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Continence aids in the management of urinary incontinence

Published online by Cambridge University Press:  05 January 2012

J Browning
Affiliation:
Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, UK
Z Zaheer
Affiliation:
Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, UK
A Orzechowska
Affiliation:
Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, UK
A Mistri*
Affiliation:
Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, UK
*
Address for correspondence: Dr AK Mistri, Senior Lecturer, Department of Cardiovascular Sciences, Robert Kilpatrick Clinical Sciences Building, University of Leicester, Leicester Royal Infirmary, PO Box 65, Leicester LE2 7LX. Email: [email protected]

Summary

Urinary incontinence is a common problem, more so in older people and those in residential or nursing homes. Guidelines promote a structure to the management of incontinence, recommending non-pharmacological measures (including continence aids) as first-line options. Anticholinergic medications are used widely for urge incontinence, and surgical measures employed in selective cases.

Whilst other treatments are being tried, or where incontinence is refractory to treatment (about 30% of cases), it is important to promote continence or contain incontinence with continence aids in order to minimize psychological complications. What can be a bewildering array of aids is available and choosing the right type of aid requires knowledge of these. Here, we suggest a classification of continence aids, describing individual characteristics and appropriate situations for use.

Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 2012

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References

1National Collaborating Centre for Women's and Children's Health. Urinary incontinence: the management of urinary incontinence in women. Clinical guideline CG40. London: NICE 2006. Available at: http://www.nice.org.uk/nicemedia/live/10996/30281/30281.pdf (accessed 23 August 2011.)Google Scholar
2Irwin, DE, Kopp, ZS, Agatep, B, Milsom, I, Abrams, P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. Br J Urol Int 2011; 108: 1132–38.CrossRefGoogle ScholarPubMed
3Hunskaar, S, Lose, G, Sykes, D, Voss, S. The prevalence of urinary incontinence in women in four European countries. Br J Urol Int 2004; 93: 324–30.CrossRefGoogle ScholarPubMed
4Wagg, A, Potter, J, Peel, P, Irwin, P, Lowe, D, Pearson, M. National audit of continence care for older people: management of urinary incontinence. Age Ageing 2008; 37: 3942.CrossRefGoogle Scholar
5Norton, P, Brubaker, L. Urinary incontinence in women. Lancet 2006; 367: 5767.CrossRefGoogle ScholarPubMed
6Scottish Intercollegiate Guidelines Network. SIGN 79. Management of urinary incontinence in primary care. 2005. Available at: http://www.sign.ac.uk/pdf/sign79.pdf (accessed 4 June 2011).Google Scholar
7Harari, D, Igbedioh, C. Restoring continence in frail older people living in the community: what factors influence successful treatment outcomes? Age Ageing 2009; 38: 228–33.CrossRefGoogle ScholarPubMed
8Dingwall, L, Mclafferty, E. Do nurses promote urinary continence in hospitalized older people? An exploratory study. J Clin Nursing 2006; 15: 1276–86.CrossRefGoogle ScholarPubMed
9Shaw, C. A review of the psychosocial predictors of help-seeking behaviour and impact on quality of life in people with urinary incontinence. J Clin Nursing 2001; 10: 1524.CrossRefGoogle ScholarPubMed
10Bogner, HR, Gallo, JJ, Sammel, MD, Ford, DE, Armenian, HK, Eaton, WW. Urinary incontinence and psychological distress in community dwelling older adults. J Am Geriatr Soc 2002; 50: 489–95.CrossRefGoogle ScholarPubMed
11Papanicolaou, S, Hunskaar, S, Lose, G, Sykes, D. Assessment of bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. Br J Urol Int 2005; 96: 831–38.CrossRefGoogle ScholarPubMed
12Armstrong, M. Factors affecting the decision to place a relative with dementia into residential care. Nursing Standard 2000; 14: 3337.CrossRefGoogle Scholar
13Royal College of Physicians. Incontinence: Causes, Management and Provision of Services. London: RCP. 1995.Google Scholar
14Ouslander, JG. Intractable incontinence in the elderly. Br J Urol Int 2000; 85 (suppl 3): 7278; discussion 81–82.CrossRefGoogle ScholarPubMed
15Brittain, KR, Perry, S, Williams, K. Triggers that prompt people with urinary symptoms to seek help. Br J Nursing 2001; 10: 7476.CrossRefGoogle ScholarPubMed
16Fonda, D, Woodward, M, D'Astoli, M, Chin, WF. Sustained improvement of subjective quality of life in older community-dwelling people after treatment of urinary incontinence. Age Ageing 1995; 24: 283–86.CrossRefGoogle ScholarPubMed
