Urinary incontinence Flashcards
what is incontinence
complaint of involuntary leakage of urine
what are the 4 main types of urinary incontincence
overflow, stress, mixed and urge
what are 2 causes of extraurethral incontinence
ectopic ureter and fistula
during storage phase, does the bladder pressure stay high?
noon pressure is low! (urethral pressure is high)
what happens during voiding phase?
the pressure in the bladder overrides the urethral pressure thus using voluntary control, manages to pee out
does the abdominal and bladder pressure increase together?
yes- particularly during coughing
where is the spinal bladder centre?
S2/3
what signs and symptoms would be seen in overflow incontincence
bladder outflow obstruction, huge palpable bladder, chronic retention, incontinence, wet at night and renal impairment
what signs and symptoms would be seen in urge syndrome
frequency- small voided volumes, increased urgency, key in door, laughing, coughing, standing up, sound of running water, involuntary passing urine (enuresis)
what can be a cause of urge incontincence
detruser overactivity
how is detrusor overactivity diagnosed?
by urodynamics
why might detrusor overactivity occur?
paraplegia- loss of central inhibition, idiopathic, pelvic fracture
what is stress incontinence
urine leaks during increased abdominal pressure without a detrusor contraction
how may a stress incontincence occur?
damage to pelvic floor or urethral function particularly with childbirth
What is used to diagnose stress incontincnce
USI
what 3 conditions are affected by an overactive bladder
mixed, wet and dry overactive bladder
how would you treat overflow urinary incontinence
assess renal function, treat obstruction- catheterise, teach bladder intermittent self catheterisation
how wold you treat urge incontincence
dietary discretion- avoid caffeine bladder retraining- time bladder emptying Antimuscarinic, B3 adrenergic neuromodulation- pacemaker for bladder surgery
how would you treat stress incontinence
weight loss, stop smoking, pelvic floor exercises (physio), surgical
how would you treat mixed incontinence
combine urge and stress therapies
where would you see vesico- vaginal fistula
in developing countries due to prolonged obstructed labour
what is mixed urinary incontinence
involuntary leakage associated with urgency and exertion- sneezing, coughing, effort
