8.2 Urinary incontinence Flashcards
define overactive bladder and symptoms
frequent and sudden urge to urinate that may be difficult to control
-urgency
-nocturia
define functional incontinence
physically cant get to the toileting time e.g. immobility
how can menopause be a risk factor for UI?
lower oestrogen so pelvic floor tone worse, also atrophy of genitals
why could lots of tea/coffee/alcohol be a risk factor for UI?
diuretic effect
ways to examine someone with UI presentation
-BMI
-abdo exam (palpable bladder?)
-S2-4 dermatomes to exclude neurolpgical
-digital rectal exam in males
-external genital stress test in females
-vaginal exam
if big volume if frequency volume chart, what should you suspect?
diabetes
pad test
dye changes colour with urine
simply, how is urodynamic testing done?
void, catheterise, measure residual volume
risk of contained continence
UTI
mechanism of action of duloxetine
prolongs bladder relaxation and closure of IUS
in females, why might you do temporary intention surgery for UI?
if further pregnancies planned
how could botulism toxin be used to treat UUI?
inhibits release of ACh so bladder stays relaxed
when would enuresis be considered abnormal? cause?
involuntary bed wetting in children aged >5 at least 2x per week with no CNS defects
insufficient ADH
management of primary enuresis in children without daytime symptoms
reassurance, reward system
desmopressin if doesn’t work
management of primary enuresis in children without daytime symptoms
refer to secondary care (usually disorders of lower urinary tract)