17Cottenden, A, Bliss, DZ, Buckley, B et al. Management Using Continence Products. In Abrams, P, Cardozo, L, Khoury, S, Wein, A (eds). Incontinence: Report of the 4th International Consultation on Incontinence. Plymouth: Health Books; 2009. pp. 1519–42.Google Scholar
18Willis, J. Consumer choice in continence products. Nursing Times. 1997; 93: 64.Google ScholarPubMed
19White, HM. Choosing continence aids. Br J Nursing 1994; 3: 1158–63.CrossRefGoogle ScholarPubMed
20Ballinger, C, Pain, H, Pascoe, J, Gore, S. Choosing a commode for the ward environment. Br J Nursing 1996; 5: 485500.CrossRefGoogle ScholarPubMed
21Fader, MJ, Pettersson, L, Brooks, RD, Cottenden, AM.Reusable female urinals: an evaluation. Disability Equipment Assessment Report IN.3 London: Medical Devices Agency; 1999.Google Scholar
22Department of Health. Good practice in continence services. London: The Stationery Office; 2000.Google Scholar
23Vickerman, J. The benefits of a lending library for female urinals. Nursing Times 2003; 99: 56.Google ScholarPubMed
24National Institute of Clinical Excellence. Lower Urinary Tract Symptoms: The Management of Lower Urinary Tract Symptoms in Men. Clinical Guideline CG97. London: NICE 2010. Available at: http://www.nice.org.uk/nicemedia/live/12984/48557/48557.pdf (accessed 24 August 2011).Google Scholar
25Logan, K, Shaw, C, Webber, I, Samuel, S, Broome, L. Patients’ experiences of learning clean intermittent self-catheterization: a qualitative study. J Adv Nursing 2008; 62: 3240.CrossRefGoogle ScholarPubMed
26Royal College of Nursing. Catheter care. RCN Guidance for Nurses. London: RCN; 2008.Google Scholar
27Addison, R, Roberts, J. Female devices: are your patients missing out? Nursing Times 2001; 97: 3.Google ScholarPubMed
28Pomfret, I. The use of sheaths in male urinary incontinence. Continence Essentials 2008; 1: 7075. Available at: http://www.continenc-uk.com/essentials_2008/Continence_Essentials_2008_Sheaths_Male_Incontinence.pdf (accessed 27 July 2011).Google Scholar
29Thelwell, S, Symon, C, Gay, S, Dean, G, Cottenden, A, Feneley, R.Penile sheaths: a comparative evaluation. Disability Equipment Assessment Report No. A15. London: Medical Devices Agency; 1995.Google Scholar
30Fader, M, Pettersson, L, Dean, G, Brooks, R, Cottenden, AM, Malone-Lee, J. Sheaths for urinary incontinence: a randomized crossover trial. Br J Urol Int 2001; 88: 367–72.CrossRefGoogle ScholarPubMed
31Saint, S, Kaufman, SR, Rogers, MA, Baker, PD, Ossenkop, K, Lipsky, BA. Condom versus indwelling urinary catheters: a randomized trial. J Am Geriatr Soc 2006; 54: 1055–61.CrossRefGoogle ScholarPubMed
32Wells, M. Managing urinary incontinence with BioDerm® external continence device. Br J Nursing 2008; 17: S2429.CrossRefGoogle ScholarPubMed
33Pieper, B, Cleland, V, Johnson, DE, O'Reilly, JL. Inventing urine incontinence devices for women. Image, Journal of Nursing Scholarship 1989; 21: 205–9.CrossRefGoogle ScholarPubMed
34Continence Foundation. Making the case for investment in an integrated continence service. London: Continence Foundation; 2000.Google Scholar
35Royal College of Physicians. National Audit of Continence Care. London: RCP; 2010.Google Scholar
36Fader, M, Cottenden, A, Getliffe, K et al. Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs. Health Technology Assessment 2008; 12: iii185.CrossRefGoogle ScholarPubMed
37Clancy, B, Malone-Lee, J. Reducing the leakage of bodyworn incontinence pads. J Adv Nursing 1991; 6: 187–93.CrossRefGoogle Scholar
38McGill, S. Catheter management: it's the size that's important. Nursing Mirror 1982; 154: 4849.Google ScholarPubMed
39Ramakrishnan, K, Mold, JW. Urinary catheters: a review. Internet J Family Practice 2005; 3 (2). Available at: http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijfp/vol3n2/urinary.xml (accessed 3 October 2011).Google Scholar
40Robinson, J. Urethral catheter selection. Nursing Standard 2001; 15: 3942.CrossRefGoogle ScholarPubMed
41Johnson, J, Kuskowski, M, Wilt, T. Systematic review: Antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients. Annals Int Med 2006; 144: 116–26.CrossRefGoogle ScholarPubMed
42Apisarnthanarak, A. Initial inappropriate urinary catheters use in a tertiary-care center: incidence, risk factors, and outcomes. Am J Infection Control 2007; 35: 594–99.CrossRefGoogle Scholar
43Refthomas, M. Diagnosis, Prevention and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infectious Dis 2010; 50: 625–63.Google Scholar
44Fader, M, Pettersson, L, Brooks, R. A multicentre comparative evaluation of catheter valves. Br J Nursing 1997; 6: 359–67.CrossRefGoogle ScholarPubMed
45Sabbuba, NA, Stickler, DJ, Long, MJ, Dong, Z, Short, TD, Feneley, RJ. Does the valve regulated release of urine from the bladder decrease encrustation and blockage of indwelling catheters by crystalline proteus mirabilis biofilms? J Urol 2005; 173: 262–66.CrossRefGoogle ScholarPubMed