Urinary Incontinence Flashcards
____ is loss of voluntary bladder control resulting in urinary leakage
Urinary incontinence
Is urinary incontinence a (Sx/Dx)?
Sx
___% women > 45 y/o have some type of urinary incontinence
__% women > 65 y/o
33%
50%
____ is experiencing the overwhelming need to urinate, even if you just went and/or being unable to hold it long enough to reach a bathroom
Urge
____ is urine loss during episodes of increased intra-abdominal pressure, such as exercise, coughing, sneezing, laughing, or any body movement, which puts pressure on the bladder
Stress
___ is incontinence occurring w/o urgency or stress
Unconscious or Overflow
What are the 2 types of urge (overactive bladder) incontinence?
Idiopathic detrusor instability (DI)
Neuropathic detrusor hyperreflexia
What are the 2 types of stress incontinence?
Urethral Hypermobility
Intrinsic Sphincter Deficiency (ISD)
What type of sx are described below?
“Hesitancy, slow stream, dribbling, incomplete emptying”
Voiding sx
What type of sx are described below?
“Frequency, urgency, interruption of sleep”
Storage sx
What should be included in the work-up for incontinence?
Review associated medical conditions, neurological sx
Medication hx (anticholinergics, alpha blockers, CCB, sedatives, alcohol)
UA + Cx
Urodynamics (bladder fxn)
What is included in the PE of incontinence?
Pelvic Exam
Q Tip test
Standing and “in position”
Estrogen status
___ is a pressure flow study
___ measures urethral closure pressure
___ measures the lowest pressure at which leakage occurs w/ straining
Cystometry
Urethral Profile Pressure
Leak Point Pressure
___ occurs when nerve passages from the bladder to the brain are damaged, causing a sudden bladder contraction
What is the name of the muscle that is contracting?
Urge incontinence
Detrusor muscle
BONUS QUESTION!!!!
What are the 2 indications to Rx Leuprolide?
endometriosis
fibroid
What is the goal of urge incontinence tx?
improve bladder stability
What are conservative tx options for urge incontinence?
Lifestyle
Behavioral modifications
- fluid manipulation
- timed voids
What medications can be used to tx urge incontinence?
Muscarinic Receptor Antagonists
What neural stimulation can be used to tx urge incontinence?
Sacral Neuromodulation
Interstim
___ occurs when pelvic muscles have been damaged
Stress incontinence
What causes stress incontinence?
Pregnancy and childbirth Radiation Trauma Prior surgery Muscle damage Hormonal changes
______ refers to the urodynamic diagnosis of stress incontinence–this condition exists under objective measures, when a patient can demonstrate urinary leakage when intra-vesical pressure exceeds the maximal urethral closure pressure in the absence of a detrusor contraction.
Genuine Stress Incontinence
____ + _____ + degree of ____ on the pt (all must be considered prior to tx of stress incontinence)
sx
objective findings
subjective effect
What is the goal of tx for stress incontinence?
To strengthen or aide the pelvic muscles that have been damaged
