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Flashcards in Incontinence Deck (32)
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1

What is the normal range of daytime voids?

4 - 7

2

Up to what age is more than 1 night-time void considered to be abnormal?

70 years

3

What is the most common cause of a neurogenic bladder in women?

MS

4

If the bladder is still palpable after voiding, what type of incontinence is this suggestive of?

Overflow

5

What is the most common cause of overflow incontinence in males?

Prostatic enlargement

6

In all patients with incontinence, a frequency/volume chart should be filled out for at least how long?

3 days

7

Other than a bladder diary, what other investigations should be performed on all patients presenting with incontinence and why?

Urinalysis and MC&S to rule out a UTI

8

Imaging is not routinely used in the investigation of incontinence; however, if it is required, what would be first line?

Ultrasound

9

What investigation should be utilised in individuals with incontinence who have recurrent UTIs, haematuria, suprapubic pain or a suspected fistula or tumour?

Cystoscopy

10

In stress incontinence, leakage from an incompetent urethral sphincter generally occurs when?

When there is increased intra-abdominal pressure

11

The loss of small (but often frequent) amounts of urine when coughing, laughing etc is most suggestive of which type of incontinence?

Stress incontinence

12

If the underlying cause of incontinence is a prolapse, what may be a useful treatment?

Pessary

13

A frequency/volume chart which identifies normal urinary frequency and normal functional bladder capacity is most suggestive of which type of incontinence?

Stress incontinence

14

When are urodynamic studies used in the investigation of stress incontinence?

Only when surgery is being considered as a treatment

15

Other than lifestyle advice, what is the first line treatment for stress incontinence?

Pelvic floor exercises

16

What is the routine of pelvic floor exercises advised by NICE for the treatment of stress incontinence?

8 contractions, 3 times daily for at least 3 months

17

If pelvic floor exercises and lifestyle advice fail as treatments for stress incontinence, what is the next line management option?

Surgical intervention e.g. mid-urethral tape procedures, injection of bulking agents

18

What is the only pharmacological agent licensed for treating stress incontinence, but is rarely used?

Duloxetine

19

Urge incontinence commonly exists alongside what other two symptoms, grouped together to form overactive bladder syndrome?

Frequency and nocturia

20

What is the cause of urge incontinence and overactive bladder syndrome?

Detrusor muscle hyper-activity

21

A frequency/volume chart showing increased diurnal frequency and nocturia is most suggestive of which type of incontinence?

Overactive bladder syndrome

22

When should urodynamic studies be performed in the investigation of urge incontinence/overactive bladder syndrome?

If there is doubt of the diagnosis, complex symptoms or medical treatment has failed

23

Other than lifestyle advice, what is the first line management option for overactive bladder syndrome/urge incontinence?

Bladder retraining

24

How long should bladder retraining be done for as a first line treatment for overactive bladder syndrome/urge incontinence?

6 weeks

25

What group of drugs are used first line in the treatment of urge incontinence?

Anti-muscarinics

26

How do anti-muscarinic drugs work in the treatment of overactive bladder syndrome/urge incontinence?

Block parasympathetic nerves and relax the detrusor muscle

27

What is the most commonly used anti-muscarinic drug used in the treatment of overactive bladder syndrome/urge incontinence?

Oxybutynin

28

Mirabegron is a 2nd line pharmacological agent used in the treatment of overactive bladder syndrome/urge incontinence- what is the mechanism of action of this drug?

Beta 3 agonist

29

When should mirabegron be used over anti-muscarinic drugs in the treatment of overactive bladder syndrome/urge incontinence?

If you are worried about anti-cholinergic side effects in a frail, elderly person

30

What may be a useful treatment in women with incontinence due to vaginal atrophy?

Oestrogen creams or pessaries