Female Urinary Incontinence

Question 1

What is meant by; urinary incontinence (UI), stress urinary incontinence (SUI), urge urinary incontinence (UUI) + mixed urinary incontinence (MUI)?

Answer 1

• any involuntary leakage of urine
• ivoluntary leakage on effort or exertion, on sneezing or coughing
• involuntary leakage accomplanied by or immediately preceeded by urgency
• involuntary leakage accompanied by or immediately preceeded by urgency + on effort or exertion, on sneezing or coughing

Question 2

What are the risk factors for urinary incontinence?

Answer 2

• age
• parity
• menopause
• smoking
• medical problems
• inc. intra-abdominal P
• pelvic floor trauma
• denervation
• connective tissue disease
• surgery

Question 3

What are the investigations for urinary incontinence?

Answer 3

• 3 days urinary diary
• fluid intake- quiantity + quality
• urine output
• daytime frequency
• nocturia
• average voided volume
• urine dipstick
• examination
• abdominal
• neuro
• gynaecological
• pelvic floor assessment (Oxford Scale)
• post voiding residual volume assessment
• bladder scanning
• urodynamics
• uroflowmetry
• multichannel cystometry

Question 4

What is the management for urinary incontinence?

Answer 4

• lifestyle changes
• stop smoking
• lose weight
• healthy diet to avoid constipation
• stop drinking alcohol and caffeine
• pelvic floor muscle training
• duloxitine
• surgery
• tension-free vaginal tape (TVT)
• transobturator tape (TOT)
• colposuspension

Question 5

What is overactive bladder syndrome?

Answer 5

• a symptoms complex usually, but not always, related to urodynamically demonstrable detrusor overactivity (DO)
• urgency (with/without urge incontinence), usually with frequency and nocturia

Question 6

What is meant by; urgency, urge incontinence, frequency + nocturia, in regard to OAB syndrome?

Answer 6

• sudden, compelling desire to pass urine that is difficult to defer
• involuntary leakage of urine accomplanied, or immediately preceeded, by urgency
• usually accompanies urgency with or without urge, they void too often by day
• usually accompanies urgency with or without urge incontinence, they have to wake up at night to void

Question 7

What are the risk factors for urge incontinence?

Answer 7

• advanced age
• diabetes
• UTIs
• smoking

Question 8

What is the management for OAB syndrome?

Answer 8

• lifestyle changes
• normalise fluid intake
• dec. caffeine, fizzy drinks, chocolate
• stop smoking
• weight loss
• bladder training programme
• timed voiding with gradually inc. intervals
• antimuscarinic (e.g. solifenacin, fesoteridine)
• tricyclical antidepressants
• botox
• neuromodulation