Incontinence Flashcards Preview

Y3 Medicine for the Elderly > Incontinence > Flashcards

Flashcards in Incontinence Deck (19)
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1
Q

what is urinary incontinence?

A

involuntary loss of urine

2
Q

what changes occur to the urinary system with ageing?

A

decreased bladder capacity and urethral closure pressure

increased post void residual volume and detrusor overactivity

3
Q

name the transient causes of incontinence

A

mnemonic = DIAPERS

delirium
infection
atrophic urethritis/vaginitis
pharmaceutical/prostate
psychological
endocrine
restricted mobility
stool impaction
4
Q

what are the five types of incontinence?

A
stress
urge
mixed
overflow
functional
5
Q

what is stress incontinence?

A

involuntary leakage on effort or exertion

6
Q

what is urge incontinence?

A

involuntary leakage accompanied by or immediately preceded by urgency

7
Q

what is mixed incontinence?

A

involuntary leakage associated with urgency and also exertion

8
Q

what is overflow incontinence?

A

leakage owing to bladder outflow obstruction of any cause, resulting in large post void residual volume

9
Q

what is functional incontinence?

A

incontinence due to inability to reach/use the toilet in time

10
Q

what investigations are done for incontinence?

A

post void bladder scan
bladder diaries
bloods
urodynamic studies (complex cases)

11
Q

what bloods should be considered in incontinence?

A

PSA
U+E’s
glucose

12
Q

what lifestyle changes can help incontinence?

A

reduced caffeine intake

weight loss

13
Q

what physical things can be done to manage incontinence?

A

pelvic floor exercises
bladder training
exercise

14
Q

when is pharmacological management of incontinence started?

A

3 months of non-pharmacological management failed

15
Q

what is the first line pharmacological management of incontinence?

A

tolterodine 2mg daily

16
Q

what is the second line pharmacological management of incontinence?

A

solifenacin 5mg once daily

no response after six weeks = increase to 10mg once daily

17
Q

what is the third line pharmacological management of incontinence?

A

mirabegron MR 50mg once daily

18
Q

what needs to be done when starting a patient on mirabegron for incontinence?

A

monitor BP before initiation, one month after and then at least annually

19
Q

what medication can be given for nocturia?

A

late afternoon diuretic

desmopressin