urinary dysfxn

Question 1

internal sphincter vs external sphincter control

Answer 1

internal is involuntary

Question 2

what happens when there is increased parasympathetic and decreased sympathetic?

Answer 2

detrusors contract
internal sphincter relax

Question 3

types of incontinence

Answer 3

urge incontinence
stress incontinence
mixed
overflow
functional

Question 4

what is overflow incontinence?

Answer 4

urinary retention, pressure exceeds urethral resistance
poor bladder emptying

Question 5

two causes of overflow

Answer 5

blockage in urinary flow
ineffective detrusor muscle

Question 6

things that cause ineffective detrusor muscle

Answer 6

d/o affecting ANS (DM, cauda equina)
anticholinergic meds

Question 7

which incontinence can be caused by anticholinergics?

Answer 7

overflow incontinence

Question 8

sx of overflow incontinence

Answer 8

hesitancy
weak stream
feeling of inadequate emptying

Question 9

how is overflow incontinence treated?

Answer 9

mirbegrom
cholinergic agents
alpha blockers

Question 10

how does mirbegrom work?

Answer 10

it is a beta-3 adrenergic agonist that activates sympathetic ANS to relax detrusor muslce

Question 11

ADR of mirbegrom

Answer 11

increased BP, UTI and HA

Question 12

what is stress incontinence?

Answer 12

pelvic floor laxity, overwhelmed sphincter
in absence of detrusor contraction, intravesical pressure exceeds maximal urethral pressure

Question 13

how is stress incontinence treated?

Answer 13

strengthen external sphincter with kegels

Question 14

risk factors for stress incontinence

Answer 14

menopause, pregnancy, obesity, etc

Question 15

what does stress incontinence look like

Answer 15

spurts of pee when you sneeze, cough, laugh, workout

Question 16

what does kegel exercises strengthen?

Answer 16

external sphincters

Question 17

what is urge/OAB incontinence?

Answer 17

overactive bladder
uninhibited detrusor muscle random contractions

Question 18

sx of urge incontinence?

Answer 18

sudden/great urine leakage
frequency
nocturia
majority are “dry”

Question 19

how is urge incontinence tx?

Answer 19

anticholinergics
kegels
bladder training

Question 20

how do anticholinergics work?

Answer 20

blocks muscarinic receptors to inhibit detrusor muscle

Question 21

ADR of anticholinergics

Answer 21

xerostomia
constipation
sedation
impaired cognitive fxn
blurred vision

Question 22

which type of incontinence can involve self-catherization?

Answer 22

overflow

Question 23

what is functional incontinence?

Answer 23

incontinence d/t physical or mental impairments

Question 24

what is mixed incontinence?

Answer 24

sx is a mix of stress and urge incontinences

Question 25

5 things that can irritate your bladder

Answer 25

acidic fruits (tomatoes)
spicy foods
carbonated drinks
artificial sweeteners
tea

Question 26

what is bladder training?

Answer 26

Adjust bathroom habits to control urge incontinence
Gradual increase in time between voids

Question 27

how can behavioral therapy help?

Answer 27

pelvic exercises
prompted/timed voiding
Alleviation of constipation
Correction of physical limitations

Question 28

with which population is prompted/timed voiding especially useful?

Answer 28

ppl in nursing homes

Question 29

urinary incontinence is

Answer 29

involuntary loss of urine that occurs when bladder pressure exceeds resistance to outflow

Question 30

impact of incontinence

Answer 30

skin infxn
UTI
falls/fractures
quality of life