Exam 1 - Urinary Incontinence (UI) Flashcards
Name the 5 types of urinary incontinence.
1) Stress Urinary Incontinence (SUI)
2) Urge Urinary Incontinence (UUI)
3) Overflow Incontinence (OI)
4) Mixed Incontinence
5) Functional Incontinence
“MUFOS” = the 5 types of UI
M - Mixed incontinence U - Urge urinary incontinence F - Functional incontinence O - Overflow incontinence S - Stress urinary incontinence
Name the UI that is associated with urethral underactivity.
Stress Urinary Incontinence (SUI)
Name the UI that is associated with bladder overactivity.
Urge Urinary Incontinence (UUI)
Name the UI that is associated with urethral overactivity and/or bladder underactivity.
Overflow Incontinence
SUI = urethral _____
SUI = urethral underactivity
UUI = bladder ______
UUI = bladder overactivity
OI = urethral _____ and/or bladder ______
OI = urethral overactivity and/or bladder underactivity
What is the type of UI that is associated with inadequate urethral-sphincter closure under increased intro-abdominal pressure?
SUI
Name the symptoms of SUI.
- Involuntary loss of small volume urine during actions that put pressure on the bladder
- -Exercise, coughing, sneezing, and lifting
What are the risk factors for SUI?
- Female: pg, childbirth, menopause, obesity, cognitive impairment, and aging
- Male (UNCOMMON): prior lower urinary tract surgery of injury
What is the type of UI associated with bladder overactivity filling due to the involuntary detrusor contractions?
UUI
What are the two actions that can occur in UUI?
1) Overactive bladder
2) Detrusor overactivity
What is the more common diagnosis - Overactive bladder or Detrusor overactivity?
OVERACTIVE BLADDER
-Symptom syndrome of urgency and frequency during the day or night with or without UI
T/F: Large amounts of leakage tend to occur in UUI.
TRUE
T/F: OUI is a less common type of UI.
TRUE
What are the symptoms of OUI?
Constant dribble of urine
Frequent urination of small amounts
What happens in OUI?
Bladder full, but cannot empty, thus the dribbling that occurs
What are the common causes of OUI?
- Men: anatomic urethral obstruction (BPH, prostate cancer)
- Women: urethral overactivity from cystocele formation or surgery
- Both: neurologic dysfunction or diseases, spinal cord injury, etc.
What is the most common combination of UI types in Mixed Incontinence?
Urgency and Stress UI (Bladder overactivity and urethral underactivity)
What is the type of incontinence that is not induced by bladder or urethra abnormalities and instead by drugs or pt disease state?
Functional Incontinence
Which UI type has leaking with activity?
SUI
Who is in the at-risk population for urinary incontinence?
- Postpartum women
- Geriatrics
Name the medications that contribute to UI.
- Diuretics, acetylcholinesterase inhibitors
- Alpha receptor antagonists
- Alpha receptor agonists
- Calcium channel blockers
- Narcotic analgesics
- Sedative hypnotics
- Antipsychotic agents
- Anticholinergics
- Antidepressants, TCAs
- Alcohol
- ACE inhibitors
Name the diuretics than can contribute to UI.
Furosemide
Bumetonide
Thiazides (HCTZ)
What do diuretics do to contribute to UI?
Polyuria, frequency, urgency (UUI)
Name the alpha receptor antagonists that can contribute to UI.
Terazosin
Prazosin
Doxazosin
What do alpha receptor antagonists do to contribute to UI?
Urethral relaxation (SUI in women)
Name the alpha receptor agonists that can contribute to UI.
Sudoephedrine
Ephedrine
What do alpha receptor agonists do to contribute to UI?
Urethral constriction (OUI)
What UI do CCBs contribute to?
Urinary retention due to reduced bladder contractility (OUI)
What UI do narcotic analgesics contribute to?
Urinary retention due to reduced bladder contractility (OUI and FUI)
What is the first-line treatment for UI?
NON-SURGICAL, NON-PHARMACOLOGIC INTERVENTION
What med aggravates Stress UI?
Alpha blockers
Name the non-pharmacologic treatment for Stress UI.
- Pelvic floor muscle training (PFMT)
- Fluid management
- Bladder training
- Weight loss in obese pts
- Female: Poise Impressa Bladder/Supports/Pessary
- Male: Penile clamp
What is the drug of choice for Stress UI?
Duloxetine (Cymbalta)
What other drugs can be used to treat Stress UI?
Venlafaxine
Estrogens
Alpha agonists - Phenylephrine, Pseudoephedrine
What is the treatment for UUI?
- Oxybutynin (Ditropan)
- OTC Oxytrol Patch
- Tolterodine (Detrol)
- Fesoterodine (Toviaz)
- Trospium (Sanctura)
What is second line treatment for UUI?
Mirabegron (Mybetriq)
