Urinary Incontinence, Retention, BPH, and Catheters

Comprehensive vocabulary flashcard deck covering urinary incontinence types, urinary tract obstruction causes, urinary retention, benign prostatic hyperplasia (BPH), continuous bladder irrigation (CBI), urinary catheters, external devices, and CAUTI prevention protocols.

Types of Urinary Incontinence

The six primary classifications of involuntary urine leakage: stress, urge, overactive bladder, functional, overflow, and transient incontinence.

Stress Incontinence

Involuntary loss of urine associated with an increase in intra-abdominal pressure, occurring during activities such as heavy lifting, laughing, coughing, or sneezing.

Urge Incontinence

Involuntary loss of urine preceded by a sudden, intense, and compelling desire to void, typically caused by uninhibited detrusor muscle contractions.

Overactive Bladder

A syndrome characterized by urinary urgency, usually accompanied by increased frequency and nocturia, which may occur with or without urge incontinence.

Functional Incontinence

Involuntary loss of urine resulting from physical, cognitive, mobility, or environmental factors that prevent a client from reaching the toilet in time.

Overflow Incontinence

Involuntary loss of urine associated with overdistention of the bladder due to incomplete emptying, severe urinary retention, or outlet obstruction.

Transient Incontinence

Temporary or episodic leakage of urine caused by acute, treatable, or reversible medical conditions, infections, medications, or delirium.

Pelvic Floor Muscle Rehabilitation

An evidence-based behavioral intervention involving structured pelvic floor muscle strengthening (such as Kegel exercises) indicated for both men and women to improve urinary continence.

Anti-Incontinence Devices

Mechanical appliances or internal/external supports designed to elevate the bladder neck or support the urethra to prevent involuntary urine leakage.

Containment Devices

Supportive management products, including absorbent briefs, pads, external collector systems, or catheter devices, used to contain involuntary urine leakage and preserve skin integrity.

Pessary

A removable intravaginal medical device prescribed for women to provide mechanical support to pelvic structures in the treatment of pelvic organ prolapse.

Pelvic Organ Prolapse

The descent or herniation of pelvic structures (such as the bladder, uterus, or bowel) into or outside the vaginal canal, which can result in urinary obstruction or retention.

Antispasmodic Drug Therapy

Pharmacologic treatment utilized to reduce uninhibited bladder spasms and detrusor contractions in clients experiencing urge incontinence or overactive bladder.

Fall Risk in Incontinence

A critical clinical safety risk in incontinent clients caused by urgency, rushing to reach the bathroom, nocturia, and slippery surfaces.

Mental Health Considerations in Incontinence

The psychosocial complications associated with urinary incontinence, including social isolation, depression, embarrassment, anxiety, and altered self-image.

Urinary Tract Obstruction

An anatomical or functional impedance that blocks or hinders the flow of urine, leading to fluid accumulation and hydrostatic back-pressure above the level of obstruction.

Renal Pelvis Calculi

Calculi (kidney stones) located within the renal pelvis that impede the passage of urine into the upper ureter.

Renal Pelvis Tumor

A neoplastic mass within the renal pelvis that physically obstructs outflow into the ureter.

Intrinsic Ureteral Obstruction

Urinary obstruction arising directly within the ureteral lumen or wall, including calculi, tumors, blood clots, and localized inflammation.

Extrinsic Ureteral Obstruction

Urinary obstruction resulting from compression outside the ureter, including pregnancy, tumors (e.g., cervical carcinoma), and ureteral strictures.

Ureteral Calculi

Stones that become lodged in the ureter, acting as foreign bodies that cause intrinsic mechanical obstruction and acute flank pain.

Ureteral Clot

A blood clot located within the ureter that creates an intrinsic luminal barrier to urine drainage.

Ureteral Inflammation

Swelling and mucosal edema of the ureter wall that results in intrinsic luminal narrowing and reduced urine flow.

Pregnancy-Related Ureteral Obstruction

An extrinsic source of ureteral compression caused by the enlarging gravid uterus pressing on the ureters.

Cervical Tumor (Ureteral Compression)

An extrinsic pelvic malignancy that encroaches upon and compresses the adjacent ureter, impeding urinary transit to the bladder.

