In the final analysis, the chances of older adults suffering from urinary incontinence are fairly high given that the population will increasingly include older adults, many of whom will be among the very old.
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Appendix A
Types of Urinary Incontinence
Type of Urinary Incontinence
Description
Stress incontinence
This condition occurs when intraabdominal pressure exceeds urethral resistance. A number of causes are rooted in anatomic damage to the urethral sphincter and weakened bladder neck supports. This phenomenon may occur when an individual sneezes, coughs, bends over, or lifts a heavy object. The amount of urine leakage is...
Individuals sense the urge to void but cannot inhibit urination long enough to reach a toilet. The volume of urine lost is moderate, and episodes occur every few hours. Postresidual urine would reveal a low volume.
Overflow incontinence
This type is a result of neurologic abnormalities of the spinal cord that affect the contractility of the detrusor muscle of the bladder. Any factor disrupting detrusor stability such as drugs, tumors, strictures, and prostatic hypertrophy will cause the bladder to become overdistended, leading to frequent or constant loss of urine.
Functional incontinence
This term refers to a situation in which the lower urinary tract is intact but the individual is limited by musculo-skeletal disability or severe cognitive impairment. Urine is lost because the individual is unaware of the need to void or is unable to reach a toilet because of arthritis, Parkinson's disease, or for hospitalized patients, their condition or raised bed rails. Environmental conditions and prescribed drug use are additional examples of factors that can create functional incontinence.
Iatrogenic incontinence
This condition is associated with medication side effects. This can be managed by decreasing the dosage of medication to maintain the primary drug effect but eliminate the secondary effects. It may be necessary to change a drug to another class of medication that is not associated with incontinence. Other iatrogenic causes of incontinence include expanded extracellular fluid compartmentalization with the development of nocturia and polyuria, as occurs in CHF, chronic venous insufficiency, and in metabolic states such as polyuria with increased glycosuria or increased calcemia.
Source: Ebersole…
