Incontinence

Question 1

Urinary incontinence

Answer 1

Involuntary leaking of urine

Question 2

Types of incontinence

Answer 2

Stress
Urge
Overflow
Mixed

Question 3

Pressures detected by a

Answer 3

Rectal transducer - ask patient to cough 3 times

Question 4

How is micturition reflex controlled?

Answer 4

Pudendal nerve S2-4

Pelvic para nerves

Question 5

What causes overflow incontinence?

Answer 5

Outflow obstruction

Question 6

Symptoms and signs of overflow incontinence

Answer 6

Huge palpable bladder, painless, can’t get below it
Insensible (no warning signals)
Often wet at night, nocturia
Dribbling

Question 7

Treatment for overflow incontinence

Answer 7

Assess renal function
Treat obstruction - catheter
Rehabilitate bladder - self catheterisation

Question 8

What is urge incontinence?

Answer 8

Frequency, voided in small volumes
Detrusor overactivity
Stress, irritation in bladder (stone), nerve damage
Elderly

Question 9

Symptoms and signs of urge incontinence

Answer 9

Urgency provoked by standing up/tap running/key in door/coughing/laughing
Wet at night

Question 10

Diagnosis of urge incontinence

Answer 10

Urodynamics

Question 11

Treatmetn for urge incontinence

Answer 11

Avoid caffeine, alcohol, fizzy juice
Bladder training
Anti-cholinergic (Oxybutynin)
Botulinum
Surgery

Question 12

Side effect of oxybutynin

Answer 12

Dry mouth

Question 13

Stress incontinence

Answer 13

Weak pelvic floor muscles, after childbirth

Coughing/sneezing

Question 14

Treatment for stress incontinence

Answer 14

Weight loss
Smoking cessation (cough)
Pelvic floor exercises
Duloxetine
Vaginal cone
Surgery - tape

Question 15

Red flags

Answer 15

Blood

Previous radiotherapy

Question 16

Investigations for incontinence

Answer 16

History and exam
Urinalysis (infection)
Bloods (renal impairment)
Bladder chart/diary
Urodynamics