Female incontinence Flashcards
how is female urinary incontinence diagnosed?
history
clinical examination
assessment i.e. QOL, urinary diary, fluid intake etc
investigations (only if suspicion of underlying problem) i
- urinalysis - MSSU, urine dipstick
- post voiding residual vol assessment
- urodynamics
what are the risk factors for urinary incontinence?
female menopause pregnancy , parity increasing age pelvic floor trauma pelvic floor surgery denervations smoking cognitive tissue disorder
what are the treatment options for urinary incontinence?
lifestyle: stop smoking & alcohol, weight loss, exercise, avoid constipation
physiotherapy - pelvic floor exercises
medical - duloxetine
surgical - tension-free vaginal tape & colposuspension
what are the presenting symptoms of urinary incontinence?
irritation:
- urgency
- frequency (>7/day)
- nocturia
- dysuria
- haematuria
incontinence:
- stress
- urgency
- coital
voiding:
- straining
- poor flow
- incomplete emptying
- recurrent UTI
what is the nerve innervation responsible for the voiding of urine?
parasympathetic (S2-S4) - innervates the internal sphincter and detrusor muscle
autonomic via pudendal nerve (S2-S4) innervates the external sphincter
what is the nerve innervation responsible for the inhibition of voiding?
sympathetic T10-T12 via hypogastric nerve which innervates the detrusor muscle and internal sphincter
what is an over active bladder?
clinical syndrome consisting of:
- urgency
- urge incontinence
- frequency
- nocturia
what are the treatment options for over active bladder syndrome?
lifestyle management: reduce fluid intake, avoid fizzy drinks, avoid caffeine etc
bladder training programme
medical:
anti muscarinics & tricyclic antidepressants
botox
neuromodulation
what are the risk factors for urge incontinence/ active bladder syndrome?
advancing age
diabetes
UTI
smoking
what medication is used to treat urinary incontinence?
duloxetine
what medication is used to treat urge incontinence?
anti muscarinics
tricyclic antidepressants
botox
neuromodulation
