urinary incontinence and retention grup10

8/17/2019 Urinary Incontinence and Retention Grup10

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Urinary Incontinenceand Retention

Members;Markita WitterEshonna Smartt Jamelle Herbert


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Objectives

Dene Urinary Incontinence and Retention

State the Etiolo!y o" Urinary Incontinence and Retention

State the Incidence o" Urinary Incontinence and Retention

E#$lain the %atho$hysiolo!y o" Urinary Incontinence and Retention

&ist the 'linical Mani"estation o" Urinary Incontinence and Retention

&ist the 'om$lications o" Urinary Incontinence and Retention

State the Dia!nostic (est Done "or Urinary Incontinence andRetention

E#$lain the Mana!ement )Medical* S+r!ical and ,+rsin!- o" UrinaryIncontinence and Retention

Develo$ a ,+rsin! 'are %lan "or a %atient .ith Urinary Incontinence

and Retention


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Denition

Urinary Incontinence- is dened as an+ncontrolled loss o" +rine that is o" s+/cientma!nit+de to be a $roblem0

Urinary Retention- is the inability to em$tythe bladder des$ite mict+ration or theacc+m+lation o" +rine in the bladder beca+seo" an inability to +rinate0 In certain cases it isassociated .ith dribblin! +rinary leaka!ecalled over1o.0


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Etiolo!y

Urinary Incontinence

Transient2 ) ca+sed by con"+sion orde$ression* restricted mobility or stoolim$action-

Congential Disorders- incl+des3 e#sto$hy o"

the bladder* ecto$ic +reteral orice0Acquired Disorders- incl+des3 Stress

incontinence* Ur!e Incontinence* Over1o.Incontinence* Re1e# incontinence*

Incontinence a"ter (ra+ma4S+r!ery* 5+nctional


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Etiolo!y cont6d

Urinary Retention2 ca+sed by t.o di7erentdys"+nction o" the +rinary system3

8ladder O+tlet Obstr+ction

Decient Detr+sor 'ontraction


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Incidence

Urinary Incontinence a7ects "ar more .omenthan men0 Estimates o" Urinary Incontinence$revalence in .orkin! older .omen e#ceed9:0 In contrast Urinary Incontinence a7ects


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%atho$hysiolo!y

Urinary retention may res+lt "rom diabetes* $rostatic enlar!ement*+rethral $atholo!y )in"ection* t+mor* calc+l+s-* tra+ma)$elvicinj+ries-* $re!nancy* or ne+rolo!ic disorders s+ch ascerebrovasc+lar accident* s$inal cord inj+ry* m+lti$le sclerosis* or

%arkinson6s disease0Some medications ca+se +rinary retention*either by inhibitin! bladder contractility or by increasin! bladdero+tlet resistance0Medications that ca+se retention by inhibitin!bladder contractility incl+de anticholiner!ic a!ents )atro$ines+l"ate* dicyclomine hydrochloride >?ntis$as* 8entyl@-*antis$asmodic a!ents )o#yb+tynin chloride >Ditro$an@* belladonna*

and o$ioid s+$$ositories-*and tricyclic antide$ressant medications)imi$ramine >(o"ranil@*do#e$in >SineA+an@-0 Medications that ca+se+rine retention by increasin! bladder o+tlet resistance incl+deal$ha2adrener!ic a!ents )e$hedrine s+l"ate*$se+doe$hedrine-*beta2adrener!ic blockers )$ro$ranolol-* and estro!ens0


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'linical Mani"estations


Some $eo$le e#$erience occasional* minor leaks o" +rine0 Others .ettheir clothes "reA+ently0

Urinary Retention

Di/c+lity startin! to +rinate

Di/c+lity "+lly em$tyin! the bladder

Inability to "eel .hen the bladder is "+ll

Increased abdominal $ress+re

Strained e7orts to $+sh +rine o+t o" the bladder

&ack o" +r!e to +rinate

0


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'om$lications

Urinary Incontinence include:

Skin problems- Rashes* skin in"ections and sores can

develo$ "rom constantly .et skin0

Urinary tract infections- Incontinence increasesyo+r risk o" re$eated +rinary tract in"ections0

Impacts on your personal life- Urinary incontinencecan a7ect yo+r social* .ork and $ersonal relationshi$s0

Urinary Retention

Cronic Infections .hich incl+des; calc+li*

$yelone$hritis* se$sis and $erineal skin break do.n0


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Dia!nostic (ests

Urinary Retention

History o" com$laints and $hysical e#amination

Urinalysis

8ladder scan

B2Ray and com$+teriCed tomo!ra$hy )'(- scan

%rostate 1+id sam$le

Urodynamic (estin!


!8ladder diary

%ost2void resid+al meas+rement


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Medical Mana!ement o" UrinaryIncontinence

"uscarinic Receptor Antagonists andAnticolinergics# purpose- red+ce overactivebladder contractions0

Alpa Adrenergic Antagonist# purpose2 red+ce+rethral s$incter resistance to +rinary o+tla.0

Tricyclic Antidepressants# purpose2 red+ceoveractive bladder contractions0

Calcium Cannel $lockers# purpose- red+cesmooth m+scle contraction stren!th0

%ormone Replacement Terapy# purpose2 locala$$lication red+ces +rethral irritation and increaseshost de"ense a!ainst U(I0


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S+r!ical Mana!ement

I" other treatments arent .orkin!* several s+r!ical $roced+rescan treat the $roblems that ca+se urinary incontinence3

Sling procedures2 Stri$s o" yo+r bodys tiss+e* syntheticmaterial or mesh are +sed to create a $elvic slin! aro+nd yo+r+rethra and the area o" thickened m+scle .here the bladderconnects to the +rethra )bladder neck-0 (he slin! hel$s kee$

the +rethra closed* es$ecially .hen yo+ co+!h or sneeCe0 (his$roced+re is +sed to treat stress incontinence0

$ladder neck suspension2 (his $roced+re is desi!ned to

$rovide s+$$ort to yo+r +rethra and bladder neck F an area o"thickened m+scle .here the bladder connects to the +rethra0


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S+r!ical Mana!ementcont6d

&rolapse surgery2 In .omen .ith mi#ed incontinenceand $elvic or!an $rola$se* s+r!ery may incl+de acombination o" a slin! $roced+re and $rola$se s+r!ery0

Arti'cial urinary spincter2 In men* a small* 1+id2lledrin! is im$lanted aro+nd the bladder neck to kee$ the+rinary s$hincter sh+t +ntil yo+re ready to +rinate0 (o+rinate* yo+ $ress a valve im$lanted +nder yo+r skin thatca+ses the rin! to de1ate and allo.s +rine "rom yo+rbladder to 1o.0 ?rticial +rinary s$hincters are $artic+larlyhel$"+l "or men .hose incontinence is associated .ithtreatment o" $rostate cancer or an enlar!ed $rostate !land

urinary incontinence and retention grup10

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