Urinary incontinence Flashcards
What is urge incontinence?
Loss of bladder control
Educate patients about
going to the bathroom every 2-3 hours
Need regular BMs
Quit smoking
Avoid alcohol and caffeinated drinks
Lose weight
Avoid spicy foods, carbonated drinks, or citrus fruits/juices
Control diabetes
What is the treatment for urge incontinence?
Pelvic floor exercises
Botox injections
Bladder nerve stimulation
For patients having urinary incontinence, what do you ask?
Are they using pads or diapers? Wetting the bed?
How many changes during the day and at night?
How many times are they voiding during the day and at night?
Duration of symptoms
Any recent infections or recurrent UTIs?
For patients having urinary incontinence, are they consuming
coffee, spicy foods, or sodas?
These can be irritants to the bladder
For patients having urinary incontinence, what urinary symptoms are they having?
Frequency, urgency, hematuria, or dysuria
For patients with urinary incontinence, have they had
any previous surgeries or had children
For patients with urinary incontinence, prior to completing a cystoscopy they need to be started on
Oxybutynin
What are side effects of Oxybutynin?
Dry mouth, dry eyes, constipation
What lifestyle modifications can you give to patients with urinary incontinence?
Limit oral intake 1-2 hours prior to bed
Avoid sodas, coffee, or spicy foods
What kind of urinary incontinence types are there?
Stress, urge, overflow, or mixed
What different surgeries can be completed for urinary incontinence?
Cystoscopy would need to be performed first, but if bladder is malpositioned may need to perform bladder lift
What is Premarin cream used for?
Estrogen cream used in premenopausal/post menopausal women to help with vaginal dryness during intercourse, helps with recurrent UTIs, and promotes growth of vaginal flora
Most common type of incontinence among men, sudden and compelling desire to pass urine that is difficult to defer and is accompanied by involuntary leakage
Urge urinary incontinence
What are the two causes of urge urinary incontinence?
Bladder outlet obstruction or overactive bladder
What are causes of BOO or OAB?
BPH, neurologic conditions (CVA, normal pressure hydrocephalus), and medications that can increase bladder contractility or exacerbate obstructive effects
Absence of bladder contraction and is due to inadequate urethral sphincter function, either from mechanical damage to the urethral sphincter or from physiologic effects that limit sphincter function
Stress urinary incontinence
What are causes of stress urinary incontinence?
Prostate surgery
Radical prostatectomy; common for men to initially experience SUI resolves over 6-12 months
TURP can cause damage to external urethral sphincter
Spinal cord injury that impairs sphincter function
Mixed incontinence can be seen in patients with
neurologic disorders, sometimes after prostate surgery, or radiation
Urine is retained in the bladder due to incomplete emptying after an attempt to urinate
Overflow incontinence
Dribbling of urine retained in the urethra after the bladder has emptied
Post-void dribbling
Sense of urgency, precipitants such as running water or hand washing or exposure to cold environment along with hesitancy, straining to void, and an intermittent or slow stream
UUI
Incontinence with physical exertion, coughing, sneezing, laughing, or lifting, or with gravitational change
SUI
Sense of incomplete emptying, pelvic discomfort, bedwetting
Overflow incontinence
Incontinence that is limited to the postpaid setting and without symptoms of UUI
Post-void dribbling
Burning, frequency, or fever
UTI
What could contribute to urinary incontinence?
Constipation
Check PSA for someone with incontinence because
PSA may help identify BPH or prostate cancer that could affect treatment
A PVR greater than
200 suggests overflow incontinence
A patient who describes being incontinent due to difficulty getting to a toilet in a timely way because of limited functional mobility is experiencing
functional incontinence
What are diet causes of incontinence?
Caffeine and alcohol consumption, constipation, or obesity
Urge urinary incontinence is often associated with other urinary symptoms including
frequency and nocturia; combination of these symptoms is referred to as LUTS
For urinary incontinence it is important to discuss
goals and expectations of treatment
treatment aimed at simply decreasing the number of incontinence episodes, etc
What is nonpharmacologic therapy for urinary incontinence?
Pelvic floor muscle exercises
For men with SUI, surgical treatment includes
Perineal sling and transurethral bulking agents, artificial urinary sphincter
If a patient has urinary incontinence and frequency, can start on Oxybutynin for urge incontinence if
patient is not retaining urine
