Glossary of Continence Terms

    A
ACE See antegrade continence enema
ADH See antidiuretic hormone
AHP See allied health professional
AUR See acute urinary retention
5-alpha reductase inhibitors (5 ARIs) Classification of drugs, which inhibits the metabolism of testosterone. This leads to a reduction in prostate size, with improvement of urinary flow rate and other symptoms associated with obstruction
Abdominal massage A technique which involves massaging up the ascending colon of the large bowel, across the transverse section from left to right, then down the descending colon to aid defaecation
Acute urinary retention (AUR) A painful, palpable or percussable bladder, when the patient is unable to pass any urine, which often develops from benign prostatic hyperplasia. Also called acute retention of urine
Allied health professional (AHP) A health professional other than a doctor or nurse. See Occupational Therapist and Physiotherapist
Alpha-adrenocepter blocking drugs (Alpha-blockers) A classification of drugs used to relax smooth muscle in benign prostatic hyperplasia, producing an increase in urinary flow rate and an improvement in obstructive symptoms. (Also used in men and women to reduce high blood pressure)
Anal fissure Fissure-in-ano is a painful, lineal split at the margin of the anus
Anal fistula An anal fistula is a tract or cavity which communicates with the ano-rectum and usually, an external opening
Anal sphincter   - external  - internal See external anal sphincterSee internal anal sphincter
Anorectal angle The angle between the rectum and anus
Antegrade continence enema (ACE) The surgical procedure to create a small, right-sided colonic stoma, through which, irrigation is performed to enable predictable colonic emptying, and prevent leakage
Anterior colporrhaphy Vaginal surgery to repair the anterior vaginal wall, in the treatment of cystocele
Anterior vaginal wall The front side of the vaginal wall on which the bladder rests
Anterior vaginal wall prolapse Descent of the front wall of the vagina. See cystocele
Anti-androgens A classification of drugs used to suppress the production of male hormones. See 5-alpha reductase inhibitors 
Antibacterials A large and diverse group of drugs which combat infections by suppressing the growth and reproduction of bacteria
Antibiotics See antibacterials
Anticholinergic drugs See antimuscarinic drugs
Antidiuretic hormone (ADH) The hormone vasopressin, which suppresses the excretion of urine. It is stored and released by the posterior lobe of the pituitary gland. See also Desmopressin
Antimuscarinic drugs Medication, which reduces bladder spasm. A class of pharmaceutical agents acting on neuromuscular junctions in the autonomic nervous system, used for overactive bladder syndrome
Anuria Production of an abnormally small volume of urine
Aperients A mild laxative medicine. See also laxatives
Artificial urinary sphincter A surgically implanted device placed around the urethra, consisting of an inflatable cuff, a reservoir of fluid to inflate the cuff and a control box. There are many considerations for the patient to discuss with their specialist before this surgery is undertaken
Atrophoderma Atrophy of the skin
Atrophic vaginitis Vaginitis occurring in post-menopausal women and associated with oestrogen deficiency. There may be intense irritation around the vagina, almost complete lack of vaginal secretions and evidence of tissue atrophy
Atrophy Gradual decrease in size of a normally developed organ or tissue, along with a reduction in its’ functional ability
 
Autonomic dysreflexia Autonomic dysreflexia is a potentially life-threatening condition for people with spinal cord injury (SCI) above T6. Noxious stimulation including catheterisation or manual evacuation of the bowel, to intact sensory nerves below the injury leads to mass over-activity of the sympathetic nervous system and dangerous blood pressure elevations with associated symptoms
Avoidant paruresis The inability or extreme reluctance to use toilets other than one particular toilet, usually at home

      B
BMI See body mass index
BPH See benign prostatic hyperplasia
Bacteriuria The presence of bacteria in the urine
Barrier creams / preparations Preparations which often contain water-repellent substances such as dimethicone or other silicones
Bedsore See decubitus ulcer
Bedwetting See nocturnal enuresis
Benign prostatic hyperplasia (BPH) Enlargement of the prostate gland in men, with an increase in normal cells, through age-associated changes. Due to the position of the prostate gland, this can result in an obstruction to the outflow of urine
Biofeedback The technique by which information about a normally unconscious physical process, is presented to the patient and / or the therapist as a visual, auditory or tactile signal (ICS, 2002)
Biofilm In this instance, related to the Foley catheter, when micro-organisms form a living surface layer, or biofilm, which develops as the micro-organisms colonise on the surface of the catheter. Can lead to recurrent infection and encrustation, leading to catheter blockage
Bladder The urinary bladder is a hollow, muscular organ, lined with a mucous membrane, which acts as a storage receptacle for urine, which it receives from the kidneys via the ureters
 
Bladdercalculi Stones, which form in the bladder, or may travel to the bladder from the upper urinary tract. They are usually composed of mineral salts and are more common in those with a long-term, indwelling catheter
cancer Bladder cancer occurs most commonly in people between 50 and 70 years of age. It is twice as common in men as in women. There are various types of bladder cancer. Among those classed as ‘superficial’, the majority can be controlled by resection and intravesical agents
capacity The maximum volume of urine the bladder hold without leakage 
diary A bladder diary records voiding times and voided volumes, leakage episodes, degree of leakage, pad usage and other information such as fluid intake. See also frequency / volume charts
expression Bladder expression comprises various manoeuvres aimed at increasing intravesical pressure (the pressure within the bladder), in order to facilitate bladder emptying. See Valsalva  manoeuvre and Credé manoeuvre (ICS, 2002)
extrophy Bladder extrophy is a congenital birth defect resulting in the malformation of the bladder and urethra, in which the bladder is turned ‘inside-out’ and exposed outside the body
lining The inner lining of the urinary bladder is a mucous membrane of transitional epithelium that is continuous with that in the ureters. When the bladder is empty, the mucosa has numerous ridges or folds called rugae. The rugae and transitional epithelium allow the bladder to expand as it fills
muscle For bladder muscle, see detrusor
outlet obstruction Bladder outlet obstruction is the term for obstruction during voiding and is characterised by increased detrusor pressure and reduced urine flow rate
overactive See overactive bladder
pressure See intravesical pressure
 
