Bladder disorders Flashcards
what part of the ANS moderates urine storage?
sympathetic
what nerve keeps the striated external sphincter contracted?
pudendal
bladder emptying is mediated by what part of the ANS?
parasympathetic
- urge incontinence
- overflow incontinence
these are due to dysfunction at what level?
bladder
what are two causes of urge incontinence?
- detrusor overactivity
- poor detrusor compliance
- stress incontinence
- intrinsic sphincter deficiency
these are due to dysfunction at what level?
outlet
what is the cause of anatomic stress incontinence?
mobility of bladder neck
what is the cause of intrinsic sphincter deficiency?
bladder neck dysfunction
mixed incontinence is a combination of _______ incontinence and ________ incontinence
urge, stress
what are the potentially reversible, transient causes of urinary incontinence?
Delirium Infections Atrophic vaginitis Pharmaceuticals Excessive urine output Restricted mobility Stool impaction
- involuntary urine leak accompanied by or immediately preceded by a strong, sudden desire to urinate
- occurs when bladder pressure overcomes sphincter mechanism
urge urinary incontinence
- intermittent involuntary bladder contractions
- may be idiopathic or neurologic
detrusor overactivity
- incremental rise in pressure as bladder volume increases
- due to loss of viscoelastic properties or disruption of neurogenic regulation
poor compliance
what are the medications for OAB / urge incontinence treatment?
- anticholinergics
- beta 3 agonists
- vaginal estrogen therapy
anticholinergics are contraindicated if the patient has what condition?
narrow angle glaucoma
what is the general cause of overflow incontinence?
bladder outlet obstruction or poor contractility
definition: stress incontinence
involuntary urine leak with any sudden increase in abdominal pressure
what are the two types of stress incontinence?
- true anatomic
- intrinsic sphincter deficiency
is there medication to help stress incontinence?
no
what is required for diagnosis of a UTI?
- pathogens
- symptoms and/or inflammatory response
infection in a healthy patient with normal GU tract
uncomplicated UTI
infection associated with factors that increase chance of acquiring bacteria and decrease efficacy of therapy
complicated UTI
what are the causes of a complicated UTI?
- abnormal GU tract (BPG, stone)
- immunocompromised
- MDR bacteria
what medications are used for a UTI?
- TMP-SMX
- fluoroquinolone
what is the suggested etiology for bladder pain syndrome?
- increased mast cell concentration in bladder (histamine release)
- deficiency in protective glycosaminoglycan layer in urothelium
how is the significance and diagnosis of UTI made?
urine examination AND clinical picture of illness