Raising Awareness of Incontinence among Primary Care Providers

LaTronica Fisher MSN, MSN, ANP-C, GNP-C

University of Miami: SONHS

DrTrybulski PhD, ANP-BC, DPNAP

Urine Incontinence

Introduction

Urinary Incontinence (UI) is an involuntary loss of control over the urine. More than 15 million older adults suffer from urinary incontinence . There is a myth concerning urinary incontinence that once the incontinence starts the incontinence is a permanent and incurable condition. There is a growing evidence base to support successful strategies for treating UI, unfortunately nursing staff and other physicians continue to relay on containment strategies like use of diapers. The predominant source for advice an individual with UI accesses media and person contact with other individuals with UI. Individuals with UI would benefit from receiving information from a care center that specializes in UI. UI patients need guidance from providers educated in successful assessment and management of UI.

Urinary Incontinence commonly affects young to middle aged women. The prevalence of Urinary incontinence in older people having age above 65 is around 8% to 30%. It can affect all age groups but mostly it is observable in women during menopause. Urinary incontinence results have serious consequences if not addressed in time, than it results in the form of medical and financial terms like increased morbidity, falls, worsening of ulcers, skin infections, and increased health care. This article will educate primary care providers about UI and present an evidence based practice guideline for UI successful management in primary care.

Discussion

Urinary Incontinence and how a healthy bladder works

The urinary system is a highly efficient mechanism for removing waste products from the blood and excreting them from the body. It is composed of the upper and lower tracts. The upper urinary tract includes two kidneys and two ureters. The kidneys are a pair of fist-sized organs that filter impurities from the blood, at a rate of one-fifth of the total blood volume every minute, and convert them into urine. They also regulate the chemical make-up of the blood and preserve the correct balance between salt and water in the body . Urine is transported from the kidneys, through the ureters, down the bladder. Bladder disorders such as unresolved or chronic urinary retention and untreated urinary tract infections can cause upper urinary tract damage

The lower urinary tract is composed of the bladder, prostate (men only), urethra, internal and external sphincters, and urethral meatus. The bladder fills and expands passively, with urine that is passed via the ureters. Urinary incontinence usually only affects the lower urinary tract.

The urinary bladder is a hollow muscular sac that is located in the pelvic region. It lies behind the public symphysis when empty and rises above the level of the pubic bone when full, making it easily palpable. It is freely movable except at the base, where it is continuous with the urethra. The wall of the bladder has three layers: An inner mucous layer, a central muscular layer, and an outer fatty layer. The central, muscular layer is made up of smooth muscle that is called the detrusor. The ...