Bladderreflex triggering Bladder reflex triggering comprises various manoeuvres performed by the patient or the therapist, in order to elicit a reflex detrusor contraction. These include suprapubic tapping and thigh scratching
retraining Bladder retraining is a form of self-help for people with urinary frequency, urgency and urge urinary incontinence
Body mass index (BMI) A method used to measure a persons height in metres and weight in kilograms, to calculate their BMI. This will determine whether an individual is of acceptable weight for their height
Bowel The intestine
Bristol Stool Form Scale A visual resource to assist patients to describe their stool type during assessment. Type 3 or 4 on this seven-point scale is considered the norm

      C
CNS See central nervous system
CVA See stroke
Caecum The shortest part of the large bowel, where the small intestine joins at the ileocaecal junction. It has a blind end where the veriform appendix is attached
Caesarian section Delivery of a foetus by incision through the abdominal wall and uterus after 28 weeks of pregnancy
Caffeine A stimulant present in drinks such as coffee and tea, food, ‘over the counter’ drugs and medication
Care pathway An integrated care pathway (ICP) is a multidisciplinary outline of anticipated care, placed in an appropriate timeframe, to help a patient with a specific condition or set of symptoms move progressively through a clinical experience to positive outcomes
Carer A person giving care to another. A carer may be a family member or employed by a Care Agency
 
Catheter A hollow tube inserted into a body cavity or organ to instil fluid into, or drain fluid from the cavity or organ
drainage bags A urine collection device, usually made from polyethylene, which connects with a catheter or urinary drainage sheath 
Catheterencrustation Deposits on the surface of the catheter within the bladder, which can cause blockage. The main components of catheter encrustations are magnesium and calcium phosphates which precipitate from the urine under alkaline conditions
valve A device which is inserted into the end of the catheter which allows bladder filling and intermittent drainage, allowing the user to dispense with urine drainage bags for all or part of the day / night
Catheterisation A technique for bladder emptying, using a catheter to drain the bladder or a urinary reservoirSee also, intermittent (in / out) catheterisation, intermittent self-catheterisation, suprapubic catheterisation and urethral catheterisation
Central nervous system (CNS) The part of the nervous system consisting of the brain and spinal cord
Cerebrovascular accident (CVA) See stroke
Charrière (Ch) Catheter size is measured by the external diameter of the catheter shaft and defined as Charrière units (Ch) or French gauge (Fg). One unit = S rd of a millimetre
Chronic retention of urine A non-painful bladder, which remains palpable or percussable after the patient has passed urine. Such patients may be incontinent (ICS, 2002)
Coccyx The coccyx is triangular in shape representing the vestige of a tail. The musculature of the pelvic floor is attached to the coccyx
Collagen A fibrous, structural protein, that provides strength and elasticity to skin and other connective tissues
Colon The colon or large bowel, is the part of the large intestine extending from the caecum to the rectum
 
Colposuspension Lower abdominal surgery for stress urinary incontinence in women, where the bladder and bladder neck are raised and supported via a transverse suprapubic incision
Commode A piece of furniture containing a removable chamber pot. Useful for those who are unable to walk to the toilet
Co-morbidity Associated with an underlying disease
Constipation Infrequent or difficult bowel evacuation
Continence The ability to control movements of the bladder and bowel
Cranberry juice Cranberries are small, red, sour-tasting berries, which are crushed with added sugar to make a palatable drink. Research suggests 200mls of cranberry juice drunk twice a day, may reduce the risk of cystitis
Credé manoeuvre The Credé manoeuvre, or manual bladder emptying, involves applying considerable pressure, usually with the ball of the hand or a fist, suprapubically over the bladder
Cystocele Protrusion of the urinary bladder through the front wall of the vagina. See also anterior vaginal wall prolapse
Cystitis See urinary tract infection (UTI)
Cystometry Cystometry is the method by which the pressure / volume relationship of the bladder is measured
Cystoscopy Visual examination of the bladder by means of an endoscope, a narrow, telescopic instrument, introduced into the urethra and passed into the bladder

      D
DDAVP (desmopressin acetate) Desmopressin acetate is a synthetic antidiuretic hormone, which causes less urine to be excreted by the kidneys. Can be used for nocturnal enuresis and to control nocturia in those under 65 years of age
DRE See digital rectal examination
DSD See detrusor sphincter dyssynergia
 
