urinary incontinence Flashcards
What do anticholinergics due to bladder?
relaxes detrusor muscle
What is urge incontinence?
the sudden uncontrollable need to void
caused by overactive bladder/ detrusor muscle
What is stress incontinence?
leakage with increased abdominal pressure
What gender gets more incontinence?
women
What is mixed urinary incontinence?
have both urgency and stress
What is overflow incontinence?
leakage due to a full bladder
Causes of overflow incontinence?
poor detrusor contractility, obstruction
What is functional incontinence?
impaired ability to reach toilet
Goals of therapy for incontinence?
relieve sx
improve bladder fx
prevent complications
avoid s/e
improve quality of life
What lifestyle modifications help with bladder issues?
lose weight (helps with stress incontinence)
no alcohol or caffeine
restrict fluids
quit smoking
What behavioural modifications can we do for bladder?
pelvic floor training
bladder training
scheduled toilets
What is first line for urge, stress and mixed incontinence? How long is it?
pelvic floor training for 12 weeks
What is bladder training?
for urge incontinence and you go every hour and increase 15 min each week
First line drug for Urge UI?
antimuscarinics to relax detrusor
Does antimuscarinics work?
yes
CI of antimuscarinics?
urinary retention
S/e of antimuscarinics?
dry mouth, constipation, confusion, blurred vision
Issues of antimuscarinics in elderly?
fall and frail risk
WHat drugs are antimuscarinics?
oxybutinin,
First line= tolterodine, solifenacin
What antimuscarinic has less BBB penetration?
tolterodine
What antimuscarinic is more selective for bladder?
tolterodine, solifenacin
How does mirabegron work? Who CANT get it?
Beta 3 agonist which relaxes detrusor
uncontrolled HTN = CI
Benefits of mirabegron?
no anticholinergic s/e
Options of drugs for stress UI?
vaginal estrogen- if urogenital atrophy
duloxetine- not well studied
