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Renal > Urinary incontinence > Flashcards

Urinary incontinence Flashcards

1
Q

What is the definition of urinary incontinence?

A

Involuntary leakage of urine

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2
Q

True or False

Urinary incontinence is more common in females

A

True

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3
Q

Describe the storage phase of the bladder, in terms of pressures exerted

A

Intravesical pressure is less than urethral pressure

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4
Q

Where does the pressure come from in the voiding phase of micturition?

A

Detrusor muscle of bladder

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5
Q

What is urodynamics?

A

Study of the pressures of the bladder/abdomen using transducers

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6
Q

What effect does coughing have on intravesical pressure?

A

Increases pressure

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7
Q

What effect does coughing have on abdominal pressure?

A

Increases pressure

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8
Q

Which nerves supply the pudendal nerve?

A

S2, 3 and 4

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9
Q

What causes overflow incontinence?

A

Bladder overflow due to obstruction

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10
Q

What can be seen clinically in a patient with overflow incontinence?

A

Large palpable bladder

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11
Q

What is urge incontinence?

A

Involuntary passing of small volumes frequently and urgently

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12
Q

What might bring on urge incontinence?

A

Sound of running water
Coughing
Laughing
Jumping

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13
Q

What is detrusor overactivity?

A

Detrusor contractions during states of inhibition of voiding.

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14
Q

How is detrusor overactivity diagnosed?

A

Urodynamic therapy

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15
Q

What might cause afferent overstimulation?

A

Irritation in bladder e.g. stone

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16
Q

What would happen if S2 and 3 were destroyed?

A

Bladder would have no tone

17
Q

What is stress incontinence?

A

Stress has been put on pelvic floor or urethra over time which causes urine leakage due to increased abdominal pressure

18
Q

What can cause stress incontinence?

A

Childbirth

19
Q

What is the treatment for overflow urinary incontinence?

A

Assess renal function
Catheterise patient
Teach intermittent self-catheterisation

20
Q

How is urge incontinence treated conservatively?

A

Diet changes

Time bladder emptying

21
Q

What pharmacological treatment can be given for urge incontinence?

A

Antimuscarinics e.g. oxybutinin or tolterodine

Beta 3 adrenergics e.g. mirabegron

22
Q

What is enterocystoplasty?

A

Surgical solution to urge incontinence where the bladder is voided permanently through a catheter

23
Q

What is the treatment for stress incontinence?

A

Wt loss
Smoking cessation
Pelvic floor exercises

24
Q

What is an ectopic ureter?

A

Additional ureter which joins the urethra below the sphincter.
Congenital

25
Q

What are the risk factors for urinary incontinence?

A

Obese
Pregnancy
Vaginal delivery

26
Q

Why should an examination be undertaken in women with incontinence?

A

To check for prolapse and assess pelvic floor strength

27
Q

What does the management of urinary incontinence involve after having taken a history and examination?

A

Urine dipstick

Bladder diary for 3 days

28
Q

How many times a day is it normal to pass urine?

A

4-8

29
Q

How much urine should be in each normal void?

A

300-600ml

30
Q

What does bladder training involve?

A

Training bladder to void every hour, then increasing that interval.

31
Q

When should urgent referral to secondary care be made?

A

Visible haematuria
Recurrent UTI with microscopic haematuria
microscopic haematuria if over 50

32
Q

When should routine referral to secondary care be made?

A

Visible prolapse that is symptomatic

Palpable bladder post-void

33
Q

What incontinence is male specific?

A

Post-micturition dribble

Post-prostectomy incontience

34
Q

What can be advised in post-micturition dribble?

A

Urethral milking.

Massaging the bulbar urethra (at perineum) to remove excess urine

35
Q

What do 5-alpha reductase inhibitors do?

A

Stops conversion from testosterone to dihydrotestosterone so prevents BPH

36
Q

When should men be referred with incontinence?

A

If painful
Recurrent infections
Haematuria

37
Q

What drugs may cause incontinence?

A

Calcium CB

Opiates

Renal (16 decks)

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