6 - Urinary Incontinence Flashcards
What is the most prevalent form of incontinence among women?
- stress urinary incontinence
What are the 3 major risk factors for stress urinary incontinence (SUI)?
- childbirth
- aging
- high BMI
What physical exam test is used to assess for SUI?
- cough stress test
What is a reliable way to measure urinary frequency?
- voiding diary
This is the complaint of interruption of sleep one or more times because of the need to void.
- nocturia
This is defined as the involuntary leakage of urine, associated with a sudden compelling desire to void.
- urgency urinary incontinence
What are the 3 primary contraindications for anti-cholinergic drugs?
- narrow angle glaucoma
- gastroparesis
- urinary retention
What are the 3 primary contraindications for B3-agonist drugs?
- uncontrolled HTN
- End stage renal disease
- liver disease
OnabotulinumtoxinA is considered what type of drug?
- FDA pregnancy category C
* no studies in pregnant women
Pessaries are mainly indicated for what condition?
- pelvic organ prolapse
Pelvic organ prolapse (POP) is most common in a patient who has undergone this procedure.
hysterectomy
What quantitative tests are used to assess pelvic organ prolapse (POP)? (2)
- POP-Q or Baden Walker
What are the transient causes of urinary incontinence? (DIAPPERS)
- Delirium
- Infection
- Atrophic vaginitis/urethritis
- Pharmaceutical agents
- Psychological disorders
- Excessive urine output
- Restricted mobility
- Stool impaction
This is defined as the involuntary leakage of urine during increased abdominal pressure, in the absence of a detrusor contraction.
stress urinary incontinence (SUI)
A decrease in this hormone may be the cause of vaginal atrophy.
decreased estrogen
What diagnostic test is used for stress urinary incontinence (SUI)?
- complex urodynamic testing
What is a non-surgical management option for SUI?
pessary with a knob
What is a surgical treatment option for SUI?
mid-urethral sling
*well tolerated and have high success rates
What are the 4 criteria used for diagnosing overreactive bladder?
- urinating 8+ times/day
- waking up >2 times/night
- an overwhelming and sudden need to urinate
- leakage of urine before she’s able to make it to the bathroom
What plexus innervates the bladder?
- inferior hypogastric plexus
What are the 2 pharmacotherapy options for overreactive bladder?
- Antimuscarinics
- B agonist (Mirabegron)
Which antimuscarinics are more useful when continence is desired at specific times?
immediate release antimuscarinics
Which antimuscarinics have been shown to have lower rates of adverse effects than immediate release agents?
extended release antimuscarinics
OnabotulinumtoxinA was first approved for what purpose?
treatment of urinary incontinence in patients with neurologic conditions who have overactivity of the bladder
This is defined as the descent of one or more aspects of the vagina and uterus.
pelvic organ prolapse (POP)
How is the POP-Q stage 2 for pelvic organ prolapse defined?
professor said she only remembers stage 2
- most distal prolapse is between 1 cm above and 1 cm below the hymen
