Female Urinary Incontinence Flashcards
Incontinence types?
Stress Urge - detrusor overactivity/neurological Retention/overflow Functional True - constant leakage
What causes true incontinence?
Rare
Congenital
Fistulas
Urge incontinence cause?
Detrusor overactivity
Neurological incoordination
Idiopathic
Other causes of incontinence?
UTI
Faecal impaction, Meds, immobility
Detrusor overactivity mnemonic?
FUN
Freq
Urgency
Nocturia
Most ppl bladder, how much can hold?
300-500ml
How many times wake per night is too much?
> 2 per night
Urge incontinence describe history?
Sudden urge: run
LARGE volume
Mixed urinary incontinence is?
Urge + stress
Questions to ask in incontinence?
Gynecologic historyhave narrow-angle glaucoma
Meds: anticholinergics, diuretics, antihypertensives
Post menopausal vaginal atrophy affects incontinence how?
Worsens overactive bladder/detrusor overactivity
Doesn’t help in pure incontinence
Investigations
MSU Post-void residual scan Bladder diary/outcome measures Urodynamic: flow Videourodynamics Cystourethroscopy
Risk of stress incontinence in preg?
Forceps
Vaginal
C-section
Term baby with weight can cause
Conservative management of incontinence?
Pelvic floor exercises
Pads
incontinence pessary
Pelvic floor exercises don’t work in?
Bladder neck Sphincter deficiency stress incontinence
If can’t do surgery to correct bladder neck, what can you do?
Peri urethral bulking agent
General advice on incontinence? Lifestyle
1.5L fluids
Avoid ETOH, caffeine, spicy food
Bladder retraining
What drugs to treat incontinence?
Anticholinergics: oxybutinin
TCAs: rare
B3: mirebegron
Summary
Rule out UTI
Conservative
Urodynamics
Surgery
What not to do in mixed incontinence?
Don’t surgery/sling or Botox the stress incontinence part, can make detrusor activity worse.
