urinary dysfxn Flashcards
internal sphincter vs external sphincter control
internal is involuntary
what happens when there is increased parasympathetic and decreased sympathetic?
detrusors contract
internal sphincter relax
types of incontinence
urge incontinence
stress incontinence
mixed
overflow
functional
what is overflow incontinence?
urinary retention, pressure exceeds urethral resistance
poor bladder emptying
two causes of overflow
blockage in urinary flow
ineffective detrusor muscle
things that cause ineffective detrusor muscle
d/o affecting ANS (DM, cauda equina)
anticholinergic meds
which incontinence can be caused by anticholinergics?
overflow incontinence
sx of overflow incontinence
hesitancy
weak stream
feeling of inadequate emptying
how is overflow incontinence treated?
mirbegrom
cholinergic agents
alpha blockers
how does mirbegrom work?
it is a beta-3 adrenergic agonist that activates sympathetic ANS to relax detrusor muslce
ADR of mirbegrom
increased BP, UTI and HA
what is stress incontinence?
pelvic floor laxity, overwhelmed sphincter
in absence of detrusor contraction, intravesical pressure exceeds maximal urethral pressure
how is stress incontinence treated?
strengthen external sphincter with kegels
risk factors for stress incontinence
menopause, pregnancy, obesity, etc
what does stress incontinence look like
spurts of pee when you sneeze, cough, laugh, workout
what does kegel exercises strengthen?
external sphincters
what is urge/OAB incontinence?
overactive bladder
uninhibited detrusor muscle random contractions
sx of urge incontinence?
sudden/great urine leakage
frequency
nocturia
majority are “dry”
how is urge incontinence tx?
anticholinergics
kegels
bladder training
how do anticholinergics work?
blocks muscarinic receptors to inhibit detrusor muscle
ADR of anticholinergics
xerostomia
constipation
sedation
impaired cognitive fxn
blurred vision
which type of incontinence can involve self-catherization?
overflow
what is functional incontinence?
incontinence d/t physical or mental impairments
what is mixed incontinence?
sx is a mix of stress and urge incontinences
5 things that can irritate your bladder
acidic fruits (tomatoes)
spicy foods
carbonated drinks
artificial sweeteners
tea
what is bladder training?
Adjust bathroom habits to control urge incontinence
Gradual increase in time between voids
how can behavioral therapy help?
pelvic exercises
prompted/timed voiding
Alleviation of constipation
Correction of physical limitations
with which population is prompted/timed voiding especially useful?
ppl in nursing homes
urinary incontinence is
involuntary loss of urine that occurs when bladder pressure exceeds resistance to outflow
impact of incontinence
skin infxn
UTI
falls/fractures
quality of life
