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Reproductive Medicine Exam 3 > Urinary Incontinence > Flashcards

Urinary Incontinence Flashcards

1
Q

What is urinary incontinence?

A

Loss of voluntary bladder control resulting in urinary leakage

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2
Q

Is urinary incontinence more commonly a symptom or a diagnosis?

A

Symptom

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3
Q

__ out of 3 women over the age of 45 have some type of urinary incontinence

A

1 out of 3

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4
Q

_____ incontinence is described as experiencing the overwhelming need to urinate even if you jest went and not being able to hold it long enough to make it to the bathroom

A

Urge Incontinence

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5
Q

What is stress incontinence?

A

Urine loss during episodes of increased intra-abdominal pressure that puts pressure on the bladder resulting in urine leakage

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6
Q

What are examples of ‘things’ that can cause stress activities?

A

Coughing
Sneezing
Exercising
Laughing

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7
Q

Can stress and urge incontinence be seen together?

A

Yes, this is described as mixed incontinence

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8
Q

What is Unconscious/Overflow Incontinence?

A

Incontinence without urge or stress

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9
Q

Overactive Bladder (OAB) is the idiopathic instability or neuropathic hyperreflexia of what muscle?

A

Detrusor Muscle

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10
Q

Stress incontinence can often be a result of what two things?

A

Urethral Hypermobility

Intrinsic Sphincter Deficiency (IDS)

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11
Q

What are the THREE most common symptoms associated with urge incontinence?

A

Frequency
Urgency
Nocturia

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12
Q

What medications may be associated with urinary changes?

A

Anticholinergics
Alpha-Blockers
CCB
Sedavites

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13
Q

Should you ask about alcohol consumption in a patient with urinary incontinence?

A

Yes

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14
Q

What is a critical portion of the evaluation of urinary incontinence?

What types of things does this measure?

A

24 hr Voiding Diary

This measures input, output, times leaking, times voiding

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15
Q

What is the average amount of urine output in a 24 hour period?

A

1500 - 2500 mL

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16
Q

What is the average number of times a patient should void in 24 hours?

A

7 - 8 times

17
Q

What is the average amount voided at one time?

A

250 mL

18
Q

What are FOUR things to include in your physical examination for urinary incontinence (in females)?

A

Pelvic Exam
Q Tip Test
Standing examination
Estrogen Status

19
Q

What ‘labs’ should you order when working up urinary incontinence?

A

Urinalysis

Urine Culture

20
Q

What is one ‘study’ that is useful in working up incontinence, especially stress incontinence?

A

Urodynamics

21
Q

What does a cystometry measure during urodynamic testing?

A

Pressure Flow

22
Q

What is a urethral profile pressure measure during urodynamics?

A

Urethral closure pressure

23
Q

What is a ‘leak point pressure’ during urodynamic testing?

A

Lowest pressure at which leakage occurs with straining

24
Q

How does urge incontinence occur?

A

Nerve passages from the bladder to the brain are damage causing a sudden bladder contraction

25
Q

Which would you expect larger volumes of urine to be ‘leaked’ out……

Urge or Stress Incontinence

A

Urge

26
Q

What class of medications can be used to treat urinary incontinence?

A

Muscarinic Receptor Antagonists

27
Q

T/F: Sacral Neuromodulation Interstim device placement can be utilized to manage urge incontinence

A

True

28
Q

What are examples of ‘things’ that can lead to stress incontinence?

A 
Pregnancy/Childbirth 
Radiation
Trauma
Surgery
Hormonal Changes
29
Q

How is stress incontinence diagnosed?

A

This condition needs to be proven under urodynamic studies that demonstrate urinary leakage when intra-vesical pressure exceeds the maximal urethral closing pressure in the absence of detrusor contraction

30
Q

T/F: There are approved medications for stress incontinence management

A

False

There are no approved medications for this

31
Q

What is the goal of stress incontinence treatment?

What are examples of these treatments?

A

Strengthen or aide the pelvic muscles that have been damaged.

Examples….

Pelvic Floor Exercises
Pessary Device
Surgery

32
Q

What two muscles are the focus of kegel exercises?

A

Urogenital sphincter (increase urethral closure)

Levator Ani (Improves urethral support)

33
Q

What muscles do pessary devices support?

A

Levator Ani Muscles

34
Q

Surgical placement of what is often indicated in stress incontinence?

A

Sling

***Minimally Invasive surgery

35
Q

T/F: Mixed incontinence is often treated with a combination of medications and surgery

A

True

Reproductive Medicine Exam 3 (10 decks)

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