Urinary Incontinence

Question 1

what is stress urinary incontinence

Answer 1

• leak when sneezing or coughing
• urine leaks whenever urethral resistance is exceeded by increased abdominal pressure

Question 2

what is the cause of stress urinary incontinence

Answer 2

bladder neck/urethral hypermobility
and/or
neuromuscular defects causing intrinsic sphincter deficiency

Question 3

what is urge urinary incontinence

Answer 3

• leakage accompanied or immediately preceded by urgency

Question 4

causes of urge urinary incontinence

Answer 4

• may be due to bladder overactivity (detrusor instability)
• pathology that irritates the bladder (infection, tumour, stone) - less common

Question 5

what is mixed urinary incontinence

Answer 5

a combination of stress urinary incontinence and urge urinary incontinence

Question 6

what could a constant leak of urine suggest

Answer 6

• fistula between bladder and vagina
• presence of an ectopic ureter draining into the vagina

Question 7

is urinary incontinence more common in men or women

Answer 7

women

Question 8

is diabetes a risk factor for urinary incontinence

Answer 8

yes (affects nerves)

Question 9

is oestrogen deficiency a cause of urinary incontinence

Answer 9

yes

Question 10

basic investigations for urinary incontinence

Answer 10

• bladder diary
• urinalysis +/- culture
• flow rate and post-void residue
• pad testing

Question 11

further investigations for urinary incontinence

Answer 11

• blood tests
• imaging
• cystoscopy - for complex cases

Question 12

conservative treatment for urinary incontinence

Answer 12

• lifestyle modification (weight loss, stop smoking, avoid caffeine etc)
• pelvic floor exercises
• biofeedback
• medication - duloxetine

Question 13

what is the main indication for injection therapy in urinary incontinence

Answer 13

female stress incontinence secondary to intrinsic sphincter deficiency in the presence of a normal bladder muscle function