Urinary incontinence Flashcards Preview

Elderly > Urinary incontinence > Flashcards

Flashcards in Urinary incontinence Deck (13)
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1
Q

Risk factors

A

Advancing age

Previous pregnancy and childbirth

High BMI

Hysterectomy

Family history

Neurological conditions (MS)

Pelvic floor surgery

Pelvic organ prolapse

2
Q

Urge incontinence

A

Overactivity of the detrusor muscle of the bladder (also known as overactive bladder)

Urge to urinate quickly followed by incontrollable leakage

3
Q

Stress incontinence

A

Weak pelvic floor muscles so organs poorly supported

Urine leaks at times of increased pressure on the bladder

When laughing, coughing, surprised

4
Q

Overflow incontinence

A

Due to bladder outlet obstruction e.g. prostate enlargement, fibroids, pelvic tumours

More common in men

Women with overflow incontinence need urodynamic testing

5
Q

Modifiable lifestyle factors

A

Caffeine consumption

Alcohol consumption

Medications

BMI

6
Q

Investigation

A

Bladder diary

Urine dipstick

Post-void residual bladder volume

Urodynamic testing when urge incontinence not responding to first-line treatments/ difficulties urinating/ retention/ previous surgery/ unclear diagnosis

7
Q

Urodynamic studies

A

Thin catheter inserted into the bladder and another into the rectum

Catheters measure the pressures in the bladder and rectum for comparison

Bladder is filled with liquid and various outcome measures are taken

8
Q

Management of stress incontinence

A

Conservative: avoid caffeine, diuretics and overfilling the bladder; avoid excessive or restricted fluid intake; weight loss

Supervised pelvic floor exercises

Surgery

Duloxetine

9
Q

Surgical options for stress incontinence

A

Tension free vaginal tape

Autologous sling procedures

Colposuspension

Intramural urethral bulking

10
Q

Management of urge incontinence

A

Bladder retraining

Anticholinergics- oxybutynin, tolterodine, solifenacin

Mirabegron (alternative to anticholinergics)

11
Q

Side effects of anticholinergics

A

Dry mouth

Urinary retention

Constipation

Postural hypotension

Cognitive decline, memory problems, worsening of dementia

12
Q

Mirabegron

A

Contraindicated in uncontrolled HTN

Blood pressure needs to be monitored regularly

Stimulates sympathetic nervous system leading to raised BP

Can cause hypertensive crisis

Increased risk of TIA and stroke

13
Q

Invasive options for urge incontinence

A

Botulinum toxin type A

Percutaneous sacral nerve stimulation

Augmentation cystoplasty

Urinary diversion