Urinary Incontinence

Question 1

what is meant by urinary incontinence?

Answer 1

the complaint of any involuntary leakage of urine

Question 2

what are the 4 main types of urethral urinary incontinence?

Answer 2

• overflow incontinence
• urge incontinence
• stress incontinence
• mixed incontinence

Question 3

what are the 2 causes of extraurethral urinary incontinence?

Answer 3

• ectopic ureter

- fistula

Question 4

during coughing, should the detrusor pressure change?

Answer 4

no, should stay the same

Question 5

what causes overflow incontinence?

Answer 5

bladder outflow obstruction causing chronic retention

Question 6

what might you notice of examination of someone with overflow incontinence?

Answer 6

huge palpable bladder

Question 7

when do patients with overflow incontinence usually experience the incontinence?

Answer 7

during the night

Question 8

what can overflow incontinence lead to?

Answer 8

renal impairment

Question 9

what do people with urge incontinence experince?

Answer 9

urgency and frequency, small voided volumes. wetting the bed at night.

Question 10

what are the common triggers for urgency?

Answer 10

• putting key in the door
• sound of running water
• standing up
• coughing, laughing

Question 11

what can urge incontinence be due to?

Answer 11

detrusor overactivity

Question 12

what would suggest detrusor overactivity?

Answer 12

bladder dysfunction characterised by detrusor contractions occuring during inhibition of voiding

Question 13

how is detrusor overactivity diagnosed?

Answer 13

urodynamics

Question 14

what could be causing urge incontinence if it is a new problem?

Answer 14

could be a bladder stone or tumour

Question 15

when is there leaks in stress incontinence?

Answer 15

urine leaks during increased intra abdominal pressure, without detrusor contraction

Question 16

what is stress incontinence usually due to?

Answer 16

damage to pelvic floor or urethral function eg in childbirth

Question 17

treatment of overflow urinary incontinence?

Answer 17

• assess renal function
• treat the obstruction and catheterise to empty bladder
• rehabilitate the bladder

Question 18

what is a patient with overflow incontinence taught to do?

Answer 18

intermittent self catheterisation

Question 19

what should be avoided in urge incontinence?

Answer 19

caffeine

Question 20

what drugs can be given in urge incontinence?

Answer 20

• antimuscarinics (eg oxybutynin, tolterodine)

- beta 3 adrenergic (mirabegron)

Question 21

what can be inserted into the bladder to treat urge incontinence?

Answer 21

neuromodulation (pacemaker for the bladder)

Question 22

what surgery can be performed in urge incontinence?

Answer 22

enterocystoplasty

Question 23

conservative managment of stress incontinence?

Answer 23

• weight loss, stop smoking

- pelvic floor exercises - physio

Question 24

drug treatments for stress incontinence?

Answer 24

duloxetine

Question 25

what are the surgical corrections for stress incontinence?

Answer 25

• open procedures- colpsosuspension

- now more minimally invasive “tape” procedure is used

Question 26

what is mixed incontinence a mix between?

Answer 26

urge and stress incontinence

Question 27

what causes a vesico-vaginal fistula commonly in developing countries?

Answer 27

prolonged obstructed labour

Question 28

what does a frequency volume chart record?

Answer 28

the volumes voided as well as the time of each micturation, day and night for atleast 24 hours