Decubitus ulcer An ulcer due to interference with the local circulation from prolonged or severe pressure on the surface body tissue, resulting in lack of oxygen to the tissue, and cell death. Also called bedsore and pressure sore
Defaecation Passing stool
Dementia A global and progressive deterioration of mental functioning which is irreversible and affects memory, intellect, judgement, personality and emotional control
Dermatitis Inflammation of the skin
Dermis The fibrous, inner layer of skin just beneath the epidermis, varying in thickness from 0.5mm to 3mm in thickness. It is well supplied with nerves and blood vessels and contains hair roots and sebaceous and sweat glands
Desmopressin See DDAVP
Detrusor The bladder muscle
Detrusor sphincter dyssynergia (DSD) Detrusor sphincter dyssynergia is uncoordinated external sphincter contractions during bladder contraction giving rise to obstructed voiding seen in neurological bladder dysfunction
Diabetes mellitus A disease where the body does not produce enough of the hormone insulin and is therefore unable to metabolise sugar and starch. Long-term effects of diabetes can involve damage to the peripheral nerves causing, among others, sight problems and bladder and bowel problems
Diarrhoea A condition in which a person has frequent, liquid, bowel movements
Dietary fibre The part of food, which is eaten, that cannot be broken down by intestinal digestive processes, and therefore passes through the colon, undigested. Vegetables, cereals and fruits are the main sources of dietary fibre
 
Digital rectal examination (DRE) Digital rectal examination (DRE) is examination of the rectum, though the anus, using the gloved index finger. In the male, the prostate gland is palpated rectally by the examiner (usually a doctor or specialist nurse), to determine enlargement and / or possible cancerous changes, of the prostate gland.  Other professionals may be taught to carry out DRE when assessing for faecal impaction or to assess the strength of the anal sphincter
Diuretic Medication which increases urine production
Diverticular disease (Diverticulosis) Diverticular disease is the presence of diverticulae in the large intestine. These small blind pouches which form in the lining and wall of the colon may become inflamed due to bacteria and other irritating agents trapped there
Dyschezia Difficulty with rectal evacuation
Dysuria Pain on passing urine

      E
EAS See external anal sphincter
Ectopic Displaced or situated in an unusual location, e.g., ectopic ureter, when a ureter opens into the vagina
Eczema A skin condition primarily affecting the epidermis, marked by redness, itching, minute papules and vesicles, weeping, oozing and crusting. May be due to an allergy
Electrical stimulation The application of electrical current to stimulate the pelvic organs
Encopresis The passage of normal stools in socially unacceptable places
Encrustation See catheter encrustation
Enema A solution introduced into the rectum to promote evacuation of faeces
Enterocele Herniation of the small intestine through the apex of the vagina
 
Enuresis Any involuntary loss of urine. When this occurs during sleep, it is called nocturnal enuresis
Enuresis alarm A device, which activates a visual or audible signal when moisture (urine) comes into contact with the sensor in the device. This alarm may be place on the bed or attached to the individuals clothing
Enzyme Any protein that acts as a catalyst, increasing the rate at which a chemical reaction occurs. The human body contains in excess of 10,000 different enzymes
Epidemiology The study of the distribution of factors determining health and disease in human populations
Epidermis The outermost layer of the skin, varying in thickness from 0.07mm to 1.4mm. It does not contain blood vessels
Episiotomy A surgical procedure in which an incision is made in the tissue between the vagina and anus to prevent tearing of this tissue during childbirth
Epispadias Epispadias is a congenital abnormality where the urethral opening is on the upper surface of the penis. This condition is treated surgically. See also hypospadias
Evacuation An emptying or removal. Material discharged from the body, especially from the bowel
Evidence based Statements and recommendations based on a level of research-based evidence
Excoriation An erosion of the skin by a scratch or abrasion, It is commonly seen in skin disorders causing itching / pruritis, or by exposure to an irritant agent, such as urine, which can cause incontinence dermatitis
External anal sphincter (EAS) The external anal sphincter is a circular, striated muscle, and therefore under voluntary control. It surrounds the internal anal sphincter
External urinary sphincter The external urinary sphincter (striated muscle) is under voluntary control and is partly responsible for urinary continence
 
      F
Fg French gauge. See Charrière
FVC See frequency / volume chart
Faecal impaction Impaction of faeces in the rectum and colon. This may be as a result of chronic constipation, which leads to impaction when the fluid content of the faeces is progressively absorbed by the colon, leaving hard rounded rocks, or scybala, in the bowel. This hard matter promotes mucus production and bacterial activity, which causes a foul-smelling brown fluid to accumulate. This material may be passed as ‘spurious’ or ‘false’, diarrhoea
Faecal incontinence Anal incontinence is the involuntary loss of flatus, liquid or solid stool that is a social or hygienic problem (Norton et al., 2001)
Faecal softeners Compounds which are taken orally or rectally in an attempt to soften the faeces
Faeces Body waste discharged from the intestine, also called stool
Fast-twitch muscle fibres The pubococcygeus muscle of the pelvic floor, comprises of about 30% of fast-twitch muscle fibres. The fast-twitch fibres, which tire easily, are responsible for the fast reflex response associated with coughing or other sudden increases in intra-abdominal pressure. See also slow-twitch muscle fibres
Fibre See dietary fibre
Flatus Gas or air in the intestinal tract which may be expelled through the anus
Flow rate See voiding flow rate
Fluid intake The volume of fluid an individual ingests usually measured over a 24 hour period
Foley catheter A catheter with a balloon which, when inflated will retain the catheter in the bladder. Invented by Dr Frederick Foley of St Paul, Minnesota, in 1934
Forceps delivery The delivery of a foetus with the assistance of a two-bladed instrument
 
