A neurologist’s opinion of the management of subjects suffering from urine or stool incontinece
Authors:
M. Bojar 1; R. Mazanec 1; Z. Kučera 2
Authors‘ workplace:
Univerzita Karlova v Praze, 2. lékařská fakulta, Neurologická klinika dospělých, FN Motol 2 Česká společnost podpory zdraví, Inco Fórum, Praha
1
Published in:
Čes Ger Rev 2009; 7(1): 5-13
Overview
Health, epidemiological, psychosocial and economical aspects of urine incontinence (UI), which permanently affects 16% adults in Czech Republic, as well as stool incontinence (SI), which is frequently combined with UI, are discussed. A survey provided by STEM/ MARK in 2003 detected high prevalence of the temporary UI among the Czech adults (n 2,447 older 15 y.) – 36%. Permanent UI was declared by 16% respondents. 60% of clients of US nursing institutions suffer from either UI or SI or both. The importance of the complex management of UI/ SI patients in the Czech Republic is discussed as well as the role of exact differential diagnostics of the IU/ SI in which neurologists play an important role. The open communication concerning all aspects of UI/ SI and the role of general practitioners cooperating with various specialists including neurologists are the key elements of the management of the UI/ SI which rising prevalence is associated with polymorbidity of the quickly aging Czech population. A review of differential diagnosis of the Nervous System disorders and electrophysiological methods (EMG, SSEP, MEP) is presented as well as conservative and surgical management of UI/ SI incl. stimulation and electronic implants.
Keywords:
epidemiology of UI/ SI – complex diagnosis and therapy of UI/ SI – electrophysiology of the pelvic muscles – communication with UI/ SI patients – seniors with SI/ UI
Sources
1. Hawker K, Frohman EM. Incontinency and Sexual Dysfunction in the Elderly. In: Sirven JI, Malamut BL (eds). Clinical Neurology of the Older Adult. Lippincot Williams&Wilkins 2002 : 200 – 213.
2. Močová inkontinence v ČR. Eklektik Porter Novelli. Praha: Stem/ Mark 2003 : 2 – 33.
3. Bojar M, Kučera Z, Svěráková M. Inkontinence moči – psychosociální a ekonomické souvislosti. Urolog listy 2004; 2 (1): 40 – 44.
4. Doležel J. Traumatické léze míšní. Urologie pro praxi 2004; 5 (4): 146 – 155.
5. Hanuš T. Dysfunkce dolních močových cest. In: Dvořáček J a kol. Urologie. Praha: ISV 1998 : 1305 – 1333.
6. Zachoval R, Záleský M, Heráček J et al. Neurogenní dysfunkce dolních močových cest. Neurologie pro praxi 2004; 4 (5): 226 – 231.
7. Hanuš T. Epidemiologie inkontinence moči. Urolog listy 2004; 2 (1): 14 – 18.
8. Nelson R. Epidemiology of fecal incontinence. Gastroenterology 2004; 126 (Suppl 1): 3 – 7.
9. Melville JL, Fan MY, Newton K et al. Fecal incontinence in US women: a population‑based study. Am J Obstet Gynecol 2005; 193 (6): 2071 – 2076.
10. Kališ V, Chaloupka P, Turek J et al. Porod a anální inkontinence: definice, klasifikace prevalence a patofyziologie. Čes gynekol 2003; 68 (4): 283 – 293.
11. Harari D, Coshall C, Rudd AG et al. New - Onset Fecal Incontinence After Stroke. Prevalence, Natural History, Risk Factors, and Impact. Stroke 2003; 34 : 144.
12. Goode PS, Burgio KL, Halli AD et al. Prevalence and Correlates of Fecal Incontinence in Community - Dwelling Older Adults. J Am Geriatr Soc 2005; 53 (4): 629 – 635.
13. Richter HE, Burgio KL, Clements RH et al. Urinary and anal incontinence in morbidly obese women considering weight loss surgery. Obstet Gynecol 2005; 106 (6): 1272.
14. Scarlett Y. Medical management of fecal incontinence. Gastroenterology 2004; 26 (Suppl 1): S55 – S63.
15. Krhut J. Neurourologické vyšetření. Urologie pro praxi 2004; 5 (4): 172.
16. Chantraine A. EMG examination of the anal and urethral sphincters. In: Desmedt JE (ed). New Developments in Electromyography and Clinical Neurophysiology. Vol 2. Karger, Basel 1973 : 433 – 438.
17. Fowler CJ. Pelvic Floor Neurophysiology. Methods in Clinical Neurophysiology 1991; 2 (1): 1 – 24.
18. Vodusek DB, Janko M. The bulbocavernosus reflex. Brain 1990; 113 : 813 – 820.
19. Ertekin C, Reel F. Bulbocavernosus reflex in normal men and patients with neurogenic bladder and/ or impotence. J Neurol Sci 1976; 28 : 1 – 15.
20. Hárdi I. Psychologie a péče o nemocného. Praha: Avicenum 1972.
21. Bojar M, Mazanec R, Kučera Z. Role neurologa v diagnostice, léčbě a rehabilitaci osob trpících inkontinencí moči. (I) Neurol pro praxi 2006; 4 : 212 – 219, (II) Neurol pro praxi 2006; 5 : 262 – 265.
22. Kegel AH. Progressive resistance exercise in the functional restoration of the perineal muscles. Am J Obstet Gyn 1948; 56 : 238 – 249.
23. Vlková J, Houžvičková E. Pohybová léčba stresové inkontinence moči. Veverská Bitýška: Hartmann‑Rico 2003.
24. Mareš J, Herzig R, Kaňovský P. Močová inkontinence z pohledu neurologa. Int Medic pro praxi 2005; 4 : 187 – 192.
25. Martínek J, Beneš M, Petrášek J et al. Léčba inkontinence stolice fyzioterapií typu biofeedback – výsledky pilotní studie. Čes a Slov Gastroent a Hepatol 2007; 61 (1): 22 – 29.
26. Horčička L. Jaké pomůcky poskytuje dnešní medicína v řešení močové inkontinence. Urologické listy 2004, 2 (1): 36 – 39.
27. Haab F et al. Quality of life and continence assessment of the artificial urinary sphincter in men with minimum 3.5 years of followup. J Urol Aug 1997; 158 (2): 435 – 444.
28. Chmel R. Chirurgická léčba ženské stresové inkontinence. Úspěšnost, komplikace, současnost a perspektiva. Lékař listy 2003; 38, 23 – 24.
29. Feyereisel J, Krofta L. Operační léčba ženské močové inkontinence – pohled urogynekologa. Urolog listy 2004, 2 (1): 26 – 35.
30. Fellus JL. Neuerorehabilitation. In: Sirven JI, Malamut BL (eds). Clinical Neurology of the Older Adult. Lippincot Williams&Wilkins 2002 : 200 – 213.
Labels
Geriatrics General practitioner for adultsArticle was published in
Czech Geriatric Review
2009 Issue 1
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Memantine Eases Daily Life for Patients and Caregivers
- Memantine in Dementia Therapy – Current Findings and Possible Future Applications
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
- Metamizole vs. Tramadol in Postoperative Analgesia
Most read in this issue
- Our experience with subcutaneous rehydration
- Antidepressants in the treatement of seniors
- Diagnosis and treatment of temporal arteritis, a case study
- Pain – undervalued problem in care of patients with dementia