Urinary Incontinence Flashcards
Who is most affected by urinary incontinence?
Elderly women
What are some of the main RF of urinary incontinence?
Increasing age
Previous pregnancy and childbirth
High BMI
What are the different types of urinary incontinence?
Urge incontinence Stress incontinence Functional incontinence Overflow incontinence Mixed incontinence
What is urge incontinence?
Sudden and involuntary loss of urine
Associated with urgency
What is urge incontinence due to?
Detrusor overactivity
What are the main RF for urge incontinence?
Recurrent UTI
High BMI
Advancing age
Caffine
What is stress incontinence?
Leaking of urine when the intra-abdominal pressure is raised putting pressure on the bladder
What can increase increase intra-abdominal pressure?
Coughing
Laughing
Sneezing
Exercising
What are the main RF for stress incontinence?
Childbirth
Hysterectomy
What is functional incontinence?
Having the urge to pass urine but unable to do so
What is functional incontinence associated with?
Dementia
Alcohol
Sedating medication
What does mixed incontinence include?
Urge and stress incontinence
What is overflow incontinence?
When small amounts of urine leak out without warning
Due to pressure on the bladder overcoming the pressure of the outlet structures
What are the causes of overflow incontinence?
Underactivity of the detrusor muscle as a result of neurological damage
Constipation
Prostatism as the urinary outlet pressures are too high
What are the main investigations for urinary incontinence?
Bladder diaries
Vaginal examination
Urinalysis
Cytometry
How long should a bladder diary be kept?
For a minimum of 3 days
Why would you carry out a vaginal examination?
To exclude pelvic organ prolapse
To see if they have the ability to initiate voluntary contraction of pelvic floor muscles (‘Kegel’ exercises)
Why would you do a urinalysis?
To rule out infection
Why would you carry out Cytometry?
To measure bladder pressure whilst voiding
What is the management of urinary incontinence dependent on?
Whether stress or urge incontinence is more common
What are the 2 forms of management of urge incontinence?
Bladder retraining
Bladder stabilising drugs
What are some examples of bladder stabilising drugs?
Oxybutynin
Tolterodine
Darifenacin
Mirabegron
Who would you avoid using oxybutynin with?
Frail older women
When would Mirabegron be useful?
If there was if concern about anticholinergic side-effects in elderly
