Urinary incontinence

Question 1

What is urge incontinence?

Answer 1

Loss of bladder control

Question 2

Educate patients about

Answer 2

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

Question 3

What is the treatment for urge incontinence?

Answer 3

Pelvic floor exercises
Botox injections
Bladder nerve stimulation

Question 4

For patients having urinary incontinence, what do you ask?

Answer 4

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?

Question 5

For patients having urinary incontinence, are they consuming

Answer 5

coffee, spicy foods, or sodas?
These can be irritants to the bladder

Question 6

For patients having urinary incontinence, what urinary symptoms are they having?

Answer 6

Frequency, urgency, hematuria, or dysuria

Question 7

For patients with urinary incontinence, have they had

Answer 7

any previous surgeries or had children

Question 8

For patients with urinary incontinence, prior to completing a cystoscopy they need to be started on

Answer 8

Oxybutynin

Question 9

What are side effects of Oxybutynin?

Answer 9

Dry mouth, dry eyes, constipation

Question 10

What lifestyle modifications can you give to patients with urinary incontinence?

Answer 10

Limit oral intake 1-2 hours prior to bed
Avoid sodas, coffee, or spicy foods

Question 11

What kind of urinary incontinence types are there?

Answer 11

Stress, urge, overflow, or mixed

Question 12

What different surgeries can be completed for urinary incontinence?

Answer 12

Cystoscopy would need to be performed first, but if bladder is malpositioned may need to perform bladder lift

Question 13

What is Premarin cream used for?

Answer 13

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

Question 14

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

Answer 14

Urge urinary incontinence

Question 15

What are the two causes of urge urinary incontinence?

Answer 15

Bladder outlet obstruction or overactive bladder

Question 16

What are causes of BOO or OAB?

Answer 16

BPH, neurologic conditions (CVA, normal pressure hydrocephalus), and medications that can increase bladder contractility or exacerbate obstructive effects

Question 17

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

Answer 17

Stress urinary incontinence

Question 18

What are causes of stress urinary incontinence?

Answer 18

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

Question 19

Mixed incontinence can be seen in patients with

Answer 19

neurologic disorders, sometimes after prostate surgery, or radiation

Question 20

Urine is retained in the bladder due to incomplete emptying after an attempt to urinate

Answer 20

Overflow incontinence

Question 21

Dribbling of urine retained in the urethra after the bladder has emptied

Answer 21

Post-void dribbling

Question 22

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

Answer 22

UUI

Question 23

Incontinence with physical exertion, coughing, sneezing, laughing, or lifting, or with gravitational change

Answer 23

SUI

Question 24

Sense of incomplete emptying, pelvic discomfort, bedwetting

Answer 24

Overflow incontinence

Question 25

Incontinence that is limited to the postpaid setting and without symptoms of UUI

Answer 25

Post-void dribbling

Question 26

Burning, frequency, or fever

Answer 26

UTI

Question 27

What could contribute to urinary incontinence?

Answer 27

Constipation

Question 28

Check PSA for someone with incontinence because

Answer 28

PSA may help identify BPH or prostate cancer that could affect treatment

Question 29

A PVR greater than

Answer 29

200 suggests overflow incontinence

Question 30

A patient who describes being incontinent due to difficulty getting to a toilet in a timely way because of limited functional mobility is experiencing

Answer 30

functional incontinence

Question 31

What are diet causes of incontinence?

Answer 31

Caffeine and alcohol consumption, constipation, or obesity

Question 32

Urge urinary incontinence is often associated with other urinary symptoms including

Answer 32

frequency and nocturia; combination of these symptoms is referred to as LUTS

Question 33

For urinary incontinence it is important to discuss

Answer 33

goals and expectations of treatment
treatment aimed at simply decreasing the number of incontinence episodes, etc

Question 34

What is nonpharmacologic therapy for urinary incontinence?

Answer 34

Pelvic floor muscle exercises

Question 35

For men with SUI, surgical treatment includes

Answer 35

Perineal sling and transurethral bulking agents, artificial urinary sphincter

Question 36

If a patient has urinary incontinence and frequency, can start on Oxybutynin for urge incontinence if

Answer 36

patient is not retaining urine