One of the more common problems is urinary incontinence. In women, menopause, previous childbirth, pelvic floor dysfunction, aging, and other health factors can cause or contribute to bladder control problems. In men, prostate problems and other associated factors in aging may cause urinary incontinence. Treatment depends on the type of urinary incontinence diagnosed. Various etiologies can impact urinary incontinence, such as:
- urinary retention
- bladder infection (urinary tract infection — UTI) in adults
- bladder control problems and nerve disease
- cystocele (prolapsed bladder)
- Bowel control problems (fecal incontinence)
- diabetes, sexual, and urologic problems
Choose two of the above disorders that can cause urinary incontinence, and:
- Describe the symptoms and the clinical manifestations seen with the disorders that you have chosen.
- Use evidence-based references to explain how you would diagnose and manage these disorders and the symptoms.
- Address both nonpharmacological and pharmacological considerations for management, including appropriate referrals to other healthcare professionals.
Two of the disorders mentioned above that can cause urinary incontinence: bladder infection (urinary tract infection – UTI) in adults and cystocele (prolapsed bladder).
- Bladder Infection (Urinary Tract Infection – UTI): Symptoms and Clinical Manifestations:
- Frequent and urgent need to urinate
- Pain or burning sensation during urination
- Cloudy or bloody urine
- Lower abdominal pain or discomfort
- Strong-smelling urine
- Mild fever and fatigue in some cases
- Cystocele (Prolapsed Bladder): Symptoms and Clinical Manifestations:
- A feeling of pressure or fullness in the pelvis or vagina
- Urinary incontinence (stress incontinence) – leaking urine when coughing, sneezing, or lifting
- Difficulty emptying the bladder completely
- Frequent urinary tract infections
- A visible bulge or protrusion in the vaginal area
- Diagnosis and Management:
Diagnosis of Bladder Infection (UTI): Diagnosis of UTI is typically based on the patient’s symptoms and a urine test to identify the presence of bacteria. A urine culture may be performed to determine the specific bacteria causing the infection and to guide antibiotic treatment.
Management of Bladder Infection (UTI): For simple cases of UTI, antibiotics are the mainstay of treatment. The choice of antibiotic is based on local resistance patterns and patient factors such as pregnancy, allergies, and previous antibiotic use. It’s important to complete the full course of antibiotics even if symptoms improve early to prevent recurrence and antibiotic resistance. Increasing fluid intake and proper hygiene practices are also helpful.
Diagnosis of Cystocele (Prolapsed Bladder): Diagnosis of cystocele is typically made through a physical examination and medical history. Sometimes, further tests such as cystoscopy or urodynamic studies may be performed to assess the bladder’s function and rule out other causes of urinary incontinence.
Management of Cystocele (Prolapsed Bladder): Nonpharmacological Considerations:
- Pelvic floor muscle exercises (Kegel exercises) can strengthen the pelvic muscles and improve bladder control.
- Weight management can reduce pressure on the pelvic organs.
- Avoiding heavy lifting and activities that strain the pelvic area can help prevent further prolapse.
Pharmacological Considerations:
- In some cases, medications called vaginal estrogen creams may be prescribed to help improve the strength and elasticity of vaginal tissues, which can support the bladder.
Referrals to Other Healthcare Professionals:
- Physical therapists specializing in pelvic floor rehabilitation can help teach and monitor pelvic floor exercises.
- Urologists or urogynecologists may be consulted for more complex cases or if surgical intervention is necessary.
It’s important to note that the above information is based on general guidelines and each patient’s condition may vary. For accurate diagnosis and management, healthcare professionals should consider individual patient factors and consult evidence-based references and clinical guidelines.