Urinary Incontinence

Question 1

Define urinary incontinence.

Answer 1

Involuntary loss of urine from urethra. it is a quality of life issue.

Question 2

How many people are affected by urinary incontinence?

Answer 2

1 in 21

Question 3

How many types of urinary incontinence are there? Describe them.

Answer 3

Urge incontinence: detrusor instability
- muscle contracts when it shouldn’t

Stress incontinence: sphincter instability
- with laughing, coughing, sneezing, jumping, etc.

Most: both problems
- most common

Question 4

Which drinks should be avoided with urinary incontinence?

Answer 4

• Alcohol
• Carbonated drinks
• Coffee/Tea with or w/o caffeine
• Citrus juices
• Artificial sweeteners

Question 5

What behavioral modifications should be recommended for patients with urinary incontinence?

Answer 5

Weight loss (especially for stress type):
- to reduce pressure

Regular but not frequent voiding

Pelvic/floor exercises:
- 3 sets of 10 - 15 contractions for 5 seconds
- daily x 3 months

Minimize fluids after dinner:
- especially in elders to reduce risk of falls d/t frequent trips to bathroom at night

Question 6

What pharmaceutical management should be considered for urinary incontinence?

Answer 6

Anticholinergics for urge/mixed:
- side effects:
- dry mouth
- dry eyes
- slow GI tract
- impaired cognition in elders

 - Mirabegron (Mybetriq):
      - fewer side effects

Estrogen for postmenopausal OAB:
- d/t E2 receptors in urinary tract

Question 7

List non-pharmaceutical management for urinary incontinence.

Answer 7

• Biofeedback
• Pelvic PT
• Pessary
• Surgery (stress type)