B section Questions

Question 1

Compare and contrast stress and urge incontinence.

Answer 1

If urine leaks out when you jump, cough, or laugh, you may have stress incontinence

Any physical exertion that increases abdominal pressure also puts pressure on the bladder.

In more severe cases, the pressure of a full bladder overcomes the body’s ability to hold in urine. The leakage occurs even though the bladder muscles are not contracting and you don’t feel the urge to urinate.

Stress incontinence occurs when the urethral sphincter, the pelvic floor muscles, or both these structures have been weakened or damaged and cannot dependably hold in urine.

Many experts believe that women who have delivered vaginally are most likely to develop stress incontinence because giving birth has stretched and possibly damaged the pelvic floor muscles and nerves. Generally, the larger the baby, the longer the labor, the older the mother, and the greater the number of births, the more likely that incontinence will result.

Age is likewise a factor in stress incontinence. As a woman gets older, the muscles in her pelvic floor and urethra weaken, and it takes less pressure for the urethra to open and allow leakage. Estrogen can also play some role, although it is not clear how much. Many women do not experience symptoms until after menopause.

Lung conditions that cause frequent coughing, such as emphysema and cystic fibrosis, can also contribute to stress incontinence in both men and women.

Question 2

Two types of stress incontinence?

Answer 2

In urethral hypermobility, the bladder and urethra shift downward when abdominal pressure rises, and there is no hammock-like support for the urethra to be compressed against to keep it closed.

In intrinsic sphincter deficiency, problems in the urinary sphincter interfere with full closure or allow the sphincter to pop open under pressure.

Question 3

Overactive bladder (urge incontinence)

Answer 3

If you feel a strong urge to urinate even when your bladder isn’t full, your incontinence might be related to overactive bladder, sometimes called urge incontinence.

Question 4

Overactive bladder can result from

Answer 4

hysical problems that keep your body from halting involuntary bladder muscle contractions. Such problems include damage to the brain, the spine, or the nerves extending from the spine to the bladder — for example, from an accident, diabetes, or neurological disease. Irritating substances within the bladder, such as those produced during an infection, might also cause the bladder muscle to contract.

Question 5

In addition, infections of the

Answer 5

urinary tract, bladder, or prostate can cause temporary urgency. Partial blockage of the urinary tract by a bladder stone, a tumor (rarely), or, in men, an enlarged prostate (a condition known as benign prostatic hyperplasia, or BPH) can cause urgency, frequency, and sometimes urge incontinence. Surgery for prostate cancer or BPH can trigger symptoms of overactive bladder, as can freezing (cryotherapy) and radiation seed treatment (brachytherapy) for prostate cancer.

Question 6

Clinical features - IBS

Answer 6

Nausea, reflux, early satiety
Passing of mucus, abdominal bloating
Extraintestinal symptoms
Generalized somatic symptoms (e.g., pain or fatigue, as in fibromyalgia)
Disturbed sexual function
Dysmenorrhea
Increased urinary frequency and urgency