Urianary Incontiance

Question 1

What are the somatic nerves that control the soincthers of the bladder?

Answer 1

The puendal nerve (S2’ 3’ 4)

Question 2

Which of the nervous systems are the detrusors muscles are under the influence of?

Answer 2

The

Parasympatheic neruones S2S3S4

Question 3

What are the differnt parts of filling?

Answer 3

Compliance (receptive relaxation), sensation of bladder feeling and no detrusor contraction

Question 4

What are the two parts of vooding?

Answer 4

Voluntary initation and complete emptying

Question 5

What are soem of the effects of a lower motor nuerone lesion on the bladder?

Answer 5

Low detrusor pressure and large residual urine +- overflow incontiance

Question 6

What effects do an unpper motor neurone lesion have on the bladder?

Answer 6

High pressure detrusor contractions and poor coordination with spinchters

Question 7

What are some of the classifactions of LUTS?

Answer 7

Sumptoms realating to storage, voidign and post mircoturition

Question 8

What is urnianry inctoninence?

Answer 8

The complaint of involuntary leakeage of uirne

Question 9

What are the different types of imcontiance?

Answer 9

Stress urinary incontainence, urge urianary incontinence, and mixed urinary incontinence

Question 10

What is stress urinary incroninance?

Answer 10

The complaint kf involuntary leakage of effort or excertion, such as sneezing or coughing

Question 11

What is urger urinary incontinenence?

Answer 11

The complaint o finvoluntary leakage of urine accompanied by or immeadalty proceeded by urgency

Question 12

What are some of the features of mixed urinary incontience?

Answer 12

The complaint of involuntart leakage of urine associated with urgency and also with excertion effor sneezing or coughing

Question 13

What are some of the Oand G rsik factors for inctonitnece?

Answer 13

Pregancy and childbrith, pelvis srugery and DXt and pelvis prolaspe

Question 14

What are some of the predisposing factors?

Answer 14

Race, family predispostion, anatical abnormalities and neuroligcal abonormlaities

Question 15

What are some of the promoting factors?

Answer 15

Co morbifpditis, obesitiy, age, increased intra abdo pressure, cognitive impariemnt, durgs p, uti and menopause

Question 16

What are some of the examinations you may do with incontiance?

Answer 16

BMI, andominal exam to exclude palanle bladder, a digital rectal exam of lrostate on males, and in females the external gentialia stress test adn a vaginal exam

Question 17

What are some of investigations that you would perform?

Answer 17

Urine dipstick, UTI, heamaturia, proteinuria, glucosuria, frequcny volume chart, a bladder diary, post micturnition residual volime, and invasive urodynamics, pad tests, cytoscopy

Question 18

What are some of the conservative managements of incotinance?

Answer 18

Modify fluid intake, weight loss, stop smoking, decrease caffeint intake, avoid constipation and timed voiding and a foxed sceudupe

Question 19

What are some of the features of contained incontinace treated?

Answer 19

Used in patients that are unsulitable for surgery, indwelling catheter, urethral or suprapubic, sheath device, analoguous to an adhesive condon, and incontinence pads

Question 20

What is the intial managment for SUI?

Answer 20

Pelvic floor musicle trainig, 8 contractions a day, and this is at least for 3 months duration

Question 21

What is the pharmological managment for SUI?

Answer 21

Duloxetine, is combined noradrenaline and serotonin uptake, and increase activity in the striated spincther during the filling period, not recommened as a first line or routine treatment

Question 22

What would be the surgerical treatments?

Answer 22

Females, there are permanent intention, low tension vaginal tapes, open retropubic suspension procedures, classical sling procedures, and temproy intention if futher pregancies planned, such as intramural bulking agent, males are a artifical urianary spinchter

Question 23

What is the management fo urge urainarry incontiance?

Answer 23

Bladader training, such as schedule of voiding, vodi ever hour druing the day, must nor vodi inbetween, wait or leak, or intervals increase by 15-30 minutes a week until a interval of 2-3 hours reached for at least 6 hours duration

Question 24

What is the pharmacoligcal managment of UUi?

Answer 24

Anticholinergics, act on muscarininc receptors, M2 and M3, and side effects due to affewcts on M receptors, such as M1 for the CNS and slavaroart glands, called oxybutin

Question 25

What are some of the surgical interventions for urge urinary incontinace?

Answer 25

Sacral nerve neuromodulation, autoaugemntation, augementation cystoplasty, urinary diversion