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urinary incontinence essays
urinary incontinence essays
Module 7: Discussion
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A nurse practitioner (NP) is talking with a 70-year-old patient who asks if she could discuss a problem that she is embarrassed to talk about with her physician. She states she has been having increasing problems with incontinence. Every time she coughs or sneezes, she notices a loss of urine. She has not had any fever or chills or pain with urination. She asks the NP if this is just a sign of getting older?

Discuss the etiology associated with incontinence in the aging adult urinary incontinence essays.

Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to grading rubric for online discussion.
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Discussion 7Subscribe
Alfonsina Perez posted Mar 3, 2021 7:25 PM
Contains unread posts urinary incontinence essays
Urinary incontinence (UI), as defined by Giraldo-Rodriguez et al., (2019), is the involuntary leakage of urine. There are several factors that correlate with urinary incontinence and these include an increase in age, ethnicity, educational level, increase in body mass index, over active bladder syndrome, vaginal birth in women, and prostate surgery in men (Giraldo-Rodriguez et al., 2019). Davis et al., (2020), attributes age related changes to the genitourinary system such as decreased bladder capacity, increased involuntary bladder muscle contractions, prostate enlargement, decreased estrogen levels, and increased night time urine production as major causes of increase prevalence of UI among older adults. Additionally, certain medications and cognitive decline in the elderly are also factors increasing the prevalence of UI in the elderly (Davis et al., 2020). As age increases, the bladder’s capacity to contract decreases which also affects an individual’s ability to hold their urine. Decreased contractability also impacts the ability to completely empty the bladder which increases post void residual (Giraldo-Rodriguez et al., 2019). Moreover, any kind of age-related physical condition or illness which limits mobility also increases risk of UI and some examples include arthritis and Alzheimer’s (Davis et al., 2020).    ReferencesDavis, N. J., Wyman, J. F., Gubitosa, S., & Pretty, L. (2020). Urinary incontinence in older Epidemiology, progression, and predictive factors of urinary incontinence in older community‐dwelling mexican adults: Longitudinal data from the mexican health and aging study. Neurourology and Urodynamics, 38(7), 1932- 1943. https://doi.org/10.1002/nau.24096Shlain, I., Lavy, Y., Arbel, R., Shveiky, D., Woloski Wruble, A., & Liebergall‐Wischnitzer, M. Daigle, S. G., Redden, D. T., & Markland, A. D. (2016). Vitamin D and incident urinary incontinence in older adults. European Journal of Clinical Nutrition, 70(9), 987-989. https://doi.org/10.1038/ejcn.2016.20less2 UnreadUnread6 ViewsViews


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View profile card for Caroline Otto
Last post March 7 at 11:30 PM by Caroline Otto
Vaughan, C. P., Tangpricha, V., Motahar-Ford, N., Goode, P. S., Burgio, K. L., Allman, R. M.,
(2018). Urinary incontinence type, symptoms, and quality of life: A comparison between grand multipara and non‐grand multipara women aged ≥50 years. Japan Journal of Nursing Science : JJNS, 15(4), 309-317. https://doi.org/10.1111/jjns.12200

Giraldo‐Rodríguez, L., Agudelo‐Botero, M., Mino‐León, D., & Álvarez‐Cisneros, T. (2019).
adults. The American Journal of Nursing, 120(1), 57-62 urinary incontinence essays. https://doi.org/10.1097/01.NAJ.0000652124.58511.24

