Urinary Symptoms

Question 1

Give examples of storage symptoms - 3

Answer 1

Urgency
Frequency
Nocturia

Question 2

Give examples of voiding symptoms - 6

Answer 2

Hesitancy
Poor flow
splitting/spraying
straining
Incomplete emptying
Dribble

Question 3

causes of storage symptoms - 2

Answer 3

Lower UTIs
Overactive bladder

Question 4

Causes of voiding symptoms - 5

Answer 4

BPH / prostate cancer
Antimuscarinic drugs (atropine, antipsychotics)
Diabetic autonomic neuropathy
Urethral stricture
Phimosis

Question 5

Define stress incontinence

Answer 5

Involuntary leakage on exertion, sneezing or coughing

Question 6

Define urgency incontinence

Answer 6

involuntary leakage accompanied by urgency

Question 7

Management of urgency incontinence (conservative-2, medical-1 and surgical-2)

Answer 7

CONSERVATIVE
- avoid caffeine, fizzy, excessive fluid intake
- pelvic floor excercises

MEDICAL
- anticholinergic medications e.g. Oxybutynin

SURGICAL
- Intravesical injection of botox (paralyses detrusor muscle)
- Sacral nerve stimulation controls overactive bladder.

Question 8

Risk factors of stress incontinence - 7

Answer 8

• pregnancy and vaginal birth
• menopause
• nerve injuries to back
• obesity
  -pelvic surgery
  -diabetes
  -chronic cough

Question 9

Management of stress incontinence (conservative-2, medical-1 and surgical-3)

Answer 9

CONSERVATIVE
- avoid caffeine, fizzys, excessive fluids
- pelvic floor excercises

MEDICAL
- Duloxetine (only if conservative fails and theyre not a surgical candidate). Increases nerve stimulation to IUS

SURGICAL
- incontinence pessaries (intravaginal and put pressure on anterior wall)
- bulking agents (injected into bladder)
- Mid-urethral slings

Question 10

Red Flags of a UTI - 5

Answer 10

Haematuria
Loin pain
Rigors
Nausea and vomiting
Altered mental state

Question 11

Name the types of incontinence - 6

Answer 11

Stress Urinary Incontinence – involuntary leakage on exertion, sneezing or coughing

Urgency Urinary Incontinence – Involuntary leakage accompanied by urgency

Mixed Urinary Incontinence – involuntary leakage associated with urgency and on exertion, sneezing or coughing

Overflow Incontinence – chronic urinary retention, the involuntary release of urine when the bladder becomes overly full.

Overactive Bladder – a frequent and sudden urge to urinate that is difficult to control

Functional Incontinence – cannot physically get to the toilet in time e.g. mobility issues.

Question 12

What are examples of lower urinary tract symptoms in women - 9

Answer 12

• burning or stinging when passing urine
• lower abdominal pain
• frequenxy
• urgency
• incontinence
• nocturea
• incomplete emptying
• slow stream
• post micturition dribble

Question 13

Causes of lower urinary tract symptoms in women - 8

Answer 13

UTI
Menopause
Urge incontinence
stress incontinence
Diabetes mellitus
Stones
Bladder cancer
Medication - diuretics, lithium, antidepressants

Question 14

Causes of LUTS in men - 7

Answer 14

BPH (most common)
Dementia
Diabeties mellitus
UTI
Injury to urethra
Drugs - diuretics, antimuscarinics
Cancer