Incontinence Flashcards
what increases risk of inconteience
women
age
multi parity
age related bladder changes
bladder capacity decline
increase in residual urine
involuntary bladder contractions
what causes atrophic vaginitis and urethritis? can lead to UTI and urgency incontinence
low estrogen
Prostatic enlargement often causes what in men?
Overflow types of incontinence
2 types of inconteinence
Reversible and non-deversible
what is DRIP? (reversible incontinence)
Delirium
restriction mobility/ retention
infection/ infalm/ impaction
polyuria/ polypharm
what can cause osmotic diuresis, increased urine output?
Hyperglycemia
urethral spinchter is weakened so that transient increases in intra-abdominal pressure raise the bladder pressure to levels that excessed urethral resistance
stress incontinence
momentary leakage of small amount of liquid with coughing, laughing, sneezing. Not associated w/ a desire to urinate.
stress incontinence
Detrusor contractions stronger than normal and overcome the normal urethral resistance. Usually a small bladder. Caused by cortical inhibition, hyper excitability of sensory pathway, deconditioning of voiding refluxes.
Urge incontinence
detrusor contraction insufficient to overcome urethral resistance. large bladder. can be due to BPH, tumor. associated w/ peripheral nerve dz at sacral level
Overflow incontinence
functional inability to get to the toliet in time.
Functional incontinence
what type of incontinence do you not use anticholinergics for.
Overflow incontinence
What two types of incontinence have initiating events? (cough, laugh, sneeze, walking)
Stress
Overflow
Does urge incontinence have high or low volume?
high
What type of incontinence has a large bladder?
overflow
What is an example of alpha-adrenergic agonist used to treat mild stress?
pseudophedrine
Oxybutynin, tolterodine, trospium are what?
Anticholinergic agents to treat urge
What are tricyclic antidepressants for?
Mixed, stress and urge
What is estrogen deficient related to?
stress and urge
If does not resolve within ____ weeks = chronic, established incontinence
6
The Q-tip test and the Bonney (Marshall) test are associated with
Stress incontinence
Treatment for stress incontinence
Kegel Estrogen (only if postmenopausal) Duloxitine – serotonin/norepinephrine reuptake inhibitor Surgery Pessary Diapers/incontinence pads
What are sensory causes of urge incontinence?
infection or inflammation
What is the goal of pharm for urge incontinence?
relax smooth muscle at base (trigone) of bladder or block the involuntary bladder contractions
What are 5 drugs for overflow incontinence?
tricyclics, narcotics, tranquilizers, CCB, anticholinergics
What incontinence can’t be treated with meds?
functional incontinence
What are irritative symptoms?
urinary frequency, urgency, nocturia