Urinary incontinence can negatively affect the quality of life in the older adult and may lead to social isolation, falls and depression (Vaughan et al., 2016).  It is important to note that there are several types of urinary incontinence which include, stress, urgency and overflow incontinence (Shlain et al., 2018).  Stress UI is defined as leakage of urine that occurs on exertion or while sneezing or coughing, urgency incontinence is when leakage of urine occurs after a person has the sudden urge to urinate but is not able to hold the urine long enough to make it to the bathroom (Shlain et al., 2018). Overflow incontinence refers to urinary leakage as a result of overfill or distended bladder which usually happens due to bladder outlet obstruction as it is found in men with enlarged prostate (Davis et al., 2020).
Mixed IncontinenceSubscribe
Caroline Otto posted Mar 7, 2021 11:14 PM
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 Lastly, the final type of incontinence is the Functional incontinence. This means that there is an involuntary loss of urine attributable to dementia or immobility, and patients are forced to pampers all the time because of this. Aoki, Y., Brown, H. W., Brubaker, L., Cornu, J. N., Daly, J. O., & Cartwright, R. (2017). Urinary incontinence in women. Nature reviews. Disease primers, 3, 17042. https://doi.org/10.1038/nrdp.2017.42 Huether, S. E., McCance, K.L. & Brashers, V.L. (2020). Understanding Pathophysiology 7th ed. Elsevier Mosbyless0 UnreadUnread
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Demaagd, G. A., & Davenport, T. C. (2012). Management of urinary incontinence. P & T : a peer-reviewed journal for formulary management, 37(6), 345–361H.
Our abdominal cavity, pelvic cavity and retroperitoneal cavity hold our organs exactly where they need to be using ligaments and muscles. Over time gravity, and wear and tear, as well as surgeries that have disrupted the strength of the abdominal muscles. Over time this may cause the bladder to sit as high as it once did, thereby causing a disruption in the usual flow and production of things.
There are four different types of Incontinence in the human population. The most common type often found in older adults is the urge incontinence, which is the involuntary loss of urine associated with the abrupt and strong desire to void. This is associated with involuntary contractions of bladder wall and does not indicate a neurological disorder, even though it may be present with one, it is not, however used as a symptom for one (Demaagd, 2012) urinary incontinence essays. The second type of incontinence, and the most common one in women above the age of sixty years old as well as men who have had prostate surgery is; stress incontinence. Stress incontinence is the involuntary loss of urine during coughing, sneezing, laughing, or other physical activity associated with increased abdominal pressure. This can be very distressful for others as the moment usually comes unexpectedly (Aoki, et.al. 2017).  The third type of incontinence is called Overflow incontinence, and I have seen this in my practice. This is the involuntary loss of urine with overdistention of bladder, associated with neurologic lesions below S1, polyneuropathies, and urethral obstruction, as in the case of an enlarged prostate. In this case, the patient will report that they are voiding however their bladders are still distended and are full, and it is the fullness that causes the overflow because the urine has nowhere else to go to. Then there is a Mixed incontinence type which is common in older women and this is a combination of both stress and urge incontinence.
Module #7: Urinary IncontinenceSubscribe
Lois Chappell posted Mar 7, 2021 7:42 PM
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According to Qaseem, Dallas, Forciea, Starkey, Denberg, and Shekelle (2014), aged 75 years and older.  Other studies show up to 75% of women greater than treatable condition  (Jopling & Meier, 2020).  This estimate may be low as there     Associated with anxiety, depression, sexual dysfunction, sleep disturbances.incontinence also carries a high cost for treatment  and can lead to nursingsymptoms of urinary incontinence and include shame, the belief that the reporting of the problem, providers often fail to screen and understand treatment     Risk factors for urinary incontinence in women include obesity, pregnancy,hysterectomy, menopause, cognitive and or functional decline of aging for both screening and treating urinary incontinence.  Screening for incontinence to overall  improved quality of life, as well as reduced medical spending for this      the well woman exam.  Urologic Nursing, 40 (3) urinary incontinence essays.      (2014).  Incontinence in Women: A Clinical Practice Guideline for the      from https://doi.org/10.7326/M13-2410/.less0 UnreadUnread
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      American College of Physicians.  Annals of Internal Medicine.  Retrieved
Qaseem, A., Dallas, P., Forciea, M., Starkey, M., Denberg, T., and Shekelle, P.
Jopling, A., & Meier, N.  (2020).  Effective screening for urinary incontinence at
 common condition.
 during the  annual well woman exam is the first step in treatment which can lead
 (Qaseem, Dallas, Forciea, Starkey, Denberg, & Shekelle, 2014).  Guidelines exist
urinary tract infections, pelvic floor trauma following vaginal delivery,
 guidelines for urinary incontinence.
 symptom is normal, and that treatment does not exist.  Compounding limited
 home admissions.  Many barriers are associated with a lack of early reporting of
 and overall sense of well being (Jopling & Meier, 2020), urinary
is often embarrassment attached to urinary incontinence.
 age 60 and greater than 40% of 40 to 60 year old women suffer from this
incontinence increases in frequency as women age: affecting up to 71% of women
Jennifer Bryant posted Mar 2, 2021 8:06 PM
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View profile card for Alfonsina Perez
Last post March 7 at 4:56 PM by Alfonsina Perez

Mayo Foundation for Medical Education and Research. (2020, March 19). Stress incontinence. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/stress-incontinence/symptoms-causes/syc-20355727.
Engberg, S., & Li, H. (2017). Urinary Incontinence in Frail Older Adults. Urologic Nursing, 37(3), 119-125. http://dx.doi.org.wilkes.idm.oclc.org/10.7257/1053-816X.2017.37.3.119

