Urinary frequency, enuresis, incontinence

Question 1

Four types of urinary incontinence

Answer 1

Stress
Urgency
Mixed
Overflow

Question 2

Urgency incontinence first line

Answer 2

Bladder training for at least 6 weeks

Question 3

Stress incontinence Treatment

Answer 3

Supervised pelvic floor muscle training for at least 3 months
If fails -> duloxetine

Question 4

Mixed incontinence first line

Answer 4

Bladder training for at least 6 weeks and supervised floor muscle training for at least 3 months

Question 5

Urgency incontinence treatment

Answer 5

1st- IR oxybutynin, tolterodine and darifenacin
IR oxybutyn should not be used in the frail, older woman
2nd line- Mirabegron if 1st line ineffective/CI

Question 6

Antimuscarinics CI

Answer 6

Severe UC
Significant bladder outflow obstruction
toxic megacolon
Urinary retention

Question 7

Antimuscarinics cautions

Answer 7

Acute MI
Arrythmias
Congestive heart failures
autonomic neuropathy
Hypertension
Hyperthyroidism
UC

Question 8

Mirabegron MOA

Answer 8

Agonist of beta 3 adrenergic receptors. Activation of these receptors cause smooth muscles to relax and increases bladder capacity

Question 9

Mirabegron CI and caution

Answer 9

CI- Severe uncontrolled hypertension (>180mmHg or diastolic blood pressure >110mmHg)
Caution- History of QT prolongation

Question 10

Mirabegron in preg + BF

Answer 10

Avoid - contraception is advised for women of child bearing age

Question 11

Mirabegron monitoring

Answer 11

Blood pressure should be monitored before starting and regularly during treatment

Question 12

Tamusulosin use in females

Answer 12

Kidney stones