Urinary Incontinence Flashcards
Outline the possible storage symptoms of urinary incontinence
Frequency
Urgency
Nocturia
Incontinence
Outline the possible voiding symptoms of urinary incontinence
Slow stream
Spitting/spraying
Intermittency
Hesitancy
Straining
Terminal dribble
Outline the possible post-micturition symptoms of urinary incontinence
Post-micturition dribble
Feeling of incomplete emptying
What is urinary incontinence?
The complaint of any involuntary leakage of urine
What is stress urinary incontinence?
Involuntary leakage on effort or exertion, or on sneezing or coughing
What is urge urinary incontinence?
Involuntary leakage of urine accompanied by or immediately proceeded by urgency
What is mixed urinary incontinence?
Involuntary leakage or urine associated with urgency and also with exertion, effort, sneezing or coughing
Outline overflow incontinence
Involuntary release of urine from an overfull urinary bladder, often in the absence of any urge to urinate
Neural lesion = between S2-S4
Outline risk factors for urinary incontinence relating to obstetrics and gynaecology
Preg
Childbirth
Pelvic surgery
Pelvic prolapse
What are the promoting risk factors for urinary incontinence
Race
Family predisposition
Anatomical abnormalities
Neurological abnormalities
Outline the predisposing risk factors relating to urinary incontinence
Co-morbidities
Obesity
Age
Increased intra-abdo pressure
UTI
Drugs
Menopause
Briefly outline the investigations used to aid diagnosis of urinary incontinence
Urine dipstick = UTI, haematuria, proteinuria, glucosuria
Frequency-volume chart
Bladder diary
Post-Micturition residual volume – in pts with voiding dysfunction
Pressure-flow studies +/- video
Pad tests
Cystoscopy
What lifestyle modifications can take take to help address urinary incontinence?
Modify fluid intake
Weight loss
Stop smoking
Decrease caffeine intake
Avoid constipation
Timed voiding
Outline treatment options for pts unsuitable for surgery and who have failed conservative management
Indwelling catheter = indwelling, suprapubic
Sheath device = adhesive condom attached to catheter tubing and bag
Incontinence pads
What is the initial management for stress urinary incontinence?
Pelvic floor muscle training
What are the male and female surgery options for stress urinary incontinence?
Females = low tension vaginal tapes, intramural bulking agents
Males = artificial urinary sphincter, male sling procedure
How is urge urinary incontinence initially managed?
Bladder training = schedule of voiding
What is the pharmacological management for urge urinary incontinence?
Anticholinergics = act on muscarinic receptors M2 and M3
Beta-3 adrenoceptor agonist = increases bladders capacity to store urine
What are the surgical options when treating urge urinary incontinence?
Sacral N neuromodulation
Autoaugmentation
Urinary diversion
