GERIATRIC SYNDROME: URINARY INCONTINENCE

URINARY INCONTINENCE is a unwanted leakage of urine, it has a several impact in the quality of life and leads to the shame and social isolation: it cause anxiety and depression in a big percentage of people who suffers it.

The Uninary incontienence imposes a several burden on caregivers and it is one of the mains causes for admission into a nursing home.

There are differents kinds of uninary incontinence:

1. Stress UI: defined as an involuntary loss of urine associated with activities that increase intra-abdominal pressure. 

2. Urge UI: characterized by an involuntary urine loss associated with a strong desire to void (urgency).  An individual with an overactive bladder may complain of urinary urgency, with or without UI. 

3. Mixed UI: usually defined as a combination of Stress UI and Urge UI

4. Overflow UI: an involuntary loss of urine associated with over-distention of the bladder and may be caused by an under-active detrusor muscle or outlet obstruction leading to over-distention of the bladder and overflow of urine.

5. Functional UI: caused by nongenitourinary factors, such as cognitive or physical impairments that result in an inability for the individual to be independent in voiding .

Treatment Treatment of UI in elderly:

 Medications

 Anti-incontinence rings incontinence rings

 Mi i ll I i S Minimally Invasive Surgery

 Behavioral Treatment

-          Bladder Diary

-          Pelvic Floor exercice – Kegel’s execice

-          Bladder training: frequent voluntary voiding

Nursing Care Strategies

A. General principles that apply to prevention and management of all forms of UI:

-          Identify and treat causes of transient UI

-          Develop an individualized plan of care using data obtained from the history and physical . Implement toileting programs as needed

-          Avoid medications that may contribute to UI

-          Avoid indwelling urinary catheters whenever possible to avoid risk for UTI

-          Monitor fluid intake and maintain an appropriate hydration schedule.

-          Limit dietary bladder irritants.

-           Modify the environment to facilitate continence.

-           Prevent skin breakdown by providing immediate cleansing after an incontinent episode and utilizing barrier ointments.