If you are experiencing any issues with continence it is important to have a full assessment by a qualified clinician.
An assessment will enable the clinician to create a care plan for you and determine what the cause of the issues are which is most important as it will determine the treatment and support you need.
If you require an assessment then starting with a discussion with your GP, nurse specialist or physio depending on your diagnosis and type of incontinence.
Some people Use DIAPERS. It is an acronym used to screen for causes of incontinence.
- D - delirium
- I - infection--urinary (symptomatic)
- A - Atrophic urethritis and vaginitis
- P - Pharmaceuticals
- P - Psychological disorders, especially depression
- E - Excessive urine output (for example, from heart failure or hyperglycemia)
- R - Restricted mobility
- S - Stool impaction
Other issues that need to be considered are:
- Decreased fluid intake
- Urinary retention
- Lack of toilet access, poor memory or mobility
- Whether the patient is emptying their bladder, especially if they have a neurological condition
What is a continence assessment?
A continence assessment is beneficial in helping to determine what may be causing incontinence and what the best treatment and/or management pathway is for an individual. An assessment includes:
- Details of signs and symptoms
- Physical examination
- Identifying the type of incontinence (ie urgency, stress-related, mixed)
- Identifying the severity (number and size of pads used, preferably pad weights)
- Determining the impact on activity or quality of life.
In patients who have mixed incontinence, such as urgency and stress incontinence, it is important to determine which is more bothersome.
In the presence of complicated lower urinary tract dysfunction, symptoms such as haematuria, recurrent UTIs, dysuria and pain will require further investigation or specialist referral to exclude malignant or infectious pathology.
During an assessment investigation into medical comorbidities, especially conditions such as diabetes, ischaemic heart disease or congestive cardiac failure, neurological conditions, chronic pulmonary disease, and obesity, can exacerbate OAB and SUI symptoms. Treating these conditions may not eliminate incontinence, but it may lessen the severity.