Female Urinary Incontinence Flashcards
What are the 2 parts of the urinary tract?
- Upper urinary tract
- Ureters and kidneys
- Low pressure distensible conduit with intrinsic peristalsis
- Transports urine from nephrons via ureters to bladder
- Lower urinary tract
- Bladder and urethra
- Bladder fills at rate of 0.5-5mls/min
- Low pressure storage of urine
What is the upper urinary tract composed of?
- Ureters and kidneys
What is the lower urinary tract composed of?
- Bladder and urethra
The bladder fills at what rate?
- Bladder fills at rate of 0.5-5mls/min
What nerves supply the bladder?
How does the bladder accomodate increasing volume at constantly low pressure?
- Accommodates increasing volume at constantly low pressure by inhibition of contractions by giving gradual awareness to filling
- Cortical activity to allow this, activates reciprocal guarding reflex by Rhabdosphincter contraction, increasing sphincter contraction and resistance
- Activates sympathetic pathway and reciprocal inhibition of parasympathetic pathway, mediates contraction at bladder base and proximal urethra
How is bladder emptying achieved?
- Requires detrusor contraction, urethral relaxation, sphincter co-ordination, absence of obstruction or shunts
- Cortical activity
- Pontine micturition centre
- Activation of parasympathetic pathway and inhibition of sympathetic pathway
What is urinary incontinence (UI)?
Any involuntary leakage of urine
What is stress urinary incontinence (SUI)?
- Involuntary leakage on effort or exertion, on sneezing or coughing
What is urge urinary incontinence (UUI)?
- Involuntary leakage accompanied by or immediately preceded by urgency
What is mixed urinary incontinence (MUI)?
- Involuntary leakage accompanied by or immediately preceded by urgency and on effort or exertion, or on coughing or sneezing
What are the different kinds of urinary incontinence?
- Urinary incontinence (UI)
- Any involuntary leakage of urine
- Stress urinary incontinence (SUI)
- Involuntary leakage on effort or exertion, on sneezing or coughing
- Urge urinary incontinence (UUI)
- Involuntary leakage accompanied by or immediately preceded by urgency
- Mixed urinary incontinence (MUI)
- Involuntary leakage accompanied by or immediately preceded by urgency and on effort or exertion, or on coughing or sneezing
What is the aetiology of female urinary incontinence?
- Anatomical defect in the anterior vaginal wall and pubo-urethral ligament
What is the prevalence of female urinary incontinence?
- 10-25% of woman age 15-60
- 15-40% of woman over 60
- Prevalence increases with age
What are risk factors for female urinary incontinence?
- Age
- Parity
- Menopause
- Smoking
- Medical problems
- Increased abdominal pressure
- Pelvic floor trauma
- Denervation
- Connective tissue disease
- Surgery