Bladder conditions Flashcards by Jay Slater

incontinence definition

any involuntary leakage of urine

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types of incontinence (4)

stress
urge
overflow
mixed (stress and urge)

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what is the problem in stress incontinence

what can cause this (4)

insufficient pelvic floor strength

child birth
obesity
smoking (chronic cough)
old age

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when does the leakage of urine occur in stress incontinence

when coughing/sneezing/exercising/laughing

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what is the problem in urge incontinence

detrusor/bladder overactivity

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when does the leakage occur in urge incontinence

when is it worse

when hearing running water/opening a door/standing up/key in the door

worse when drinking alcohol/coffee

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which type of incontinence presents with frequency and urgency

urge

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what is the most common type of incontinence

mixed - urge and stress

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what can cause overflow obstruction

bladder outflow obstruction eg benign prostatic hyperplasia

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which type of incontinence presents with constant dribbling

overflow incontinence

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investigations for incontinence (5)

lower abdo exam 
urinalysis for infection
U&amp;Es for renal impairment 
bladder diary 
urodynamics

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what do you want to ask someone that comes in with incontinence

does it happen when you cough/sneeze

does it happen when you hearing water running/stand up

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where are the 2 probes in urodynamics

what else do you need

what are you trying to figure out

one in bladder
one in rectum/vagina

catheter in bladder

detrusor muscle pressure in different situations (eg coughing)

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conservative treatment for stress incontinence

stop smoking
weight loss
pelvic floor exercises
‘learn to hold your pee’

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surgical treatment for stress incontinence

transvaginal tape

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conservative treatment for urge incontinence

reduce caffeine
reduce fluids
bladder training

surgical treatment for urge incontinence

botulinum toxin (botox)

drug for stress incontinence

is it used

duloxetine

not really only temporary - suicidal thoughts side effects

drug for urge incontinence

is it used

oxybutynin

yes

how does oxybutynin work in urge incontinence

antimuscarinic drug = decreases detrusor muscle activity

treatment of overflow incontinence

catheter to drain urine

fix problem

what other symptoms is overflow incontinence associated with

nocturia
poor flow
urinary retention (chronic and painless, or acute and painful)

examination of someone with overflow incontinence

abdo exam (fluid retention) neuro exam (eg spinal cord abnormalities)

males - PR exam for prostate, penis inspection
females - vaginal inspection

most common bladder cancer

transitional cell carcinoma

bladder cancer associated with schistomiasis and catheters

squamous cell carcinoma

bladder cancer associated with cystitis cystica

adenocarcinoma

most common part of bladder for transitional cell carcinoma

trigone

risk factors for transitional cell carcinoma (4)

dyes smoking men >50 y/o

presentation of bladder cancer

painless haematuria

investigations for transitional cell carcinoma (2)

``` CT urogram (can see a half filled bladder) flexible cystoscopy ```

what does transitional cell carcinoma of the bladder look like on flexible cystoscopy

sea anemone

treatment of transitional cell carcinoma of the bladder (3)

TURBT (transurethral resection of bladder tumour) cystectomy (removal of part of bladder if detrusor muscle involved) stoma for urinary diversion

what may happen to the kidneys in someone with a bladder cancer

hydronephrosis

are bladder cancers likely to reoccur

yes need to give them follow ups

what is cystitis

inflammation of the bladder from infectious or non infectious causes

where does tuberculosis spread from if it infects the bladder

kidneys (from tuberculose pyelonephritis)

where do people present with schistomiasis bladder infections

Africa (tropical countries)

painless frank haematuria

bladder cancer