Treating and Managing Urinary Incontinence

TREATING AND MANAGING URINARY INCONTINENCE

Before prescribing any treatment, the doctor or other health care professional must first identify the causes of the urinary incontinence.  The patient can help in the diagnosis, by giving accurate answers to questions such as:

· Under what circumstances does urine leakage occur?
· How often does urine leakage occur and how much urine is lost?
· Is there a sudden urge to pass urine?
· Can the patient sometimes hold on and pass urine voluntarily?

The assessing professional should have access to the patient’s case notes, and be aware of any relevant previous history, such as repeated urinary tract infection.

The assessor should inform the patient of all appropriate treatment options, including medication, surgery and conservative methods of treatment.

Surgery is considered mainly in cases where anatomical changes have occurred.  Conservative methods are preferred in cases where surgery appears unlikely to be successful or the risk is too great, or where the underlying condition cannot be corrected by surgery.  In such cases, conservative treatment is available to alleviate the effects of incontinence.  Conservative methods of treatment include:

Toileting Programmes

An individual toileting programme aims to pre-empt bladder emptying, so preventing incontinence by getting the patient to go to the lavatory in time.  By examining the pattern of voiding and incontinence, a programme is planned for the individual, documenting set times or set intervals for visits to the lavatory.

Pelvic Floor Training

Pelvic Floor Exercises aim to strengthen the muscles supporting the bladder and urethra and are often effective in the treatment of stress and urge incontinence.  Electrical Stimulation can also be used to stimulate and strengthen the pelvic floor muscles.  Both these treatments are available from a specialist Physiotherapist or Continence Service.

 Bladder Reflex Triggering

Bladder reflex triggering is used mainly in paraplegic patients and comprises of various techniques to elicit a reflex detrusor contraction.  Techniques used include suprapubic tapping and thigh scratching.  The aim is to completely empty the bladder so that the patient can remain continent during the intervals between treatments.

Catheterisation

Indwelling catheters involve a high risk of infection should only be used after careful consideration, and having discussed the benefits and risks with the patient and carers.  Initial insertion should be by a health care professional competent in the procedure.

Intermittent catheterisation is a procedure that does not carry the same long-term complications as indwelling catheterisation.  This procedure is performed either by the patient, a family member or carer and is taught under supervision, using a clean technique.  The hands and the genital area must be thoroughly washed before each intermittent catheterisation.  Single use catheters may reduce the risk of infection.

Urinary Sheath Systems

Urinary sheath systems can be used to manage incontinence in men.  Special urinary sheaths are applied to the penis and attached to a drainage bag, which is attached to the upper or lower leg, to collect the urine.

If correctly selected and fitted, urinary sheath systems are a reliable method of managing incontinence. Urinary sheath systems facilitate discreet management of incontinence in mobile male patients and enable them to pursue their normal social activities without embarrassment.  Wheelchair users and bedridden male patients can also successfully use this management system.

Medication

Medication may be prescribed to help some causes of bladder dysfunction, such as the treatment of an overactive bladder or enlargement of the prostate gland.  In the near future, medication is expected to be available for stress urinary incontinence.

Absorbent Incontinence Products

Modern, disposable incontinence briefs or pads enable the patient to lead an almost normal life despite incontinence problems.  Absorbent incontinence products can be worn discreetly inside the underwear, absorbing the urine quickly and reliably, whilst at the same time protecting sensitive skin and preventing unpleasant odours.  They give the patient a feeling of security and restore self-confidence.

Incontinence products are also essential in the care of bedridden patients, where they improve the basic hygienic conditions and help to prevent the occurrence of complications such as skin lesions.  It is for this reason that incontinence products are often provided free of charge by health care providers.

The Colour Coding of the Moli range from HARTMANN

The colour coding used for the Moli range from HARTMANN enables you to identify at a glance which product is suitable for which degree of incontinence.

The five colours represent the five degrees of severity of incontinence:

· Yellow for slight incontinence
· Green for moderate incontinence
· Blue for severe incontinence
· Magenta for severe/very severe incontinence
· Violet for very severe incontinence.

In addition to the colours used on the packaging and on the products themselves, the droplet symbols are a further aid to rapid identification of the absorption capacity of the product.

Article published by HARTMANN Direct - an online shopping site for incontinence and personal hygiene products. Products delivered direct to your door in discreet packaging. www.hartmanndirect.co.uk

This article is copyright protected and is not for republishing