This condition is caused by physical, psychological, environmental and neurological factors urinary incontinence essays. Some of the recognized neurological causes include herpes, stroke, Alzheimer’s disease, Parkinson disease, spinal injuries, diabetes and focal neuropathy. These conditions interfere with the nerve signals that control the bladder activities. Also, temporary urinary incontinence can be caused by drinks such as alcohol, chocolate, caffeine, and carbonated drinks which stimulate the bladder and increase the volume of urine (Mayo Clinic, 2021). Moreover, treatable medical conditions such as constipation and urinary tract infections can also cause this condition. UTI irritates the bladder thus bringing the feeling and urge of urinating. Furthermore, UI can be caused by underlying physical problems including menopause, enlarged prostate, prostate cancer, obstruction, childbirth and pregnancy. It should be noted that the primary risk factors include gender, age, smoking, family history and obesity.
Module 7 DiscussionSubscribe
Melissa Morgan posted Mar 3, 2021 9:55 PM
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The patient could be experiencing stress incontinence where involuntary loss of urine during cough, sneezing or laughing occurs (Huether, McCance & Brashers, 2020). Incontinence can be caused by lower urinary tract obstruction (LUT). This obstruction could be as a result of urethral stricture, pelvic prolapse, and tumor compression (Huether, McCance & Brashers, 2020). Older women frequently have overactive bladder syndrome (OAB), which is idiopathic and results in “involuntary contractions of the detrusor muscle resulting in urge incontinence” (Huether, McCance & Brashers, 2020, p. 731). These symptoms are usually more common in people age 65 and older, and are a continual source of embarrassment, discouragement, depression, and can cause skin breakdown (Huether, McCance & Brashers, 2020).ReferencesGovender, Y., Gabriel, I., Minassian, V., & Fichorova, R. (2019). The Current Evidence on the Association Between the Urinary Microbiome and Urinary Incontinence in Women. Frontiers in cellular and infection microbiology, 9, 133. https://doi.org/10.3389/fcimb.2019.00133 less1 UnreadUnread2 ViewsViews
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View profile card for Cassie Fritzinger
Last post March 4 at 12:00 PM by Cassie Fritzinger
Huether, S., McCance, K., and Brashers, V.  (2020).  Understanding Pathophysiology (7th ed.).  Elsevier
Aoki, Y., Brown, H. W., Brubaker, L., Cornu, J. N., Daly, J. O., & Cartwright, R. (2017). Urinary incontinence in women. Nature reviews. Disease primers, 3, 17042. https://doi.org/10.1038/nrdp.2017.42
The patient should have a full physical examination, urinalysis (if warranted), detailed history that focuses on whether the patient had a vaginal birth, surgery for pelvic organ prolapse, hysterectomy, and medications. Urodynamic tests, renal imaging, and labs that measure serum creatinine can help diagnose the cause of incontinence. Treatment includes medications, behavioral therapy, diet modification, and neuromodulation if other therapies have failed (Huether, McCance & Brashers, 2020). Urinary incontinence can be the result of several different urinary tract disorders, which makes diagnosing it difficult (Govender, Gabriel, Minassian & Fichorova, 2019). Normal urinary microbes help to maintain a healthy bladder milieu: “cumulative evidence suggests that certain Lactobacillus species may play a role in maintaining a healthy bladder milieu. Higher bacterial diversity in the absence of Lactobacillus dominance was associated with urgency UI and resistance to anticholinergic treatment for this condition” (Govender, Gabriel, Minassian & Fichorova, 2019). The hammock hypothesis is an interesting explanation of stress urinary incontinence. It states that damages to the pelvis and tissues result in decreased anatomical support of the bladder neck and the urethra (Aoki, et al., 2017). This results in leakage, a feeling of not being able to hold urine, and frequently having to empty the bladder.
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Hilary Szpara posted Mar 2, 2021 10:15 PM
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Urinary incontinence is the involuntary loss of urine and tends to be more frequent among women than men (Aoki et al., 2017). There also tends to be slight differences in the causes of incontinence between men and women. Incontinence in men often results from enlargement of the prostate or damage from surgery or radiation used to treat prostate cancer. In women, incontinence is often a result of dysfunction of the bladder or pelvic floor muscles, which can occur after pregnancy, childbirth, or during menopause (Aoki et al., 2017). As a result, incontinence is often more common as people age, but it is not a normal part of aging for people. In a study by Suskind et al., it was found that higher body mass index (BMI) and higher amounts of body fat were found to be markers for both stress urinary incontinence and urgency urinary incontinence in women (2017). It has been found that stress urinary incontinence in women with higher BMIs may in part result from an increase in abdominal pressure, which can result in intravesical pressure and urethral sphincter mobility (Suskind et al., 2017). Urgency urinary incontinence in older women who are overweight may be due to the effects of oxidative stress over time, which can result in ischemia of the bladder and detrusor muscle instability (Suskind et al., 2017). Conversely, older adults with lower than average BMIs may have an increased risk of incontinence. This may occur if the weight loss that they undergo is that of lean muscle mass opposed to fatty tissue. When this loss of lean muscle mass occurs, older adults may become frail, which may interfere with normal toileting habits. Lower muscle mass and strength in extremities may be associated with lower strength of the pelvic muscle floor as well as its function, which can result in the leaking of urine (Suskind et al., 2017). So, while urinary incontinence may be more prevalent in older adults, it is not a normal process of aging and it often results from certain conditions which can develop or evolve over the lifespan, resulting in more incontinence in older adults.  Aoki, Y., Brown, H. W., Brubaker, L., Cornu, J. N., Daly, J. O., & Cartwright, R. (2017). Urinary incontinence in women. Nature reviews. Disease primers, 3, 17042. https://doi.org/10.1038/nrdp.2017.42 less1 UnreadUnread7 ViewsViews
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View profile card for Jazmin Jerez-Rivera
Last post March 4 at 9:49 AM by Jazmin Jerez-Rivera
Suskind, A. M., Cawthon, P. M., Nakagawa, S., Subak, L. L., Reinders, I., Satterfield, S., Cummings, S., Cauley, J. A., Harris, T., Huang, A. J., & Health ABC Study (2017). Urinary Incontinence in Older Women: The Role of Body Composition and Muscle Strength: From the Health, Aging, and Body Composition Study. Journal of the American Geriatrics Society, 65(1), 42–50. https://doi.org/10.1111/jgs.14545

