Urinary Incontinence Flashcards
Why is urinary incontinence more common in men?
Men have a bladder neck mechanism and a strong urethral sphincter (Women only have a physiological IUS)
what are the 3 main types of urinary incontinence?
1) Urgency
2) Stress -> Increase in abdominal pressure and associated with cough/sneeze
3) Overfilling (Fistula)
[4) Mixed]
How is stress incontinence caused in women?
Secondary to birth trauma
What is the treatment for stress incontinence in females?
1) pelvic floor exercises (Kegel)
2) Duloxetine
3) Surgery
How is stress incontinence caused and treated in men?
Neurogenic/Iatrogenic (Radical prostatectomy)
- Artificial Sphincter
- Sling
What information can be interpreted from a bladder diary?
1) Frequency
2) Volume
3) Functional capacity
4) Incontinence/day
What symptoms are found in an overactive bladder?
Urgency and frequency in absence of local pathology would account for these symptoms
What is the main treatment for an overactive bladder?
1) Behavioural e.g. limit caffeine, alcohol, etc.
2) Pelvic floor physio (Kegel exercises)
3) Muscarinic antagonists
4) beta 3 agonists
5) Botox
6) Cystoplasty
What are main personal effects of incontinence?
- Personal hygiene
- Mental health/social life
What happens in overflow incontinence?
Problem with emptying bladder, ineffective detrusor sees swelling up and gradual slow leakage
What are the differences between a reflexic and areflexic bladder?
R: Reflex cycle for micturition is normal (Can have detrusor overactivity)
Ar: Acontractile with no innervation of any use
What role does the cortex have in micturition?
Sensation and voluntary initiation of voiding the bladder
What is the role of PMG/PAG in micturition
Co-ordination and completion of voiding
