LUTS in the Elderly Flashcards
Is urinary incontinence a normal part of ageing?
No
What is stress urinary incontinence?
Involuntary leakage on effort/exertion such as coughing or sneezing.
What is urge urinary incontinence?
Involuntary leakage accompanied by, or immediately preceded by urgency.
What is mixed urinary incontinence?
Involuntary leakage associated with urgency aswell as exertion, effort, sneezing or coughing.
What is overflow urinary incontinence?
Leakage owing to bladder outflow obstruction of any cause which leaves post-voidal residue.
Can be caused by constipation or BPH.
What is functional urinary incontinence?
Incontinence resulting from an inability to reach/use the toilet in time.
What are red-flag symptoms of urinary incontinence?
Haematuria
Recurrent UTIs
What is used to diagnose urinary incontinence?
Bladder scan
Bladder diary
Blood test
May need to undertake urodynamic studies also.
Does constipation play a part in urinary incontinence?
Yes
How long should pelvic floor exercises be implemented for in stress urinary incontinence?
Atleast 3 months.
What is used to treat urgency/mixed urinary incontinence?
Bladder training
AIms to extend the interval between voiding.
What is first-line medication for incontinence?
Tolterodine 2mg bd
This is an anticholinergic, give for 4-6 weeks to observe an impact.
What is second-line medication for incontinence?
Solifenacin
What is third-line for incontinence?
Mirabegron
Can cause hypertension - monitor BP closely.
How should nocturia be treated?
A diuretic (e.g. furosemide) in the late afternoon.
Could also give desmopressin.
