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Understanding Continence Promotion: Effective Management of Bladder & Bowel Dysfunction in Adults

Welcome to the course

Introduction to Module 1

1.1 – Capturing your thinking

1.2 – What do we mean by ‘continence’ and ‘incontinence’?

1.3 – Attitudes towards incontinence

1.4 – Incontinence is a ‘Big Issue’!!!

1.5 – How does a person’s bladder and bowel affect their life?

1.6 – Impact of bladder and bowel dysfunction on a person with spinal cord injury

1.7 – Impact of incontinence

1.8 – The continence paradigm

1.9 – Is incontinence inevitable and normal?

1.10 – Separating continence promotion from managing incontinence

1.11 – Reflection

Welcome to Module 2

2.1 – Anatomy of the lower urinary tract

2.2 – Lower Urinary Tract Quiz

2.2 – Lower Urinary Tract

2.3 – Male urethra

2.4 – Male urethral sphincters

2.5 – Female urethra and urethral sphincter

2.6 – The pelvic floor

2.7 – Pelvic floor muscles

2.8 – How continence is acquired and maintained

2.9 – Bladder cycle of filling and emptying

2.10 – Pressures acting on the bladder to maintain continence

2.11 – Innervation of the bladder

2.12 – Micturition control centres

2.13 – Check your understanding

2.13 – Check your understanding

2.14- Reflect on what you have learned

Welcome to Module 3

3.1 – Causes of urinary incontinence

3.2 – Overactive bladder

3.3 – Case study: Joyce who has an overactive bladder

3.4 – How to diagnose overactive bladder

3.5 – Causes of stress incontinence

3.6 – Case study: Susan who has stress incontinence

3.7 – Underactive bladder

3.8 – Case study: Jean who has an underactive bladder

3.9 – Identifying an underactive bladder

3.10 – Bladder outlet obstruction

3.11 – Case study: James who has bladder outlet obstruction

3.12 – Reflex incontinence

3.13 – How neurological conditions affect bladder function

3.14 – Check your understanding

3.14 – Check your understanding

3.15 – Spinal cord injuries and the bladder

3.16 – Bladder dysfunction associated with Multiple Sclerosis

3.17 – Bladder dysfunction associated with Parkinson’s

3.18 – Bladder dysfunction after a stroke

3.19 – Bladder dysfunction with diabetes mellitus

3.20 – Transient causes

1 of 2

Welcome to Module 4

4.21 – What’s causing Jim’s faecal incontinence?

4.22 – Faecal impaction with overflow

4.23 – Constipation

4.24 – Reflection

2 of 2

Welcome to Module 5

5.1 – Principles of assessment

5.2 – Components of a comprehensive bladder and bowel assessment

5.3 – Assessing bladder dysfunction – taking a history

5.4 – Assessing bowel dysfunction – taking a history

5.5 – Bladder diary analysis

5.6 – Urinalysis

5.7 – Bladder scanning

5.8 – Physical examination – female

5.9 – Digital vaginal assessment

5.10 – Physical examination – Male

5.11 – Digital rectal examination – men

5.12 – Assessing in practice

5.13 – Diagnosing type of bladder and/or bowel dysfunction

5.14 – The ‘Incontinence’ Poem

5.15 – Reflection

Welcome to Module 6

6.1 – What does self-management of continence involve?

6.2 – Behavioural Intervention Groups

6.3 – Using ISC to self-manage bladder dysfunction

6.4 – Self-managing bowel dysfunction

6.5 – Evidence on effectiveness of lifestyle changes

6.6 – Fluid management

6.7 – What is behavioural therapy?

6.8 – Pelvic floor muscle exercises

6.9 – Bladder training

6.10 – Toileting Assistance Programmes (TAPs)

6.11 – Abdominal massage

6.12 – Electrical stimulation

6.13 – Medication

6.14 – Laxatives

6.15 – Challenges of bladder and bowel problems

6.16 – Promoting continence in people with dementia

6.17 – Reflection

Welcome to Module 7

7.1 – Managing incontinence by containing leakage using absorbent products

7.2 – Managing urinary incontinence by containing leakage using indwelling catheters

7.3 – Exploring the effectiveness of health and social care support services

7.4 – Sharing ideas for service improvement

7.5 – Delivering better services for people with long-term conditions

7.6 – Facts and myths about effects of ageing on continence

7.7 – Is using the toilet a fundamental human right?

7.8 – Do bladder and bowels get sufficient media and government recognition?

7.9 – Thank you and goodbye

7.10 – Reflection

7.11 – Key resources to support effective management of bladder and bowel dysfunction

7.12 – Continue learning with the Association for Continence Professionals

2.13 – Check your understanding

Understanding Continence Promotion: Effective Management of Bladder & Bowel Dysfunction in Adults
Welcome to Module 2
2.13 – Check your understanding
2.13 – Check your understanding

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Question 1 of 9

1. Question

How long is the female urethra?

1-2 cm
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4-5 cm
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8-9 cm
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18-20 cm
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Question 2 of 9

2. Question

What nerve innervates the pubococcygeus muscle?

Pudenal Nerve
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Pelvic Nerve
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Vagus Nerve
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Sciatic Nerve
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Question 3 of 9

3. Question

What is a “compliant bladder”?

A bladder that does what it is told to do.
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The bladder fills with no significant rise in detrusor pressure.
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The bladder fills with a significant rise in detrusor pressure.
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The bladder does not fill beyond 150 mls.
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Question 4 of 9

4. Question

What is normal bladder control?

Voiding 4-7 times a day, volumes of 300-400 mls with no urgency.
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Voiding 1-2 times a day, volumes of 300-400 mls with no urgency.
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Voiding 4-7 times a day, volumes of 150-200 mls with no urgency.
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Voiding 4-7 times a day, volumes of 300-400 mls with urgency.
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Question 5 of 9

5. Question

How will damage to the pons affect the micturition process?

It causes stress incontinence.
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It causes urinary tract infection
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It causes atrophic vaginitis
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It causes detrusor-sphincter dyssynergia.
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Question 6 of 9

6. Question

What part of the urinary tract is innervated by the sympathetic nerves?

The ureters
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The trigone
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The prostate gland
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The internal urethal sphincter
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Question 7 of 9

7. Question

If the level of arginine vasopressin (antidiuretic hormone) produced by the hypothalamus does not increase at night how will this affect bladder function?

Strong urine, nocturia and small voids.
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Urine will smell of pear drops
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Weak urine, nocturia or polyuria.
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No effect on bladder
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Question 8 of 9

8. Question

When are the parasympathetic inputs to the bladder inhibited?

1 hour after voiding.
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During bladder emptying.
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During bladder filling, the storage phase.
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When doing a pelvic floor contraction.
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Question 9 of 9

9. Question

What type of muscle is the internal urethral sphincter?

Smooth muscle
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Cardiac muscle
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Striated muscle
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Skeletal muscle
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