Urinary Incontinence Flashcards
which two diagnostic exams/tests are done to distinguish between the different types of urinary incontinence?
cystometrics and urodynamic studies
what are the reversible causes of urinary incontinence?
DIAPPERS (delirium, infection, atrophic vaginitis, psychiatric, pharma, excessive production, restricted mobility, stool impaction)
what are the IRREVERSIBLE causes of urinary incontinence?
Total, Urge, Functional, Stress, Overflow .. (this urine flow is so outrageous)
what is defined as continuous urinary and/or fecal leakage due to a fistulous tract?
total incontinence
stress incontinence is when there is a loss of urine secondary to what process?
an increase in intrabdominal pressure (for example, when coughing, laughing, exercise, etc.)
what is the anatomical cause for stress incontinence?
urethral hypermotility and/or sphincter dysunction tha tmaintains enough closing pressure at rest, but not with exertion
this type of incontinence is caused by unopposed detrusor muslce contraction
urge incontinence (remember, the most common symptom here is a SUDDEN feeling of urgency followed by emptying of the bladder)
this type of incontinence is associated with constant dribbling +/- urgency with INABILITY to empy the bladder
overflow incontinence
what is the anatomical cause of overflow incontinence? what are the two main pathologies behind this?
detrusor UNDERactivity - this can be due to an neuropathy or urethral obstruction
this type of incontinence involves pt recognition of the need to urinate, but the inability to make it to the restroom on time.
functional incontinence
what is the test for stress urinary inconitnence?
Q-tip test
how is the q-tip test performed and how does one interpret the results?
a cotton swab in placed in the urethra - a change in the angle between the q-tip and the woman’s body is measured upon stnading - NORMAL is less than 30degrees. a + test is one with an angle greater than 30 degrees (increased upward direction of the q-tip)
this evaluation test provides measurements of the relationship of pressure and volume in the bldder
cystometry
do urodynamic studies evaluate lower or upper urinary tract function?
LOWER!!
what is the main pharmacologic treatment for stress incontinence?
alpha agonists (remember, for the non pharmacological route, you can counsel pts on Kegel exercises)
