BOO and urinary incontinence Flashcards
what is bladder outflow obstruction (BOO)
blockage at base/ neck of bladder that stops/ reduces urine flow
what are causes of bladder outflow obstruction
BPH, prostate cancer, urethral stricture/ scar tissue, prostate cancer, bladder stones
what are symptoms of BOO
increased frequency, increased urgency, nocturia, hesitancy passing, poor flow, incomplete emptying, dribbling, bed wetting
what are red flags for bladder cancer
haematuria, suprapubic pain, recurrent UTIs
what investigations can be done for BOO
IPSS questionnaire, frequency chart, urinalysis, renal USS, cystoscopy, USS
what management is given to relax the prostate
alpha blockers eg tamsulin
what management is given to shrink the prostate
5-alpha reductase inhibitors
what muscle relaxants are given to inhibit smooth muscle contraction of the bladder
anti-cholinergics and beta blockers
what pressures act on the bladder (4)
intrvesical pressure, abdo pressure, urethral pressure and atmospheric pressure
what happens in the voiding stage of micturition
detrusor contracts (increases intravesicle pressure) urethra relaxes
what are symptoms of urge incontinence
desperate, urgent need to go to the toilet, daytime frequency, can cause involuntary enuresis (small volumes)
what can trigger urge incontinence
knowing you are close eg putting key in the door
what causes urge incontinence
detrusor contracting when it shouldnt - UTIs, diabetes, stress, neurological damage to S2,3 eg pelvic surgery
what is seen in urodynamics of urge incontinence
detrusor pressure and intravesical pressure increase - detrusor overactivity (coughing does not cause)
what is overactive bladder syndrome
urgency +/- incontinence
what are symptoms of overactive bladder syndrome
nocturia, urge and polyuria
what non-medical management can be done for urge incontinence
diet: avoid caffeine, bladder rehab
what medical management can be done for urge incontinence
antimuscarinics eg oxybutyin, B3 agonists eg mirabegron, bladder pacemaker, surgery
what is stress incontinence
leaking of urine due to increases intra-abdo pressure and failure of pelvic floor
what are the symptoms of stress incontinence
wet when coughing, exercise or sneezing, small leakage
how do you diagnose stress incontinence
urodynamic studies
what can cause stress incontinence
damage to pelvic floor/ urethral function eg childbirth, surgery, obesity, diabetes
what non-medical management can be done for stress incontinence
weight loss, no smoking, pelvic floor exercises
what medical management can be done for stress incontinence
SNRI eg duloxetine
