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Oral board studying Prep book > Urinary incontinence > Flashcards

Urinary incontinence Flashcards

1
Q

What are the different types of urinary incontinence?

A
  1. Stress urinary incontinence
  2. Mixed urinary incontinence
  3. Urge urinary incontinence
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2
Q

What is the clinical presentation for stress urinary incontinence?

A

Urine leakage under stress such as coughing, laughing, sneezing

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3
Q

What is the clinical presentation for urge urinary incontinence?

A

Urine leaking with urgency and frequency

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4
Q

What is the clinical presentation for mixed urinary incontinence?

A

Urine leakage after stress and urgency

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5
Q

If a patient has a frequent dribble of urine what kind of incontinence is that?

A

Overflow incontinence

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6
Q

How do you evaluate for urinary incontinence?

A
  1. Medical history
  2. Physical exam
  3. Demonstration of stress incontinence
  4. Assessment of urethral mobility
  5. UA
  6. PVR
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7
Q

What is the normal frequency of urination per day?

A

8 times or less

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8
Q

What is the normal frequency of urination overnight?

A

1 time or less

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9
Q

How do you define microscopic hematuria?

A

> 3 RBCs per high power field

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10
Q

When do you further evaluate microscopic hematuria?

A

> 25 RBCs per high power field

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11
Q

What medical history do you care about in evaluating for urinary incontinence?

A
  1. Past medical history
  2. Past surgical history
  3. Medications being used
  4. Degree and severity of incontinence
  5. Aggravating factors and timing of leakage in relation to aggravating factors
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12
Q

What physical exam components do you perform to assess urinary incontinence?

A
  1. Weight
  2. Assess for prolapse
  3. Assess vaginal tissues
  4. Neuro exam
  5. Demonstation of stress incontinence with cough test
  6. Assess urethral mobility with Q tip test
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13
Q

What do you do if cough stress test negative in supine and standing positions and patient reports symptoms of stress incontinence?

A

Urodynamic testing

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14
Q

What do you do if cough stress test negative in supine and standing positions and patient reports symptoms of stress incontinence?

A

Urodynamic testing

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15
Q

What is an abnormal PVR test?

A

> 150cc

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16
Q

What are typical indications for clinical cystoscopy?

A

Hematuria
Recurrent UTIs
Refractory urge incontinence

17
Q

In general what are the nonsurgical treatments for urinary incontinence?

A

Behavior modification
Pharmacologic therapy

18
Q

What are behavior modifications for urinary incontinence?

A

Pelvic floor exercises
Weight loss
Dietary/fluid modification/bladder retraining
Devices (plugs, pessaries, weighted cones)

19
Q

What kind of incontinence can you treat with medications?

A

Urge urinary incontinence

20
Q

What medications are used for urge urinary incontinence?

A

Antimuscarinic meds
Beta 3 agonists
Onabotulinumtoxin A

21
Q

How does antimuscarinic meds work for urge urinary incontinence?

A

Blocks parasympathetic M2/M3 receptors to inhibit involuntary detrusor contraction

22
Q

What are the side effects of antimuscarinic meds?

A

Dry mouth
Constipation
Dry eyes

23
Q

How do beta 3 agonists work?

A

Relaxes detrusor muscle and increases bladder capacity

24
Q

What are side effects of beta 3 agonists?

A

Headache
Tachycardia
Diarrhea

25
Q

When should you not use beta 3 agonists?

A

Uncontrolled severe HTN
Severe liver disease
Severe renal disease

26
Q

What are side effects of Onabotulinumtoxin A?

A

UTI
Urinary retention

27
Q

What are the surgical options for stress urinary incontinence?

A

Midurethral slings
Urethral bulking agents

28
Q

Which candidates are urethral bulking agents more useful for?

A

Patients with stress incontinence with lack of urethral mobility

29
Q

When is sacral neuromodulation used?

A

Urge urinary incontinence refractory to other treatments

30
Q

What are complications for surgical procedures for urinary incontinence?

A

UTI
Surgical site bleeding
Urinary retention
Erosion of sling material
Worsening of incontinence
Injury to ureter or bowel

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