Incontinence Flashcards
Functional incontinence
Non-urinary causes, such as knee arthritis, stops them from making it to toilet in time
Stress incontinence RFs
Obesity
Age (post menupause)
Pregnancy
Urge incontinence triggers
Latchkey incontinence
Cold
Sound of running water
Drinks (coffee, tea, cola)
Stress incontinence rx
Pelvic floor exercise (8 contractions, 3*day, 3 months)
Intravaginal electrical stimulation
Duloxetine
Surgery
Surgical options for stress incontinence
Bulking of urethra
Vaginal tape
Urge incontinence conservative rx
Incontinence diary for 3 days
Bladder retraining
Wt loss
Absorbant pads or condom catheters!
Bladder retraining
Go when you dont need to
Try and not to go when you get urges
Have voiding schedule
Gradually extend times between voiding
When get urges, calm down and make it go away using your brain
Meds for detrusor overactivity/urge
1st line: Tolterodine
2nd line: Mirabegron
(Topical E2, Botox, Gabapentin, Desmopressin)
Antimuscarinics examples for urge incontinence
Tolterodine
Solifenacin
Trospium (M3)
Fesoterodine (M3)
Mirabegron mech of action
B3 agonist
PTNS
used for urge
percutaneous posterior tibial nerve stimulation
S2-S4 nerve stimulation of dont like botox
Every 3months
Gabapentin use in incontinence
modulation of afferent input from bladder
Desmopressin use in incontinence
nasal spray used at night, causes fluid retention, so helps with nocturia (worseining the incontinence)
Surgery for urge
Clam ileocystoplasty
cut bladder in half, sew in 25cm of ileum (how the hell does this help!!)
