Urinary Incontinence Flashcards
What are the types of urinary incontinence?
Stress incontinence
Urge incontinence
Overflow incontinence
Functional incontinence
Mixed incontinence
What is stress incontinence?
Incontinence when intra-abdominal pressure is raised
What is urgency incontinence?
The sudden and involuntary loss of urine associated with the urge to urinate
What is overflow incontinence?
The leakage of small amounts of urine without warning
Why does overflow incontinence occur?
When the pressure of the bladder overcomes the pressure of the outlet structures - usually due to underactivity of the detrusor muscle, or extra pressure on the urinary outlet structures
What can put extra pressure on the urinary outlet structures?
BPH
Constipation
What is functional incontinence?
The patient has the urge to pass urine, but is unable to access the necessary facilities
What are the causes of functional incontinence?
Sedating medications
Alcohol
Dementia
What are the risk factors for stress incontinence?
Childbirth
Hysterectomy
What can trigger stress incontinence?
Laughing
Coughing
Physical activity
Sneezing
What are the risk factors for urge incontinence?
Recent or recurrent UTI
High BMI
Smoking
Caffeine
What investigations are helpful in diagnosing urinary incontinence?
Questionnaires
Bladder diary
Cystometry - measures bladder pressure whilst voiding
Cystogram - radiological image with contrast
Urine dip
MSU
What lifestyle advice can improve stress incontinence?
Pelvic floor exercises
Avoiding alcohol and caffeine
Avoiding excessive fluid intake
What is the surgical management of stress incontinence?
Incontinence pessaries - supports the base of the bladder
Urethral bulking agents - injections into the area around the urethra to improve the sphincter’s ability to close
Mid urethral sling procedure (gold standard)
What is the medical management of urge incontinence/ overactive bladder?
Anticholinergic medications
- Oxybutynin
- Tolterodine
- Festerodine
