Living with urinary incontinence: Why diagnosing is important
Living with urinary incontinence is still today considered a tabu and is connected to a feeling of shame and humiliation. This knowledge article aims to give a view of why diagnosing urinary incontinence is important for patients living with incontinence.
Symptoms of incontinence
How to detect it
Many people experience occasional minor leaks of urine. In comparison, others might leak a small to moderate amount of urine more regularly. Incontinence is experienced differently, anxiety and depression as a consequence of suffering from the condition. Even very small leakages can be annoying and lead to social isolation. An input/output chart is a good way to measure the fluid balance and control the problem, so the problem does not control the patient. To assess how much fluid you drink, to measure your urine volume, to record how often you pass urine over 24 hours and to show any episodes of incontinence (leakage).
The results are important in diagnosing the cause of your urinary symptoms and deciding how best to treat them. You should fill in the chart as accurately as possible over three consecutive normal days. Analyzing the fluid balance chart in collaboration with the doctor can give an idea of if the patient deals with incontinence and what type of incontinence there might be talk about.
Based on the information on the charts and the physical examinations, the doctor will make the diagnosis and suggest which treatment to start with. The doctor may also choose to refer you to a specialist department for further investigation.
Establishing cause and type of incontinence
During a person’s first consultation with their doctor or healthcare practitioner, finding the type and cause of incontinence is the first step before finding the proper treatment for the individual patient. The goal is to cure the incontinence or significantly reduce the symptoms. Hereafter, healthcare professionals can give advice concerning beneficial products, medication, and lifestyle changes that may relieve the patient’s symptoms. Purpose of diagnosing:
- to confirm or exclude incontinence,
- to classify the type of incontinence,
- to exclude serious illness,
- to identify simple causes of incontinence,
- to assess how bothered the patient is by the problem,
- to identify those patients who require further investigation,
- to assess treatment and care needs.
Based on the patient's needs, expectations and capabilities, a relevant examination program can be planned. There are several types of incontinence, and it is important to establish which type the individual patient is dealing with, so the treatment fits the case.
When the type of incontinence is found, the treatment can be targeted accordingly and based on the patient's ability to cope. For more in-depth knowledge on the individual types of incontinence and how to treat these, learn more in our knowledge article “Types of Incontinence”.
Improving Continence Care
It is estimated in a report from EAU that around 55-60 million people in Europe (about twice the population of Texas) live with some form of incontinence. On an international scale we look at 430 million people living with incontinence. To maintain or optimize quality of life, the patient should be offered a thorough assessment according to the “minimal care principle”. Diagnosing according to the minimal care principle ensures a systematic and uniform way of working based on a relevant, minimal and predominantly non-invasive method. With the minimal care principle, the problem is uncovered, its extent and how it affects the quality of life and the person's ability.
Using minimal care it can easily be determined whether changes to current habits, daily toilet routines can relive the problem and if a general practitioner should be contacted with a view of assessing the lower abdomen in relation to different kinds of treatment with the aim of curing the incontinence or alleviate the symptoms and getting the situation under control with the right aids.
With an initial detection of incontinence among all patients, it is clarified whether the person is incontinent and to what extent. Any patient that requests an incontinence aid needs assessment. The assessment should be carried out by a nurse who is specialized or has much interest in the continence care discipline. The nurse will be in charge of the assessment and interviewing the patient regarding the involuntary urination.
The aim is to achieve systematic access to detection when a resident experiences incipient incontinence and improve the incontinence status or even cure it. The assessment according to minimal care principles extends over a period with interviewing and visits the patient.
- Interview the client regarding involuntary urination: Begin with asking openly about daily inconveniences caused by involuntary urination to determine the problem of involuntary urination.
- Urination anamnesis:
- Present symptoms and duration
- Aspects influencing involuntary urination
- Prior treatments and results
- Urine sample: due to UTI can be the cause of urinary incontinence and therefore the urine must be tested. The urine is tested for glucose, blood, nitrite, and leucocytes.
- Input/output chart: The caregiver fills in the input/output chart in partnership with the client. It should cover three days. Every liquid input and urinary output should be measured in milliliters. Every urinary leak should be noted in time and in what circumstance/activity. This gives a good picture of urinary frequencies, leak situations, and fluid intake. These charts identify the type of incontinence and if habits should be changed.
- Evaluation of results: The results of the initial assessment are evaluated by the nurse; The overall condition of the client forms the basis of any future specialized examination and treatment plan.
- General practitioners: In each case the general practitioner should determine to what extent the individual’s overall situation is investigated, for example, out from what the citizen can cope with from their mental – and physical status.
After the data has been collected the nurse analyzes them and identify the type of incontinence and considers what can be changed in relation to treatment, daily habits and routines and what useful cooperation partners can be relevant for example the general doctor, physiotherapist, care staff etc. After analyzing the data, a plan of action for the individual patient will be made as a choice of aids including incontinence products if still needed or medical treatment if relevant. Also, changes in medical treatment and environmental changes if they are assessed could be beneficial. It’s important to remember, always do individualized continence care and that the professional assessment always shall lie before the choice of an incontinence product.
If you want to learn more about continence care and how to choose the right incontinence product don’t hesitate to reach out.
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