French gauge See Charrière
Frequency (of micturition) The number of times an individual passes urine over a given time
Frequency / volume chart (FVC) A frequency / volume chart records the volumes voided as well as the time of each micturition, day and night, for at least 24 hours (ICS, 2002)
Functional incontinence Incontinence, which occurs as a result of illness, severe learning or physical disability, or behavioural problems. There may or may not be an underlying bladder or bowel dysfunction

      G
Gastrocolic reflex An increase in peristalsis after food enters the empty stomach
Genitalia The reproductive organs, also called the genitals
Genitourinary  Pertaining to the genitalia and urinary tract
medicine Genitourinary medicine (GUM) is the medical specialty concerned with the diagnosis and treatment of sexually transmitted diseases (STDs)
system The organs of reproduction, together with the organs concerned with the production and excretion of urine (also called urogenital system)
Genuine stress incontinence See urodynamic stress incontinence, and stress urinary incontinence
Giggle incontinence Urine leakage, which occurs when laughing and continues until the bladder is empty. Suffered by some girls, it is thought to be a combination of stress urinary incontinence and overactive bladder
Glycosuria The presence of glucose in the urine
Gut transit times The length of time taken for foods to pass through the digestive system. This can be measured by use of radio-opaque markers and X-rays
Gynaecology A branch of medicine which specialises in the female reproductive system
 
      H
HRT See hormone replacement therapy
Habit retraining Habit retraining attempts to match voiding intervals to an individuals’ own natural voiding pattern, usually in a long-term care setting
Haematuria The presence of blood or blood cells in the urine
Haemorrhoids A swelling caused by the haemorrhoidal veins within the anal canal. The haemorrhoids may prolapse into the anal lumen as they enlarge. Also called ‘piles’ 
Hesitancy Hesitancy is the term used when the individual describes difficulty in initiating micturition, resulting in a delay in the onset of voiding after the individual is ready to pass urine (ICS, 2002)
Hirschsprung’s disease Congenital absence of nerve cells in part of the lower bowel, resulting in the absence of peristalsis in the affected portion of the colon, resulting in a massive enlargement of the colon, constipation and obstruction. Also called Megacolon 
Hormone replacement therapy (HRT) Hormone replacement therapy is appropriate for alleviating menopausal symptoms such as vaginal atrophy and ‘hot flushes’. HRT contains a low dose of oestrogen and, for women with an intact uterus will be combined with progestogen. See also topical oestrogens and menopause
Hydronephrosis Dilation of the kidney with uninfected urine due to an obstruction to the ureter or beyond. If left untreated, the functioning units of the kidney will be destroyed
Hypospadias Hypospadias is a congenital abnormality affecting 1 in 600 boys. The urethral opening is on the undersurface of the penis. This condition is treated surgically. See also epispadias
Hysterectomy Surgical removal of the uterus
 
      I
IAS See internal anal sphincter
IBS See irritable bowel syndrome
ICP See care pathway
I-PSS See international prostate symptom score
ISC See intermittent self-catheterisation
Iatrogenic Resulting from the activity of a doctor. Said of any adverse condition in a patient resulting from treatment by a doctor or surgeon
Idiopathic Of unknown cause
Imperforate anus Having no opening. A congenital defect of the anus, where there is partial or complete obstruction of the anal opening
Incidence The incidence of a disease is the rate at which new cases occur in a population during a specific period (Farmer, in Norton and Chelvanayagam, 2004 )
Inhibitory reflex A reflex within the parasympathetic fibres in pelvic nerves, which inhibits detrusor contraction during the bladder storage phase
Intermittent (in / out) catheterisation Drainage or aspiration of the bladder or a urinary reservoir with subsequent removal of the catheter (ICS, 2002)
Intermittent self-catheterisation (ISC)   Intermittent self-catheterisation (ISC) is performed by the patient himself / herself
Internal anal sphincter (IAS) The internal layer of rectal smooth muscle. Weakness or disruption of the IAS results in the passive leakage of faeces, and incontinence of flatus
Internal urinary sphincter The smooth muscle present at the bladder neck
International Prostate Symptom Score (I-PSS) A symptom index for bladder symptoms, especially related to benign prostatic hyperplasia, and including a ‘Quality of Life’ question
Intravesical Within the bladder
 
Intravesical pressure The pressure within the bladder, measured in centimetres of water (cmH20). The normal bladder accommodates to changes in volume, from empty to full with little rise in pressure
Involuntary Not under voluntary control, for example, smooth muscle is not under voluntary control
Irritable bowel syndrome (IBS) Irritable bowel syndrome (IBS) is a condition which causes the intestines (or bowels, or gut) to be over sensitive. This can cause a variety of abdominal and bowel symptoms. There is no cure, but most people can, with the help of their doctor, learn to control and live with their irritable bowel. Symptoms include: abdominal pains, especially on the left side, or across the lower abdomen, bloating and fullness of wind, constipation, diarrhoea or alternating between one and the other, a sensation of having to rush to the toilet, difficulty opening the bowels, or feeling as though they haven't emptied adequately and feeling nauseated

      K
Kegel, Arnold An American gynaecologist, Arnold Kegel (1948), was the first to report on an uncontrolled study of 500 women doing pelvic floor muscle exercises. Consequently, in America they are referred to as ‘Kegel exercises’ (Getliffe and Dolman, 2003)
Kegel exercises See pelvic floor muscle exercise
Ketonuria An excess of ketone bodies in the urine. Excessive production of ketones can occur in diabetes mellitus
Kidney Either of two bean-shaped organs in the lumbar region that filter the blood, excreting the end products of body metabolism in the form of urine

