Urinary incontinence

Question 1

What is the most common type of urinary inceontinence in males?

Answer 1

Urge urinary incontinence.

Question 2

What is overactive bladder syndrome?

Answer 2

Urinary urgency with or without incontinence, which is often accompanied by nocturia and urinary frequency.

This syndrome is often associated with urge urinary incontinence and are often used interchangeably.

Question 3

Name causes of urge urinary incontinence in males and females

Answer 3

Males:

• Neurological problems, such as stroke.
• BPH
• Certain drugs (Many different)

Females:
More commonly seen in older females, occure with age, often due to bladder abnormalitis or neurological problems.

Question 4

What is the pathophysiology of urge urinary incontinence.

Answer 4

Inflammatory conditions or neurogenic disorders → sphincter dysfunction, detrusor overactivity or overactive bladder → autonomous contractions of the detrusor muscle and premature initiation of a normal micturition reflex

Question 5

What is the most common type uf urinary incontinence seen in younger females and also after post-monoupause.

Answer 5

Stress urinary incontinence

Question 6

What is the pathophysiology of stress urinary incontinence?

Answer 6

Urethral hypermobility:
- This occure due to poor pelvic support due to
postmenopausal estrogen loss, connective tissue
disorders, or childbirth (i.e: damage of the pelvic floor
muscle levator ani and/or the S2–S4 nerve roots).
This causes the urethra and bladder neck to lose the
ability to completely close against the anterior
vaginal wall. With increases in intra-abdominal
pressure (eg, from coughing or sneezing) the
muscular tube of the urethra fails to close, leading to
incontinence.

Intrinsic sphincteric deficiency:
- Results from a loss of intrinsic urethral mucosal and
muscular tone that normally keeps the urethra closed.
In general, ISD results from neuromuscular damage
and can be seen in women who have had multiple
pelvic or incontinence surgeries. ISD can occur in the
presence or absence of urethral hypermobility.
Typically results in severe urinary leakage even with
minimal increases in abdominal pressure.

Question 7

What could you say is the big difference in pathophysiology of urge urinary incontinence and stress urinary incontinence?

Answer 7

Stress urinary incontinence = Nothing to do with bladder contraction.

Urge urinary incontinence = Due to bladder contraction.

Question 8

What is the most common causes of stress urinary incontinence in males?

Answer 8

Prostata surgery (most common cause), such as radical prostatectomy to treat prostate cancer.
- HOWEVER, typically improves or resolves over 6 to 12
months.

Spinal cord injury or disease that impairs sphincter function.

Question 9

Name types of urinary incontinence

Answer 9

Stress incontinence

Urgent incontinence

Mixed incontinence

Overflow incontinence