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Flashcards in Urinary incontinence Deck (37):
1

What is the definition of urinary incontinence?

Involuntary leakage of urine

2

True or False
Urinary incontinence is more common in females

True

3

Describe the storage phase of the bladder, in terms of pressures exerted

Intravesical pressure is less than urethral pressure

4

Where does the pressure come from in the voiding phase of micturition?

Detrusor muscle of bladder

5

What is urodynamics?

Study of the pressures of the bladder/abdomen using transducers

6

What effect does coughing have on intravesical pressure?

Increases pressure

7

What effect does coughing have on abdominal pressure?

Increases pressure

8

Which nerves supply the pudendal nerve?

S2, 3 and 4

9

What causes overflow incontinence?

Bladder overflow due to obstruction

10

What can be seen clinically in a patient with overflow incontinence?

Large palpable bladder

11

What is urge incontinence?

Involuntary passing of small volumes frequently and urgently

12

What might bring on urge incontinence?

Sound of running water
Coughing
Laughing
Jumping

13

What is detrusor overactivity?

Detrusor contractions during states of inhibition of voiding.

14

How is detrusor overactivity diagnosed?

Urodynamic therapy

15

What might cause afferent overstimulation?

Irritation in bladder e.g. stone

16

What would happen if S2 and 3 were destroyed?

Bladder would have no tone

17

What is stress incontinence?

Stress has been put on pelvic floor or urethra over time which causes urine leakage due to increased abdominal pressure

18

What can cause stress incontinence?

Childbirth

19

What is the treatment for overflow urinary incontinence?

Assess renal function
Catheterise patient
Teach intermittent self-catheterisation

20

How is urge incontinence treated conservatively?

Diet changes
Time bladder emptying

21

What pharmacological treatment can be given for urge incontinence?

Antimuscarinics e.g. oxybutinin or tolterodine
Beta 3 adrenergics e.g. mirabegron

22

What is enterocystoplasty?

Surgical solution to urge incontinence where the bladder is voided permanently through a catheter

23

What is the treatment for stress incontinence?

Wt loss
Smoking cessation
Pelvic floor exercises

24

What is an ectopic ureter?

Additional ureter which joins the urethra below the sphincter.
Congenital

25

What are the risk factors for urinary incontinence?

Obese
Pregnancy
Vaginal delivery

26

Why should an examination be undertaken in women with incontinence?

To check for prolapse and assess pelvic floor strength

27

What does the management of urinary incontinence involve after having taken a history and examination?

Urine dipstick
Bladder diary for 3 days

28

How many times a day is it normal to pass urine?

4-8

29

How much urine should be in each normal void?

300-600ml

30

What does bladder training involve?

Training bladder to void every hour, then increasing that interval.

31

When should urgent referral to secondary care be made?

Visible haematuria
Recurrent UTI with microscopic haematuria
microscopic haematuria if over 50

32

When should routine referral to secondary care be made?

Visible prolapse that is symptomatic
Palpable bladder post-void

33

What incontinence is male specific?

Post-micturition dribble
Post-prostectomy incontience

34

What can be advised in post-micturition dribble?

Urethral milking.
Massaging the bulbar urethra (at perineum) to remove excess urine

35

What do 5-alpha reductase inhibitors do?

Stops conversion from testosterone to dihydrotestosterone so prevents BPH

36

When should men be referred with incontinence?

If painful
Recurrent infections
Haematuria

37

What drugs may cause incontinence?

Calcium CB
Opiates