Incontinence Flashcards
1
Q
epidemiology
A
200m worldwide (~1 in 30); F >M 40% of women >60y; overall 25-45% men 5-39% increases with age: YA 20-30%, middle-age 30-40%, elderly 30-50% urinary/double: 57% HCE, 29% RH, 63% NH faecal 3/4%; catheter 17/4/13%
2
Q
types - transient
A
DIAPPERS
delirium, infection, atrophy, pharma, psych, excess urine, reduced mobility, stool
3
Q
types - established
A
DOUSE
detrusor instability, OAB/overflow, urge, stress, everything else (cognitive, mobility, neuro)
4
Q
pathophysiology
A
weak outlet (EUS, PFM, meds) bladder pressure BOO fistulae function/cognitive/affective
5
Q
definitions
A
detrusor overactivity: spontaneous contraction while filling
overactive bladder: urgency + urge incontinence
overflow incontinence: constant
urge incontinence: desire + involuntary
stress incontinence: pressure/IAP
6
Q
impact
A
fear of going out smell/hygiene nocturia and sleep, QoL and Fx £354m cost per year: direct and indirect (e.g. wages) emotional impact: depp/anx falls, pressure sores, infections ^Ax/CH
7
Q
management
A
MDT/non-pharma: training, PFM exercises, continence advisor
education: weight, drinks, food
meds: anti-ACH, duloxetine (SNRI), med r/v, laxatives, vaginal Oe
surgery: TVT, cystoplasty, CS, bulking
8
Q
symptoms
A
'LUTS': nocturia, OAB, urge/stress, detrusor overactivity nocturnal polyuria/nocturia urgency hesitancy
9
Q
add more LO?
A
add
