Urinary incontinence: considering the physical and psychological implications.

Abstract

This article looks at urinary incontinence (UI) from the perspective of the social stigma attached, the prevalence, assessment and types of UI and at the practical means of assistance available for those whose symptoms have not yet been resolved. The International Continence Society (ICS) defines UI as any involuntary loss of urine, but retain their previous definition of ‘involuntary loss of urine that is a social or hygienic problem’ (Abrams et al, 2010: 29). There is a social stigma around the symptoms of UI and people may be reluctant to seek help due to embarrassment, or because they do not construe UI as a suitably medical problem, considering it is a normal part of childbirth or ageing. It is important that nurses (or others involved) create opportunities to identify UI and give patients the opportunity to mention what some may feel is unmentionable (Norton, 2014; Strickland, 2014). The Bladder and Bowel Foundation (2016) estimates that in the UK, more than 14 million adults have problems with bladder control. UI is a symptom, not a diagnosis and management should commence with an assessment to investigate the cause (Nazarko, 2013). As urinary tract infection (UTI) can exacerbate UI, a fresh specimen of urine should be dipstick tested; if positive for nitrite and leucocytes and symptoms include dysuria, frequency and urgency of micturition, a midstream specimen of urine should be sent for culture and sensitivity (Reid, 2014; Bardsley, 2015). After any UTI has been treated, the patient should complete a frequency volume chart/bladder diary, indicating patterns in micturition, UI and fluid intake; National Institute for Health and Care Excellence (NICE, 2015) recommends that this is for a minimum of 3 days.