Urinary Incontinence Flashcards
Describe the sphincters and nervous systems involved in micturition
- internal sphincter: involuntary
- external sphincter: voluntary
- autonomic NS: sympathetic T10-L3 release norepi to relax bladder, parasympathetic S2-S4 release Ach to contract detrusor muscle
- somatic NS: motor neurons from S2-S4 supply external urethral sphincter
Describe the detrusor muscle and its actions/functions
- smooth muscle
- contracts & pushes urine out of the bladder (voiding phase)
- relaxed & allows bladder to fill (storage phase)
Describe the etiology of urinary incontinence
Describe the etiology & RF for stress urinary incontinence (SUI)
Describe the presentation of stress UI
Describe the treatment for stress UI
Describe the etiology of urgency urinary incontinence (UUI)
Describe the presentation of urgency UI
Describe the diagnosis of UUI/OAB
Describe the initial management of urgency UI
Describe the pharm for urgency UI
List some bladder irritants
Describe the etiology of overactive bladder syndrome
Describe the presentation of overactive bladder syndrome
Describe the etiology of mixed UI
Describe the etiology of overflow incontinence
Describe the diagnosis of overflow incontinence
Describe the treatment for overflow incontinence
Describe the etiology of neuropathic incontinence
Describe the presentation of neuropathic incontinence at the different levels of injury/lesion
List some health complications of urinary incontinence
- risk of death in nursing home
- MH and social concerns
- incontinence associated dermatitis (contact)
- tricky balance between incontinence and retention
what are some side effects of anticholinergics?
dry mouth, dry eyes, constipation, exacerbation of dementia/cog impairment
what physiologic effect does mirabegron (beta agonist) have on the urinary tract?
relaxes the bladder/detrusor muscle
what PVR would you expect in a patient with overflow incontinence?
> 200 ml
what PVR would you expect in a patient with urge incontinence?
normal <50 ml
a male pt has OI secondary to BPH, what are some pharm options?
Finasteride (5A reductase inhib), alpha blockers
What is a potential derm complication of urinary incontinence?
contact dermatitis (incontinence associated dermatitis)
why would we pee our pants if we get scared if sympathetic retains urine and parasympathetic releases urine?
limbic system throws sympathetic function out of whack
