Six Types of UI: Assess & Manage

1. URGE

DEFINITION: A medium to large amount of urine lost with a strong sense of urgency.

PATHOPHYSIOLOGY

• Involuntary detrusor contractions (overactive bladder) (DI )
• Detrusor hyperactivity with impaired bladder contractility (DHIC)
• Involuntary sphincter relaxation
• Commonly associated with neurological diseases such as CVA, Parkinson's disease, or infection.

SIGNS & SYMPTOMS

Loss of urine with an abrupt desire to void; frequently a loss of urine on the way to the bathroom. The patient with DHIC has elevated post-voided residual urine (PVR), and needs referral to a urologist.

CHARACTERISTIC FINDINGS of uncomplicated Urge Incontinence

Detrusor instability, normal PVR, no complications.

MANAGEMENT OPTIONS

• Behavioral
  • Pelvic muscle exercise
  • Biofeedback
  • Vaginal weight training with cones
  • Pelvic floor electrical stimulation
  • Bladder training, which is usually systematic delay of voiding.

Bladder training, and electrical stimulation are discussed at this site by University of Bergen, Norway. Please explore these treatment options, and look for the answer to this question:

What are 3 main characteristics of bladder training programs?

• Pharmacologic
  • Oxybutynin
  • Propantheline
  • Detrol; a new drug generally well tolerated by adults of all ages.
• Complicated urge incontinence may need surgery.

More about Oxybutynin (Ditropan) at this manufacturer's (Ortho-Mcneil Pharmaceutical) site. Then, answer this Instant Feedback question:

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