urinary incontinence Flashcards
Define urinary incontinence
Urinary incontinence is the involuntary loss of urine which is objectively demonstrable and is a social or
hygienic problem.
Genuine Stress Incontinence
There is leakage of small amounts of urine during physical movement.
eg. coughing, sneezing, exercising.
Overflow Incontinence:
There is leakage of usually small amounts of urine as a result of a very full
bladder.
Mixed Incontinence
Both stress and urge incontinence occurring together.
Functional Incontinence:
Occurs in conditions of immobility.
Transient Incontinence
Results from temporary conditions. Eg. Infection, medications.
Urge Incontinence
There is leakage of large amounts of urine unexpectedly following detrusor muscle activity.
Fistulae
Total incontinence of urine. Results from an abnormal communication from the urinary bladder.
3 most important contributors to resting urethral pressure
Rhabdosphincter effects
Smooth muscle effects
Vascular plexus
Pathophysiology of urinary incontinence
Intrinsic sphincter dysfunction
• Bladder base becomes flat and lies in line with the posterior wall of the proximal urethra
• Descent of proximal urethra below the pelvic diaphragm such that intraabdominal pressure during stress is not equally transmitted to the bladder neck.
Detrusor overactivity caused by a known mortor neurone disease is known as
Detrusor hyper-reflexia
Detrusor overactivity in the absence of a recognised neuropathology is known as
Detrusor instability
What is the commonest cause of urinary retention in obstetrics and gynecology
Postoperative retention of urine
Standard practice for treatment of obstetric fistulas
Allow for an interval of 3-4 months between the injury and timing of surgical repair in cases of obstetric fistulas
Standard practice for treatment of radiation induced fistulas
allow an interval for about 12 months
