Incontinence Flashcards
why is female incontinence more common?
only have 1 sphincter
men have 2
1st part of micturition cycle?
storage/filling phase
the detrusor muscle is ___ during the filling phase
relaxed
the detrusor muscle is ___ during the emptying phase
contracted
the micturition centre is located in what area of the spinal cord?
S2-S3
what does the micturition centre do to the autonomic nerves when you are going to pee?
increases parasympathetic control to detrusor
decreases sympathetic control to detrusor
when the detrusor muscle is excited by parasympathetics in the micturition reflex, what happens?
sends efferent signals urethral sphincter telling it to relax
what do stretch receptors do?
send signal to the micturition centre in the pons when bladder is full which will send neurons to the detrusor and sphincter when it is timely to urinate
name the 2 micturition centres?
S2-3 in spinal cord
pons
extra-urethral causes of incontinence?
fistula
ectopic ureter
name the 4 kinds of incontinence?
urge
stress
mixed
overflow
medical term for bedwetting?
nocturnal enuresis
what causes overflow incontinence?
bladder outflow obstruction
neurological causes of incontinence
parkinsons
MS
stroke
spinal injury
how do you assess urgency?
ask what brings it on eg water, cough
what bladder problem could cause urge incontinence?
detrusor overactivity
how is detrusor overactivity diagnosed?
urodynamics
cause of stress incontinence?
increased intraabdominal pressure
Tx of overflow incontinence?
catheterise
treat obstruction
Tx of urge incontinence?
retrain bladder
antimuscarinics
botox injection
surgery
what drugs can cause urinary incontinence?
diuretics
sedatives
max flow rate is higher in what gender and why?
women because there is less resistance (less sphincters)
detrusor pressure is normal in __ incontinence
stress
Tx of stress incontinence?
pelvic floor exercises
duloxetine
surgery
85 yr old with bed wetting?
overflow incontinence
