Mechanisms of incontinence Flashcards
Define dysuria
Difficult or painful passage of urine
Define stranguria
Straining or hesitancy associated with urination
Define Pollakuria
Increased frequency of urination
Define Nocturia
The urge need to urinate over night
Define Enuresis
Unconscious leakage of urine during sleep
What is the difference between UMN lesion and LMN lesion?
UMN: Spastic paralysis, hyper/normoreflexia, slow muscle wastage
LMN: flaccid paralysis, hypo/areflexia, rapid muscle wastage
With regard to the bladder will damage to the sacral spine or pelvic plexus be UMN or LMN?
LMN lesion
What are the urinary signs of LMN damage?
Absent voluntary micturition Atonic bladder Atonic urethral sphincters Absent detrusor reflex Concurrent reduced perineal reflex and anal tone
With regard to the bladder will damage to the brain/high spinal cord be LMN or UMN?
UMN lesion
What are the urinary signs of UMN damage?
Absent voluntary micturition
Increased urethral sphincter tone
High volume urinary retention
Development of automatic bladder
What may cause a constant dribble of urine?
Ectopic ureter
A Congenital malformation causing the ureters to enter directly into the urethra
What is reflex dyssynergia?
Initiation of detrusor reflex with reflex contraction of the urethral sphincter
What is SMI?
Sphincter mechanism incompetence
Normal voiding but with a few leaks
What is the signalment for SMI?
Commoner in female than male
Common in large/giant breeds female
Common in speyed female
How do you treat SMI?
Alpha-adrenergic agonists (eg phenylpropanolamine)
Oestrogens
