Others Flashcards
Urinary Incontinence
Classification
- Stress Incontinence
- Urgency Incontinence
- Mixed Incontinence
- Overflow Incontinence
Stress Incontinence
Causes
Outlet incompetence due to urethral hypermobility or intrinsic sphincter deficiency which will lead to leak when the intra-abdominal pressure is increased like during sneezing or lifting objects
Urgency Incontinence
Causes
Overactive bladder (detrusor instability) which will lead to leak with urge to void immediately
Overflow Incontinence
Causes
Incomplete emptying due to detrusor underactivity or outlet obstruction which will lead to leak with overfilling
Stress Incontinence
Risk factors
- Obesity
- Vaginal delivery
- Prostate surgery
Stress Incontinence
Diagnosis
Have the patient stand and cough; observe for leakage
Urgency Incontinence
Diagnosis
Pressure measurement in half-full bladder; manometry
Urgency Incontinence
Treatment
- Pelvic floor muscles exercises (Kegel)
- Bladder training like timed voiding and distraction or relaxation techniques
- Local anticholinergic therapy:
- Oxybutynin
- Tolterodine
- Solifenacin
- Dariferancin
- Surgical tightening of urethra
Stress Incontinence
Treatment
- Pelvic floor muscles exercises (Kegel)
- Weight loss
- Local estrogen cream or pessaries
- Surgical tightening of urethra
Overflow Incontinence
Diagnosis
Increased post-void residual volume on catheterization or U/S
Overflow Incontinence
Treatment
- Catheterization
- Relieve obstruction e.g. alpha-blockers for BPH
RBC casts
Disease(s) or Disorder(s)
- Glomerulonephritis
- Malignant hypertension
WBC casts
Disease(s) or Disorder(s)
- Tubulointerstititial inflammation
- Acute pyelonephritis
- Transplant rejection
Fatty casts ("oval fat bodies")
(Disease(s) or Disorder(s))Nephrotic syndrome (associated with “Maltese cross” sign)
Granular (“muddy-brown”) casts
Disease(s) or Disorder(s)
Acute tubular necrosis
