Over active bladder syndrome Flashcards
What are the 5 types of incontinence? (sx)
Stress - increased pressure on the bladder -> small volume incontinence (most common)
Urge - strong urge to urinate often and dont get to bathroom in type- large losses
Mixed - >2 types -often stresss and urge
Overflow - difficulty emptying bladder -> over filling-> incontinence
functional-> cant walk to bathroom (mobility) -> incontinence
other causes - UTI, DM, etc
What are the ix of overactive bladder syndrome (incontinence)
Speculum examination- eclude pelvic organ prolapse and ability to vluntarry contract pelvis muscle
+ ask for cough (vasvala)- see if leak
Urine dipstick - for UTI/DM
Bladder diaries - min 3 days - if not move to–
urodynamic testing -3 pressures measured from rectum and urethra
What is the management of stress incontinence?
Most common- increased pressure on bladder causin incontinence (RF- Age, children, bad delivery, pelvic surgery, obesity)
check for red flags (trigone tumour)- if yes reffer
1st line- Lifestyle, weight loss, pelvis floor exercise (3m)- physio
2nd - surgical treatment or SNRI (duloxetine)
What is the management of Urge overactive bladder syndrome (incontinence)?
Strong urge and dont make it in time - RF- age, obesity, smoking, Fhx, DM
check for red flags- trigone tumour
1st line (conservative)- lifestyle and bladder training -6 w progressive hold on going to toilet by 25mins (+ avoid fizzy drinks + control DM)
2nd line -
antimuscarinics (dont give if glaucoma!)- Oxybutyn (care for fals-not for frails
Darifenacin
(ADH analogues- desmopressin
3rd line- Mirabegon (b3 agonist)-if concerns over anti muscarinics
4th line- surgery- botox
What is the management of overflow overactive bladder syndrome (incontinence)
Difficulty emptying bladder -> overfilling- > incontinence
Refer to specilist
1st line - timed voiding
Dribbling incontinence after having a child with a prolonged labour, suspect a vesicovaginal fistula à urinary dye studies