Ureteral Stricture

A fixed fibrotic narrowing of the ureter that resists urine flow from the kidney to the bladder.

Narrowing of Ureterovesical Junction

An anatomic constriction at the anatomical junction where the ureter enters the bladder wall, obstructing urine from draining into the bladder.

Bladder Calculi

Stones located in the urinary bladder that can physically occlude the bladder neck or internal urethral orifice.

Bladder Tumors

Intravesical neoplasms that can obstruct the bladder outlet or infiltrate the bladder wall, causing urinary flow impairment.

Functional Bladder Obstruction

Incomplete bladder emptying caused by neurogenic bladder dysfunction or altered neuromuscular coordination rather than a fixed mechanical block.

Prostatic Hyperplasia Obstruction

Mechanical compression and narrowing of the prostatic urethra caused by nonmalignant cellular growth of the prostate gland.

Prostatic Carcinoma

Malignant neoplasm of the prostate gland that can compress the urethra and cause progressive urinary outflow obstruction.

Urethral Stricture

An abnormal narrowing of the urethral lumen resulting from scar tissue, trauma, infection, or instrumentation.

Urinary Retention

The incomplete emptying of the bladder or the complete inability to pass urine voluntarily.

Post-Void Residual

The volume of urine remaining in the bladder immediately following voluntary voiding, measured via bladder ultrasonography or straight catheterization.

Normal Post-Void Residual Volume

A normal residual bladder volume measuring between $50\text{ mL}$ and $75\text{ mL}$; values persistently above this require further diagnostic evaluation.

Obstructive Causes of Urinary Retention

Mechanical blockages preventing urine evacuation, specifically identified as pelvic organ prolapse, benign prostatic hypertrophy, and stones.

Infectious Causes of Urinary Retention

Inflammatory and infectious conditions of the urinary tract that impair voiding, specifically identified as prostatitis, urinary tract infection, and urethritis.

Prostatitis

Infection or inflammation of the prostate gland that can lead to localized swelling, dysuria, pelvic pain, and acute urinary retention.

Urinary Tract Infection

Microbial infection of the lower or upper urinary tract capable of causing mucosal inflammation, edema, and secondary urinary retention.

Urethritis

Inflammation or infection of the urethra that causes dysuria, erythema, swelling, and potential obstruction of urinary outflow.

Pelvic Surgery or Trauma (Urinary Retention)

Mechanical disruption, local swelling, or nerve manipulation following pelvic operations or physical trauma that causes post-procedural urinary retention.

Guillain-Barré Syndrome (Urinary Retention)

An acute neurological polyneuropathy that causes autonomic and somatic nerve dysfunction, leading to acute non-mechanical urinary retention.

Childbirth Complications (Urinary Retention)

Perineal tissue trauma, local edema, hematomas, or regional anesthesia effects following labor and delivery that temporarily prevent normal bladder voiding.

Benign Prostatic Hyperplasia

A noncancerous enlargement of prostate tissue (abbreviated BPH) that compresses the urethra, causing progressive bladder outlet obstruction.

Primary Cause of Urinary Retention in Males > 50 Years Old

Benign prostatic hyperplasia (BPH), which represents the #$1$ cause of urinary retention in men older than $50\text{ years}$ of age.

Metabolic Syndrome (in BPH)

A systemic cluster of metabolic abnormalities identified as a significant risk factor associated with a higher occurrence of BPH.

Family History (in BPH)

A non-modifiable genetic risk factor predisposing male individuals to a higher occurrence of benign prostatic hyperplasia.

FUN Acronym for Prostate Problems

A clinical mnemonic highlighting the hallmark symptoms of prostatic enlargement: Frequency, Urgency, and Nocturia.

Urinary Frequency

Urinating more frequently than the client's typical pattern, resulting from incomplete bladder emptying and reduced functional bladder capacity in BPH.

Urinary Urgency

A sudden, intense, and compelling desire to urinate with a sense of immediacy, seen with prostate enlargement.

Nocturia

Awakening from sleep one or more times during the night to pass urine, a classic manifestation of lower urinary tract obstruction in BPH.

Hematuria in Prostate Disease

The presence of blood in the urine caused by stretching and rupture of friable, engorged mucosal veins on the enlarged prostate surface.