      
L
LUTS See lower urinary tract symptoms
Laxatives A laxative is an agent which facilitates evacuation of the bowel
Levator ani Main muscle group supporting the pelvic floor
Lower urinary tract The lower urinary tract is made up of the bladder and bladder neck, the urethra and urethral sphincter mechanism, and the pelvic floor
Lower urinary tract symptoms (LUTS) Symptoms relating to the lower urinary tract

      M
MS See multiple sclerosis
MSU See midstream specimen of urine
Manual evacuation The digital removal of faeces from the rectum
Medication Medicinal agent
Medicine 1. Any drug or remedy 2. The science of the diagnosis and treatment of disease and maintenance of health
Megacolon See Hirschsprung’s disease
Menopause A natural physiological process that results from the normal ageing of the ovaries. The levels of female hormones gradually decrease, which can result in symptoms of vaginal dryness and hot flushes. See also hormone replacement therapy and topical oestrogens
Microbiology The study of micro-organisms, including bacteria
Miction protocol See bladder diary
Micturition The passing of urine from the bladder
 
Midstream specimen of urine (MSU) The collection of a urine specimen whereby the first part of the stream is passed into the toilet, to ensure any bacteria in the urethra do not contaminate the sample, and the midstream is collected for laboratory testing
Mixed urinary incontinence Mixed urinary incontinence is the complaint of involuntary leakage associated with urgency and also with exertion, effort, sneezing or coughing (ICS, 2002)
Mobility Free movement
Motor nerve (motoneurone) Pertaining to movement. A neuron having a motor function
Multiple sclerosis (MS) Multiple sclerosis is a chronic disease of the central nervous system. MS is the result of damage to myelin - a protective sheath surrounding nerve fibres of the CNS. When myelin is damaged, this interferes with messages between the brain and other parts of the body
Muscle fibres, slow-twitch and fast-twitch See slow-twitch muscle fibres and fast-twitch muscle fibres

      N
Necrosis Changes indicative of cell or tissue death
Necrotic tissue Tissue which had undergone necrosis
Nelaton, Auguste Auguste Nelaton of Paris, was a physician to Napoleon III. He used a method of forming and shaping rubber, known as vulcanisation, to produce a flexible rubber catheter, with a solid tip and a single eye (Getliffe and Dolman, 2003) 
Nelaton catheter Plastic catheter with a solid tip and single eye, used for the collection of urine samples and by patients’ practising intermittent self-catheterisation
Neurogenic bladder Neurological disease or injury affecting bladder function
Neurogenic bowel Neurological disease or injury affecting bowel function. This may give symptoms of constipation and faecal incontinence
 
Neurogenic incontinence Incontinence secondary to local nerve damage, for example, damage to the pudendal nerve during childbirth, major neurological injury, or chronic pathological process affecting the nervous system
Neurological disease Disease affecting the nervous system
Neurological injury In injury to the nervous system, for example, spinal cord injury
Neuropathy A general term denoting functional disturbances and pathological changes in the peripheral nervous system See peripheral nervous system
Neutrophil Neutrophil granulocytes, generally referred to as neutrophils, are the most abundant type of white blood cells and form an integral part of the immune system
Nitrites (urinary) Most species of bacteria (but not all), that colonize in the urine cause nitrates, which are derived from dietary metabolites, to be converted to nitrites. Urine testing to detect nitrites has become part of a routine urinalysis. A positive result may indicate urinary tract infection
Nocturia Nocturia is the complaint that the individual has to wake at night one or more times to void. (ICS, 2002)
Nocturnal enuresis Incontinence of urine during sleepSee also primary nocturnal enuresis        and secondary nocturnal enuresis
Nursing home An independent, registered unit which offers nursing care to those with complex health care needs who cannot be cared for in their own home

      O
OT See Occupational Therapist
Obstetric history As part of a continence assessment, information regarding the number of children a woman has had, weight of baby, method and history of delivery
Occlusive continence devices Devices, which cause pressure to prevent leakage from the bladder or bowel, such as anal plugs. For urinary incontinence, penile clamps are now rarely used due to the risk of tissue damage
 
Occupational therapy Occupational Therapy is the assessment and treatment of physical and psychiatric conditions using specific, purposeful activity to prevent disability and promote independent function in all aspects of daily life
Occupational therapist (OT) An Allied Health Professional (AHP) working in occupational therapy
Oestrogen A female hormone produced by the  ovary, oestrogen controls female sexual development. Locally, the effects of oestrogen maintain the vaginal and urethral mucosa. Menopause is associated with a decrease in circulating oestrogen levels and therefore a ‘drying out’ of tissues.
Oliguria Oliguria is the production of a lower than normal volume of urine (less than or equal to 0.5ml/kg/hr)
Outlet obstruction See bladder outlet obstruction
Overflow faecal incontinence A condition secondary to constipation and stool impaction. Incontinence occurs of solid stool or of liquid stool, referred to a ‘spurious’ (false) diarrhoea, however the rectum and often a large part of the colon remains impacted with faeces
Oxford grading scale A graded scale used by clinicians, when carrying out a digital assessment of the pelvic floor muscle

      P
PSA See prostate specific antigen
PSS See International Prostate Symptom Score
PVR See post-void residual urine
Pad A cushion-like mass of soft material. A continence pad or product may be disposable or reusable (washable) and is designed to maintain the social acceptability of the user
Pad weighing test An objective measure of urinary leakage, by recording the weight of a dry pad, then weighing after wearing and deducting the dry weight from the wet weight to determine actual urine loss.
Paruresis See avoidant paruresis
 
