Urinary Incontinence Flashcards
In the context of an emergency room. What causes of urinary incontinence need to be ruled out?
Cauda equina syndrome
Cord compression
MRI and CT
What is a pharmaceutical treatment for stress incontinence?
What is its mechanism of action
Duloxetine
Increases activity of striated sphincter during the filling phase
What is the main investigation that should be carried out in the context of over-flow incontinence?
Post-voidal residual volume
What non-urinary symptoms may accompany a lower motor neurone lesion causing UI?
Reduced perianal sensation
Lack anal tone
What are the 4 classifications of UI?
Stress
Urge (OABS)
Mixed
Overflow (outlet obstruction BPH)
Give some risk factors for UI.
Pregnancy/ childbirth Pelvic prolapse Menopause Increased intra abdominal pressure Neurological abnormalities
What are some general conservative measures that can be taken in context of UI.
If these are failed what can you try?
Stop smoking Restricts fluid uptake Discourage constipation and over straining Decrease caffeine intake Timed voiding - fixed schedule Weight loss
Indwelling catheters
Sheath device
Incontinence pads
Outline initial pharmacological and surgical management of SUI
Initial - PFMT
Duloxetine
Women
- Low tension vaginal tapes
- Open retropubic suspension procedures
- Classical sling procedures
- Intramural bulking agents
Men
- Male artificial uriary sphincter
Outline initial, pharma and surgical treatment for UUI.
Initial - bladder training
Pharma - oxybutynin (anticholinergic)
B3 agonist - mirabegron
Intravesicle botulinum toxin infection
Surgical
- Sacral nerve augemntion
- Autoaugmentation
- Augmentation cystoplasty
- Urinary diversion
What muscarinic receptors are found in the CNS?
M1 M4 and M5
What is normal functional bladder capacity?
300-400mls
