female urinary incontinence

Question 1

What does the sympathetic innervation of the bladder do and which nerve controls it

Answer 1

Hypogastric nerve (T10-L2)

• causes relaxation of the detrusor muscles and constriction of the sphincters to store the urine

Question 2

What is the parasympathetic innervation of the bladder and what does it do

Answer 2

Pelvic splanchnic nerves (S2-4)
It contracts the detrusor muscle and relaxes the urinary sphincters

Question 3

What is urinary incontinence

Answer 3

Involuntary leakage of urine

Question 4

What is stress urinary incontinence

Answer 4

Involuntary leakage of urine on exertion such as a cough

Question 5

What is urge urinary incontinence

Answer 5

Involuntary leakage as well as urgency

Question 6

What is mixed urinary incontinence

Answer 6

Involuntary leakage of urine with urgency and on exertion such as a cough

Question 7

What are the risk factors for urinary incontinence

Answer 7

• Age
• pregnancy
• Parity
• Menopause
• Smoking
• Pelvic floor trauma
• Surgery
• Catheterisation

Question 8

What are the lifestyle changes advised to help with urinary incontinence

Answer 8

• Normalise fluid intake
• Reduce caffeine, fizzy drinks and chocolate
• Stop smoking
• Weight loss
• Avoid constipation

Question 9

What is the treatment for urinary incontinence

Answer 9

• Pelvic floor muscle training
• Duloxetine - used for stress urinary incontinence
• Anticholinergics and antimuscarinic - solifenacin or fesoteridine
• Beta3 agonist spasmodic - Mirabegron
• Imipramine - Tricyclic antidepressant