During the course of our discussion, we would be looking at the different types of urinary leakages and incontinence that are commonly found in women in different parts of the world. Women are more affected than men by the problems of urinary leakage. This inequity incontinence is partly due to the physiological effects due to pregnancy, childbirth and menopause.
Continence of women involves three active factors, the smooth sphincter, the striated sphincter and pelvic floor muscles (support system of the pelvic organs). Alteration of one of these active or nervous controls of these factors can cause incontinence.
There are three main types of urinary incontinence very different both in their symptoms than existing treatments:
• The stress urinary incontinence in 50% of cases.
• The urge incontinence in 20% of cases.
• Mixed urinary incontinence in 30% of cases.
Stress incontinence is the most common in women. Other types of incontinence, urge incontinence and mixed incontinence that combines urge incontinence and stress incontinence are more common in older women.
Furthermore it is also important to mention that the mode of treatment that is applied for the cure of this disease varies in accordance and correspondence to the type of incontinence that the patient is basically suffering from. (Harris, 2006)
Urinary incontinence in women
Women suffering from the disorder and disease of urinary incontinence commonly suffer from the condition primarily because of a condition to the point of cloistered women in her home. She experiences urine loss occurring during the effort, when coughing or laughing. Progressively lesser effort may trigger the loss of urine. It forces the victim to be permanently protected. It should not be confused with urinary incontinence bladder instability manifested by the pressing needs, although some treatments may be common to both conditions. Furthermore in order to understand the condition and the dynamics of the disease at a more organized level it is important to develop an understanding about the different causes of the disease. Professional assignment paper are here for your all needs
The cause of incontinence:
-Perineal insufficiency by birth trauma or aging.
-Failure to close the sphincter.
-Overflow with urethral obstruction
-Irritation by infection, tumor or sclerosis of the bladder.
-Vesico-vaginal fistula: the flight is permanent and is done through the vagina.
Drug: beta-blocker, alpha-stimulating antiparkinsonnien, calcium channel blockers, neuroleptics, antihistamines, opioid.
-Question psychological association with signs of spasmophilia.
-Neurological disease multiple sclerosis.
In all cases, talk to your doctor who will do a urinalysis looking for an infection and a local review to eliminate one of the cases cited above.
It will guide you in choosing treatments.
Remove any medications that may worsen incontinence.
Program dumps the bladder:
-Empty the bladder every hour during the first week. Then every hour and a half the second week. Then every two hours the third week.
-And so on until a spacing of urination 3 to 4 hours. Another important type of treatment mode involved in the disease is that with the use of biofeedback sessions.
With a sensor, the unit can be rented from a store of medical supplies
Control-abdominal (intra-rectal transducer).
-Control the anus (anal sensor).
-Bladder control (sensor intra-bladder).
Control-lifters (intra-vaginal sensor).
Electrostimulation with a vaginal probe:
-Can be undertaken after failure of gymnastics and biofeedback.
-Probe is connected to a biphasic current:
-Stimulation are 0.2 to 0.5 ms at a frequency set at 10 hertz.
-The unit can be rented from a store of medical supplies.
To avoid if pregnant or wearing a pacemaker.
Depending on the local review and possible additional tests, your doctor may prescribe drugs:
-To restore the mucosa:
Promestriene cream and eggs, bac.de Doderlein/ estriol/ progesterone vaginal capsules, oral estrogen.
-To release the bladder:
-To increase the tone of the urethra:
alpha-agonists: Dénoral, 3CO/ d.
(But a urodynamic test requirement may result in reverse: alfuzoxine)
-Operation is to tie a strip with the posterior wall of the urethra.
Cons to surgery or a failed previous surgical treatment:
Shutter-sterile urethral Viva, replace every 3 or 4 hours.
-Fitting of an artificial sphincter.
In most cases it will be the method of salvation. It is also important to note that it is effective as a preventive. It is often started with a physiotherapist.
For curative efficacy is judged after 4 to 6 months, and if this therapy is effective, it will be continued for life. There is also a specific type of gymnastic exercise that is performed for the prevention of this disease which is referred to as perineal gymnastics. The technique of the entire procedure has been described below.
The technique of perineal gymnastics:
Seated, press the left hand inside the right knee and right hand inside the left knee, trying to reach the knees, preventing the movement with your hands. Lie on your back, legs apart, as if you wanted to retain your balance, without contracting the gluteal muscles. Then spread the contraction forward as if holding a tampon which would tend to slip. Levator muscle contraction propels the contents of the pelvis upwards and forwards. This exercise is paramount; it will be played 5 minutes, 3 times per day. To do these exercises you must obtain a battery of special plastic cones, each with a different weight. Contraction exercises of the vagina, with control of contraction by putting two fingers into the vagina. During urination, interrupting the stream several times. It is also important to be seated cross-legged in order to minimize leakage. At night, sleep preferably flat belly. In an effort to cough or before, lock the perineum, not to lose the urine, and especially to prevent pelvic floor relaxation. (Goodwin and Gruen, 2007)
Historical and physical examination of patient
Before the application of the all the above described it is first and foremost important that the diagnosis of the disease and the patient suffering from the disorder is properly assessed and analyzed. The different stages involved in the diagnosis are the analysis and the assessment of the different type of laboratory tests and physical examinations that the patient from the disease has earlier performed.
With the periodic conduction of these tests and examination a number of aspects and dimensions are revealed to practitioners which help them in the determination of the gravity of the entire case and the subsequent treatment modes that can be applied in order to prevent the situation from undergoing further aggravation (Mills, 2008). During the diagnostic process many specialists and practitioners by properly understanding the different aspects of the disease prepare a table in which they advise the patient to register the urinary changes and fluctuations that he is undergoing through. Commonly referred to as the Bladder Diary a sample of this diary has been presented below:
Real life case of Urinary Incontinency
In the School of Nursing of national University of Singapore a 64-year old overweight patient with a history of diabetes and hypertension was admitted. Upon further assessment and analysis of the diagnostic history of the patient it was revealed that she had also been showing signs and symptoms of urinary incontinency and complained of dripping urine before she could actually reach to the place where she could excrete it.
Upon further analysis of the case it was also leaned that the patient did not completely understand the complexity of the disease but doctors claimed that she had been suffering from stress and urge type of incontinency. The patient was very worried and alarmed about the future condition of her children as she feared that they would be send to old folks primarily because of her serious condition. The nurse tried her utmost to calm her and make her understand that despite of the suffering she can pursue all her normal routine activities without facing any complication or barrier towards her independence.
The nurse tried to explain her that majority of the victims suffering from this disease are elderly women primarily due to a number of factors in which obesity, diabetes and childbirth are the most significant factors. Hence after the diagnosis and identification of the disease the treatment mode that was applied for the patient. The prophylactic measures employed included avoiding the intake of fluids and foods that may increase the level of irritation in the human bladder and further facilitate the occurrence of the disease.
Furthermore the treatment applied also included a fixed time table and schedule for visiting the toilet so that a lot of time is not required or the patient does not have to wait for first emptying the bladder in the first place. In addition to this as mentioned there are also a number of different exercises that can be used for the treatment of the disorder as mentioned earlier and hence in this context also the suggested exercises were Kegel exercises which have been designed primarily for the exercise of bladder and associated sphincter muscles. Other than these absorbent pads are also provided to such patients so that even in case if urine dripping occurs in public they may not have to face embarrassment and humiliation.
However as the last resort of treatment it is the surgical option that remains valid which either comprises of injection therapy or bladder transplantation. (Beaven and Craig, 2007)