Urinary Incontinence Flashcards
what are the risk factors for urinary incontinence?
- advancing age
- previous pregnancy and childbirth
- high BMI
- hysterectomy
- FHx
what is the cause of overactive bladder/urge incontinence?
detrusor overactivity
describe overactive bladdler/urge incontinence
- urge to urinate is quickly followed by uncontrollable leakage
- few drops –> complete bladder
describe stress incontinence
leaking small amounts when coughing or laughing
what is mixed incontinence?
urge + stress incontinence
what is outflow incontinence?
due to bladder outlet obstruction
e.g. due to prostate enlargement
what is functional incontinence?
comorbid physical conditions impair the patient’s ability to get to a bathroom in time
name some causes of functional incontinence
- dementia
- sedating medication
- injury/illness
name the different classifications of urinary incontinence
- overactive/urge
- stress
- mixed
- outflow
- functional
what is the initial investigation in urinary incontinence?
- bladder diaries (min of 3 days)
- vaginal examination
- urine dipstick and culture
- urodynamic studies
what is the initial management of urge incontinence?
bladder retraining (minimum of 6 weeks)
increase the intervals between voiding
what are the first line medications used in urge incontinence?
bladder stabilising drugs –> anti-muscarinics
* oxybutynin (immediate release)
* tolterodine (immediate release)
* darifenacin (once daily)
what anti-muscarinic should be avoided in frail older women?
oxybutynin (immediate release)
what is the alternative to anti-muscarinics in urge incontinence?
mirabegron (beta-3 agonist)
useful if concern about anticholinergic effects
what is the initial management of stress incontinence?
pelvic floor muscle training
8 contractions performed 3 times per day for minimum of 3 months
