9: Urinary incontinence and prolapse Flashcards
What is stress incontinence?
Leakage on increased intra-abdominal pressure
What is urge incontinence?
Urinary leakage preceded by a strong urge to go
An overactive bladder causes urgency (with / without) incontinence.
‘wet’ or ‘dry’ overactive bladder
Incontinence becomes (more / less) common as you have more children.
multiparity is a risk factor
Which body state increases your risk of incontinence?
What happens in the menopause to cause incontinence?
Relaxation of pelvic muscles, endopelvic fascia and pelvic ligaments
Which type of infection can cause urinary incontinence?
Which structure should be felt for in any abdominal/pelvic examination of a woman?
What examinations should you do in a woman complaining of urinary incontinence?
What test should you do in any woman complaining of urinary symptoms?
What is the conservative management of an overactive bladder?
drink less alcohol and caffeine
drink less fluid in general
pelvic floor exercises and/or bladder training
Which muscle do antimuscarinics act on?
Detrusor smooth muscle
Inhibit parasympathetics, reducing contraction
What are some examples of antimuscarinic drugs used for urge incontinence?
What are some side effects of antimuscarinics like oxybutynin and tolterodine?
Which new drug will soon be used instead of antimuscarinics to manage overactive bladder?
B3 adrenoceptor agonist
RELAXES detrusor smooth muscle, reducing urge to void