Urinary Incontinence Flashcards
1
Q
What are the Risk factors for Urinary Incontinence?
A
- Advanced age
- Previous pregnancy and childbirth
- High BMI
- Hysterectomy
- Family History
2
Q
What is overactive bladder/ urge incontinence?
A
- Due to detrusor overactivity
- the urge to urinate is quickly followed by uncontrollable leakage ranging from a few drops to complete bladder emptying
3
Q
What is stress incontinence?
A
- leaking small amounts when coughing or laughing
4
Q
What is mixed incontinence?
A
- both urge and stress
5
Q
What is overflow incontinence?
A
- Due to the bladder outlet obstruction, due to prostate enlargement
6
Q
What is functional incontinence?
A
- comorbid physical conditions impair the patients ability to get to the bathroom in time
- Causes: Dementia, sedating medications, injury/illness causing decreased ambulation
7
Q
What are the investigations for Urinary Incontinence?
A
- Bladder diaries for 3 days
- Vaginal examinations to exclude pelvic organ prolapse and ability to initiate voluntary contraction of the pelvic floor muscles (Kegel’s exercises)
- Urinary dipstick and culture
- Urodynamic studies
8
Q
What is the management for Urinary Incontinence if Urge is predominant?
A
- Bladder retraining (minimum 6 weeks)
- Antimuscarinics - oxybutyin (immediate release), tolterodine (immediate release), darifenacin (once daily preparation)
- mirabegron ( used in frail elderly patients with worry about antimuscarinic side effects)
9
Q
What is the managment for Urinary incontinence if Stress is the predominant?
A
- Pelvic floor muscle training ( 8 contractions performed 3 times a day for 3 months)
- Surgical procedure (retropubic mid-urethral tape procedures)
- Duloxetine (if the women declines surgical procedure)
works as a noradrenaline and serotonin reuptake inhibitor
increased synaptic concentration of noradrenaline and serotonin within the pudendal nerve, increased stimulation of urethral striated muscles within the sphincter
