INCONTINENCIA URINARIA Una Enfermedad Silenciosa[:en]URINARY INCONTINENCE A Silent Disease

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urinary incontinence

INCONTINENCIA URINARIA Una Enfermedad Silenciosa

Incontinencia urinaria (IU), una enfermedad silenciosa, definida por la Sociedad Internacional de Incontinencia como “la manifestación por parte del paciente de escape de orina” constituye un problema médico y social muy importante para la persona que lo padece, con una prevalencia creciente debido al envejecimiento y a la mayor supervivencia de la población en los países desarrollados.

Es una enfermedad silenciosa, que generalmente se oculta por razones culturales y sociales, de ahí que aunque conocemos datos epidemiológicos muy fiables, es mucho mas frecuente de lo que los datos oficiales nos proporcionan.

urinary incontinence

 

En España se realizó un estudio epidemiológico muy bien diseñado (estudio EPICC) avalado por la Asociación Española de Urología (Actas Urol Esp. 2009;33(2):159-166) en el que participamos en su elaboración y cuyos resultados revelaron que la prevalencia de INCONTINENCIA URINARIA en España se acerca:

  • al 10% en mujeres entre 25 y 64 años,
  • está alrededor del 5% en varones entre 50 y 65 años
  • es superior al 50% en personas de más de 65 años de ambos sexos.

Cifras similares a los estudios publicados en países de nuestro entorno y nivel de desarrollo.

 

La IU no es un proceso con riesgo vital para el que lo padece, pero deteriora significativamente la calidad de vida de los pacientes, limita su autonomía y reduce su autoestima.

La afectación de la calidad de vida relacionada con la salud (CVRS) por la IU puede incluso ser mayor que la provocada por algunas enfermedades crónicas como la diabetes o la hipertensión arterial.

 

Los pacientes ingresados en instituciones para la tercera edad, etc., en particular las mujeres, representan un grupo particular de elevada prevalencia de IU, alrededor de 60%, siendo la incontinencia urinaria unos de los mayores problemas para el cuidado de estas personas y la mayor causa de reingreso.

 

urinary incontinence

TIPOS DE INCONTINENCIA URINARIA

 

En base a criterios sintomáticos y funcionales la Sociedad Internacional de Incontinencia, define los siguientes tipos de incontinencia:

 

Incontinencia urinaria de esfuerzo

La IU de esfuerzo (IUE) se define como la pérdida involuntaria de orina asociada a un esfuerzo físico que provoca un aumento de la presión abdominal (como por ejemplo toser, reír, correr, andar).

Se produce cuando la presión intravesical supera la presión uretral como consecuencia de un fallo en los mecanismos de resistencia uretral.

Es la forma más común de incontinencia y sobreviene en mujeres adultas, con antecedentes de partos.

Afecta a más del 50% de mujeres menores de 75 años.

La causa por la que se produce este tipo de incontinencia es por una lesión en los mecanismos de soporte de la uretra, asociada muchas veces a otras lesiones del suelo pélvico (prolapsos) por debilitamiento de los ligamentos y fascias que soportan los órganos pélvicos adecuadamente.

Ante un esfuerzo, el fallo de estas estructuras, ocasiona un cierre ineficiente de la uretra, ocasionando el escape de orina.

urinary incontinence

Incontinencia urinaria de urgencia

La IU de urgencia (IUU) es la pérdida involuntaria de orina acompañada o inmediatamente precedida de “urgencia”.

Por “urgencia” o “imperiosidad” se entiende cuando el paciente refiere la aparición súbita de un deseo miccional intenso, difícil de contener y que llega a producir escapes de orina.

Esta sensación de urgencia es consecuencia de una contracción involuntaria del detrusor vesical.

Es la forma más común de IU en mayores de 75 años, sobre todo en los hombres (40-80%) y es debido a un deterioro neurológico en los mecanismos de control de la contracción del músculo vesical.

 

Incontinencia urinaria mixta

La incontinencia urinaria mixta (IUM) es la aparición de pérdida involuntaria de orina asociada tanto a urgencia como al esfuerzo.

 

Incontinencia urinaria continua

IU continua (IUC) es la pérdida involuntaria y continua de orina, debido a una fístula, desembocadura ectópica ureteral o a una lesión del esfínter uretral grave.

 

Enuresis nocturna

Enuresis nocturna es la pérdida involuntaria de orina durante el sueño, muy frecuente entre los niños.

 

Incontinencia urinaria inconsciente

La incontinencia urinaria inconsciente (IUI) se define como la pérdida involuntaria de orina sin deseo miccional e independientemente de cualquier aumento de la presión abdominal.

Este tipo de IU se presenta sólo con grandes volúmenes de orina dentro de la vejiga y aunque poco frecuente es de interés reconocerla entre la población geriátrica.

Desde el punto de vista etiológico es una forma extrema de disfunción de vaciado vesical, bien por una obstrucción en el tracto urinario inferior (crecimiento prostático, esclerosis del cuello vesical) o por un detrusor acontráctil (neurológico o por otros factores).

