Lesson 10: Extraurethral Incontinence

Question 1

Pathology

Answer 1

Constant leakage of urine caused by urine bypassing sphincter mechanism

Leakage unresponsive to behavioral or Rx therapy

Question 2

Etiology

Answer 2

Fistula creating abnormal opening between bladder and adjacent organs
- Caused by obstructed labor, pelvic malignancy, radiation, or pelvic sx
- Vesicovaginal = between bladder and vagina
- Vesicocutaneous = between bladder and skin

Ectopic ureter that bypasses sphincter

Question 3

Presentation

Answer 3

• Constant leakage of urine
• No sense of bladder filling
• No urgency
• No response to behavioral or rx therapy
• May report current UTIs

Question 4

Diagnostics

Answer 4

Vesicovaginal fistula
- Tampon placement in vagina and administration of methylene blue

Definitive = imaging studies of urinary tract

Question 5

Management

Answer 5

Determined by etiologic factors + goals of therapy

Definitive treatment = surgery
- Repair of fistulous tract
- Reimplantation of ectopic ureter

Containment + absorptive products
- To manage leakage
- Must include skin care to prevent dermatitis