Urinary incontinence in the elderly
It increases with age and physical disability. It is well known that urinary incontinence is accompanied by psychological depression, which may reduce the willingness to seek help. Urinary incontinence belongs to a frequent, though usually embarrassingly hidden disorder of elderly people. According to various sources, it concerns from 7 to over 30% of people living in their own home, about 30% in hospitals and 50% in nursing homes. Women suffer about twice as much as men than men.
The reason - there is a deterioration of the urinary system
The changes associated with aging lead to a decrease in the volume of the bladder, delaying micturition and slowing down the rate of urinary influence and the ability to stop urge to urinate. There may also be a pre-existing volume of residual urine, which usually does not exceed 50-100 ml. The rhythm of urine excretion from the daily up to 12 episodes can change every night. These changes, however, do not cause urinary incontinence, although they dispose to him. It is enough to have a small physiological, pathological or drug stress to increase this risk.
Mental, cutaneous and other effects of urinary incontinence
Incontinence often causes embarrassment, embarrassment, isolation and withdrawal from active life. It also promotes skin irritations, pressure ulcers, recurrent urinary tract infections, and even falls and fractures. It is one of the reasons for placing people affected by this syndrome in nursing homes. Despite the wide prevalence of the phenomenon, the enormity of suffering and costs associated with running patients with incontinence - unfortunately, the problem is often neglected by both affected people and health and social care workers.
Urinary incontinence also occurs in young people - for example, mothers with multiple pregnancies
Almost half of mothers with multiple pregnancies suffer from incontinence. The author and the team presented the results of research carried out on a group of 733 mothers of twins and triplets. The average age of women surveyed was 37 years, and the average period after delivery was 7.6 years. 57% of these women had a caesarean section, and 41.9% had at least one natural birth. Almost half of the 733 women (49.8%) had problems with incontinence. Urgent urinary incontinence was reported by 45.5% women, urinary incontinence at 27.3% and 22.9% urinary incontinence of various types. Faecal incontinence occurred in 10% of women, bulging or vaginal compression in 20.4%, and pelvic pain in 17.2%. Additional data showed that caesarean section reduced the risk of stress incontinence by 52%.
Urinary incontinence may be transient or permanent
Transient urinary incontinence may affect every third person who develops one of the aforementioned ailments.
In any case of urinary incontinence, it is recommended to exclude or confirm and properly treat these potentially reversible causes of urinary incontinence.
Incontinence may also occur in the course of many diseases:
• stroke
• Parkinson's disease
• Alzheimer's disease
• severe discopathy
• severe diabetic neuropathy
• state after prostatectomy
• damage to the spinal cord
• cancers of the urinary system
The diagnosis of causes of urinary incontinence is comprehensive and consists of:
• per rectum tests (touch method)
• in women - gynecological examination
• neurological examination
• psychological tests, cognitive impairment tests
• ultrasound examination, especially in the case of a large amount of residual urine, and in difficult cases
• urodynamic tests.
From examination to treatment
After careful diagnosis, it is advisable to take specialist treatment promptly, depending on the diagnosis of urinary incontinence.
Who is treating the patient?
.
Most often the primary care physician is the one who first encounters the problem of incontinence in the patient's charge. Due to the wide knowledge about the health and environmental conditions of the patient's condition, he is the most predisposed to solve these important life problems for patients. Due to the fact that this problem is extremely sensitive and embarrassing for seniors and is one of the major factors leading to depressive and resignation reactions, its rather extensive discussion in the monograph devoted to psychogeriatry seems fully justified.
Doctor of Medicine Janusz Krzyżowski
Psychiatrist
Private office tel. 22 833 18 68
00-774Warszawa, Dolna 4 lok. 15
