According to the Interstitial Cystitis Association (ICA),¹ interstitial cystitis (IC), a painful and puzzling bladder disorder, “is a condition that consists of recurring pelvic pain, pressure, or discomfort in the bladder and pelvic region, often associated with urinary frequency and urgency.” The RAND Interstitial Cystitis Epidemiology study² reported in 2009 that approximately 3 to 8 million women and 1 to 4 million men suffer from IC.

  Historically, IC was considered a chronic pelvic pain syndrome originating in the bladder, but epidemiological studies comparing IC with similar conditions belie the simplicity of this statement. International researchers working to describe what is happening to an IC bladder are including other syndromes similar to IC; hence, IC is referred to alternatively as painful bladder syndrome (PBS), bladder pain syndrome (BPS, used primarily in Europe), and hypersensitive bladder syndrome (HBS, used primarily in Asia). Men also may be diagnosed with chronic prostatitis (CP), which shares similar symptom characteristics with IC. For the purpose of simplicity, in this article the condition will be called IC.

Prevalence of Urge Incontinence

  An estimated 17 million community-dwelling adults in the US have daily urinary incontinence (UI), and an additional 33 million suffer from the overlapping condition, overactive bladder (OAB).¹ Although UI and OAB occur far more frequently in women than men, symptoms become more prevalent with advancing age, the gender gap closing in the elderly.² Whether older persons are homebound or nursing facility residents, more than half in either setting are incontinent. Incontinence represents one of the leading common diagnoses among the aged and one of the top reasons for placing an individual in an institutional residence where care is provided by staff.³

Index: Ostomy Wound Management 2011;57(12):22–28

Abstract

  Ileal pouch anal anastomosis (IPAA) is a two- or three-stage surgical procedure performed to treat patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP). Following ileostomy closure and anastomosis, patient goals of care typically include obtaining continence and preventing complications. Nursing interventions to achieve these goals may include developing a skin care regimen, pelvic muscle floor exercises (PFME), diet changes, medication use and coping strategies. Research suggests that patient quality of life following surgery is generally good, especially in patients with a functioning pouch or a history of severe UC and a functioning pouch. However, the procedure is relatively new, and long-term (>20 years) outcomes remain largely unknown. Ongoing assessments to monitor complications such as pouchitis and pouch stricture are needed, as is research to determine the long-term effects of vaginal delivery and of living into the seventh, eighth, and ninth decades of life.

Index: Ostomy Wound Management 2011;57(12):36–46

Abstract

  Care of chronic and stalled wounds is hampered by the lack of diagnostic tools to help direct clinicians to specific treatments or diagnose specific conditions. Studies have shown a correlation between high protease levels and nonhealing wounds; a diagnostic protease test is under development. Seven wound care experts (two podiatrists, two vascular surgeons, a physician expert in hyperbaric oxygen therapy, a physical therapist with a specialty in home health, and a registered nurse) met to reach consensus on several aspects about a point-of-care protease test. They agreed that although disease states interfere with wound healing, such states do not automatically mean that wound healing will be impaired or that the wound becomes stalled after inception; and that patient comorbidities, patient factors, patient medications, and the microenvironment of the wound all affect the risk of nonhealing.