An Essay On: Incontinence in the aging adult

Question Instructions :

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?

1. Discuss the etiology associated with incontinence in the aging adult

 

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Sample Written Essay :

Incontinence in the Aging Adult Essay

The etiology associated with incontinence in the aging adult.

Urinary incontinence is a common problem in the elderly population, especially women.  This problem is usually undertreated due to underreporting.    The patient is suffering from stress urinary incontinence (SUI).  According to Falah-Hassanni et al. (2021), SUI refers to the involuntary leakage of small amounts of urine during a task, for example, coughing, heavy lifting, or sneezing whereby bladder pressure goes beyond the pressure at which sphincter muscles can stay close. Stress incontinence occurs when the pelvic floor becomes more and weaker after a woman reaches menopause. Intra-abdominal pressure can increase when one sneezes or coughs, leading to leakage of urine (Sabzwari & Amin, 2020).

The etiology of u incontinence in elderly women is more complex. According to  Falah-Hassani et al.,( 2021), a combination of weakening of the urethral sphincters, bladder neck, and pelvic ‘s muscular structures and disruption of the connective tissues that support the urethra and bladder all result in decreased urethral closure pressure along with reduced abdominal leak point pressure resulting in stress urinary incontinence.

Urinary incontinence is not caused by getting older, as one gets old,  there are changes in the functioning of the lower urinary tract which can increase the risk of older individuals to incontinence and might be worsened by comorbidities.  According to Parul University of Ayurveda (2021), age-related changes in the functioning of the urinary tract which may contribute to urinary incontinence in females include atrophy of urethral areas, weakened bladder contractility, detrusor overactivity, and decreased pressure in urethra closure Risk factors for these genitourinary changes include complex or multiple vaginal deliveries, a history of hysterectomy, high infant birth weight, as well as physiological changes associated with the transition to post-menopause. A high body mass index (BMI) is an additional risk factor.

References

Falah-Hassanni, K., Reeves, J., Shiri, R., Hickling, D., & McLean, L.(2021). The Pathophysiology of stress urinary incontinence: a systematic review and meta-analysis.  International Urogynecology Journal, 32,501-552. https://doi.org/10.1007/s00192-020-04622-9

Parul University of Ayurveda. (2021).  Proceeding of International Conference Sthaviropakrama – 2021. Book Rivers.

Sabzwari, S., & Amin, F. (2020). Urinary Incontinence in the Elderly: An Overlooked and Under-Treated problem.  Family Medicine and Medical Science Research, 9(2), 249. doi:10.35248/2327-4972.20.9.249.