Urinary Incontinence Flashcards
Definition of stress incontinence
An involuntary loss of urine that occurs during physical activity
Def urge incontinence
Involuntary leakage with or just before urgency
Define detrusor overactivity
Urodynamic observation
- involuntary detrusor contractions
Define mixed urinary incontinence
Involuntary leakage associated with urgency, exertion etc
When does continuous urinary incontinence occur?
If urine is leaking through channels other than the urethra
How quickly does the bladder fill?
0.5-5ml/min
When do you first sense bladder fullness?
150-250ml
When do you get a strong desire to urinate?
400-600ml
Risk factors for urinary incontinence
- age
- delirium
- infection
- atrophic changes
- pharmacologic
- excess urinary output
- restricted mobility
- stool impaction
- obesity
- family history
- childbirth
- surgery
- medication
- smoking
Causes of urinary incontinence
- stress incontinence
- detrusor overactivity
- retention and overflow
- fistulae
- congenital
- urethral diverticulum
- temporary (UTI)
- functional (immobility)
When are urodynamic studies indicated?
- when surgery is considered
- failed conservative management
- failed medical or surgical treatment
- complex cases
- voiding dysfunction
- medico-legal cases
Use of perineal ultrasound
- residual volume
- bladder neck mobility
- bladder neck funneling
- diverticulum
- effect of a prolapse
Aims of assessing incontinence
- exclude underlying condition
- assess desire for intervention
- institute therapy
- prompt referral
Conservative management of stress urinary incontinence
- lifestyle modification
- physical therapy (Kegels)
- pessaries
- urethral plugs
Medical management of SUI
Duloxetine (SSRI)
