Urinary Incontinence Flashcards
What is Urinary Incontinence?
Involuntary leakage of urine
What are the 2 types of Urinary Incontinence?
- Urge
- Stress
What is Mixed Incontinence?
Pt with features of both types of incontinence (most common)
What is the definition of Stress Incontinence?
Involuntary urine leakage @ increased intra-abd pressure
When is Stress Incontinence typically seen?
After childbirth (aka most common causative factor)
What is Stress Incontinence due to?
Weakness of pelvic floor + sphincter muscles
What occasions does urine leak out with Stress Incontinence? (4 things)
- Laughing
- Coughing
- Sneezing
- Surprised
What is Urge incontinence caused by?
Overactivity of detrusor muscle
What is another name for Urge incontinence?
Overactive bladder
What are the RF for Urinary Incontinence? (8 things)
- Age
- BMI
- Postmenopausal
- Vaginal delivery
- Pelvic organ prolapse
- Pelvic floor surgery
- Neurological conditions (e.g MS)
- Cogn impairment / Dementia
What are the CF of Stress Incontinence? (3 things)
- Leakage @ exertion (ask pt to cough)
- SMALL volume leakage
- Prolapse of urethra + ant vaginal wall (@ exam)
What are the CF of Urge Incontinence? (4 things)
- Urgency
- Frequency
- Nocturia
- LARGE volume leakage
What are some triggers for urgency in Urge Incontinence? (2 things)
- Hearing running water
- Cold weather
What is the aim of the primary investigation for sus Incontinence?
Excluding UTI
What are the 2 main investigations for Incontinence?
- Frequency / volume charts
- Urodynamic studies
How do you distinguish between Stress vs Urge with Frequency / volume charts?
- Stress = Normal frequency
- Urge = Increased frequency
What is the point of doing Urodynamic Studies? (2 points)
- Done for Stress incontinence when considering surgery
- Used to confirm Dx + rule out detrusor over-activity
What is important a pt does before Urodynamic Studies are done?
Stop taking anticholinergic meds 5 days before
What are some important Modifiable lifestyle factors you should ask about in the Hx of sus Incontinence? (3 things)
- Caffeine / Alcohol consumption
- Meds
- BMI
What are you checking for @ examination of sus Incontinence? (5 things)
- Pelvic tone
- Pelvic organ prolapse
- Atrophic vaginitis
- Urethral diverticulum
- Pelvic mass
What are the CONSERVATIVE Mx options for Stress Incontinence? (4 things)
- X caffeine / alcohol / overfilling bladder
- Weight Loss
- TUC (e.g chronic cough)
- Pelvic floor exercises (supervised)
How long should Pelvic floor exercises be done for before considering Surgery?
3 months
What are the SURGICAL Mx options for Stress Incontinence? (2 things)
- Tension Free Vaginal Tape (TVT) (most common)
- Laparoscopic colposuspension
What does Tension Free Vaginal Tape (TVT) involve?
Tape placed under mid-urethra via small vaginal incision