Decreased Urinary Stream

A progressive loss of force, caliber, and velocity of the urine stream caused by prostatic urethral narrowing.

Increased Residual Urine in BPH

Urine remaining in the bladder following micturition due to the inability to thoroughly drain the bladder past the obstructing prostate.

Hesitancy in BPH

Difficulty or delay in initiating a urinary stream despite client effort and a strong sense of urgency.

Dysuria

Painful, burning, or uncomfortable urination that occurs secondary to urinary stasis, infection, or prostate enlargement.

Digital Rectal Exam

A diagnostic physical exam (DRE) where a clinician palpates the prostate through the rectal wall to evaluate its size, symmetry, shape, and consistency.

Prostate-Specific Antigen Test

A blood test (PSA test) measuring a protein produced by prostate cells, utilized clinically as a screening tool for prostate cancer.

Purpose of the PSA Test

To screen for prostate cancer and help distinguish malignant neoplasia from noncancerous benign prostatic hyperplasia.

Transurethral Resection of the Prostate

A surgical treatment (TURP) for BPH where excess obstructing prostate tissue is excised endoscopically through the urethra using a resectoscope.

Continuous Bladder Irrigation

A post-surgical nursing intervention (CBI) using sterile saline continuous infusion through a three-way catheter to flush blood clots from the bladder while continuously draining urine.

Target Drainage Color in CBI

A light cranberry color, indicating that the infusion rate is effectively clearing operative clots without active severe hemorrhage.

Strict Intake and Output in CBI

The mandatory clinical practice of subtracting the total instilled saline volume from the total collection bag volume to calculate true urine output.

Administration Port (Three-Way Catheter)

The inflow arm of a three-way catheter connected to the irrigation tubing that delivers sterile saline continuously into the bladder.

Drainage Port (Three-Way Catheter)

The main outflow lumen of a three-way catheter connected to drainage tubing that carries urine, irrigation fluid, and flushed clots into the drainage bag.

Inflation Port (Three-Way Catheter)

The specialized side port with a valve used to inject sterile water to inflate the retention balloon that secures the catheter inside the bladder.

Four Routes of Urinary Catheterization

The four anatomical approaches for catheter placement: urethral, ureteral, suprapubic, and nephrostomy tube.

Urethral Catheter Route

The most common route for urinary catheterization, in which a flexible catheter is passed directly through the urethra into the urinary bladder.

Ureteral Catheter Route

A catheter inserted directly through the urethra and bladder up into the ureter to bypass obstructions or drain the kidney pelvis directly.

Suprapubic Catheter Route

A urinary drainage catheter surgically inserted directly into the bladder through a small puncture wound in the lower anterior abdominal wall above the symphysis pubis.

Nephrostomy Tube

A catheter surgically placed percutaneously through the flank directly into the renal pelvis to provide external urinary diversion when the ureter is obstructed.

External Urinary Device Replacement Frequency

External urinary collection devices must be changed every $8\text{ hours}$ or more frequently if soiled.

Wick Catheter (PureWick)

A non-invasive external female urinary management device placed between the labia against the urethra that uses continuous suction to wick urine away into a canister.

Minimum Suction for Wick Catheter

Continuous wall suction connected to a wick catheter set to the lowest effective level possible, but at least $40\text{ mmHg}$.

External Urinary Device Assessment Frequency

Skin and external urinary devices must be assessed every $2\text{ hours}$ or more frequently with client position changes.

Condom Catheter

An external male urinary collection sheath secured over the shaft of the penis and connected to a collection bag to manage urinary incontinence non-invasively.

Catheter-Associated Urinary Tract Infection

A healthcare-associated infection (CAUTI) occurring along the urinary tract attributable to the placement and presence of an indwelling catheter.

CAUTI Prevention Strategies

Evidence-based protocols to minimize catheter-related infections: avoid unnecessary catheterizations, ensure early removal of indwelling catheters, maintain aseptic technique, perform hand hygiene, and wear gloves for catheter care.

Highest Risk Factor for Hospital-Acquired UTI

The presence of an indwelling urinary catheter (such as in a hospitalized, immobile client with incontinence), representing the single greatest risk factor for developing a urinary tract infection.