Pathogen Any disease-producing agent or micro-organism
Pelvic floor  The muscles, ligaments and fascia which form the sling-like support for the organs of the lower pelvis
Pelvic floor muscles The muscles of the pelvic floor concerned with maintaining continence, are the levator ani and the pubococcygeus
Pelvic floor muscle exercise Regular, repetitive, voluntary tightening of the pelvic floor muscle, aimed at increasing muscle bulk
Penile sheath See urinary drainage sheath
Penis The external male organ of urination and coitus
PERFECT mnemonic In the assessment of the pelvic floor muscle contraction, PERFECT relates to: P=power, E=endurance, R=repetitions, F=fast, and ECT=every contraction timed (Laycock, 1994)
Perineum The region of the body between the anus and genitals
Peripheral nervous system The portion of the nervous system consisting of the nerves and ganglia outside the brain and spinal cord
Peristalsis Wavelike contractions, produced by the contraction of smooth muscle, that pass along tubular organs, such as the intestines
Pessary Medical device designed to be inserted into the vagina either to support a displaced womb or for administering drugs locally, such as a contraceptive, antibiotic, antifungal agent, or oestrogen. See also ring pessary
PH (urinary) This represents the acidity / alkaline balance. In urine, the normal range varies between 4.5 and 8.0
Physiotherapist An Allied Health Professional (AHP) working in physiotherapy
Physiotherapy The use of physical means for the treatment and prevention of injury and disease and for the restoration of function
Piles See haemorrhoids
Polypharmacy ‘Any drug regime with at least one unnecessary medication’ (Hogan, 1997). In older people, the absorption, metabolism and elimination of drugs depend on processes which are affected by ageing
 
Polyuria The excessive production of urine; can be a symptom of various diseases, most notably diabetes mellitus
Post micturition symptoms Urinary symptoms which are experienced immediately after micturition
Posterior vaginal wall The posterior (back) wall of the vagina on which the rectum rests
Posterior vaginal wall prolapse Descent of the back wall of the vagina. See rectocele
Post-void residual urine (PVR) The volume of urine left in the bladder at the end of micturition
Pressure sore See decubitus ulcer
Prevalence The total number of cases of a specific condition or disease in existence in a given population at a given time
Primary nocturnal enuresis Incontinence of urine during sleep, when the child has never been dry for a significant period of time. See also secondary nocturnal enuresis
Procidentia Third degree uterine prolapse, or procidentia. The uterus lies entirely outside the introitus (vaginal opening) and denotes complete failure of all the genital supports
Prolapse Downward displacement of an organ or part. See also cystocele, enterocele, procidentia, rectal prolapse and rectocele
Prostate gland A chestnut-shaped body that surrounds the neck of the bladder and urethra in the male. It controls the flow of urine from the bladder and also secretes a milky fluid, which is added to semen during ejaculation
Prostatectomy Surgical removal of the prostate gland. This may be done retropubically (through an incision over the lower abdomen) or transurethrally (through the urethra). See also trans-urethral resection of the prostate (TURP)
 
Prostate specific antigen (PSA) Prostate specific antigen (PSA), is a protein produced by the prostate and released in very small amounts into the bloodstream. When there’s a problem with the prostate, such as when prostate cancer develops and grows, more and more PSA is released, until it reaches a level where it can be easily detected in the blood.A blood test measures the PSA level. PSA levels under 4 ng/mL are usually considered "normal," results over 10 ng/mL are usually considered "high," and results between 4 and 10 ng/mL are usually considered "intermediate"
Proteinuria Proteinuria is protein in the urine. The loss of up to 150 mg of protein per day is normal; this may be expressed as normal is less than 4 mg per hour per square metre of body surface area. Proteinuria may be increased by a factor of 2-3 times by strenuous exercise or fever
Pubococcygeus The pubococcygeus muscle is a hammock-like muscle, found in both sexes, that stretches from the pubic bone to the coccyx (tail bone) forming the floor of the pelvic cavity and supporting the pelvic organs. It controls urine flow and contracts during orgasm. It surrounds the rectum, the vagina (in women) and bladder openings. It aids in urinary control, and childbirth
Puborectalis muscle The puborectalis muscle of the pelvic floor, forms a sling around the anorectal junction. When this muscle contracts, it maintains the anorectal angle and prevents faeces passing into the anal canal.
Pudendal nerve Main nerve supplying the pelvic floor, bladder and urethra. Damage to this nerve can cause incontinence
 
      Q
Quality of life (QoL) Quality of Life includes physical, mental and social well-being, and not just the absence of disease or illness. There are many QoL questionnaires relating to health care and some specific to continence problems

      R
Receptors A sensory nerve ending that responds to various stimuli
Rectal examination See digital rectal examination
Rectal prolapse A condition in which the rectum slips out of its normal position within the body through the anus. It may be put back in place (reduced) by insertion of the finger. If this is not possible, surgery may be required
Rectocele Protrusion or herniation of the rectum into the vagina. This can occur if pelvic muscles are weakened by childbirth. See also posterior vaginal wall prolapse
Rectovaginal fistula A rectovaginal fistula is a medical condition where there is a fistula or abnormal connection between the rectum and the vagina. If the opening between the rectum and vagina is wide it will allow both flatulence and faeces to escape through the vagina. There is an association with recurrent urinary and vaginal infections
Rectum The last several inches of the large intestine that ends at the anus and stores faeces before it is eliminated
Residual urine See post-void residual urine
Retention of urine See Acute retention of urine and chronic retention of urine
Ring pessary Rubber or plastic device that is inserted through the vagina to help hold the uterus in place in women who have prolapse of the uterus

