Geriatrics- Incontinence Flashcards
(29 cards)
Is incontinence more common in men or women?
Women
Give some causes of incontinence which are extrinsic to the urinary system.
Lots of layers if cold
Drinking too much, or at the wrong time
Medication
Reduced mobility
Confusion
Constipation
Home circumstances e.g. bathroom difficult to access
Which medication can cause incontinence?
Diuretics
What are some of the basics of intrinsic factors causing incontinence?
Two parts- bladder and outlet
Each may be too weak or too strong
When may incontinence occur if the bladder outlet is too weak?
Urine leak on movement:
Laughing
Coughing
Squatting
->common in women after menopause
Treatment if bladder outlet is too weak and causing incontinence?
Physiotherapy
Oestrogen cream
Duloxetine
Surgical options if required.
What is recommended to strengthen the pelvic floor after childbirth?
Pelvic floor exercises involving contracting the pelvic floor
How could you describe contracting the pelvic floor in exercises?
Stopping peeing mid-flow
Different to clenching buttocks!
What is the only cause of incontinence which is more common in men?
Bladder outlet is too strong
e.g. blockage to urethra due to prostate enlargement
What are some of the characteristics if the bladder outlet is ‘too strong’?
Poor urine flow
Double voiding
Hesitancy
Post micturition dribbling
What is the treatment in the bladder outlet is ‘too strong’ e.g. due to prostatic enlargement?
Alpha blockers e.g. Tamsulosin
Anti-androgens e.g. finasteride (shrinks prostate)
Surgery e.g. TURP
What happens if the bladder muscle is ‘too strong’?
Urge incontinence- detrusor muscle contracts at low volumes, sudden urge to pass urine immediately
What can cause urge incontinence?
Usually idiopathic
Bladder stones
Strokes
->doctors can be prone to bladder stones due to not drinking enough and not going to the toilet
Treatment for urge incontinence?
Anti-muscarinics to relax the detrusor muscle
Bladder retraining can be helpful
What are the three main types of incontinence?
Overflow
Stress
Urge
What can cause overflow incontinence?
Urethral blockage
Bladder unable to empty properly
What can cause stress incontinence?
Relaxed pelvic floor
Increased abdominal pressure
What can cause urge incontinence?
Bladder oversensitivity from infection
Neurological disorders
What can cause underactive bladder?
Long-term catheter use as no awareness of bladder filling, resulting in overflow incontinence
What is the only effective treatment for underactive bladder?
…catheterisation
But this is also a cause… yay
If someone presents with incontinence, which examinations would you want to do?
Rectal and vaginal examination
->common exam question, but lecturer argues any examination would be useful e.g. if they have a cough, check the chest
Why would you want to do a MSSU/urinalysis for incontinence?
UTI can cause incontinence
Why might a scan be done for incontinence?
To look if any residual volume in bladder, suggests bladder outlet obstruction
