Columbus Community Hospital 100 Miles in 100 Days Introduction WOC Health Center Dr Ronald Ernst Medical Director Suite 210 Visiting Physicians Clinic Wound Ostomy Continence Certified Nurses ID: 788069
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Slide1
Bladder & Pelvic Health
Columbus Community Hospital
100 Miles in 100 Days
Slide2Introduction
W.O.C. Health Center
Dr. Ronald Ernst, Medical Director
Suite 210, Visiting Physicians Clinic
Wound,
Ostomy
, Continence Certified Nurses
Jennifer
Fjell
BSN, RN, CWOCN
Danelle Kratochvil BSN, RN, CWOCN
Slide3How Your Bladder Works- Anatomy
The Bladder
A hollow muscular organ shaped like a small balloon that sits in your lower abdomen (pelvis)
Held in place by ligaments attached to other organs and the pelvic bone
The Kidney
Bean shaped organ near the middle back, below ribs
Remove urine from the blood stream
Ureters
Two tiny tubes that carry urine from the kidney to the bladder
Slide4How Your Bladder Works
Slide5How Your Bladder Works
Urine travels from the kidneys down the ureters to the bladder
Bladder will hold the urine until going to the bathroom
A healthy bladder can hold up to 2 cups of urine for 2-5 hours
Nerves in the bladder tell your brain when it is time to urinate
Urethra is a single thin tube that passes urine from your bladder to the toilet.
Slide6When Things Go Wrong
Overactive Bladder (OAB)
Stress Incontinence
Mixed
Incontinence
Bladder Outlet Obstruction
Slide7Causes of Incontinence
Aging
UTI
Declined Estrogen levels
Childbirth/Pregnancy
Medications
Diseases of Nervous System
Benign Prostatic Hyperplasia
Cancer
Surgery
Radiation
Obesity
Certain Occupations
Dietary irritants
Dehydration
Depression
Excess Urine Production
Restricted mobility
Stool impaction
Vaginitis
or
Urethritis
Slide8Overactive Bladder
Urgency and Frequency Common
Bladder “working overtime
”
Void 8+ times per day
Up more than 2+ at night
Causes
Abnormal sensitivity to bladder filling
Feels uncomfortable or painful
Uncontrollable
contractions of the bladder (detrusor)
muscles due to stimuli
Cold, running water, low urine volumes
Urge to void cause a bladder contraction without the person wanting to
Difficult to stop/control urine
Slide9Stress/Mixed Incontinence
Stress Incontinence
Urine leakage during physical activity or sudden
exertion
Involuntary loss of urine during increased abdominal pressure
Laugh, cough, sneeze, lifting, exercising
Causes
Weak muscles and lack of support for bladder
Bladder
sphincter is too weak to hold urine
Mixed IncontinenceCombination of OAB and Stress
Incontience
Slide10Bladder Outlet Obstruction
Blockage at the base of the bladder
BPH-
Benign Prostatic
Hyperplasia
“Anti-Incontinence” Surgery
Prolapse
Strictures of the Urethra
Foreign Object
Stool Impaction
Slide11Pelvic Organ Prolapse
According to the Mayo Clinic, POP happens when the muscles
and ligaments supporting a woman's pelvic organs
weaken and the
pelvic organs can slip out of place and create a bulge in the vagina (
prolapse
).
Pelvic Organs
Bladder
Intestines
VaginaCervixUterus
Urethra
R
ectum
Slide12Pelvic Organ Prolapse
Slide13Pelvic Organ Prolapse
Risk Factors
Genetics
Race
Caucasian
women are more likely than African American women to develop pelvic organ
prolapse
.
Lifestyle
SmokingPelvic Floor Injury
V
aginal delivery
S
urgery,
Pelvic radiation
F
ractures
to the back and pelvis caused by falls or motor vehicle accidents.
Hysterectomy or surgery of pelvic floor muscles
Other Health
Condiditons
Chronic
constipation
Chronic
coughing
Obesity
obese
women have a 40 to 75% increased risk of pelvic organ
prolapse
.
