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Pathophysiology of Urinary Incontinence

Urinary incontinence can occur due to detrusor hyperreflexia in suprapontine lesions and suprasacral. It is often associated with the frequency and when the sensory pathways are intact, there will be a sensation of urgency. LMN lesions associated with sphincter weakness that can manifest as stress incontinence and the inability of the detrusor contraction resulting in chronic retention with overflow. There is some division of urinary incontinence, but are generally divided into 4 groups :

Nursing Care Plan for Total urinary Incontinence
  1. Stress urinary incontinence occurs when urine uncontrollably out due to increased pressure in the stomach. In this case, the pressure in the bladder becomes greater than the pressure on the urethra. Symptoms include urinating when coughing, straining, laughing, sneezing, running, or anything else that increases the pressure in the abdominal cavity. Treatment can be done without surgery (eg with Kegel exercises, and some types of drugs), as well as operation (way more often used).
  2. Urge incontinence occurs in a state of unstable detrusor muscle, which is muscle overreact. Symptoms include feeling to urinate sudden, repeated urination, urinary night. The treatment is done with the administration of drugs and exercise.
  3. Total urinary incontinence which flows out at all times and in all positions of the body , usually caused by fistulas (abnormal channels connecting the one organ in the body), for example, vesicovaginal fistula (channel formed between the bladder to the vagina) and or fistula urethrovaginalis (channel between urethra with the vagina). If this is found, it can be treated with surgery.
  4. Overflow incontinence is urine flowing contents are already too much in the detrusor muscle of the bladder due to weak. Usually it is found in nerve disorders due to diabetes, injury to bone marrow, or urinary tract blockage. Symptoms include feelings of discontent after urinating (feel urine remaining in the bladder), urine comes out a little and weak radiance. Treatment is directed at the source of the cause.


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