6 - Urinary Incontinence

Question 1

What is the most prevalent form of incontinence among women?

Answer 1

• stress urinary incontinence

Question 2

What are the 3 major risk factors for stress urinary incontinence (SUI)?

Answer 2

• childbirth
• aging
• high BMI

Question 3

What physical exam test is used to assess for SUI?

Answer 3

• cough stress test

Question 4

What is a reliable way to measure urinary frequency?

Answer 4

• voiding diary

Question 5

This is the complaint of interruption of sleep one or more times because of the need to void.

Answer 5

• nocturia

Question 6

This is defined as the involuntary leakage of urine, associated with a sudden compelling desire to void.

Answer 6

• urgency urinary incontinence

Question 7

What are the 3 primary contraindications for anti-cholinergic drugs?

Answer 7

• narrow angle glaucoma
• gastroparesis
• urinary retention

Question 8

What are the 3 primary contraindications for B3-agonist drugs?

Answer 8

• uncontrolled HTN
• End stage renal disease
• liver disease

Question 9

OnabotulinumtoxinA is considered what type of drug?

Answer 9

• FDA pregnancy category C

* no studies in pregnant women

Question 10

Pessaries are mainly indicated for what condition?

Answer 10

• pelvic organ prolapse

Question 11

Pelvic organ prolapse (POP) is most common in a patient who has undergone this procedure.

Answer 11

hysterectomy

Question 12

What quantitative tests are used to assess pelvic organ prolapse (POP)? (2)

Answer 12

• POP-Q or Baden Walker

Question 13

What are the transient causes of urinary incontinence? (DIAPPERS)

Answer 13

• Delirium
• Infection
• Atrophic vaginitis/urethritis
• Pharmaceutical agents
• Psychological disorders
• Excessive urine output
• Restricted mobility
• Stool impaction

Question 14

This is defined as the involuntary leakage of urine during increased abdominal pressure, in the absence of a detrusor contraction.

Answer 14

stress urinary incontinence (SUI)

Question 15

A decrease in this hormone may be the cause of vaginal atrophy.

Answer 15

decreased estrogen

Question 16

What diagnostic test is used for stress urinary incontinence (SUI)?

Answer 16

• complex urodynamic testing

Question 17

What is a non-surgical management option for SUI?

Answer 17

pessary with a knob

Question 18

What is a surgical treatment option for SUI?

Answer 18

mid-urethral sling

*well tolerated and have high success rates

Question 19

What are the 4 criteria used for diagnosing overreactive bladder?

Answer 19

• urinating 8+ times/day
• waking up >2 times/night
• an overwhelming and sudden need to urinate
• leakage of urine before she’s able to make it to the bathroom

Question 20

What plexus innervates the bladder?

Answer 20

• inferior hypogastric plexus

Question 21

What are the 2 pharmacotherapy options for overreactive bladder?

Answer 21

• Antimuscarinics

- B agonist (Mirabegron)

Question 22

Which antimuscarinics are more useful when continence is desired at specific times?

Answer 22

immediate release antimuscarinics

Question 23

Which antimuscarinics have been shown to have lower rates of adverse effects than immediate release agents?

Answer 23

extended release antimuscarinics

Question 24

OnabotulinumtoxinA was first approved for what purpose?

Answer 24

treatment of urinary incontinence in patients with neurologic conditions who have overactivity of the bladder

Question 25

This is defined as the descent of one or more aspects of the vagina and uterus.

Answer 25

pelvic organ prolapse (POP)

Question 26

How is the POP-Q stage 2 for pelvic organ prolapse defined?

professor said she only remembers stage 2

Answer 26

• most distal prolapse is between 1 cm above and 1 cm below the hymen