S7.2 Urinary Incontinence

Question 1

Define stress UI

Answer 1

Involuntary leakage on effort or exertion (sneezing, coughing).

Question 2

Define urge UI

Answer 2

Involuntary leakage accompanied/immediately proceeded by urgency

Question 3

Define mixed UI

Answer 3

Mix of SUI and UUI, involuntary leakage associated with urgency and also effort or exertion

Question 4

Define overflow incontinence

Answer 4

Urine can’t go anywhere else but leak out.

E.g. detrusor fibrosis so can’t distend further

Question 5

What are the risk factors for developing urinary incontinence?

Answer 5

Predisposing: family history, race, anatomical and neurological abnormalities

Promoting: menopause, drugs, UTI, increased intra-abdominal pressure, obesity

Obs and Gyn: pregnancy, childbirth, pelvic surgery

Question 6

What investigations can be done to diagnose UI?

Answer 6

Dipstick

Non-invasive urodynamics: frequency volume chart

Question 7

How can lifestyle factors help UI?

Answer 7

Modify fluid intake, lose weight, stop smoking, timed voiding (fixed schedule)

Question 8

How should UI be treated in those unsuitable for surgery?

Answer 8

Indwelling catheter, sheath device, incontinence pads

Question 9

What is the specific management for stress UI?

Answer 9

Pelvic floor training
Duloxetine
Surgery: vaginal tapes, male sling procedure

Question 10

What is the specific management for urge UI?

Answer 10

Bladder training
B3 agonist mirabegron
Surgery: cytoplasty