3.2.1 Urinary and Fecal Incontinence Flashcards
What is the testing for fecal incontinence?
What are some of the options for anti-cholinergics/anti-muscarinics?
Defecation is the result of what? Innervation?
Synchronous relaxation of the external anal sphincter and puborectalis; S3-4
How does the severity of urinary incontinence change with age?
Frequency and volume increase with age
What is peripheral tibial nerve stimulation?
Why is the prevalence of urinary incontinence underestimated?
Less than half of patients report it
What are some sources of fecal incontinence?
How is the surgery onabotulinum toxin performed?
Paralyzes the detrussor, 100 units
Name the urinary incontinence in order of prevalence
Stress > Mixed > Urgency
What are the three surgical options for stress incontinence?
Midurethral slings, bulking agents, pubovaginal slings
What are some of the common side effects of anti-cholinergics?
Dry mouth, constipation, drowsiness, confusion/impaired cognitive function, tachycardia, blurred vision
What are the possible treatments for fecal incontinence?
What is sacral neuromodulation?
Diagram urge urinary incontinence
Bladder is overactive
Initial management of urinary incontinence diagram
What is the definition of fecal incontinence?
What are some of the surgical treatments of urinary incontinence?
What are the risk factors for urinary incontinence?
Parity, obesity, urinary sx, non-hispanic/white, functional impairment
What this be?
sphincteroplasty
What is the most common treatment for stress incontinence?
Structural, so Surgery (S, S, S)
What assessments are included when evaluating fecal incontinence?
Inspect anus for gaping or scarring
Squeeze looking for uniform circular contraction
Anocutaneous relax (rubbing perianal skin)
Palpate sphincter (digital examination)
What is a clinical way to determine severity/frequency of urinary incontinence?
Voiding diary
How does living in a nursing home affect prevalence?
Increases
Is there a correlation b/t urinary and fecal incontinence?
What is the definition of urinary incontinence? Orgins in young and elderly?
Involuntary loss of urine
What are the four classifications of urinary incontinence?
Urge, stress, mixed, overflow
Diagram stress urinary incontinence
Insufficient strength of the closure of the bladder
What are some tests for urinary incontinence?
Bladder stress test/Cough stress test
Lab tests (UA, Urine culture)
PVR (NL <50, Abn >200)
What are the three questionnaires for fecal incontinence?
FIQL, FISI, Wexner score
What is the Birch procedure?
Midurethral sling connected to cooper’s ligament
Using the criteria of 1 leak per year, what % of women leak?
up to 51%
What are the three components of the anal sphincter complex?
Internal/external anal sphincter, puborectalis
What are some of the characteristics of pharmacologic therapies for urinary incontinence: % w/ improvement, adherence, dosage in elderly, time for onset of effects?
What are the pharmacologic methods to treat an overactive bladder?
Anticholinergics, B3 Adrenergics
What this be?
Sphincteroplasty
What is the B3 Adrenergic for urinary incontinence?
Mirabegron (Myrbetriq)
What are some conservative measures in the management of urinary incontinence?
Weight loss, dietary changes, bladder training, pelvic muscle exercises and biofeedback
What this be?
Secca procedure
How does the prevalence of urinary continence change with age?
Increases
What racial groups are at greater risk of urinary incontinence?
White and Mexican > African American
(Lecturer wasn’t too keen on this distinction, thinks that AAs may just not be reporting)
What is the etiology behind each type of urinary incontinence?
