A nurse practitioner (NP) is talking with a 70-year-old patient who asks if she could discuss a problem that she is embarrassed to talk. She states she has been having increasing problems with incontinence. Every time she coughs or sneezes, she notices a loss of urine. She has not had any fever or chills or pain with urination. She asks the NP if this is just a sign of getting older? 1. Discuss the pathophysiology associated with incontinence. A. Please respond to my classmate discussion for post listed above. I am will post classmate response.B. sources must be evidenced based and from within the last 5 years and must be from the USA. Please be original as this has to go through turnitin Classmate response:The 70-year-old patient is likely experiencing stress incontinence, which results in loss of urine due to increased intra-abdominal pressure resulting from sneezing or coughing. It is estimated that 10% to 40% of post-menopausal women experience stress urinary incontinence (SUI). There are several pathways that lead to the inability of the urethra to oppose elevations in abdominal pressure. The sympathetic and parasympathetic nervous systems, the motor fibers of the prudendal nerves, and the structures that make up the pelvic floor work collaboratively together. Dysfunction of any of these components can lead to involuntary loss of urine. Obesity, advanced age, and vaginal delivery typically weaken the structures of the pelvic floor, thereby predisposing women to SUI. During a vaginal delivery, the nerves are compressed and stretched when the fetus passes through the birth canal (Capobianco et al., 2018). An identified cause of SUI is weak or excessive detrusor bladder function. Bladder detrusor activity is dominated by the sacral nerves, which enhance pelvic floor muscle strength. The perineal nerve regulates detrusor muscle function that controls urination. Electroacupuncture (EA), used by many in Asia to treat stress incontinence, has been studied to treat stress incontinence and found to be safe and efficacious. EA is used to stimulate targeted nerves that are necessary to the process of urination. For example, EA successfully stimulates the perineal nerve, which controls the detrusor muscle function necessary for urination. Treatments for SUI are important because SUI impacts one’s quality of life and sense of well-being. SUI is also related to complications with diabetes, hyperlipidemia, and chronic kidney disease (Lai et al., 2020).
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