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Inkontinensia Urin

Asuhan Keperawatan Inkontinensia urin


Pengertian

Inkontinensia urine adalah pelepasan urine secara tidak terkontrol dalam jumlah yang cukup banyak.
Sehingga dapat dianggap merupakan masalah bagi seseorang.


Klasifikasi

Inkontinensia urine di klasifikasikan menjadi 3 ( Charlene J.Reeves at all )
  1. Inkontinensia Urgensi

    Adalah pelepasan urine yang tidak terkontrol sebentar setelah ada peringatan ingin melakukan urinasi. Disebabkan oleh aktivitas otot destrusor yang berlebihan atau kontraksi kandung kemih yang tidak terkontrol.

  2. Inkontinensia Tekanan

    Adalah pelepasan urine yang tidak terkontrol selama aktivitas yang meningkatkan tekanan dalam lubang intra abdominal. Batuk, bersin, tertawa dan mengangkat beban berat adalah aktivitas yang dapat menyebabkan inkontinensia urine.

  3. Inkontinensia Aliran Yang Berlebihan ( Over Flow Inkontinensia )

    Terjadi jika retensi menyebabkan kandung kemih terlalu penuh dan sebagian terlepas secara tidak terkontrol, hal ini pada umumnya disebabkan oleh neurogenik bladder atau obstruksi bagian luar kandung kemih.

Etiologi

Inkontinensia urine pada umumnya disebabkan oleh komplikasi dari penyakit seperti infeksi saluran kemih, kehilangan kontrol spinkter dan perubahan tekanan yang tiba-tiba pada abdominal.


Manifestasi klinik
  • Urgensi
  • Retensi
  • Kebocoran urine
  • Frekuensi

Patofisiologi

Inkontinensia urine bisa disebabkan oleh karena komplikasi dari penyakit infeksi saluran kemih, kehilangan kontrol spinkter atau terjadinya perubahan tekanan abdomen secara tiba-tiba. Inkontinensia bisa bersifat permanen misalnya pada spinal cord trauma atau bersifat temporer pada wanita hamil dengan struktur dasar panggul yang lemah dapat berakibat terjadinya inkontinensia urine. Meskipun inkontinensia urine dapat terjadi pada pasien dari berbagai usia, kehilangan kontrol urinari merupakan masalah bagi lanjut usia.


Pemeriksaan Diagnosa
  • Pengkajian fungsi otot destrusor
  • Radiologi dan pemeriksaan fisik ( mengetahui tingkat keparahan / kelainan dasar panggul )
  • Cystometrogram dan elektromyogram

Therapi
  • Urgensi
    Cream estrogen vaginal, anticolenergik, imipramine (tofranile)
    Diberikan pada malam hari
    Klien dianjurkan untuk sering buang air kecil

  • Over flow inkontinensia
    Farmakologis prazocine (miniprise) dan cloridabetanecol (urecholine)
    Diberikan untuk menurunkan resistensi bagian luar dan meningkatkan kontraksi kandung kemih.


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