Incontinence

Question 1

Types of urinary incontinence

Answer 1

stress urinary incontinence
urge urinary incontinence
mixed urinary incontinence
overflow urinary incontinence

Question 2

What causes stress urinary incontinence?

Answer 2

increased abdominal pressure under stress (weak pelvic floor muscles)

Question 3

What causes urge urinary incontinence?

Answer 3

involuntary contraction of the bladder muscles

Question 4

What causes overflow incontinence?

Answer 4

due to blockage of urethra (bladder outlet obstruction or underactive bladder)

Question 5

What causes neurogenic incontinence?

Answer 5

disturbed function of nervous system

Question 6

Causative factors of stress urinary incontinence

Answer 6

increasing age
pregnancy and vaginal delivery
prolapse/hysterectomy
constipation
obesity
drugs = ACE-is, antidepressants, antihistamines, antimuscarinic

Question 7

What is the severity index for urinary incontinence?

Answer 7

questionnaire of 2 items which assess the frequency (4 levels) and amount (3 levels) of urine leakage

Question 8

What grading system assesses pelvic floor muscle contraction?

Answer 8

modified oxford grading system

Question 9

Urinary incontinence investigation

Answer 9

urinalysis + urine culture
bladder stress test
pad test
xrays or ultrasound
urodynamics
electromyogram (EMG)
cytoscopic exam
cystourethrogram

Question 10

Complications of chronic urinary incontinence

Answer 10

skin problems - rashes, infections, sores
UTIs

Question 11

Who are more likely to have faecal incontinence?

Answer 11

age >65
not physically active
certain chronic diseases, medical conditions or health problems
had gallbladder removed
current smoker

Question 12

Types of faecal incontinence

Answer 12

urge faecal incontinence
passive faecal incontinence

Question 13

Faecal incontinence investigations

Answer 13

bloods - inflammation, anaemia, infection
stool tests
urine tests

bowel function tests:
- anorectal manometry
- defecography
- electromyography

endoscopy:
- anoscopy
- colonoscopy
- flexible sigmoidoscopy
- rectoscopy

imaging:
- lower GI series
- MRI
- US

Question 14

Faecal incontinence treatment

Answer 14

incontinence products
dietary changes - water, avoid alcohol + caffeine, avoid sweeteners like sorbitol
medicine - loperamide if diarrhoea, laxatives if constipated
pelvic floor exercises
bowel retraining
surgery