2: Incontinence Flashcards
Describe the prevalence of incontinence?
F > M, institutional settings, older
What % of women experience incontinence at some point between 40-64?
72%
What types of populations also experience incontinence?
Gymnasts, men after prostate surgery
What are causes of incontinence in women?
Weak bladder muscles, overactive bladder, weak pelvic floor, nerve damage, comorbidities, prolapse
What are causes of incontinence in men?
Prostatitis, nerve damage, benign prostate hyperplasia
What are risk factors for urinary incontience?
BMI, age, pregnancy, prolapse, DM, depression, constipation, bladder irritation, loss of ADL skills, impaired cognition, neuro disorders, psychogenic disorders, high impact exercise, tobacco use, UTI
What are the five types of incontience?
- Stress
- Urge
- Mixed
- Functional
- Overflow
Describe stress incontinence
Involuntary loss of urine during physical exertions. Inability to cover come increase in intraabdominal pressure, weakness of pelvic floor musculature
Describe urge incontinence
Detrusor muscle contraction occurs and sensation of bladder fullness is perceived after leakage
What is the primary cause of urge incontinence?
Behavioral training, JIC
Describe mixed incontinence
Combination of stress and urge symptoms
Describe functional incontinence
Leakage due to inability or unwillingness to toilet
Describe overflow incontinence
Urinary retention, decreased or lacking urge, continuous leaking of bladder or incomplete voiding
What are pathologies that can lead to overflow incontinence?
Anatomical obstruction such as prostate enlargement or neurogenic bladder (MS or spinal lesion)
What does OAB stand for?
Overactive bladder
What are the four criteria for clinical diagnosis of OAB?
- Urinary urgency
- Urinary frequency
- Nocturia
- Urgency urinary incontinence
What are the four symptoms of OAB?
- Sudden urge that is hard to control
- Lose urine without meaning to after an urgent need to urinate
- Urinates 8+ times in 24 hrs
- Nocturia more than twice a night
What is urgency anal incontinence?
Involuntary but recognized passage of gas or stool
What is passive anal incontinence?
Unrecognized, leakage of mucus, fluid, or stool
What population is likely to experience AI?
3rd or 4th sphincter following vaginal delivery
What are traumatic causes of anal incontinence?
Obstetric, direct, surgery
What are congenital abnormalities that can cause anal incontinence?
Imperforate anus, Hirschsprung’s disease, spina bifida
What are neurologic causes of anal incontinence?
Stroke, PD, dementia, SCI, cauda equina, pudendopathy, DM
What are colorectal causes of anal incontinence?
Atrophy due to aging, inflammatory bowel diseases, diarrhea, prolapse, rectocele