S7) Urinary Incontinence Flashcards

1
Q

What is urinary incontinence?

A

Urinary incontinence is the unintentional passing of urine due to loss of bladder control

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2
Q

There are 4 types of urinary incontinence.

Identify them

A
  • Stress Urinary Incontinence
  • Urge Urinary incontinence
  • Mixed Urinary Incontinence
  • Overflow Incontinence
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3
Q

What is stress urinary incontinence?

A

Stress Urinary Incontinence is the involuntary leakage of urine on effort, exertion, sneezing or coughing

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4
Q

What is urge urinary incontinence?

A

Urge Urinary incontinence is the involuntary leakage of urine accompanied by urgency

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5
Q

What is mixed urinary incontinence?

A

Mixed Urinary Incontinence is the involuntary leakage of urine associated with urgency and also with exertion, effort, sneezing or coughing

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6
Q

What is overflow incontinence?

A

Overflow incontinence is the involuntary leakage of urine from an overfull bladder, often in the absence of any urge to urinate

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7
Q

Have an understanding of the prevalence of urinary incontinence with age

A
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8
Q

Describe the incidence of the different types of urinary incontinence

A
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9
Q

Identify 6 risk factors for urinary incontinence

A
  • Obesity
  • Age
  • Gender (more common in females)
  • Smoking
  • Family history
  • Neurological disease/diabetes
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10
Q

Identify and describe 4 causes of urinary incontinence in females

A
  • Pregnancy – due to hormonal changes and uterine expansion
  • Childbirth – weakens muscles needed for bladder control and damages bladder nerves and supportive tissue
  • Hysterectomy – due to possible damage of the supporting pelvic floor
  • Menopause – due to loss of oestrogen which causes urethra and bladder to deteriorate
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11
Q

Identify and describe 4 causes of urinary incontinence in males

A
  • Prostate cancer – often incontinence occurs as a side effect of treatments
  • Enlarged prostate gland – benign prostatic hyperplasia (more common in older men)
  • Prostatectomy – often surgery damages urinary structures
  • Prostatitis – prostate swells and compresses urethra
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12
Q

State 4 initial investigations for urinary incontinence

A
  • Urine dipstick (UTI, haematuria, proteinuria, glucosuria)
  • Non-invasive urodynamics (frequency-volume chart)
  • Invasive urodynamics (pressure-flow studies)
  • Cystoscopy
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13
Q

In the conservative management of urinary incontinence, identify 5 general lifestyle interventions

A
  • Modify fluid intake
  • Weight loss
  • Stop smoking
  • Decrease caffeine intake (UUI)
  • Avoid constipation
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14
Q

Identify 3 forms of management for patients with urinary incontinence who are unsuitable for surgery / failed conservative management

A
  • Catheter (suprapubic/urethral)
  • Sheath device
  • Incontinence Pads
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15
Q

What is the initial management for SUI?

A

Pelvic floor muscle training – 8 contractions x3/day, at least 3 months duration

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16
Q

What is the pharmacological management for SUI?

A

Duloxetine – combined noradrenaline and serotonin uptake inhibitor increases activity in the striated sphincter during continence phase

17
Q

Identify 2 types of surgical management for males with SUI?

A
  • Artificial urinary sphincter
  • Male sling procedure
18
Q

Identify 2 types of surgical management for females with SUI

A
  • Low-tension vaginal tapes (permanent)
  • Intramuscular bulking agents (temporary)
19
Q

What is the initial management for UUI?

A

Bladder training – scheduled voiding for at least 6 months duration

20
Q

Identify and describe 2 types of pharmacological management of urinary incontinence

A
  • β3-adrenoceptor agonist increases bladder’s capacity to store urine
  • Anticholinergics act on muscarinic receptors to promote urine retention
21
Q

Identify 4 types of surgical management for UUI

A
  • Sacral nerve neuromodulation
  • Autoaugmentation
  • Augmentation cystoplasty
  • Urinary diversion