Urinary continence Flashcards

1
Q

What are the different types of urinary incontinence

A
stress 
overactive / urge 
overflow 
functional 
mixed
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2
Q

what is urinary incontinence

A

involuntary leakage of urine

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3
Q

what is stress urinary incontinence

A

leakage on increased stress / intrabdominal pressure e.g. cough, sneeze, laughter
from intrinsic sphincter deficiency

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4
Q

what is urge urinary incontinence

A

leakage accompanied by feeling of urgency

due to bladder detrusor muscle overactivity

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5
Q

what does the FUN mnemonic stand for in urge incontinence

A

Frequency
Urgency
Nocturia

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6
Q

What is overflow urinary incontinence

A

results from bladder outflow obstruction

usually in males with BPH

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7
Q

symptoms of overflow incontinence

A

difficulty starting
weak flow / poor stream
post micturition dribbling

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8
Q

Neurological causes of urinary incontinence

A

MS
stroke
Parkinsons
spinal shock

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9
Q

risk factors for urinary incontinence

A
female 
age 
childbirth 
smoking 
alcohol 
caffeine 
neurological conditions 
anatomical anomalies 
pelvic surgery
diabetes 
obesity 
recurrent UTI
poor nutrition 
cognitive deficits 
oestrogen deficiency
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10
Q

red flags in urinary incontinence

A

pain
haematuria
recurrent UTI
new neurological deficit

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11
Q

examinations for urinary incontinence

A

abdo exam

chaperoned PR +- PV exams

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12
Q

basic investigations for incontinence

A

bladder diary
urinalysis + culture
flow rate and post void volume
urodynamics

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13
Q

list conservative methods of SUI management

A
Pelvic floor exercises
bladder retraining 
weight loss 
reduce caffeine and alcohol intake 
biofeedback
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14
Q

list medical management of SUI

A

antimuscarinics - duloxetine

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15
Q

conservative management of overactive bladder

A

bladder retraining
pelvic floor exercises
biofeedback
reduce BMI, caffeine, alcohol

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16
Q

what medication class can be used for overactive bladder

A

anticholinergics:
oxybutynin
tolterodine
solifenacin

B3 agonists:
mirabegron

17
Q

side effects of anticholinergics are generally well tolerated, true or false

A

FALSE

dry mouth, urinary retention, blurred vision, constipation, cognitive impairment

18
Q

contraindications to anticholinergics

A

narrow angle glaucoma, MG, BOO, bowel disorders

19
Q

contraindication to mirabegron

A

uncontrolled hypertension

20
Q

in MFE patients, what other factors should be considered in urinary incontinence

A
constipation 
red flags 
mobility 
falls risk 
cognition
21
Q

How can catheterisation contribute to incontinence

A

prolonged catheterisation in the elderly can result in loss of bladder tone

22
Q

how can gabapentin, amlodipine and NSAIDs contribute to incontinence

A

they lead to ankle oedema which can lead to nocturia