Urinary incontinence Flashcards
(37 cards)
What is the definition of urinary incontinence?
Involuntary leakage of urine
True or False
Urinary incontinence is more common in females
True
Describe the storage phase of the bladder, in terms of pressures exerted
Intravesical pressure is less than urethral pressure
Where does the pressure come from in the voiding phase of micturition?
Detrusor muscle of bladder
What is urodynamics?
Study of the pressures of the bladder/abdomen using transducers
What effect does coughing have on intravesical pressure?
Increases pressure
What effect does coughing have on abdominal pressure?
Increases pressure
Which nerves supply the pudendal nerve?
S2, 3 and 4
What causes overflow incontinence?
Bladder overflow due to obstruction
What can be seen clinically in a patient with overflow incontinence?
Large palpable bladder
What is urge incontinence?
Involuntary passing of small volumes frequently and urgently
What might bring on urge incontinence?
Sound of running water
Coughing
Laughing
Jumping
What is detrusor overactivity?
Detrusor contractions during states of inhibition of voiding.
How is detrusor overactivity diagnosed?
Urodynamic therapy
What might cause afferent overstimulation?
Irritation in bladder e.g. stone
What would happen if S2 and 3 were destroyed?
Bladder would have no tone
What is stress incontinence?
Stress has been put on pelvic floor or urethra over time which causes urine leakage due to increased abdominal pressure
What can cause stress incontinence?
Childbirth
What is the treatment for overflow urinary incontinence?
Assess renal function
Catheterise patient
Teach intermittent self-catheterisation
How is urge incontinence treated conservatively?
Diet changes
Time bladder emptying
What pharmacological treatment can be given for urge incontinence?
Antimuscarinics e.g. oxybutinin or tolterodine
Beta 3 adrenergics e.g. mirabegron
What is enterocystoplasty?
Surgical solution to urge incontinence where the bladder is voided permanently through a catheter
What is the treatment for stress incontinence?
Wt loss
Smoking cessation
Pelvic floor exercises
What is an ectopic ureter?
Additional ureter which joins the urethra below the sphincter.
Congenital
