Urinary Incontinence Flashcards Preview

Renal and Urology > Urinary Incontinence > Flashcards

Flashcards in Urinary Incontinence Deck (29):
1

What is urinary incontinence?

the complaint of any
involuntary leakage of urine.

2

What is stress incontinence

Stress urinary incontinence is involuntary leakage on
effort or exertion, or on sneezing or coughing.

3

What is urge incontinence

Urgency urinary incontinence is involuntary leakage
accompanied by, or immediately preceded by
urgency.

4

What is urgency

Urgency is the complaint of a sudden compelling
desire to pass urine, which is difficult to defer

5

What is urgency

Urgency is the complaint of a sudden compelling
desire to pass urine, which is difficult to defer

6

What is overactive bladder syndrome/urge syndrome

Urgency, with or without urge incontinence, usually with
frequency and nocturia, can be described as overactive bladder
syndrome, urge syndrome or urgency-frequency syndrome.

7

What is mixed urinary incontinence

Mixed urinary incontinence is involuntary leakage associated
with urgency and also with exertion- effort, sneezing or
coughing.

8

What is a frequency volume chart

frequency volume chart (FVC) records the volumes voided as
well as the time of each micturition, day and night for at least 24 hrs

9

What is a frequency volume chart

frequency volume chart (FVC) records the volumes voided as
well as the time of each micturition, day and night for at least 24 hrs

10

What gender is urinary incontinence more common in

women

11

How may urine leak in an extra urethral route

ectopic ureter
fistula

12

What effect does increased intrabdominal and intravesicla pressure have on detrusor pressure

no effect

13

What spinal nerve routs give rise to the nerves that contol the bladder

s2 and 3

14

What spinal nerve routs give rise to the nerves that contol the bladder

S2 and 3

15

What are the symptoms of overflow incontinence

Bladder outflow obstruction
Huge palpable bladder
chronic retention
wet at night

16

What are the symptoms or urge incontinence

Frequency
Urgency
Enuresis

17

What may be a 'trigger' for urgency in urge incontinence

key in door
running water
standing up
coughing laughing

18

What is thought to be a mechanism for urge incontinence

detrusor overactivity

19

how is detrusor overactivity diagnosed

urodynamics

20

what else may cause urge incontinence

paraplegia (loss of central inhibition)
excess central facilitation
destruction of S2/3

21

what else may cause urge incontinence

paraplegia (loss of central inhibition)
excess central facilitation
destruction of S2/3
pelvic surgery - parasympathetic nerve damage

22

what else may cause urge incontinence

paraplegia (loss of central inhibition)
excess central facilitation
destruction of S2/3
pelvic surgery - parasympathetic nerve damage
idiopathic

23

what characterises stress incontinence

Urine leaks during increased intra
abdominal pressure, without a detrusor
contraction
Due to damage to pelvic floor or urethral
function - childbirth

24

how is stress incontinence diagnosed

urodynamics

25

how do you when the mass you are feeling is a bladder

Painless palpable mass
arising from pelvis
•Cannot “get below” it
•Dull to percussion
=overflow incontinence bladder

26

how do you treat overflow incontinence

Assess renal function
Treat the obstruction
Catheterise
rehabilitate the bladder
Teach intermittent self catheterisation

27

How do you treat urge incontinence

 Dietary discretion (avoid caffeine)
 Biofeedback
 Bladder retraining, Time bladder emptying
 Pharmacotherapy
 Antimuscarinics - (e.g. oxybutynin, tolterodine)
 Beta 3 adrenergics (mirabegron)
 Botulinum toxin injection – unlicenced
 Neuromodulation (“pacemaker” for the bladder)
 Surgery
 Enterocystoplasty

28

how do you treat stress incontinence

Weight loss
 Stop smoking!
 Pelvic floor exercises - physiotherapy
 Pharmacotherapy – (not very much role)
 Duloxetine (serotonin (5-HT) and norepinephrine
(NE) reuptake inhibitor)
 Surgical correction
 Open procedures – colposuspension
 largely replaced by:
 Minimally invasive “tape” procedures

29

what causes a vesico vaginal fistula

prolonged obstructed labour