Urinary Incontinence Flashcards
definition of urinary incontinence
involuntary leakage of urine
when urine is collecting in the bladder what is shut
- the internal urethral sphincter which is under involuntary control
- the external urethral sphincter which is skeletal muscle under voluntary control
as the bladder is filling there are
- specialised sense receptors in the bladder wall which sense this filling and send afferent impulses to the level of S2-S3 and to the pointine storage and pointing micturition centre
- This increases the parasympathetic innervation and reduces the sympathetic innervation causing the internal and external urethral sphincters to relax and it also reduces the motor innervation to the external urethral sphincter causing it to relax which is called the micturition reflex
the pons is the region of the
brain that is trained to voluntary control urination the pointing stage centre can override the micturition reflex and the pointing micturition centre allows the micturition reflex to occur
types of urinary incontinence
- urge
- stress
- overflow
- mixed
urge incontinence
is the sudden urge to urinate followed by immediate involuntary urination caused by an overactive bladder
urge incontinece is usually caused by
an uninhibited detrusor muscle which contracts randomly
treatment of urge incontinence
avoid caffeine, bladder retraining, anti-muscarinic medication (oxybuticin), neuromodualtion (pacemaker for the bladder0
diagnosis of urge incotiennence
urodynamics
stress incotinence
urine leaks out when intra-abdominal pressure rises there is NO contraction of the detrusor muscle
stress incontinence usually occurs during
coughing, sneezing and laughing
stress incontinene is usually caused by
damage to the pelvic floor or the urethra during childbirth
stress incontinence diagnosed using
urodynamics
classically in stress incontinene
when you press the bladder urine leaks out
treatment of stress intoinence
weight loss stop smoking and kegel exercises