Incontinence Flashcards
What number is acceptable for a postvoid residual volume?
<150
How do you assess for urethral mobility and what degree is considered abnormal?
Q tip test
> 30 degrees deviation is abnormal
When should you perform cystoscopy when you’re evaluating for urinary incontinence?
Microscopic hematuria
Acute onset or refractory urge incontinence
Recurrent UTIs
Suspicion for fistula or foreign body
What type of urinary incontinence is it when you have uncontrolled contractures of detrusor muscle leading to urgency?
Detrusor instability aka urge incontinence
What type of urinary incontinence is it when you have a strong urge to void at small bladder volumes?
Urge incontinence
What is the initial treatment for urge incontinence ?
– Avoiding bladder irritants like caffeine or alcohol
- Timed voiding and bio feedback
One medication can be used for Detrusor instability?
Anticholinergics
What receptor do anticholinergics work on to treat urge incontinence?
M3 muscarinic receptors
What is the absolute contraindication to using anti-cholinergics for detrusor instability
Acute angle glaucoma
What would the cystometrogram look like on a patient with urge incontinence?
Detrusor contraction with no concomitant increase and abdominal pressure
What is Mirabegrom used to treat?
Urge incontinence
When do you see urine flow with stress incontinence?
with increased abdominal pressure
When do you see urine flow with detrusor instability?
with increase pressure in the detrusor
What type of urinary incontinence frequently has nocturia?
Detrusor instability
What does the cystometrogram look like for a patient with detrusor instability?
Detrusor contraction with no concomitant increase in abdominal pressure
What is the initial treatment for detrusor instability?
LIFE STYLE CHANGES: avoid bladder irritants (caffeine, alcohol); timed voiding and biofeedback
What medication is used in detrusor instability?
Anticholinergics (target M3 muscarinic receptors to limit side effects)
What is the absolute contraindication in using anticholinergics?
Acute angle glaucoma
What kind of medication is Mirabegron?
Beta agonist ( activates beta 3 adrenergic receptor
What type of incontinence is Mirabegron used for?
Detrusor instability
What are the adverse events seen with mirabegron?
Tachycardia, headache, diarrhea
What conditions is mirabegron not recommended in?
Severe HTN, end-stage renal disease, liver impairment
When can you use intravesical botulinum toxin?
For detrusor instability
What’s the primary risk with intravesical botulinum toxin?
Urinary retention
