Urinary incontinence Flashcards
What ir urinary incontinence?
The complaint o ay involunary leakage o urine
What are the 4 types o incontinence?
Overflow
Urge
Stress
Mixed
In what ways can urine leak via an extra-urethral route?
Ectopic ureter
Fistula
What causes overflow incontinence?
Bladder outflow obstruction Chronic retention Insensible incontinence Oten wet at night Renal impairment
How is urine passed in urge incontinence?
requent small voided volumes
What provokes urge incontinence?
Key in door
Sound of running water
Standing up
Coughing, laughing
Cause of urge incontinence
Destrusor overactivity
How is detrusor overactivity diagnosed?
Urodynamics
What can cause detrusor overactivity?
Afferent overstimulation
Excess central facilitation
Paraplegia - loss of central inhibition
Destruction of S2/3 centre
Pevlic surgery or fracture (parasympathetic nerves damaged)
What is stress incontinence?
Urine leaks during increased intrabdominal pressure without a detrusor contraction
What causes stress incontinence/
Damage to pelvic floor or urethral function (childbirth)
What does a painless palpable mass arising from the pelvis that you “can’t get below” suggestive of?
Full bladder
Treatment of overflow incontinence
Treat the obstrction (catheter)
Rehabilitate the bladder (teach intemittent self catheterisation)
What lifestyle change can help urge incontinence?
Avoid caffiene
Pharmacotherapy for urge incontinence
Antimuscarinics (e.g. oxybutin)
Beta 3 adrenergics (mirabegron)
bladder “pacemaker”