      
S
SCI See spinal cord injury
SUI See stress urinary incontinence
Secondary nocturnal enuresis Incontinence of urine during sleep, after a significant period of being dry. The ‘significant period’ is generally accepted as being 12 months or more beyond the age of 3 years (Getliffe and Dolman, 2003)
Sensory nerves A peripheral nerve that conducts impulses from a sense organ to the spinal cord or brain. Also called afferent nerve. See also peripheral nervous system
Shearing A tearing or stretching of tissue resulting from movement which puts strain on delicate nerve fibres and blood vessels causing them to stretch to the point of breaking, and is one cause of skin damage
Sheaths See urinary drainage sheaths
Signs Signs are observed by the physician, to confirm and quantify symptoms
Skin The outer covering of the body and the largest organ of the body
Slow stream Slow stream is reported by the individual as his or her perception of reduced urine flow, usually compared to previous performance or in comparison to others (ICS 2002)
Slow-twitch muscle fibres The pubococcygeus muscle of the pelvic floor, comprises of about 70% of slow-twitch muscle fibres. The slow-twitch fibres, maintain the pelvic floor strength during normal intra-abdominal pressure. See also fast-twitch muscle fibres
Smooth muscle Muscle which is not under voluntary control
Sphincter A circular muscle that constricts a passage or closes a natural orifice. When relaxed, a sphincter allows materials to pass through the opening
Spina bifida A developmental anomaly characterised by defective closure of the bony covering of the spinal cord
Spinal cord That part of the central nervous lodged in the spinal column
 
Spinal cord injury (SCI) A traumatic lesion of nerve elements in the spinal cord, resulting in any degree of sensory and / or motor deficit, autonomic dysfunction, and bladder / bowel dysfunction
Star charts A chart used to record positive gains, as part of an intervention programme
Stoma An artificial orifice, either temporary or permanent, from the gastrointestinal or urinary tract
Stool Faecal discharge from the bowel
Straining An overstretching or overexertion of some part of the musculature which involves excessive effort
Stress urinary incontinence (SUI) Stress urinary incontinence is the complaint of involuntary leakage on effort or exertion, or on sneezing or coughing (ICS 2002)
Stricture An abnormal narrowing of a passage. See urethral stricture
Stroke (CVA) A disorder of the blood vessels serving the cerebrum. The main causes of stroke are cerebral haemorrhage, cerebral embolism, or cerebral thrombosis, resulting in an impaired blood supply to a part of the brain. The result can be major disability with paralysis and neurological symptoms
Subcutis The subcutis is the layer of tissue directly underlying the cutis. It is mainly composed of adipose tissue. Its physiological function includes insulation and storage of nutrients
Suppository A type of medication designed to encourage bowel movements. They are in a solid form and are inserted up the anus into the rectum
Suprapubic catheterisation A catheter inserted into the bladder, by passing it through a surgically made incision in the lower abdomen. Suprapubic catheterisation, or percutaneous suprapubic cystotomy, offers an alternative method to urethral catheterisation
Sympathetic nervous system A part of the nervous system that causes relaxation of the bladder and contraction of the internal sphincter. Urine storage in the bladder is primarily the result of a functional sympathetic system. Not under voluntary control
Symptoms Any indication of disease perceived by the patient
 
T
TURP See transurethral resection of the prostate
TVT See tension-free vaginal tape
Tension-free vaginal tape (TVT) A newer treatment for stress urinary incontinence in women, using a mesh-like tape that is surgically inserted through the vagina to support the urethra
Testosterone The male hormone, made primarily in the testes. It stimulates blood flow, growth in certain tissues, and the secondary sexual characteristics. In men with prostate cancer, it can also encourage growth of the tumour
Toilet training The process of teaching a child to control urination and bowel movements
Toileting programme An individual programme for a client, planned to meet the clients toileting needs and prevent incontinence.There is considerable evidence that individualised management plans can restore continence or greatly improve the quality of life for patients living with incontinence (Button et al, 1998)
Topical oestrogens Topical oestrogens are those applied locally to the vagina in the treatment of atrophic vaginitis and may help women who have urinary incontinence resulting from menopause. It can be beneficial in women who have mild stress urinary incontinence
Transurethral resection of the prostate (TURP) Surgical procedure to remove tissue from the prostate using an instrument inserted through the urethra
Trigone The triangular area at the base of the bladder where urine enters the bladder via the ureters and leaves the bladder via the urethra
Trigonitis Inflammation of the trigone

