Urinary Incontinence Flashcards
What is the definition of urinary incontinence (UI)?
UI is the complaint of any involuntary leakage of urine. It can also be a social or hygienic problem when prevalence is studied.
How common is UI among women?
Affects 5%–70% of women, with 5%–15% experiencing daily UI. Incidence increases with age, especially among middle-aged women.
What anatomical factors contribute to continence?
Bladder pressure must remain lower than urethral pressure.
The detrusor muscle contracts to expel urine.
The levator ani muscle supports the urethra, resting on the anterior vaginal wall.
What factors increase the risk of UI?
Lifestyle: Fluid intake, obesity, smoking.
Medical conditions: UTI, diabetes, neurologic disorders, aging, and pregnancy.
Anatomical changes: Levator ani lacerations, urethral sphincter deficiency.
Why do many women with UI not report symptoms?
Belief that UI is a normal part of aging.
Lack of awareness of effective treatments.
Negative past experiences with healthcare providers.
What tools and methods are used to assess UI?
History tools: Leakage Index Questionnaire, 3-day voiding diary.
Diagnostics: Cystometrogram, quantified standing stress test, urethral pressure profile, ultrasound, or MRI.
How can UI be prevented?
Address risk factors: obesity, diabetes, excessive caffeine or alcohol intake.
Promote pelvic muscle exercises and bladder training.
What are key nonpharmacologic treatments for UI?
Lifestyle interventions (e.g., voiding diary, beverage management). Pelvic muscle exercises (Kegel exercises). Use of incontinence pessaries or other barrier devices.
What are common pharmacologic treatments for UI?
Urge UI: Anticholinergic agents (e.g., oxybutynin, tolterodine), tricyclic antidepressants (imipramine), or mirabegron.
Stress UI: Alpha-adrenergic agonists (pseudoephedrine) and duloxetine.
Postmenopausal UI: Vaginal estrogen.
What surgical treatments are available for UI?
Urge UI: Sacral nerve stimulators, botulinum toxin injections.
Stress UI: Bulking agents, surgical suspensions, and slings.
What complementary therapies are effective for UI?
Biofeedback, acupuncture, yoga, Pilates, and Tai Chi.
When should a woman with UI be referred to a specialist?
Management is ineffective. Results do not meet patient expectations. Complicating factors are suspected. Refer to urogynecologists or UI specialists.
What emerging treatments are being studied for UI?
Stem cell therapy. Innovations in physiologic and mechanical factors affecting UI.
What should be included in patient education for UI?
Explanation of UI diagnosis and types. Available treatment options. Healthy bladder habits (e.g., appropriate fluid intake and voiding intervals).
How does UI differ in adolescents?
Common urinary leakage can lead to psychological issues. Address risk factors and consider early intervention.
