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Surg Spec (Urology) > Incontinence > Flashcards

Incontinence Flashcards

1
Q

What is the normal range of daytime voids?

A

4 - 7

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2
Q

Up to what age is more than 1 night-time void considered to be abnormal?

A

70 years

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3
Q

What is the most common cause of a neurogenic bladder in women?

A

MS

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4
Q

If the bladder is still palpable after voiding, what type of incontinence is this suggestive of?

A

Overflow

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5
Q

What is the most common cause of overflow incontinence in males?

A

Prostatic enlargement

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6
Q

In all patients with incontinence, a frequency/volume chart should be filled out for at least how long?

A

3 days

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7
Q

Other than a bladder diary, what other investigations should be performed on all patients presenting with incontinence and why?

A

Urinalysis and MC&S to rule out a UTI

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8
Q

Imaging is not routinely used in the investigation of incontinence; however, if it is required, what would be first line?

A

Ultrasound

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9
Q

What investigation should be utilised in individuals with incontinence who have recurrent UTIs, haematuria, suprapubic pain or a suspected fistula or tumour?

A

Cystoscopy

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10
Q

In stress incontinence, leakage from an incompetent urethral sphincter generally occurs when?

A

When there is increased intra-abdominal pressure

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11
Q

The loss of small (but often frequent) amounts of urine when coughing, laughing etc is most suggestive of which type of incontinence?

A

Stress incontinence

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12
Q

If the underlying cause of incontinence is a prolapse, what may be a useful treatment?

A

Pessary

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13
Q

A frequency/volume chart which identifies normal urinary frequency and normal functional bladder capacity is most suggestive of which type of incontinence?

A

Stress incontinence

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14
Q

When are urodynamic studies used in the investigation of stress incontinence?

A

Only when surgery is being considered as a treatment

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15
Q

Other than lifestyle advice, what is the first line treatment for stress incontinence?

A

Pelvic floor exercises

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16
Q

What is the routine of pelvic floor exercises advised by NICE for the treatment of stress incontinence?

A

8 contractions, 3 times daily for at least 3 months

17
Q

If pelvic floor exercises and lifestyle advice fail as treatments for stress incontinence, what is the next line management option?

A

Surgical intervention e.g. mid-urethral tape procedures, injection of bulking agents

18
Q

What is the only pharmacological agent licensed for treating stress incontinence, but is rarely used?

A

Duloxetine

19
Q

Urge incontinence commonly exists alongside what other two symptoms, grouped together to form overactive bladder syndrome?

A

Frequency and nocturia

20
Q

What is the cause of urge incontinence and overactive bladder syndrome?

A

Detrusor muscle hyper-activity

21
Q

A frequency/volume chart showing increased diurnal frequency and nocturia is most suggestive of which type of incontinence?

A

Overactive bladder syndrome

22
Q

When should urodynamic studies be performed in the investigation of urge incontinence/overactive bladder syndrome?

A

If there is doubt of the diagnosis, complex symptoms or medical treatment has failed

23
Q

Other than lifestyle advice, what is the first line management option for overactive bladder syndrome/urge incontinence?

A

Bladder retraining

24
Q

How long should bladder retraining be done for as a first line treatment for overactive bladder syndrome/urge incontinence?

A

6 weeks

25
Q

What group of drugs are used first line in the treatment of urge incontinence?

A

Anti-muscarinics

26
Q

How do anti-muscarinic drugs work in the treatment of overactive bladder syndrome/urge incontinence?

A

Block parasympathetic nerves and relax the detrusor muscle

27
Q

What is the most commonly used anti-muscarinic drug used in the treatment of overactive bladder syndrome/urge incontinence?

A

Oxybutynin

28
Q

Mirabegron is a 2nd line pharmacological agent used in the treatment of overactive bladder syndrome/urge incontinence- what is the mechanism of action of this drug?

A

Beta 3 agonist

29
Q

When should mirabegron be used over anti-muscarinic drugs in the treatment of overactive bladder syndrome/urge incontinence?

A

If you are worried about anti-cholinergic side effects in a frail, elderly person

30
Q

What may be a useful treatment in women with incontinence due to vaginal atrophy?

A

Oestrogen creams or pessaries

31
Q

What is the most common type of urinary incontinence?

A

Stress incontinence

32
Q

Continuous dribbling incontinence is suggestive of what diagnosis? What investigation can be used to confirm this diagnosis?

A

Vesicovaginal fistula - urinary dye studies

Surg Spec (Urology) (8 decks)

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