Urinary disorders

Question 1

General urinary symptoms

Answer 1

• Frequency of micturition
• Dysuria
• Haematuria
• Urinary retention

Question 2

Cystitis

Answer 2

Inflammation of the bladder

Causes = E.Coli, Proteus, other pathogens, radiation, drugs

Symptoms = urgency, frequency, dysuria, lower abdominal pain, tenderness

Complications = pyelonephritis

Question 3

Transitional cell carcinomas

Answer 3

Most common in men over 50

Notoriously silent; 50% are incurable at diagnosis

Symptoms = painless haematuria, dysuria, frequency, urgency

Diagnosis = cytology

Treatment = tumour resection, radiotherapy, cystectomy

Question 4

Urge incontinence

Answer 4

Due to detrusor overactivity with leakage of urine

Usually an isolated event secondary to local factors

Treatment = bladder training, anti-muscarinic drugs, treatment of overlying cause

Question 5

Stress incontinence

Answer 5

Occurs when intra-abdominal pressure is increased (cough/sneeze)

Due to weak pelvic floor or urethral sphincter

Common in women after childbirth

Treatment = pelvic floor exercises

Question 6

Overflow incontinence

Answer 6

Leakage of urine from a full distended bladder

Common in men with prostatic obstruction

Treatment = removal of obstruction

Question 7

Functional incontinence

Answer 7

Passage of urine owing to inability to get to a toilet due to disability

Treatment = improve facilities, regular urinary voiding, absorbent padding