3.2.1 Urinary and Fecal Incontinence

Question 1

What is the testing for fecal incontinence?

Answer 1

Question 2

What are some of the options for anti-cholinergics/anti-muscarinics?

Answer 2

Question 3

Defecation is the result of what? Innervation?

Answer 3

Synchronous relaxation of the external anal sphincter and puborectalis; S3-4

Question 4

How does the severity of urinary incontinence change with age?

Answer 4

Frequency and volume increase with age

Question 5

What is peripheral tibial nerve stimulation?

Answer 5

Question 6

Why is the prevalence of urinary incontinence underestimated?

Answer 6

Less than half of patients report it

Question 7

What are some sources of fecal incontinence?

Answer 7

Question 8

How is the surgery onabotulinum toxin performed?

Answer 8

Paralyzes the detrussor, 100 units

Question 9

Name the urinary incontinence in order of prevalence

Answer 9

Stress > Mixed > Urgency

Question 10

What are the three surgical options for stress incontinence?

Answer 10

Midurethral slings, bulking agents, pubovaginal slings

Question 11

What are some of the common side effects of anti-cholinergics?

Answer 11

Dry mouth, constipation, drowsiness, confusion/impaired cognitive function, tachycardia, blurred vision

Question 12

What are the possible treatments for fecal incontinence?

Answer 12

Question 13

What is sacral neuromodulation?

Answer 13

Question 14

Diagram urge urinary incontinence

Answer 14

Bladder is overactive

Question 15

Initial management of urinary incontinence diagram

Answer 15

Question 16

What is the definition of fecal incontinence?

Answer 16

Question 17

What are some of the surgical treatments of urinary incontinence?

Answer 17

Question 18

What are the risk factors for urinary incontinence?

Answer 18

Parity, obesity, urinary sx, non-hispanic/white, functional impairment

Question 19

What this be?

Answer 19

sphincteroplasty

Question 20

What is the most common treatment for stress incontinence?

Answer 20

Structural, so Surgery (S, S, S)

Question 21

What assessments are included when evaluating fecal incontinence?

Answer 21

Inspect anus for gaping or scarring

Squeeze looking for uniform circular contraction

Anocutaneous relax (rubbing perianal skin)

Palpate sphincter (digital examination)

Question 22

What is a clinical way to determine severity/frequency of urinary incontinence?

Answer 22

Voiding diary

Question 23

How does living in a nursing home affect prevalence?

Answer 23

Increases

Question 24

Is there a correlation b/t urinary and fecal incontinence?

Answer 24

Question 25

What is the definition of urinary incontinence? Orgins in young and elderly?

Answer 25

Involuntary loss of urine

Question 26

What are the four classifications of urinary incontinence?

Answer 26

Urge, stress, mixed, overflow

Question 27

Diagram stress urinary incontinence

Answer 27

Insufficient strength of the closure of the bladder

Question 28

What are some tests for urinary incontinence?

Answer 28

Bladder stress test/Cough stress test Lab tests (UA, Urine culture) PVR (NL \<50, Abn \>200)

Question 29

What are the three questionnaires for fecal incontinence?

Answer 29

FIQL, FISI, Wexner score

Question 30

What is the Birch procedure?

Answer 30

Midurethral sling connected to cooper's ligament

Question 31

Using the criteria of 1 leak per year, what % of women leak?

Answer 31

up to 51%

Question 32

What are the three components of the anal sphincter complex?

Answer 32

Internal/external anal sphincter, puborectalis

Question 33

What are some of the characteristics of pharmacologic therapies for urinary incontinence: % w/ improvement, adherence, dosage in elderly, time for onset of effects?

Answer 33

Question 34

What are the pharmacologic methods to treat an overactive bladder?

Answer 34

Anticholinergics, B3 Adrenergics

Question 35

What this be?

Answer 35

Sphincteroplasty

Question 36

What is the B3 Adrenergic for urinary incontinence?

Answer 36

Mirabegron (Myrbetriq)

Question 37

What are some conservative measures in the management of urinary incontinence?

Answer 37

Weight loss, dietary changes, bladder training, pelvic muscle exercises and biofeedback

Question 38

What this be?

Answer 38

Secca procedure

Question 39

How does the prevalence of urinary continence change with age?

Answer 39

Increases

Question 40

What racial groups are at greater risk of urinary incontinence?

Answer 40

White and Mexican \> African American (Lecturer wasn't too keen on this distinction, thinks that AAs may just not be reporting)

Question 41

What is the etiology behind each type of urinary incontinence?

Answer 41