Urinary incontenince

Question 1

Stress Incontinence

Cause? tx?

Answer 1

weakened pelvic floor can cause bladder to fall into the vagina = cystocele. any increase in intraabdominal pressure can cause leakage of urine. dx via PE. Tx = pessaries to strengthen floor. if that doesnt work do surgery

Question 2

urge to void the bladder is at —-cc.

Answer 2

250

Question 3

when the bladder reaches —cc and above it becomes painful.

Answer 3

500

Question 4

Motor/Hypertonic Incontinence

how do you dx? tx?

Answer 4

random detrusor muscle contractions that can occur at any time, randomly & @all volumes.

• day & night urination w/insuppressible urges.
  dx: cytometry = shows contractions at all volumes.
  tx: antispasmodics(solifenacin) or antimuscarinics(oxybutynin)

Question 5

Overflow or Hypotonic Incontinence

how do you dx? tx?

Answer 5

lesions of the pine or nerves of any kinda(trauma, diabetic neuropathy, multiple sclerosis) = loss of sensory feedback indicating fullness. involuntary loss of urine day and night WITHOUT THE URGE OR ABILITY TO VOID. Bladder never empties.

dx: cystometry shows absence contractions
tx: timed voids w/bithanechol or cathiterization

Question 6

pt w/constant and continuous leak of urine day or night…dx?

Answer 6

fistula

dx: inject dye into bladder or rectum and insert tampon in vagina if leak then the dye will leak onto tampon