Incontinence

Question 1

A 72-year-old female with a BMI of 30 and a 40 year pack history presents to the clinic with complaints of urinary incontinence since having a stroke two months ago. She reports having a sudden and intense urge to urinate, which is difficult to control and often results in involuntary urine leakage.

Question 2

What type of incontinence does this lady have?

Answer 2

Urgency due to involuntary leakage of urine and an intense urge to urinate which is difficult to control.

Question 3

The doctor suspects that the patient has urge incontinence. What are some of the first line investigations?

Answer 3

Urine dipstick- UTI, haematuria, proteinuria and glucosuria
Frequency-volume chart
Bladder diary
Post-micturition residual volume
Urodynamics

Question 4

You have a look at her bladder diary. What lifestyle interventions could you recommend?

Answer 4

Decrease caffeine intake
Weight loss
Quit smoking

Question 5

What is the difference in the initial management for UUI and SUI?

Answer 5

UUI= bladder training
SUI= pelvic floor muscle training

Question 6

If patients are unsuitable for surgery what other options could you offer them?

Answer 6

• Indwelling catheter
• Sheath device
• Incontinence pads

Question 7

How does oxybutynin work to treat a UUI?

Answer 7

Oxybutynin works by blocking the muscarinic receptors in the bladder, which prevents acetylcholine from binding to these receptors and stimulating bladder contractions. This results in relaxation of the bladder muscle and a decrease in the frequency and intensity of bladder contractions, which can help reduce the symptoms of UUI.