URINARY INCONTINENCE Flashcards
what is urinary incontinence
involuntary leakage of urine
what are the 3 types of urinary incontinence
- urgency
- stress
- mixed
what is urgency incontinence
- sudden immediate need to pass urine
- difficult to delay
what is stress incontinence
leakage on effort, excertion, sneezing or coughing
what is mixed incontinence
urgency + stress but one type is more predominant
risk factors for urinary incontinence
- old age
- pregnancy
- vaginal delivery
- obesity
- smoking
- constipation
- family history
- medicines (diuretics)
- caffeine
how is caffeine linked to urinary incontinence
caffeine increases urine production and can exacerbate incontinence
non-drug tx of urinary incontinence
- modify fluid intake
- weight loss
- reduce caffeine
drug tx of urinary incontinence (urgency)
1) bladder training 6WK at least
2) antimuscarinic (oxybutynin or tolterodine)
3) mirabegron
drug + non-drug
tx of urinary incontinence (stress)
1) pelvic floor muscle training 3MT
2) surgery or duloxetine
drug and non-drug
tx of urinary incontinence (mixed)
1) bladder training (>6wk) and pelvic floor muscle training (>3MT)
2) drug tx depends on dominating type
antimuscarinics examples
- fesoterodine
- solifenacin
- trospium
- oxybutynin
- tolterodine
which group of pt does antimuscarinics increase adverse effects in
elderly
which adverse effects in elderly is increased due to antimuscarinics
- constipation
- dry mouth
- flushing
- dizziness
- drowiness
- tachycardia
when is antimuscarinics CI
- angle closure glaucoma
- gastro-intestinal obstruction
