Incontinence

Question 1

Give 10 common causes of urinary incontinence

Answer 1

Diabetes
Pregnancy and childbirth
OAB 
Enlarged prostate 
Weak bladder muscles
Weak sphincter muscles 
UTIs 
Parkinson’s/ MS 
Spinal cord injury 
Constipation

Question 2

If a patient comes with incontinence how would you investigate then

Answer 2

Fullurinary tract US and uroflowmetry to check if incomplete voiding

Question 3

Investigate stress incontjnence

Answer 3

Multichannel filling and voiding custometry

Urodynamics

Question 4

What are the main causes of urge incontinence

Answer 4

Detrusor contracts and signals need to urinate even when not full
Usually damage to the brain spine or nerves extending from spine to bladder I.e. diabetes trauma neurological disease

Question 5

Treat stress

Answer 5

Pelvic floor muscle training

2 nd line duloxetine

Question 6

Treat urge

Answer 6

Bladder training first line
Can give anyicholinefgics (oxybutylin)
Or mirabegron (beta 3 agonist)

Question 7

How does overflow occur

Answer 7

Occurs either when something blocks urine from flowing (BpH tumour gallstones fissure prolapse)
Or bladder can’t sense when it’s full like diabetes or CVD or nerve damage

Question 8

Diagnose overflow

Answer 8

Post voidal residual volume by bladder scan

Urodynamics