Elderly Incontinence

Question 1

extrinsic examples of urinary incontinence? (4)

Answer 1

reduced mobility
confusion
constipation
social/home circumstances

Question 2

what muscle is internal and external urethral sphincter made of?

Answer 2

internal - smooth

external - striated

Question 3

parasympathetic innervation?

Answer 3

S2-S4

increases strength and frequency of contractions

Question 4

what causes detrusor muscle to relax?

Answer 4

sympathetic T10-L2

b-adrenoreceptors

Question 5

what causes contraction of neck of bladder/internal sphincter?

Answer 5

sympathetic T10-S2

a-adrenoreceptors

Question 6

what causes contraction of pelvic floor muscles and external urethral sphincter?

Answer 6

S2-S4 somatic

Question 7

what happens in stress incontinence?

Answer 7

bladder outlet is too weak

urine leak on coughing etc

Question 8

what happens in urinary retention?

Answer 8

bladder outlet is too strong

poor urine outflow

Question 9

what happens in urge incontinence?

Answer 9

bladder muscle is too strong

detrusor muscle contracts at low volumes

Question 10

treatment for stress incontinence? (3)

Answer 10

physiotherapy
oestrogen cream
duloxetine

Question 11

treatment for urinary retention? (2)

Answer 11

alpha blocker - Tamsulosin

anti-androgen - finasteride

Question 12

treatment for urge incontinence? (1)

Answer 12

antimuscarinics

Question 13

what do antimuscarinics do?

Answer 13

relax detrusor

Question 14

what do alpha blockers do?

Answer 14

relax sphincter and bladder neck

Question 15

what do anti-androgens do?

Answer 15

shrink prostate

Question 16

what is neuropathic bladder?

Answer 16

no awareness of bladder filling resulting in overflow incontinence

Question 17

treatment for neuropathic bladder?

Answer 17

catheterisation is only treatment

Question 18

what examination for assessing incontinence?

Answer 18

rectal and vaginal