Urinary Incontinence Flashcards Preview

Renal and Urology > Urinary Incontinence > Flashcards

Flashcards in Urinary Incontinence Deck (29)
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1
Q

What is urinary incontinence?

A

the complaint of any

involuntary leakage of urine.

2
Q

What is stress incontinence

A

Stress urinary incontinence is involuntary leakage on

effort or exertion, or on sneezing or coughing.

3
Q

What is urge incontinence

A

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

4
Q

What is urgency

A

Urgency is the complaint of a sudden compelling

desire to pass urine, which is difficult to defer

5
Q

What is urgency

A

Urgency is the complaint of a sudden compelling

desire to pass urine, which is difficult to defer

6
Q

What is overactive bladder syndrome/urge syndrome

A

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
Q

What is mixed urinary incontinence

A

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

8
Q

What is a frequency volume chart

A

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
Q

What is a frequency volume chart

A

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
Q

What gender is urinary incontinence more common in

A

women

11
Q

How may urine leak in an extra urethral route

A

ectopic ureter

fistula

12
Q

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

A

no effect

13
Q

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

A

s2 and 3

14
Q

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

A

S2 and 3

15
Q

What are the symptoms of overflow incontinence

A

Bladder outflow obstruction
Huge palpable bladder
chronic retention
wet at night

16
Q

What are the symptoms or urge incontinence

A

Frequency
Urgency
Enuresis

17
Q

What may be a ‘trigger’ for urgency in urge incontinence

A

key in door
running water
standing up
coughing laughing

18
Q

What is thought to be a mechanism for urge incontinence

A

detrusor overactivity

19
Q

how is detrusor overactivity diagnosed

A

urodynamics

20
Q

what else may cause urge incontinence

A

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

21
Q

what else may cause urge incontinence

A

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

22
Q

what else may cause urge incontinence

A
paraplegia (loss of central inhibition)
excess central facilitation
destruction of S2/3
pelvic surgery - parasympathetic nerve damage
idiopathic
23
Q

what characterises stress incontinence

A
Urine leaks during increased intra
abdominal pressure, without a detrusor
contraction
Due to damage to pelvic floor or urethral
function - childbirth
24
Q

how is stress incontinence diagnosed

A

urodynamics

25
Q

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

A
Painless palpable mass
arising from pelvis
•Cannot “get below” it
•Dull to percussion
=overflow incontinence bladder
26
Q

how do you treat overflow incontinence

A
Assess renal function
Treat the obstruction
Catheterise
rehabilitate the bladder
Teach intermittent self catheterisation
27
Q

How do you treat urge incontinence

A

 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
Q

how do you treat stress incontinence

A
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
Q

what causes a vesico vaginal fistula

A

prolonged obstructed labour