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Repro. Med 3 > Urinary Incontinence > Flashcards

Urinary Incontinence Flashcards

1
Q

____ is loss of voluntary bladder control resulting in urinary leakage

A

Urinary incontinence

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2
Q

Is urinary incontinence a (Sx/Dx)?

A

Sx

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3
Q

___% women > 45 y/o have some type of urinary incontinence

__% women > 65 y/o

A

33%

50%

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4
Q

____ is experiencing the overwhelming need to urinate, even if you just went and/or being unable to hold it long enough to reach a bathroom

A

Urge

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5
Q

____ is urine loss during episodes of increased intra-abdominal pressure, such as exercise, coughing, sneezing, laughing, or any body movement, which puts pressure on the bladder

A

Stress

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6
Q

___ is incontinence occurring w/o urgency or stress

A

Unconscious or Overflow

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7
Q

What are the 2 types of urge (overactive bladder) incontinence?

A

Idiopathic detrusor instability (DI)

Neuropathic detrusor hyperreflexia

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8
Q

What are the 2 types of stress incontinence?

A

Urethral Hypermobility

Intrinsic Sphincter Deficiency (ISD)

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9
Q

What type of sx are described below?

“Hesitancy, slow stream, dribbling, incomplete emptying”

A

Voiding sx

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10
Q

What type of sx are described below?

“Frequency, urgency, interruption of sleep”

A

Storage sx

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11
Q

What should be included in the work-up for incontinence?

A

Review associated medical conditions, neurological sx

Medication hx (anticholinergics, alpha blockers, CCB, sedatives, alcohol)

UA + Cx

Urodynamics (bladder fxn)

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12
Q

What is included in the PE of incontinence?

A

Pelvic Exam
Q Tip test
Standing and “in position”
Estrogen status

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13
Q

___ is a pressure flow study

___ measures urethral closure pressure

___ measures the lowest pressure at which leakage occurs w/ straining

A

Cystometry

Urethral Profile Pressure

Leak Point Pressure

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14
Q

___ occurs when nerve passages from the bladder to the brain are damaged, causing a sudden bladder contraction

What is the name of the muscle that is contracting?

A

Urge incontinence

Detrusor muscle

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15
Q

BONUS QUESTION!!!!

What are the 2 indications to Rx Leuprolide?

A

endometriosis

fibroid

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16
Q

What is the goal of urge incontinence tx?

A

improve bladder stability

17
Q

What are conservative tx options for urge incontinence?

A

Lifestyle
Behavioral modifications
- fluid manipulation
- timed voids

18
Q

What medications can be used to tx urge incontinence?

A

Muscarinic Receptor Antagonists

19
Q

What neural stimulation can be used to tx urge incontinence?

A

Sacral Neuromodulation

Interstim

20
Q

___ occurs when pelvic muscles have been damaged

A

Stress incontinence

21
Q

What causes stress incontinence?

A 
Pregnancy and childbirth
Radiation
Trauma
Prior surgery 
Muscle damage 
Hormonal changes
22
Q

______ refers to the urodynamic diagnosis of stress incontinence–this condition exists under objective measures, when a patient can demonstrate urinary leakage when intra-vesical pressure exceeds the maximal urethral closure pressure in the absence of a detrusor contraction.

A

Genuine Stress Incontinence

23
Q

____ + _____ + degree of ____ on the pt (all must be considered prior to tx of stress incontinence)

A

sx
objective findings
subjective effect

24
Q

What is the goal of tx for stress incontinence?

A

To strengthen or aide the pelvic muscles that have been damaged

25
Q

T/F: There are more medications for tx for stress incontinence than urge incontinence

A

F: there are NO medications for stress incontinence

26
Q

What can be used to tx stress incontinence?

A

Pelvic floor exercises (kegels)
Pessary devices
Surgery / Minimally invasive procedures (slings)
Bulking agents

27
Q

Kegel Exercises……
Strengthen the striated urogenital sphincter, which helps increase ______

Strengthening the levator ani muscles helps w/ improving _____ or ______

A

Increases urethral closure force

Improve support or proximal urethra

28
Q

How does the use of pessarys help in the tx of stress incontinence?

A

Strengthen and support the levator ani muscles

Compressive effect on urethra

29
Q

Slings for stress incontinence: a sling or hammock shape material is placed below the ____.
It compress urethral lumen at level of ____, as well as urethral support.
Long term data shows success of ____%

A

Urethra
Bladder neck
>90%

30
Q

How is mixed incontinence tx?

A

Both surgery and drug therapy

31
Q 
Average (normal): 
24 hour urine output? 
Total # daily voids?
Average voided volume?
Functional Bladder capacity (largest volume voided in normal daily life)?
A

24 hr urine output: 1500-2500 mL
Total # daily voids: 7-8
Average voided volume: 250 mL
Functional Bladder capacity: 400-600 mL

Repro. Med 3 (14 decks)

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