Incontinence Flashcards
Stress Incontinence
Cause: Weakening of the pelvic floor muscles and urethral sphincter, often due to factors such as childbirth, menopause, obesity, or chronic coughing.
Clinical Presentation/Symptoms: Involuntary leakage of urine during activities that increase intra-abdominal pressure, such as coughing, sneezing, laughing, or exercising.
Diagnosis: Medical history, physical examination, urine tests, bladder diary, and urodynamic testing.
Treatment: Pelvic floor muscle exercises (Kegel exercises), lifestyle changes (weight loss, avoiding bladder irritants), use of vaginal pessaries, electrical stimulation, and surgical interventions (such as sling procedures or urethral bulking agents).
Urge Incontinence (Overactive Bladder):
Cause: Involuntary contractions of the bladder muscle, often due to neurological conditions, bladder infections, bladder irritants, or unknown causes.
Clinical Presentation/Symptoms: Sudden and strong urge to urinate, followed by involuntary urine leakage before reaching the bathroom.
Diagnosis: Medical history, physical examination, urine tests, bladder diary, urodynamic testing, and cystoscopy.
Treatment: Behavioral therapies (bladder training, timed voiding), pelvic floor muscle exercises, medications (anticholinergic or antispasmodic drugs), nerve stimulation techniques, and in some cases, botulinum toxin injections into the bladder muscle.
Overflow Incontinence
Cause: Obstruction or dysfunction of the bladder outlet, leading to incomplete emptying of the bladder and urinary retention.
Clinical Presentation/Symptoms: Frequent or constant dribbling of urine, feeling of incomplete bladder emptying, weak urine
stream, and sometimes urinary urgency.
Diagnosis: Medical history, physical examination, urine tests, bladder ultrasound, urodynamic testing, and cystoscopy.
Treatment: Treating the underlying cause, such as relieving bladder outlet obstruction, using intermittent catheterization to empty the bladder, medications (alpha-blockers), or in severe cases, surgery.
Functional Incontinence
Cause: Physical or cognitive impairments that make it difficult to reach the toilet in time, such as mobility issues, dementia, or environmental barriers.
Clinical Presentation/Symptoms: Inability to reach the toilet due to physical or cognitive limitations, resulting in urine leakage.
Diagnosis: Medical history, physical examination, cognitive assessment, and evaluation of mobility and functional abilities.
Treatment: Addressing the underlying impairments, modifying the environment to improve accessibility, scheduled toileting, caregiver assistance, and sometimes the use of absorbent pads or garments.
Mixed Incontinence:
Cause: Combination of stress and urge incontinence.
Clinical Presentation/Symptoms: Symptoms of both stress and urge incontinence, including urine leakage during activities that increase intra-abdominal pressure and a sudden urge to urinate.
Diagnosis: Medical history, physical examination, urine tests, bladder diary, urodynamic testing, and cystoscopy.
Treatment: Combination of treatments for stress and urge incontinence, including behavioral therapies, pelvic floor exercises, medications, and, if necessary, surgical interventions.
