Urinary incontinence

Question 1

1st line Medication in stress incontinence

Answer 1

Duloxetine - noradrenaline + serotonin reuptake.
Stimulation of urethral striated muscles within sphincter to increase contraction.

Question 2

Important conditions to rule out in pt w urinary incontinence + Ix to do this

Answer 2

Urinalysis
* UTI
* Diabetes mellitus

Question 3

If the bladder is still palpable after urination, what incontinence is it?

Answer 3

Overflow.

Question 4

Causes of overflow incontinence

Answer 4

General - bladder outlet obstruction
Males- prostate enlargement
Females - neurogenic bladder (complication of Diabetes, chronic alcoholic, surgery to pelvic area)

Question 5

Differential diagnosis Q: Pt w continious dribbling inconsistence after prolonged labour and from a country with poor obstetric services? + investigation

Answer 5

Vesicovaginal fistulae
Ix - Urinary dye studies

Question 6

Drug med for urge incontinence?

Answer 6

• Anti muscarinics - Oxybutynin, Tolterodine, solifenacin.

Question 7

What name + class of drug more suitable for elderly pt w urge incontinence

Answer 7

• Mirabegron (beta-3 agonist)