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Added on  2020-05-16

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1Running head: NURSING Nursing Name of student:Name of university:Author note:

2NURSING Female stress urinary incontinence (UI) is a common symptom experienced bysignificant numbers of adult women. The concern has drawn the significant attention of thehealthcare sectors worldwide due to the continuously ageing population. The present essayis an evidence-based discussion on the nursing topic of female stress urinary incontinence(UI). The essay provides a definition of stress UI and the prevalence of the same in Australia.Next, it assesses the financial impact of stress UI on a client. Pathophysiology of the disease,risk factors and complications, and impact of stress UI on psychological wellbeing andintimate relationships with the client are next discussed. The following part of the essayfocuses on the recommended referrals, including services available in the area of BrimbankCouncil. Further, treatment of stress UI would be highlighted with special reference toAustralia. Lastly, the role of community nurses in managing and supporting clients withstress UI would be outlined. Wood and Anger (2014) provided the definition for stress UI as a clinical sign, aurodynamic observation and a symptom involving involuntary leakage of urine on effortssuch as coughing, sneezing and exertion. It is an involuntary loss of urine and is so severethat it is known to have adverse hygiene and social consequences. Stress UI in females is ahealth concern leading to distress and inconvenience in a significant section of the womenpopulation around the globe. Though it is common among women of older age, problemswith urinary bladder are not always a consequence of age and limited to the elderlypopulation.Stress UI has effected millions of women across the globe that leads to poor qualityof life in those who suffer from it. Urinary incontinence is becoming a high burden ofsuffering in Australia, and statistics had been gathered by healthcare departments to

3NURSING support this. The Australian Bureau of Statistics Survey of Disability, Ageing and Carershighlighted the prevalence of stress UI in their report published in the year 2012, thatindicated that about 1.8% people in Australia suffer incontinence. This finding is determinedby the need for assistance with bladder or bowel control and the use of aids. There has beenan increase in the rate of this condition by 24% between 2009 and 2012. While 13% ofAustralian men suffer from stress UI, 37% of women in the country suffer from thiscondition (aihw.gov.au, 2016). As per the reports of Continence Foundation of Australia(2017), almost 4.2 million people in Australia were living with urinary incontinence in theyear 2010. Further estimates were made than the number would increase to 5.6 million bythe year 2030. On the basis of such data, it can be rightly said that stress UI have had, andwould have in future, a drastic impact on the lives of women in the country. While the impact of female stress UI on quality of life of sufferers draw specialattention in research, the financial impact of the condition for the patient is also worthmentioning. The noteworthy financial loss relates to the high cost of healthcare servicesaccessed to treat the condition. The overall costs for diagnosis, treatment and aftercare areoften high, placing patients in a financially draining situation. A detailed view of the financialimpact of stress UI had been given by Continence Foundation of Australia (2017) thatpointed out that almost $271 million was spent in the year 2010 in Australia for stress UI.Sinclair and Ramsay (2011) had opined that UI is common among women who areemployed, and thus the potential impact on employment and working life draws muchattention. Symptoms of the condition cause loss of ability to concentrate on work, loss ofability to carry out physical tasks and increased number of breaks. As a result, most of these

4NURSING women remain absent from work for a considerable amount of time and are bound to sufferfinancial loss. The pathophysiology of stress UI can be well understood by reading the researchpaper of Arshiya et al., (2015). The continence pathophysiology has the underlyingmechanism involving a series of muscles, nerves, and connective tissue that play a role indynamically influencing bladder control. The organised arrangement allows complete andtimely bladder emptying, and the individual is able to maintain continence when there isabdominal pressure. Continence depends on the lower urinary tract which has to befunctionally and structurally normal. Stress UI is the condition occurring when there isconsiderable damage suffered in the nerves, connective tissue and nerves of the pelvic floor.The main determinants of continence are a function of the urethral muscle, vesical neckfunction, and urethral support. The action of the levator ani muscles supports the urethrathrough the connection built with the endopelvic fascia of the anterior vaginal wall. Whenthere is damage suffered in this connection between the muscle and fascia, nerve supply tothe muscle is lost. There are also high chances of suffering direct muscle damage. Thiscondition results in incontinence. Further, impairment of vesical neck closure leads toincontinence even when the urethral support is normal. It is to be remembered that themain causes of damage suffered are linked to hyperglycemia, obesity, chronic bacterialcolonization and urinary tract infections. Bagnola et al., (2017) outlined the risk factors for stress UI in their research paperthat linked childbirth menopause and pregnancy with UI as the major risk factors. Some ofthe other risk factors for UI can be attributed to problems of constipation, underlyingmusculoskeletal or neurological conditions and impaired mobility. The common underlying

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