Stress incontinenceSubscribe
Aina Oluwo posted Mar 3, 2021 4:23 PM
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Urinary incontinence (UI) as defined by the National institute of aging is basically when a person leaks urine by accident and guided literature suggests this is prevalent in the older population especially women. UI is one of the most common geriatric syndromes and affects overall health, quality of life, and economical burden in patients. (Sohn et al., 2018).  Although urinary incontinence can occur in the younger age population, it is not often seen unless the etiology is associated with pathological and medically induced etiologies such as strokes or cancer. The prevalence of urinary incontinence is estimated to be 5-10% among the general elderly population, 10-20% among those receiving home care, and at least 50% among those individuals living in long-term care institutions (Southall et al., 2017). Most studies indicate that women have a higher prevalence of urinary incontinence than men, due to differences in the structure of the male and female urinary tracts. The causes of urinary incontinence among women include childbirth, menopause, obesity, presence of lower urinary tract symptoms and decreased mobility. It is common for men to experience urinary incontinence following a prostatectomy, as suggested by the prevalence rate for men spiking from 5% to over 60% following this surgery. (Southall et al., 2017).            Our patient is a 70 y/o female who experiences urinary incontinence with coughing or sneezing has been embarrassed talking to her physician about this and this is a common theme seen with patient’s incontinence. Patients with UI experience elements of stigma, including embarrassment and shame. (Devendorf et al., 2020). Patients are often reluctant discussing UI as bodily fluids expulsion is typically a private affair and the vulnerability associated with the lack of control over one’s bodily function is one that can render reduction in self-esteem. Several studies have also shown that this can lead to self-isolation as well as depression given the particular age population that this medical condition is related to.The etiology of UI is vast however several common factors come into play in the most prevalence group; elderly population. Incontinence can happen for many reasons however for the purpose of this case study we will focus on etiology of UI as related to our patient who experiences these symptoms with coughing or sneezing. This component of UI is called stress incontinence. Factors of incontinence can be associated with major neurological damage or can be functional or iatrogenic however in the case of stress incontinence, the notable factors of causes are usually the result of the age related changes that can lead to the weakening of or damage to the muscles used to prevent urination, such as the pelvic floor muscles and the urethral sphincter. When pelvic organs are out of place, the bladder and urethra are not able to work normally, which may cause urine to leak. Many individuals go to great lengths to deny and hide urinary incontinence, which can pose physical and psychosocial impediments to the enjoyment of life.The etiology of urinary incontinence in the elderly population can often be multifactorial and this is where adequate history taking as well as physical exam will play a major role in diagnosing as well as treatment associated with the type of urgency. Treatment of stress incontinence will include kegel exercises, bladder training, vaginal estrogen cream and medications that increase urethral sphincter contraction amidst others (Huether et al., urinary incontinence essays2020).
ReferencesDevendorf, A. R., Bradley, S. E., Barks, L., Klanchar, A., Orozco, T., & Cowan, L. (2020).Stigma among veterans with urinary and fecal incontinence. Stigma and Health. Advanceonline publication. https://doi.org/10.1037/sah0000260 Pathophysiology (7th ed.).  Elsevier.Sohn, K., Lee, C. K., Shin, J., & Lee, J. (2018). Association between female urinary incontinenceand geriatric health problems: Results from korean longitudinal study of ageing(2006). Korean Journal of Family Medicine, 39(1), 10-14. https://doi.org/10.4082/kjfm.2018.39.1.10     https://www.acog.org/womens-health/faqs/urinary-incontinence  less0 UnreadUnread
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Urinary Incontinence in Older Adults. (2017, May 16). National Institute on Aging.