 

Incontinencia Mujeres…TIPOS:

urinary incontinence

 

Incontinencia Hombres…TIPOS:

 

urinary incontinence

 [:en]

urinary incontinence

URINARY INCONTINENCE A Silent Disease

Urinary incontinence (UI) defined by the International Incontinence Society as “patient manifestation of urine leakage” is a very important medical and social problem for the person who suffers from it, with an increasing prevalence due to aging and greater population survival in developed countries.

 

It is a silent disease, which is usually hidden for cultural and social reasons, so although we know very reliable epidemiological data, it is much more frequent than the official data provide us.

 

In Spain, a well-designed epidemiological study (EPICC study) was carried out and supported by the Spanish Urology Association (Actas Urol Esp. 2009; 33 (2): 159-166).

 

The prevalence of URINARY INCONTINENCE in Spain is:

  • close to 10% in women between 25 and 64 years old,
  • it is around 5% in men between 50 and 65 years old
  • it is superior to 50% in people over 65 years of both sexes.

Figures similar to the studies published in countries of our environment and level of development.

UI is not a life-threatening process for the patient, but it significantly impairs patients’ quality of life, limits their autonomy and reduces their self-esteem.

The impact of health-related quality of life (HRQL) on UI may even be greater than that caused by some chronic diseases such as diabetes or high blood pressure.

 

Patients admitted to institutions for the elderly, etc., particularly women, represent a particular group of high UI prevalence, around 60%, with urinary incontinence being one of the major problems for the care of these people and the greater cause of reentry.

Man covering his crotch with both hands

Causes of Incontinence

Incontinence can happen for many reasons. For example, urinary tract in­fections, vaginal infection or irritation, constipation, and some medicines can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:

  • Weak bladder muscles
  • Overactive bladder muscles
  • Damage to nerves that control the bladder from diseases such as mul­tiple sclerosis or Parkinson’s disease
  • Blockage from an enlarged prostate in men
  • Diseases such as arthritis that may make it difficult to get to the bath­room in time

What’s Happening?

The body stores urine in the bladder.

During urination, muscles in the bladder tighten to move urine into a tube called the urethra.

At the same time, the muscles around the urethra relax and let the urine pass out of the body. Incontinence typically occurs if the muscles relax without warning.

 

Diagnosis

The first step in treating incontinence is to see a doctor.

He or she will give you a physical exam and take your medical history.

The doctor will ask about your symptoms and the medicines you use. He or she will want to know if you have been sick recently or had surgery. Your doctor also may do a number of tests. These might include:

  • Urine and blood tests
  • Tests that measure how well you empty your bladder
  • In addition, your doctor may ask you to keep a daily diary of when you urinate and when you leak urine.
  • Your family doctor may also send you to an urologist, a doctor who specializes in urinary tract problems.

 

Types of Incontinence

There are different types of incontinence:

Stress incontinence:

Occurs when urine leaks as pressure is put on the bladder, for example, during exercise, coughing, sneezing, laughing, or lifting heavy objects. It’s the most common type of bladder control problem in younger and middle-age women. It may begin around the time of menopause.

urinary incontinence

Urge incontinence:

Happens when people have a sudden need to urinate and aren’t able to hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.

 

Overflow incontinence:

Happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injury can also cause this type of incontinence.

 

Functional incontinence:

Occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.

 

Urinary Incontinence WOMEN…

urinary incontinence

 

Urinary Incontinence MEN…urinary incontinence

Treatment

Today, there are more treatments for urinary incontinence than ever be­fore.

The choice of treatment depends on the type of bladder control problem you have, how serious it is, and what best fits your lifestyle. As a general rule, the simplest and safest treatments should be tried first.

Bladder control training may help you get better control of your bladder. Your doctor may suggest you try the following:

  • Pelvic muscle exercises (also known as Kegel exercises) work the muscles that you use to stop urinating. Making these muscles stronger helps you hold urine in your bladder longer.
  • Biofeedback uses sensors to make you aware of signals from your body. This may help you regain control over the muscles in your bladder and urethra. Biofeedback can be helpful when learning pelvic muscle exercises.
  • Timed voiding may help you control your bladder. In timed voiding, you urinate on a set schedule, for example, every hour. You can slowly extend the time between bathroom trips. When timed voiding is combined with biofeedback and pelvic muscle exercises, you may find it easier to control urge and overflow incontinence.
  • Lifestyle changes may help with incontinence. You may benefit from: losing weight, quitting smoking, saying “no” to alcohol, drinking less caffeine (found in coffee, tea, and many sodas), preventing constipation, and avoiding lifting heavy objects.
Urinary Incontinence and ORTOHISPANIA:

It can be so discreet that the affected person tolerates this problem without consulting his/herdoctor even if it is intense enough to require the use of pads or swabs.

This problem has an impact on the social life of the patient.

Which may try to avoid any social relationship for fear of being discovered by the smell of urine, which can cause stress or anxiety or lead to depression.

At ORTOHISPANIA we have a wide range of technical aid products for incontinence from some of the better known suppliers…Ugari, DPM, Garcia 1880, Ubio,…You can take at these in our Tienda- On-line/Incontinencia

 

 

Links: 

https://www.nia.nih.gov/health/publication/urinary-incontinence

http://www.iaua.es/incontinencia_orina.html

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