      
U
UTI See urinary tract infection
Ultrasound A diagnostic technique, which uses high-frequency sound waves to create an image of the internal organs
Urea The main nitrogen-containing waste product in urine, arising from protein metabolism. Its concentration in blood can be used as a measure of kidney function
Urease An enzyme that breaks down urea
Ureter The muscular tubes about 8-12 inches long, one on either side, that carry urine down to the urinary bladder
Urethra (female) The tube 3 to 5 cm in length, through which urine leaves the bladder. The female urethra extends from the bladder to the urinary opening at the vulva
Urethra (male) The tube approximately 20cm in length, through which urine leaves the bladder. The male urethra extends along the length of the penis. It also conveys the seminal fluid
Urethral caruncle A urethral caruncle is a soft, red fleshy protrusion of the urethral lining from the urethral opening. It is believed to be due to the prolapse of the posterior wall of the urethra. A caruncle generally does not cause symptoms and occurs in postmenopausal women
catheterisation The process of inserting a catheter into the urinary bladder via the urethra
meatus Exterior opening of the urethra. The urinary meatus is located at the tip of the penis in men and in front of the vaginal opening in women
sphincter A ring-like muscle that is normally tight, and when relaxed allows urine to flow from the bladder
Urethrocele Prolapse of the urethra into the vagina
Urgency Urgency is the complaint of a sudden compelling desire to pass urine, which is difficult to defer
Urge urinary incontinence Urge urinary incontinence is the complaint of involuntary leakage accompanied by or immediately preceded by urgency (ICS, 2002)
 
Urinalysis Analysis of the urine as an aid in the diagnosis of disease
Urinary drainage sheath A sheath for the penis, similar to a condom. It is attached to a tube and bag which collects urine as it drains away. Also called penile sheath, external male catheter or condom catheter
catheter A flexible tube for withdrawing fluids from (or introducing fluids into) a cavity of the body, especially one for inserting into the bladder through the urethra to remove urine
frequency Increased daytime frequency is the complaint by the patient who considers that he / she voids too often by day. This term is equivalent to pollakisuria used in many countries (ICS, 2002)
incontinence Urinary incontinence is the complaint of any involuntary leakage of urine (ICS, 2002)
retention See acute retention of urine and chronic retention of urine
Urinarytract infection (UTI) An infection in the urinary tract caused by the invasion of disease-causing micro-organisms, which proceed to establish themselves, multiply, and produce various symptoms in their host. Infection of the bladder, better known as cystitis, is particularly common in women, mainly because of the much shorter urethra, which provides less of a barrier to bacteria. In men, infection is usually associated with obstruction to the flow of urine, such as prostate gland enlargement
urgency Urgency is the complaint of a sudden compelling desire to pass urine, which is difficult to defer (ICS, 2002)
Urination See voiding
Urine Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra
Urine flow rate Urinary flow rate is the volume of urine passed in a certain time, measured in mls per second. It is usually measured electronically, for which, several types of equipment are available
 
Urodynamic stress incontinence Urodynamic stress incontinence is noted during filling cystometry, and is defined as the involuntary leakage of urine during increased abdominal pressure, in the absence of a detrusor contraction Urodynamic stress incontinence is now the preferred term to ‘genuine stress incontinence’ (ICS, 2002)
Urodynamic studies Tests in which the bladder is filled with fluid, and pressures in the bladder and urethra are measured during filling and emptying. It is an important means of finding out why a person is incontinent
Uroflowmetry A urodynamic test that measures urine flow either visually, electronically, or with the use of a disposable flowmeter unit
Urogenital system See Genitourinary system
Urogynaecologist A surgeon who has been trained in the full range of investigations and treatments required for the management of pelvic floor disorders
Urologist A doctor who specializes in diseases of the male and female urinary systems and the male reproductive system
Urology A medical specialty that deals with disturbances of the urinary (male and female) and reproductive (male) organs
Urostomy Urostomy is an operation that is carried out to divert the normal flow of urine from the kidneys. Urine is diverted away from the bladder and into a specially created stoma. The individual will then drain urine through the stoma, completely bypassing the bladder. This is collected in a pouch which adheres to the skin around the stoma
Uterus The womb. The pear-shaped organ in women that holds and nourishes the growing embryo and foetus

      
V
VFC See volume / frequency chart
VFR See voiding flow rate
Vagina The canal in the female which leads from the uterine cervix to the external genitalia
Vaginaldryness See atrophic vaginitis
tape See tension-free vaginal tape (TVT)
weighted cones Vaginal weighted cones are small weights which. can be used by women as an adjunct to pelvic floor muscle exercises
Vaginitis Inflammation of the vagina, often characterized by redness, irritation, itching and / or discharge. Vaginitis may be caused by a variety of factors for example, bacteria, candida, and hormonal changes).
Valsalva manoeuvre A manoeuvre used to greatly increase intra-abdominal pressure and attempt to enable bladder emptying by straining, which involves inhaling deeply and then exhaling forcefully against a closed glottis
Vasopressin See antidiuretic hormone (ADH)
Videocystometry Videocystometry is a urodynamic investigation which allows visualization of the moment of leakage during cough and straining tests, in combination with cystometry, and provides information on other abnormalities of the lower urinary tract
Void Evacuate, excrete or discharge from the body
Voiding Urinating. Sometimes also called ‘peeing’ or ‘passing water’
Voiding symptoms Symptoms which are experienced during the voiding phase
Voiding flow rate (VFR) The volume of urine measured in ml, expelled via the urethra over time, measured in seconds. This is expressed as ml per second (ml/s)
 
      W
WHO World Health Organisation

References

Button D, Roe B, Webb C et al 1998, Consensus Guidelines: Continence promotion and management by the primary health care team. London, Whurr

Bowel Continence Nursing. Edited by Christine Norton and Sonya Chelvanayagam.
Beaconsfield Publishers Ltd, 2004

Promoting Continence. A Clinical and Research Resource, second edition. Edited by Kathryn Getliffe and Mary Dolman.
Bailliére Tindall, 2003

The Standardisation of Terminology of Lower Urinary Tract Function: Report from the Standardisation Sub-committee of the International Continence Society.
Neurourology and Urodynamics 21:167-178 (2002)

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