible Causes of Urinary Incontinence
Urinary incontinence can be a symptom of a variety of reversible conditions. Common and reversible causes of urinary incontinence include polyuria, exposure to irritants (including concentrated urine), infection, urinary retention, use of pharmaceuticals, stool impaction or constipation, atrophic urethritis or vaginitis, restricted mobility or dexterity, psychological conditions, and delirium or acute confused state. Healthcare professionals can use existing assessment strategies, tools, and parameters to guide decisions and treatment options to manage these conditions. First-line assessment tools are reviewed, including the use of a voiding and bowel diary, simple dipstick urinalysis, catheterization for post-void residual, the Folstein Mini Mental Status evaluation, and the Geriatric Depression Scale. Guidelines for estimating normal ranges of urine output, the influence of irritants, the risk of incontinence caused by stool impaction, and urinary retention are discussed. Primary care providers are well positioned to rule out or treat many of the reversible causes of urinary incontinence using simple assessment tools and pragmatic guidelines.
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Male Bladder Control Problems: A Guide To Assessment
Overactive bladder is a common health problem that affects millions of men and women. Despite its prevalence, provider knowledge is lacking with regard to evaluation and treatment modalities. Although bladder control problems are less common in men than in women, the burden of incontinence may be more significant. In men presenting with symptoms of urgency and frequency, a differential diagnosis between overactive bladder and benign prostatic disease must be made because their cause and treatment are different. Empiric treatment of urgency symptoms may cause them to worsen if the diagnosis is not correct. Symptom assessment should include a medical history, physical examination, urinalysis, and post void residual study. Over the past several years, many new medications have become available to treat both overactive bladder and benign prostatic disease. These medications, in combination with behavioral interventions, are safe and effective. The evaluation and treatment of men with symptoms of overactive bladder and/or incontinence is discussed. KEYWORDS: urinary incontinence, urinary retention, benign prostatic hypertrophy, post void residual, overactive bladder
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Modern Management of Women with Stress Urinary Incontinence: Part 1
Stress urinary incontinence is a prevalent condition that may have a significant negative impact on a woman?s quality of life. With improved awareness and research, new nonsurgical and surgical managements are being developed; noninvasive measures should be considered before invasive treatments. Pelvic floor exercises, biofeedback, and electrical stimulation may be helpful depending on the individual. With the release of duloxetine, the first FDA-approved medication for stress urinary incontinence, pharmacologic therapy (which has not had a significant role in stress urinary incontinence) will gain more attention. Surgical treatments have become minimally invasive with good efficacy. Overall, as the understanding of the pathophysiology of stress urinary incontinence evolves, so will management of this disease state. KEYWORDS: stress incontinence, behavioral therapy, pharmacologic therapy, continence surgery, urethral bulking agents
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