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Geriatrics > 1: Urinary Incontinence > Flashcards

1: Urinary Incontinence Flashcards

1
Q

What is urinary incontinence

A

Involuntary leakage of urine

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2
Q

What are the 5 types of incontinence in a female

A
  1. Stress incontinence
  2. Urge incontinence
  3. Mixed incontinence
  4. Functional incontinence
  5. Continous incontinence
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3
Q

What is stress incontinence

A

Due to an incompetent sphincter - which results on the leakage of urine when there is an increase in intra-abdominal pressure

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4
Q

What is urge incontinence

A

Sudden urge to urinate followed by uncontrollable emptying of the bladder

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5
Q

What is mixed incontinence

A

A mix of urge and stress incontinence

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6
Q

What is functional incontinence

A

Physiologically individual is normal, however, cannot make it to the toilet in time due to other co-morbidities

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7
Q

What is continous incontinence

A

When there is a continous leakage of urine

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8
Q

What is the most common type of incontinence in females

A

mixed and stress

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9
Q

What are the 3 causes of stress incontinence (3Ps)

A

pelvic floor weakness
prolapse
pelvic mass

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10
Q

What are may cause urge incontinence

A 
latchkey incontinence
organic brain damage
UTI
diabetes 
diuretics
atrophic vaginitis
uretheritis
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11
Q

What is latckey incontinence

A

sudden urge to urinate when arriving home

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12
Q

What organ brain damage may lead to urge incontinence

A

PD
Stroke
Dementia
MS

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13
Q

What may cause functional incontinence

A

Dementia
Delirium
Immobility

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14
Q

What may cause continous incontinence

A

vesicovaginal fistula

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15
Q

What is the mneomonic to remember reversible causes of incontinence

A

D I A P E R S

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16
Q

What are reversible causes of incontinence

A 
Delirium 
Infection 
Atrophic vaginitis 
Psychological 
Excess fluid output 
Reduced mobility 
Stool impaction
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17
Q

What are 6 risk factors for stress incontinence

A 
childbirth
pregnancy
hysterectomy
previous pelvic surgery 
obesity 
ageing
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18
Q

What are 3 risk factors for urge incontinence

A

diabetes
UTI
neurological disorder

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19
Q

What is a risk factor for functional incontinence

A

dementia

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20
Q

how does stress incontinence present

A

leakage of urine when there is an increase in intra-abdominal pressure (eg. coughing, laughing, sneezing)

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21
Q

How does urge incontinence present

A

urge to urinate followed by a complete emptying of the bladder

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22
Q

What is the mneumonic to remember storage symptoms

A

FUN

23
Q

What are the storage symptoms

A

Frequency
Urgency
Nocturia

24
Q

What is the pneumonic to remember voiding symptoms

A

WIS

  • weak stream
  • intermittency
  • straining
25
Q

After a history, what examination should be performed to examine incontinence

A

supine pelvic examination

26
Q

Following examination what may be performed to investigate incontinence

A

bladder diary

27
Q

Why may a urine dip be performed

A

check for UTI may be causing incontinence. A urine dip should be performed in all women with incontinence

28
Q

When would a urine culture be taken from someone with urinary incontinence

A

If someone has symptoms of an UTI

29
Q

What are 3 other tests may be performed for urinary incontinence

A
  1. Flow rate and PR volume
  2. Pad testing
  3. Urodynamic studies
30
Q

What does a reduced flow rate indicate

A

bladder outlet obstruction or reduced contractibility

31
Q

What is a normal PVR

A

<50ml

32
Q

What is pad testing

A

incontinence pad is taken and weighed to see how much a person is urinating

33
Q

In what type of urinary incontinence may urodynamic studies be indicated for

A

urge incontinence

34
Q

What is first step in management of stress incontinence

A

Kegel exercises

35
Q

What are kegel exercises

A

8 pelvic contractions, 3 times a day for 3 months

36
Q

When is a ring pessary used

A

Evidence of vaginal prolapse

37
Q

What are two other management options for stress incontinence

A

Tension-free vaginal tape

Urethral Bulking Agents

38
Q

What are the two lifestyle measures for urge incontinence

A

Reduce caffeine

Weight loss

39
Q

What should patients do before being started in pharmacotherapy for urge incontinence

A

Complete an incontinence chart for 3 days

40
Q

What is first-line for urge incontinence

A

Bladder training - should be performed for a minimum of 6 weeks

41
Q

What medications may be given for urge incontinence

A

Anti-muscarinics

42
Q

Name an anti-muscarinic given for urge incontinence

A

Tolterodine

43
Q

When is topical oestrogen given

A

Vaginal prolapse

44
Q

When may a B3 adrenergic agonist be given

A

Anti-muscarinics are contraindicated

45
Q

What are 2 surgical management options for urge incontinence

A
  1. Botox

2. Percutaneous sarcal stimulation

46
Q

What are the two broad categories of causes for overflow incontinence

A

Atonic Bladder

Obstruction to flow

47
Q

What may cause an outlet obstruction to urinary flow in males

A

BPH

Bladder outlet obstruction

48
Q

What are 4 causes of atonic bladder

A 
Idiopathic
Iatrogenic
Trauma
Infection
Compressed sacral N
49
Q

What are the storage symptoms of overflow incontinence

A

Frequency
Urgency
Nocturia

50
Q

What are the voiding symptoms of overflow incontinence

A

Weak stream
Intermittency
Straining

51
Q

How does overflow incontinence present

A

Continous/intermittent dribbling of urine when the bladder is full without an urge to urinate

52
Q

How should overflow incontinence be investigated

A

As BPH

53
Q

What is used to treat overflow incontinence

A

Intermittent catheterisation followed by a trial without catheter

+ treat the cause

Geriatrics (5 decks)

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