urinary incontinence

Question 1

task

Question 2

d/d

Answer 2

Causes of incontinence (DIAPPEERSS)
D – elirium
I – infection of UT
A -trophic urethritis
P – harmacological (diuretics)
P – sychological (acute distress)
E – ndocrine (hypercalcemia)
E – nvironmental (unfamiliar surrounding)
R – estricted mobility
S – tool impaction
S – hincter damage or weakness
Drugs Causing Incontinence
- Antihypertensives/vasodilators - (ACEI, prazosin,
labetalol, phenoxybenzamine)
- Bladder relaxants – (anticholinergics, TCAs)
- Bladder stimulants – (cholinergic, caffeine)
- Sedatives – (antidepressants, antihistamines,
antipsychotics, hypnotics, tranquilizers)
- Others: alcohol, loop diuretics, lithium

Question 3

hx

Answer 3

-how much, when u laugh, cough, exercise?do you lose a lot when you try to reach?any masses down below?
-frequency, burning sensation, frothy, polydypsia, polyphagia
-mesntrual hx: regular, stopped>hot flushes>now hot flushes
-early onset heart disease, osteoporosis family
-previous sx
-birth hx : 3 babies NVD 3400g, difficult labour
-pmhx: cough chronic, constipation
-SADMA?BMI
-psychosocial

Question 4

examinaton

Answer 4

General examination, bmi
abdoman
-speculum : vaginal epitheium, minimal prolapse ant vaginal wall, asked to cough
-PVE : uterus normal, adnexae appear normal

Question 5

ix

Answer 5

BSL, UDP

Question 6

explanation

Answer 6

-urine microscopy should be done to exclude uti
-due to mixed nature>urodynamic studies>confirm diagnosis
GSI
>pelvic muscle exercise>ring pessary
-stop smoking, weight control
DETRUSOR INSTABILITY
-imipramine, oxybutynin
-HRT 1-2yrs with minimal risk
-bladder training exercises
IF MEDICAL NOT EFFECTIVE
-sx may be needed to strength bladder neck