Urinary Incontinence and Retention
The urinary system control urine. Any malfunctioning causes a lot of harm to the individual.
Definition. Urinary incontinence is the involuntary loss of urine from the bladder. Most people suffer urinary incontinence without telling the doctor because of shame and the feeling of embarrassment. Most go as far as using absorbent pads. Urinary incontinence is a symptom of various disorders.
TYPES OF URINARY INCONTINENCE
1. Functional Incontinence: This is when the organs that control urine malfunction or when the lower urinary tract does not perform its functions.
2. Urge Incontinence: This is when the urge to urinate cannot be suppressed thereby causing the release of urine from the bladder. Miller 2006 describes it as a situation where a patient is aware of the need to void but is unable to reach a toilet in time.
3. Stress Incontinence: In this case, the urinary organs are intact and in good condition. But urine is lost because of coughing, sneezing, laughing or change in position. Brunner and Suddarth 2010 states that stress incontinence predominately affects women who have had vaginal deliveries and it’s thought to be the result of decreasing ligament and pelvic floor support of the urethral wall and bladder base.
4. Iatrogenic Incontinence: is the involuntary loss of urine because of certain medical factors, medications or diseases. An example of such a drug is the administration of a drug to reduce blood pressure (alpha-adrenergic) it causes the bladder to relax leading to urine loss. Once the medication is discontinued, urine loss ends.
FACTORS THAT CAN LEAD TO URINE INCONTINENCE
2. Episiotomy- This is usually done at the second stage of labour to enlarge the opening of the vagina. An incision (the tissue between the opening of the vagina and the anus).
4. Weakness of the pelvic muscle: The pelvic muscle helps to control the flow of urine so when it is weak, urine incontinence.
6. Change in urinary function due to ageing.
8. Administration of sedatives: when someone is on a sedative, urine incontinence is prone to happen.
9. Unavailability of toilet facilities: In a case where someone is pressed but there is nowhere to be void, urine incontinence occurs.
10. Relaxation of the sphincter: Normally, the sphincter needs to contract but when it doesn’t urine incontinence happens.
11. Exercise that put too much pressure on the bladder.
Ways of preventing urine incontinence are:
1. Regular doing of pelvic Muscle Exercise: According to Brunner & Suddarth in their book, Textbook of Medical-Surgical Nursing (2010) PME involves gently tightening the same muscles used to stop flatus or the stream of urine for 5-10 second increments, followed by 10- second resting phases.
To be effective, these exercises need to be performed two or three times a day for at least a week. (page 1369). The aim of this exercise is to muscles (voluntary muscles) that helps in urinating and defecation. For women, it helps reduce stress and urge. The exercise is not restricted to females alone.
2. Taking enough water: Normally, one should take at least 1500mL of water not at once but between meals. It will help to decrease the risk of having urinary tract infections and help in the movement of the bowel.
3. Avoid or reduce alcohol intake as it causes urine incontinence.
4. Make sure you empty the bladder early in the morning before you have breakfast, lunch and dinner, before going to bed and once with e night.
5. Avoid smoke either from cigarettes or any other way. Because the smoke triggers coughing
6. Avoid taking sweeteners that are artificial because they irritate the walls of the bladder.
Urine Retention: One has urine retention when the bladder finds it difficult to release urine. It can be caused by so many factors.
1. Diabetes triggers urine retention.
2. Enlargement of the prostrate: When the prostrate is enlarged, emptying the bladder becomes difficult.
3. Spinal cord injury: Normally, the brain send signals to the spinal cord which goes through the nerves. The nerves has the duty of informing the brain when the bladder needs emptying. When the spinal cord is injured, signals are not sent thereby causing urine retention.
4. Infection that affect the urinary system, for example Gonorrhea.
5.Presence of tumour.
6. Stroke can also cause retention of urine.
Ways to help the bladder empty are:
1. Taking of hot tea
2. Smoothing the abdomen.
3. Smoothing the thighs and pubic areas.
4. Dipping of hands into warm water to achieve calmness.
5. Taking of pain reliever when pains is experienced easily after childbirth.
6. Visit the hospital to lay complaints.