7. Urinary incontinence

Question 1

describe the 3 types of urinary incontinence

Answer 1

1. STRESS URINARY INCONTINENCE (47%)
   - involuntary leakage on effort or exertion, sneezing or coughing
   - due to increased abdominal pressure (pressure on bladder) that overwhelms sphincter muscles
2. URGE URINARY INCONTINENCE (21%)
   - involuntary leakage accompanied by or immediately preceded by urgency, results in frequency and nocturia
   - due to uninhibited detrusor muscle contracting randomly (overactive bladder)
3. OVERFLOW INCONTINENCE
   - probs emptying bladder, due to blockage (eg BPH) or ineffective detrusor muscle… bladder fills up and overflows causing leakage through sphincters
   - results in slow stream, intermittency/hesistancy and straining

Question 2

suggest possible causes for stress urinary incontinence as well as possible treatments

Answer 2

Causes:

• pregnancy and labour
• menopause (decreased Oe causing mucle weakness)
• obesity

Treatment:
- strengthening EUS with Kegel exercises

Question 3

suggest possible causes for urge urinary incontinence as well as possible treatments

Answer 3

Causes:

• cystitis (inflammation of bladder epithelium)
• CNS problems, eg MS, stroke and Parkinson’s

Treatment:

• bladder training with schedule of voiding
• medication:
  
  • B3 R agonists (promote detrusor relaxation)
  • M3 R antagonists (prevent detrusor contraction)