Incontinence Flashcards
What is urinary incontinence?
Involuntary passage of urine
What is stress incontinence?
Leakage occurring when intra-abdominal pressure exceeds urethral pressure
What causes stress incontinence?
Weakness of pelvic floor muscles
What are risk factors for stress incontinence?
Post-partum
Constipation
Obesity
Pelvic surgery
What are features of stress incontinence?
Leakage post
- straining
- coughing
- laughing
- sneezing
How is stress incontinence managed?
Pelvic floor training
Duloxetine - SNRI (increases urethral contractions)
Tension free vaginal tape
What is urge incontinence?
Leakage of urine following urge
What is the cause of urge incontince?
Overactive bladder - detrusor overactivity
What are risk factors for urge incontinence?
Stroke
Infection
Malignancy
Cholinesterase inhibitors
How is urge incontinence managed?
Bladder retraining
Oxybutynin - antimuscarinic (inhibit detrusor contraction)
Botulinum toxin A injections
What is overflow incontinence?
Constant leakage of urine due to loss of bladder sensation
Consequence of chronic urinary retention
What is functional incontinence?
When patient is unable to get to the toilet in time
Often related to mobility
What makes up a continence examination?
Bladder + bowel diary Abdo exam + PR Urine dip + MSU External genitalia exam Post micturition bladder scan
What is the first line management for incontinence?
Decaffeinated drinks Good bowel habit Regular oral intake Bladder retraining Pelvic floor exercises
