Urinary Elimination

Urinary elimination is a precise system of filtration, reabsorption, and excretion of the wastes that have accumulated in your body.  All of those processes help to maintain the fluid and electrolyte balance within your body, while filtering and eliminating the wastes.  The primary organs involved in this process are the kidneys.  Want to hear a fun fact?  Well, most adults produce between 1,500 and 2,000 milliliters (mL) of urine per day…that’s like two 2-liter bottles full!

Here’s how the urinary elimination process works:

1. Once filtered, your urine passes through the ureters and into the bladder.
2. The bladder stores the urine…it usually will store up to 200 mL at a time.
3. The bladder then sends a signal to the brain to tell you to go urinate!
4. The person then will relax both the internal and external sphincters.
5. Urine will pass from the bladder through the urethra…where it exits the body!

Neat huh!  It’s a pretty complicated process that goes on in your body over and over again…thank goodness it is not that complicated to explain in words!  Of course, there are factors that affect normal urinary elimination, which include:

• Age (Older Adults)
• Enlargement of the prostate will begin to occur after age 40 in men which will lead to urinary frequency, hesitancy, retention, incontinence, and urinary tract infections.
• Gravity, and history of childbirth that a woman may have experienced may lead to a weakened pelvic floor which could cause bladder prolapse that will most likely result in stress incontinence.
• Loss of muscle tone in the bladder, leading to urinary frequency.
• Inefficient emptying of the bladder will cause residual urine to be left behind which is a reservoir for infection…leading to urinary tract infections.
• Increase in getting up in the middle of the night to urinate.
• Diet
• An increase in sodium levels will lead to decreased urination, which may lead to swelling, heart problems, etc.
• Intake of caffeine and alcohol lead to increased urination, which may lead to dehydration, etc.
• Immobility
• May lead to incontinence if an individual is unable to get up and go to the bathroom or is unable to gain assistance to use the bedpan/urinal as needed.
• Psychosocial Factors
• Emotional stress and anxiety can result in holding the urine, or becoming incontinent at times.
• Individuals may not be given enough time to urinate completely.
• Pain
• There could be an obstruction, such as a kidney stone that results in abnormal and/or painful urinary elimination.
• Having arthritis or painful joints may cause immobility and delays in urination.
• Surgery
• Lower abdominal surgery may create edema and inflammation, delaying the process of urination.
• Medications used for pain relief may slow the urinary processes resulting in a decreased urine output.
• Medications
• Diuretics will prevent the reabsorption of water.  For example, “Water pills” work to get rid of all your excess fluid.
• Antihistamines and anticholinergics lead to a decrease in urine.
• Take note that some medications you may be on may change the color of your urine, such as:
• Pyridium – orange
• Amitriptyline – green/blue
• Levodopa – brown/black
• Chemotherapy tends to be toxic to the kidneys.

In the older adult population, it seems as if urinary incontinence, or the inability to make it to the bathroom on time, is more common.  Urinary incontinence significantly contributes to altered skin integrity and places individuals more at risk for falls.  Believe it or not, there are 6 major types of incontinence and Total Home Health wants to you be aware…so let us simply and quickly explain:

1. Stress – Loss of small amount of urine when coughing, sneezing, laughing or lifting mainly due to weak pelvic muscles.
2. Urge – Inability to stop the flow of urine long enough to reach the bathroom.
3. Overflow – Retention of urine due to the bladder enlarging and frequent loss of small amounts of urine due to impaired muscles.
4. Reflex – Involuntary loss of a moderate amount of urine usually without warning, usually from altered spinal cord activity.
5. Functional – Inability to get to the bathroom in time due to physical, cognitive, or social decline.
6. Total – Unpredictable, involuntary loss of urine that does not generally respond to treatment.

Total Home Health understands that any deviation in your normal urinary elimination patterns could cause you embarrassment and take a shot at your dignity.  Our professionals will deliver high-quality, client-centered care and we will take measures in order to give your confidence a boost and try to get your urinary elimination pattern back on the right track.  Depending upon your situation we may encourage you to do the following tasks:

• Establish a toileting schedule and allow yourself enough time to completely get finished.
• Monitor your fluid intake during the day and decrease your fluid intake prior to bedtime to help eliminate those nighttime trips to and from the bathroom.
• We will provide you with the correct incontinence products to maintain your dignity and to keep your skin clean and dry to avoid any breakdown.
• Educate you on how to correctly perform peri-care to decrease your risk for urinary tract infections…for example, women will be taught to clean themselves from front to back.
• Instruct you on proper way to take medication that may help with incontinence.

Total Home Health has a program that is just right for you if you are suffering from urinary elimination problems.  We will continually encourage you to express your feelings and will always be at your side to offer you the positive emotional support you need to keep your confidence up where it should be.  Don’t wait any longer!  Contact us for enrollment as soon as possible so we can help you get back in the way of life you used to lead.