Urinary Incontinence Flashcards
What is detrusor overactivity?
Detrusor overactivity is the most common cause of urge incontinence, especially in the elderly. It occurs when the bladder muscle (detrusor) contracts involuntarily, leading to leakage.
What is stress incontinence?
Involuntary leakage of urine during physical activities that increase intra-abdominal pressure, such as coughing, sneezing, or lifting.
What is overflow incontinence?
Involuntary leakage of urine associated with bladder overdistention, often without a strong urge to void. This results from a bladder that is overfilled and unable to empty properly, leading to constant or intermittent dribbling.
What is functional incontinence?
Involuntary loss of urine due to the inability to reach the toilet in time, even though the lower urinary tract function is intact.
What is pediatric enuresis?
Involuntary urination, usually at night (nocturnal enuresis), in children who are old enough to have achieved bladder control
Compare primary vs secondary nocturnal enuresis.
Primary Nocturnal Enuresis: Most common form, where the child has never achieved consistent nighttime dryness. Often due to delayed maturation or genetic/hormonal factors.
Secondary Nocturnal Enuresis: Occurs in children who have previously been dry at night for at least six months but then begin wetting again.
What are signs of detrusor (bladder) overactivity?
- strong and sudden urge to urinate
- frequent urination including nocturia
- involuntary leakage of urine
What is a major sign of stress incontinence?
urine leakage during physical activities (but rare when resting).
What are signs of overflow incontinence?
- persistent and postvoid dribbling
- large post void residual volume
- feeling of incomplete bladder emptying
What is a major sign of pediatric enuresis?
nocturnal enuresis (bed wetting)
What drug groups help to manage UI or pediatric enuresis?
Anticholinergics, adrenoceptor agonists, dual SNRI, vaginal estrogens, cholinometrics, TCAs, and vasopressin analogues.
What is the mechanism of action of anticholinergics?
Inhibit the action of acetylcholine on muscarinic receptors in the bladder’s detrusor muscle, reducing involuntary bladder contractions which manages urge incontinence and detrusor overactivity.
What are adverse effects of anticholinergics?
Dry mouth, constipation, blurred vision, cognitive effects (confusion), and urinary retention.
What is the mechanism of action of adrenoceptors?
Stimulate alpha-adrenergic receptors in the bladder neck and urethra, increasing urethral tone and closing pressure which helps to manage stress incontinence.
What are adverse effects of adrenoceptors?
Hypertension, chest pain, and tachycardia.