Urinary Incontinence. (2020, July). ACOG.

measures. SAGE Publications. https://doi.org/10.1177/2055668317738943
J. W. (2017). Assessing the stigma content of urinary incontinence intervention outcome
Southall, K., Tuazon, J. R., Djokhdem, A. H., van den Heuvel, Eleanor A, Wittich, W., & Jutai,

Huether, S., McCance, K., and Brashers, V.  (2020).  Understanding urinary incontinence essays

            Urinary incontinence can carry added factors along with the main diagnosis such as loneliness, isolation and depression and should not be the only focus of the initial encounter with the patient. Health practitioners should approach incontinence with methods of evaluation that address the physical and mental health indicators, as well as the impact on the quality of life of the patient. But firstly getting the patient to discuss the problem is the first priority and then treatment should be personalized based on the individual patient preferences and goal of therapy.

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Cassie Fritzinger posted Mar 2, 2021 7:24 PM
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Much like the discussion prompts urinary incontinence (UI) can be an embarrassing condition which many who suffer from do not feel comfortable discussing with their providers. For this reason, the number of patients who have UI is unknown (American Urology Association, 2021). However, it is reported to be more common among women over the age of 50 (Ellis, 2020). There are four forms of UI, stress urinary incontinence (SUI), overactive bladder (OAB), mixed incontinence (SUI and OAB) and overflow incontinence (American Urology Association, 2021). Urinary incontinence is not a normal part of aging and is not a disease, but it is a symptom of many different medical problems or can be caused by everyday problems or habits.  The Mayo Clinic, (2019) refers to other types of urinary incontinence; stress, urge, overflow, functional, and mixed incontinence. Further breaking it down into temporary and persistent incontinence.Underlying physical problems which could cause UI include pregnancy which places additional pressure on the bladder as the fetus grows, childbirth which can weaken the pelvic floor muscles urinary incontinence essays. These muscles can also be affected with any women’s reproductive surgeries such as a hysterectomy. Aging patients lose capacity of their bladder and have involuntary bladder contractions causing frequent urination. The hormone estrogen helps keeping the lining of the bladder healthy, which is lost when a patient experiences menopause. An Enlarged prostate, Prostate cancer or obstruction from tumors or urinary stones can cause an incontinence as well. Lastly another cause of persistent UI may include types of neurological disorders such as Multiple sclerosis, Parkinson’s disease, stroke, or spinal cord injury (Mayo Clinic, 2019). ReferencesEllis, M. (2020). Why Am I Experiencing Urinary Incontinence? Healthline. Retrieved March 2, 2021 from: https://www.healthline.com/health/urinary-incontinenceless0 UnreadUnread
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Mayo Clinic, (2019). Urinary Incontinence. Mayo Clinic. Retrieved March 3, 2021 from https://www.mayoclinic.org/diseases-conditions/urinary-incontinence/symptoms-causes/syc-20352808#:~:text=Urinary%20incontinence%20isn’t%20a,determine%20what’s%20behind%20your%20incontinence.
American Urology Association. (2021). Urinary Incontinence. Urology Care Foundation. Retrieved March 3, 2021 from 

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