Urinary Incontinence Flashcards
What is stress incontinence?
Involuntary, spontaneous urine loss that occurs with strenuous physical activity
What is urgency incontience?
Involuntary, spontaneous urine loss that occurs with an uncontrollable sense of urgency
What is mixed incontinence?
urgency and stress
What can urinary incontience be caused by?
alterations in anatomical support and/or neuromuscular function of the pelvic floor, or may be idiopathic
What is epid of UI?
- puerperal period
2. older and obese women with neurological conditions.
What are RF for urinary incontinence?
- Increasing age
- Pregnancy
- Obesity
- Lower UTI
- Dementia
- Constipation
- Stroke
- Parkinson’s disease
What is the presentation of urinary incontience?
- Involuntary urine leakage on effort, exertion, sneezing or coughing
- Involuntary urine leakage accompanied by or immediately preceded by urgency
- Frequency of urination
- Suggestive bladder diary
- Vaginal bulge/pressure
- Urogenital atrophy
What are Ix for urinary incontinence?
- Empty supine stress test
- Urinalysis
- Post-void residual measurement
- Cough stress test
What is management for urinary incontinence?
1st line: behavioural approaches plus lifestyle changes
Pharmacotherapy
When do you refer urgently (within 2 weeks) using a suspected cancer pathway referral for bladder cancer if the woman?
- Is aged 45 years and over with:
- Unexplained visible haematuria without urinary tract infection, or
- Visible haematuria that is persistent or recurrent after successful treatment of urinary tract infection, or - Is aged 60 and over with unexplained non-visible haematuria and dysuria or a raised white cell count on a blood test.
What is a common cause of incontinence in men?
- Enlarged Prostate
2. TURP and other pelvic surgery can weaken bladder sphincter
What is urge incontinence due to?
detrusor overactivity
What are other causes of urinary incontinence in men?
- Detrusor overactivity
- Primary bladder neck obstruction
- Urethral stricture
What is 1st line treatment in stress incontinence?
pelvic floor exercises
What other management can be used in stress incontinence?
- Ring pessary can help uterine prolapse
- Intravaginal electrical stimulation
- Surgery: e.g. tension free vaginal tape
- medicine
