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Fluid balance and continence care
Published in Barbara Smith, Linda Field, Nursing Care, 2019
Overflow incontinence (Table 6.5) is caused by an outflow obstruction such as benign prostatic hyperplasia in males, faecal impaction, or an atonic or hypotonic bladder. Sometimes referred to as: obstructive incontinence. Symptoms include: dribbling urine, feeling of bladder fullness, frequency, hesitancy, stop-and-start flow; susceptibility to urinary tract infections; leakage of urine is normally small and is associated with incomplete bladder emptying, resulting in urinary retention (Marjoram, 1999;Yates, 2018a); this accounts for less than 10 per cent of incontinence in older people. Contributing factors include the side effects of some medications, constipation and sudden immobility.
Incontinence
Published in Susan Carmody, Sue Forster, Nursing Older People, 2017
Overflow incontinence occurs when the bladder is unable to empty normally, and fills up until it overflows. This might be because the bladder muscle (the detrusor) is unable to contract effectively to expel the urine, or because there is an obstruction in the bladder outlet through which urine cannot pass. Typical symptoms include hesitancy when starting to void, poor or interupted urinary stream, frequency, having to urinate more often than normal overnight (nocturia), and not feeling completely empty at the end of a void.
Urinary Incontinence in Older Adults
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Nicole Strong, Sara Z. Salim, Jean L. Nickels, K. Rao Poduri
Established incontinence may take several forms. It is important to determine the type of incontinence prior to initiating a medication. A medication to cause urinary retention may help for urge incontinence but would worsen overflow incontinence.
High-intensity focused ultrasound therapy for pediatric and adolescent vulvar lichen sclerosus
Published in International Journal of Hyperthermia, 2022
Vulvar lichen sclerosus (VLS) is a chronic inflammatory disease, and its etiology is unclear and complex. It has a bimodal starting age, in prepubertal and postmenopausal age groups. There is a clear peak of incidence in girls aged four to six years old, which represents 7–15% of all VLS cases [1]. The main clinical manifestations are vulvar pruritus, irritation and pain, bleeding due to skin fissures and constipation [2,3]. Urinary tract symptoms, including dysuria, holding urine for fear of voiding and overflow incontinence may also be presenting features [4]. VLS has also been associated with a reduced quality of life among premenarchal girls. Since the symptoms of VLS can mimic other conditions, it is often initially misdiagnosed [5], and its diagnosis in girls is often delayed by an average of 1–2 years from the onset of symptoms to a final diagnosis. However, early diagnosis and treatment are crucial in improving symptoms and reducing the long-term sequelae of scarring.
Management of Neurogenic Bowel Dysfunction in Adults after Spinal Cord Injury
Published in The Journal of Spinal Cord Medicine, 2021
Jeffery Johns, Klaus Krogh, Gianna M. Rodriguez, Janice Eng, Emily Haller, Malorie Heinen, Rafferty Laredo, Walter Longo, Wilda Montero-Colon, Catherine S. Wilson, Mark Korsten
In individuals with SCI, several factors contribute to fecal incontinence. Anorectal sensibility and voluntary contraction of the external anal sphincter muscle are reduced or absent.5,16,17 Individuals with reflexic NBD tend to have increased tone and contractility of the rectum,5,7,8,22 causing reflex defecation.4 In those with areflexic NBD, poor emptying of the rectum, hypotonic rectum, and poor sphincter function may cause fecal impaction and incontinence.8–10 Fecal incontinence in NBD depends on several factors, including reduced or absent anorectal sensibility, lack of voluntary contraction of the external anal sphincter muscle, fecal impaction, and reflex defecation.9,10,22 Overflow incontinence from significant constipation should always be a consideration in both reflexic and areflexic NBD.
Evaluation and treatment of urinary incontinence in the aging male
Published in Postgraduate Medicine, 2020
Stress urinary incontinence (SUI) refers to the involuntary loss of urine during activities that increase abdominal pressure (e.g., coughing, sneezing, straining, lifting, exercising) [12]. Mixed urinary incontinence encompasses both UUI and SUI. Overflow incontinence refers to involuntary leakage of urine caused by overfilling of the bladder. Reflex incontinence indicates leakage of urine without urge and may occur in those with underlying neurological disease. Those who leak urine due to a physical disability or barrier (e.g., person using a walker not being able to get to the restroom quickly enough to void) have functional incontinence and nocturnal enuresis refers to leakage of urine during sleep.