Exam 1 - Urinary Incontinence (UI)

Question 1

Name the 5 types of urinary incontinence.

Answer 1

1) Stress Urinary Incontinence (SUI)
2) Urge Urinary Incontinence (UUI)
3) Overflow Incontinence (OI)
4) Mixed Incontinence
5) Functional Incontinence

Question 2

“MUFOS” = the 5 types of UI

Answer 2

M - Mixed incontinence
U - Urge urinary incontinence
F - Functional incontinence
O - Overflow incontinence
S - Stress urinary incontinence

Question 3

Name the UI that is associated with urethral underactivity.

Answer 3

Stress Urinary Incontinence (SUI)

Question 4

Name the UI that is associated with bladder overactivity.

Answer 4

Urge Urinary Incontinence (UUI)

Question 5

Name the UI that is associated with urethral overactivity and/or bladder underactivity.

Answer 5

Overflow Incontinence

Question 6

SUI = urethral _____

Answer 6

SUI = urethral underactivity

Question 7

UUI = bladder ______

Answer 7

UUI = bladder overactivity

Question 8

OI = urethral _____ and/or bladder ______

Answer 8

OI = urethral overactivity and/or bladder underactivity

Question 9

What is the type of UI that is associated with inadequate urethral-sphincter closure under increased intro-abdominal pressure?

Answer 9

SUI

Question 10

Name the symptoms of SUI.

Answer 10

• Involuntary loss of small volume urine during actions that put pressure on the bladder
• -Exercise, coughing, sneezing, and lifting

Question 11

What are the risk factors for SUI?

Answer 11

• Female: pg, childbirth, menopause, obesity, cognitive impairment, and aging
• Male (UNCOMMON): prior lower urinary tract surgery of injury

Question 12

What is the type of UI associated with bladder overactivity filling due to the involuntary detrusor contractions?

Answer 12

UUI

Question 13

What are the two actions that can occur in UUI?

Answer 13

1) Overactive bladder

2) Detrusor overactivity

Question 14

What is the more common diagnosis - Overactive bladder or Detrusor overactivity?

Answer 14

OVERACTIVE BLADDER

-Symptom syndrome of urgency and frequency during the day or night with or without UI

Question 15

T/F: Large amounts of leakage tend to occur in UUI.

Answer 15

TRUE

Question 16

T/F: OUI is a less common type of UI.

Answer 16

TRUE

Question 17

What are the symptoms of OUI?

Answer 17

Constant dribble of urine

Frequent urination of small amounts

Question 18

What happens in OUI?

Answer 18

Bladder full, but cannot empty, thus the dribbling that occurs

Question 19

What are the common causes of OUI?

Answer 19

• Men: anatomic urethral obstruction (BPH, prostate cancer)
• Women: urethral overactivity from cystocele formation or surgery
• Both: neurologic dysfunction or diseases, spinal cord injury, etc.

Question 20

What is the most common combination of UI types in Mixed Incontinence?

Answer 20

Urgency and Stress UI (Bladder overactivity and urethral underactivity)

Question 21

What is the type of incontinence that is not induced by bladder or urethra abnormalities and instead by drugs or pt disease state?

Answer 21

Functional Incontinence

Question 22

Which UI type has leaking with activity?

Answer 22

SUI

Question 23

Who is in the at-risk population for urinary incontinence?

Answer 23

• Postpartum women

- Geriatrics

Question 24

Name the medications that contribute to UI.

Answer 24

• Diuretics, acetylcholinesterase inhibitors
• Alpha receptor antagonists
• Alpha receptor agonists
• Calcium channel blockers
• Narcotic analgesics
• Sedative hypnotics
• Antipsychotic agents
• Anticholinergics
• Antidepressants, TCAs
• Alcohol
• ACE inhibitors

Question 25

Name the diuretics than can contribute to UI.

Answer 25

Furosemide Bumetonide Thiazides (HCTZ)

Question 26

What do diuretics do to contribute to UI?

Answer 26

Polyuria, frequency, urgency (UUI)

Question 27

Name the alpha receptor antagonists that can contribute to UI.

Answer 27

Terazosin Prazosin Doxazosin

Question 28

What do alpha receptor antagonists do to contribute to UI?

Answer 28

Urethral relaxation (SUI in women)

Question 29

Name the alpha receptor agonists that can contribute to UI.

Answer 29

Sudoephedrine | Ephedrine

Question 30

What do alpha receptor agonists do to contribute to UI?

Answer 30

Urethral constriction (OUI)

Question 31

What UI do CCBs contribute to?

Answer 31

Urinary retention due to reduced bladder contractility (OUI)

Question 32

What UI do narcotic analgesics contribute to?

Answer 32

Urinary retention due to reduced bladder contractility (OUI and FUI)

Question 33

What is the first-line treatment for UI?

Answer 33

NON-SURGICAL, NON-PHARMACOLOGIC INTERVENTION

Question 34

What med aggravates Stress UI?

Answer 34

Alpha blockers

Question 35

Name the non-pharmacologic treatment for Stress UI.

Answer 35

- Pelvic floor muscle training (PFMT) - Fluid management - Bladder training - Weight loss in obese pts - Female: Poise Impressa Bladder/Supports/Pessary - Male: Penile clamp

Question 36

What is the drug of choice for Stress UI?

Answer 36

Duloxetine (Cymbalta)

Question 37

What other drugs can be used to treat Stress UI?

Answer 37

Venlafaxine Estrogens Alpha agonists - Phenylephrine, Pseudoephedrine

Question 38

What is the treatment for UUI?

Answer 38

- Oxybutynin (Ditropan) - OTC Oxytrol Patch - Tolterodine (Detrol) - Fesoterodine (Toviaz) - Trospium (Sanctura)

Question 39

What is second line treatment for UUI?

Answer 39

Mirabegron (Mybetriq)