Incontinence

1. Types of incontinence.

1. "Stress incontinence" occurs when intra-abdominal pressure increases, such as when sneezing, coughing, etc.

2. "Functional incontinence" occurs because of an inability to reach the toilet.

3. "Urge incontinence" is associated with a sudden, strong desire to void produced by spasm or irritated bladder walls.

4. "Neurogenic incontinence" results from a lesion of the nervous system.

2. Possible causes of incontinence.

1. Various diseases.

2. Confusion or coma.

3. Outlet obstruction.

4. Sphincter dysfunction.

5. Neuropathy disorders.

6. Medications.

7. Functional inability to toilet.

3. Measures to prevent or manage urinary incontinence.

1. Perineal exercises to improve and strengthen muscles, which is especially good for stress incontinence.

1. Stop and start stream during urination.

2. Press buttocks together then relax.

3. Contract perineal muscles for three seconds, then relax for three seconds; continue the routine for about 25 times, five times a day.

2. Frequent use of bedpan or bathroom.

3. Limiting oral fluid intake in the evening to decrease incontinence at night.

4. Medications as ordered.

5. Constant or intermittent catherization as instructed.

6. Bladder training (Provide "Bladder Training" handout.)

7. Surgical repair.

4. Products available for incontinence.

1. Indwelling and external catheters.

2. Full and partial diapers.

3. Bed protectants.

5. Measures to protect skin from incontinence.

1. Keep skin clean and dry.

2. Use ointments to protect skin from moisture.

3. Assess frequently for skin breakdown.

4. Avoid powder because of possible caking and irritation.

6. Possible complications of incontinence.

1. Skin breakdown.

2. Depression and loss of self-esteem.

3. Urinary tract infections (cloudy, foul-smelling urine).