Female incontinence; 4.15 Flashcards Preview

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Flashcards in Female incontinence; 4.15 Deck (21):
1

What kind of androgen receptors are found in the bladder dome?

Beta-receptors

2

What is the effect of having beta-receptors in the bladder dome when sympathetics are active?

The bladder relaxes...this is the case while STORING urine

3

What kind of androgen receptors are found at the bladder neck (internal urinary sphincter)?

Alpha-receptors

4

What is the effect of having alpha-receptors in the bladder neck when sympathetics are firing?

The sphincter constricts...this would also be necessary while STORING urine

5

Where else are alpha-receptors in the urinary system?

The urethra...again, sympathetics would cause the urethra to constrict so the bladder won't leak

6

Besides sympathetic activity, what else is going on during urine storage?

Cholinergics are inhibited

7

What nerve sends the sympathetic control to the bladder?

Hypogastric nerve

8

What nerve sends the cholinergic activity?

Pudendal nerve

9

What are some lifestyle modifications that can be made to treat stress incontinence?

Weight loss
Fluid retention
Smoking cessation

10

What can be done to strengthen the pelvic floor?

Kegel exercises
Electrical stimulation
Biofeedback
Extracorporeal magnetic innervation

11

What are devices that can be used to occlude the urethra?

Pessary
Urethral inserts

12

What are some meds that can be used to treat stress incontinence, despite not being approved?

Intravaginal estrogen
Duloxetine
Alpha-adrenergic drugs

13

Why is estrogen given intravaginally?

Because it would WORSEN the condition if it was given SYSTEMICALLY

14

What is the problem with duloxetine?

Duloxetine has more side effects

15

Are alpha-adrenergics commonly used?

No...alpha-adrenergics are not commonly used

16

What are some non-medicinal treatment options for urge/overactive bladder?

Bladder retaining
Remove worsening drugs if possible
Pelvic floor strengthening

17

What are some medicinal treatments for urge/overactive bladder?

Anticholinergics
Beta-agonists
Intravaginal estrogen
Botulinum toxin

18

When are anticholinergics contraindicated?

Narrow angle glaucoma
Dementia
GI obstruction
Old frail people

19

What is a risk of using beta-agonists?

Urinary retention (worse with concurrent anticholinergic use)

20

Besides meds and lifestyle changes, how else can urge/overactive bladder be treated?

Tibial nerve stimulation
Implantable neuromodulators

21

What causes transient incontinence?

DIAPPERS:
Delerium
Infection (acute UTI)
Atrophic vaginitis
Pharmaceuticals
Psychological disorder (depression)
Excessive urine output
Reduced mobility/Reversible urinary retention
Stool impaction