16. URINARY INCONTINENCE

The urinary system consist of two kidneys, two ureters, the urinary bladder, and the urethra. The urinary system supports homeostasis by eliminating wastes and excessive fluid from the body.

The kidneys decrease in size from approximately 400 g at age 40 to only 250 g by age 80. By age 70, they lose approximately one-third of their efficiency and they lack functional reserve. Others changes are decreased number of functional nephrons, decreased blood supply, decreased muscle tone…etc.

One of common disorders seen in the aging is urinary incontinence, the involuntary loss of urine, isn`t a routine or normal occurrence with aging. The urinary incontinence is when urine is lost involuntarily and objective, and may occur as a result of psysiologic changes, or other medical problems.

The incontinent person suffers, because she is worried all day, for if her urinate on herself, urine going to smell…

The highest prevalence was found in those units where the stay is greater, particularly in residential institutions₅.

Epidemiological studies show that IUE is the most common symptom of IU referred_4.

Is produced with major frequency in woman_4. And more frequent incontinence is incontinence due to detrusor instability

Is the acute and chronic urinary incontinence. The acute incontinence is transitory and sudden onset, and  Within the chronic there are various types of urinary incontinence: stress incontinence, urge incontinence, overflow incontinence, functional incontinence, total incontinence…

Stress incontinence is most commonly observed in woman, particularly those who have weakened perineal muscles resulting from aging and childbearing.

I wanted to provide this information, because as women are most affected by this pathology, for which of the incontinence was also the most common in them.

When a patient comes to the emergency department with this pathology or consultation, the valuation is very important to find out by asking questions type of incontinence you have, and also write down all your data. Emphasize the importance of writing the pharmacological history.

Treatment depends on the type of problem you have and what best fits your lifestyle. It may include simple exercises, medicines, special devices or procedures prescribed by your doctor or surgery_1.

Some general measures found in books and studies advise:

Measures to reduce constipation, change in the type of clothes to use (comfortable and easy openings) or modification of those medications that affect continence may also be beneficial measures.₆

There is a proven association between smoking and IU₇, perhaps due to increased abdominal pressure in chronic smokers.

 Facilitate access to the bathroom avoiding physical barriers and have domestic substitutes (urinals, sanitary wedges, etc.) or some adaptation. This is especially important in patients with IUU or IUM fundamentally if they have limited mobility (elderly).

An acceptable treatment in overweight women is weight reduction. Today it is considered as an effective preventive measure to avoid the overhead of maintaining pelvic floor adecuado₇ weight.

An abundant fluid intake, especially in the hours before the night's rest, is related to a greater number of episodes of UTI. Narrow this intake from snack and reduce exciting substance use (alcohol, coffee, tea) can have effects

Search other items, has helped me learn about other measures, and data very curious, but I also have noticed that there is data that match.

Finally, I would like to say, the UI is obviously not a life-threatening process, but significantly impairs the quality of life of patients, limiting their autonomy and self-esteem reduces_3.

Bibliography:

1. Medline. Incontinencia Urinaria. Medline Plus. [Revisado el 20 de abril del 2013]. Disponible en: http://www.nlm.nih.gov/medlineplus/spanish/urinaryincontinence.html

2. Incontinencia urinaria. Clinica Universidad de Navarra. [Revisado el 15 de abril del 2013]. Disponible en: http://www.cun.es/area-salud/enfermedades/sistema-nefro-urinario/incontinencia-urinaria

3. Espuña Pons M. Incontinencia de orina en la mujer. Med Clin (Barc) 2003; 120: 464-472

4. Robles, J.E. Urinary Incontinence. Anales. [Revisado el 16 de mayo del 2013]. Disponible en: http://www.cfnavarra.es/salud/anales/textos/vol29/n2/revis2a.html

5. Rexach Cano L, Verdejo Bravo C. Incontinencia urinaria. Inf Ter Sist Nac Salud 1999; 23: 149-159.

6. Sampselle CM, Palmer MH, Boyington AR, O´Dell KK, Wooldridge L. Prevention of Urinary Incontinence in Adults: Population-Based Strategies. Nursing Research 2004; 53 (Supl. 6): S61-S67. 

7. Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG 2003; 110: 247-254.