Urinary incontinence Flashcards

1
Q

what is incontinence

A

complaint of involuntary leakage of urine

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2
Q

what are the 4 main types of urinary incontincence

A

overflow, stress, mixed and urge

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3
Q

what are 2 causes of extraurethral incontinence

A

ectopic ureter and fistula

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4
Q

during storage phase, does the bladder pressure stay high?

A

noon pressure is low! (urethral pressure is high)

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5
Q

what happens during voiding phase?

A

the pressure in the bladder overrides the urethral pressure thus using voluntary control, manages to pee out

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6
Q

does the abdominal and bladder pressure increase together?

A

yes- particularly during coughing

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7
Q

where is the spinal bladder centre?

A

S2/3

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8
Q

what signs and symptoms would be seen in overflow incontincence

A

bladder outflow obstruction, huge palpable bladder, chronic retention, incontinence, wet at night and renal impairment

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9
Q

what signs and symptoms would be seen in urge syndrome

A

frequency- small voided volumes, increased urgency, key in door, laughing, coughing, standing up, sound of running water, involuntary passing urine (enuresis)

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10
Q

what can be a cause of urge incontincence

A

detruser overactivity

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11
Q

how is detrusor overactivity diagnosed?

A

by urodynamics

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12
Q

why might detrusor overactivity occur?

A

paraplegia- loss of central inhibition, idiopathic, pelvic fracture

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13
Q

what is stress incontinence

A

urine leaks during increased abdominal pressure without a detrusor contraction

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14
Q

how may a stress incontincence occur?

A

damage to pelvic floor or urethral function particularly with childbirth

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15
Q

What is used to diagnose stress incontincnce

A

USI

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16
Q

what 3 conditions are affected by an overactive bladder

A

mixed, wet and dry overactive bladder

17
Q

how would you treat overflow urinary incontinence

A

assess renal function, treat obstruction- catheterise, teach bladder intermittent self catheterisation

18
Q

how wold you treat urge incontincence

A
dietary discretion- avoid caffeine
bladder retraining- time bladder emptying
Antimuscarinic, B3 adrenergic 
neuromodulation- pacemaker for bladder
surgery
19
Q

how would you treat stress incontinence

A

weight loss, stop smoking, pelvic floor exercises (physio), surgical

20
Q

how would you treat mixed incontinence

A

combine urge and stress therapies

21
Q

where would you see vesico- vaginal fistula

A

in developing countries due to prolonged obstructed labour

22
Q

what is mixed urinary incontinence

A

involuntary leakage associated with urgency and exertion- sneezing, coughing, effort