Menopause
Nerve and muscle
diseases
that decrease pelvic floor strength
Heavy
lifting
Slide14Taking Control-Who Can Help
Primary Care Physician
PA/NP
Urologist
OB/GYN
Urogynecologist
Slide15How Diagnosed
?
Health
History
Past Medical, Surgical, Family, Psycho-Social
Review Dietary/Fluid History
Exam
Urinalysis
Blood Test
Ultrasound
Urodynamic Testing
Slide16Before my appointment…..
What Can I do??
Slide17Retrain Your Bladder
Life Style and Behavior
Changes
May
take 6 weeks or more.
Bladder
Diary
Monitor fluids
Urination Schedule
Gradually increase to holding urine for 3 to 4 hours
Suppress the UrgeRelaxConcentrate Quick ContractionsPelvic Floor Exercises
Distraction
Slide18Pelvic Floor Exercises
Appropriate for Stress, Urge, and Mixed Incontinence
Locate
the pelvic floor muscles
Squeeze this muscle for 3 seconds
Do not tighten Abdominal Muscles at the same time
Upper legs should not move
Body should not rise up or down
Do not hold your breathe
Repeat these exercises
several times daily
Slide19Additional Options for Strengthening Pelvic Floor Muscles & Bladder Management
Biofeedback
Vaginal weight cones
Knack
Electrical stimulation
Medication
Surgery
Physical Therapy for pelvic muscles
Vaginal Devices (
Pessary
)Non-Surgical TreatmentFit by clinician
Absorbent products
Portable toilets
External catheters- Males
Slide20Bladder Health Tips
Lifestyle Modifications
Maintain proper body weight
Obesity leads to bladder problems
Stay Hydrated!
6-8 cups of fluid a day
Increase with exercise or hot weather
Avoid alcohol and beverages with caffeine
Cause increased bladder activity
Eat a healthy diet
Fruits, Vegetables, high-fiber carbohydrates, low-fat, low-salt and lean meat meals
Avoid foods with artificial sweeteners
Do not Strain to empty bladder or bladder
Avoid Constipation
Full rectum can disturb the bladder and cause need to go more frequently
Exercise at least 5 times per week for 30 minutes
Pelvic floor muscle exercises should be done daily
Slide21Bladder Health Tips Continued…
Smoking is the main cause of Bladder Cancer.
Chemicals in tobacco smoke are absorbed into the blood, filtered through the kidneys and stored in the bladder
Smokers are 2-3 times as likely to develop Bladder Cancer
Men are 3 times more likely to be affected than women
CCH has Smoking Cessation Groups available!!
Slide22Signs Medical Attention May Be Needed!
Blood in your urine
Need to urinate frequent/urgent
Sensation of pain or burning with urination
Cloudy or foul smelling urine (infection)
Unusual cramping or tenderness in the area of your bladder
Feeling unable to empty your bladder
Nocturia- Get up more than once at night to urinate
Incontinence- Leaking of urine
Sudden inability to empty bladder
Trauma
Slide23Resources
Bladder Health. (
n.d
.)
Retreived
December 4, 2015, from https://www.suna.org/download/members/bladder_health.pdf
Crowe
, K. (2008).
Bladder Matters: A Guide to Managing
OVeractive
Bladder. Deerfield, IL: Astellas US LLC. Doughty, D. (2006). Urinary & fecal incontinence: Current management concepts
(3rd ed.). St. Louis, Mo.: Mosby Elsevier.
Pelvic
organ
prolapse
. (
n.d
.). Retrieved December 14, 2015, from http://www.mayoclinic.org/diseases-conditions/pelvic-organ-prolapse/basics/definition/con-20036092
Take
the Floor : Pelvic Organ
Prolapse
. (2008). Retrieved December 14, 2015, from http://www.voicesforpfd.org/p/cm/ld/fid=6