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Renal SOH > Incontinence > Flashcards

Incontinence Flashcards

1
Q

Definition

A

Any involuntary leakage of urine

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2
Q

Why does it arise?

A

Problems with the sphincter

Overactive detrusor muscle

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3
Q

Incontinence is more common in males. True or false?

A

False

- females

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4
Q

Risk factors

A 
Woman 
Caucassian 
Neurological problems 
Anatomical variations
Pelvic surgery 
Radiotherapy
Diabetes
Smoking - due to coughing
Obesity 
UTI 
Increased fluid intake 
Previous childbirth
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5
Q

Clinical features

A

Voiding symptoms

  • poor flow
  • splitting or spraying of stream
  • hesitancy
  • straining
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6
Q

Examination

A

Painless palpable mass arising from pelvis
Cant get below it
Dull percussion
PR exam

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7
Q

Investigations

A

Urinalysis
Uroflometry
Pad test
Bladder diary (3 day)

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8
Q

What does uroflometry measure

A

How much urine you pass and how quickly

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9
Q

What should a bladder diary quantify

A

How many times you have went to the toilet

How much you have passed

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10
Q

Investigation if there are abnormalities in the bladder

A

Cystoscopy

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11
Q

Which investigation do you do to diagnose detrusor over-activity?

A

Urodynamics

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12
Q

Who gets urodynamics?

A

An patient with incontinence who is going for surgery

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13
Q

Name 4 types of incontinence

A

Urge incontinence
Stress incontinence
Mixed U+S incontinence
Overflow incontinence

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14
Q

What is nocturnal enuresis

A

Bed wetting at night

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15
Q

Urge incontinence - definition

A

Involuntary leakage of urine accompanied by or immediately preceded by urgency (sudden desire to void)

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16
Q

Urge incontinence - cause

A

Overactivity of the detrusor muscle

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17
Q

Urge incontinence - clinical frequency

A 
Daytime frequency
Small voided volumes 
Urgency 
Provoking symptoms
- sound of running water 
- standing up
18
Q

Urge incontinence - Management (lifestyle)

A

Avoid caffeine

Decrease fluid intake

19
Q

Urge incontinence - management

A 
Bladder retraining 
- holding in pee
Antimuscarinics
- work on M2 and M3 receptors to block detrusor contraction
Beta 3 andrenergics
Botox
Surgery
20
Q

Give 2 examples of anti-muscarinic medication used in urge incontinence?

A

Oxybutynin

Tolterodine

21
Q

Give an example of bet 3 adrenergic medication for urge incontinence?

A

Mirabegron

22
Q

Stress incontinence - definition

A

Invuluntary leakage of urine due to increased abdominal pressure

23
Q

In stress incontinence the bladder is not strong enough - true or false?

A

True

24
Q

Stress incontinence - causes

A

Damage to pelvic floor or urethral function

  • childbirth
  • coughing
  • laughing
  • sneezing
25
Q

Stress incontinence - investigations

A

Urodynamics

26
Q

Stress incontinence - lifestyle management

A

Decreased fluid intake
Stop smoking (cough)
Manage chronic cough
Weight loss

27
Q

Stress incontinence - management

A

Pelvic floor exercises
- to invrease sphincter contractility

Serotonin (5-HT) and norepinephrine reuptake inhibitor (doluxetine)

Surgery - inject bulking agents

28
Q

Overflow incontinence - definition

A

Build up of urine which eventually overflows

29
Q

Overflow incontinence is due to a problem with the detrusor muscle. true or false?

A

True

30
Q

Overflow incontinence - causes

A

Bladder outflow obstruction

31
Q

Overflow incontinence - who gets it ?

A

Elderly patients

32
Q

Overflow incontinence - clinical features

A

Bed wetting
Huge palpable bladder
Chronic retention

33
Q

Overflow incontinence can be linked with renal impairment - true or false?

A

True

- pressure inside the bladder is too high and there is reflux back into the kidneys (hydronephrosis)

34
Q

Overflow incontinence - investigations

A

Assess renal function

- look for signs of hydronephrosis

35
Q

Overflow incontinence - management

A

Treat obstruction

Catheterise patient

36
Q

Name 2 types of incontinence associated with extra-urethral route

A

Ectopic ureter

Fistula

37
Q

Ectopic ureter usually occurs with a duplex kidney. True or false?

A

True

38
Q

Ectopic ureter is congenital/acquired?

A

Congenital

39
Q

Ectopic ureter - clinical features

A

Antenatal hydronephrosis

40
Q

Fistula - cause

A

Prolonged obstructed labour

Renal SOH (25 decks)

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