Urinary Incontinence

Question 1

Which type of incontinence?

• Urethral blockage (overactive urethra)
• Bladder unable to empty properly (underactive bladder)

Answer 1

Overflow Incontinence

Question 2

Which type of incontinence?

• Relaxed pelvic floor
• Increased abdominal pressure
• MC women- after preg, post-menopausal (dec. estrogen)

Answer 2

Stress incontinence

Question 3

Which type of incontinence?

• Overactive bladder
• from infection or neurologic disorder

Answer 3

Urge Incontinence

Question 4

Both Volitional and involuntary contractions of the detrusor muscle are mediated by activation of postsynaptic _______ receptors by _______

Answer 4

Both Volitional and involuntary contractions of the detrusor muscle are mediated by activation of postsynaptic muscarinic receptors by acetylcholine

Question 5

Which receptor is responsible for emptying contractions of nml micturition as well as involuntary bladder contractions that may result in UI?

Answer 5

M₃ receptors

(most pharmacologic antimuscarinic therapy is primarily anti-M₃ based)

Question 6

What is the pharmacologic therapy of choice for urge incontinence?

Answer 6

anticholinergic/antispasmodic agents

Agents= Oxybutynin, darifenacin, fesoterodine, solifenacin, tolterodine

(“Darla Sold Oxy To Fern)

Question 7

What are the 2 pharmacologic therapies of choice in stress incontinence (uretheral underactivity)?

Answer 7

alpha-adrenergic receptor agonists and topical (vaginal) estrogens

(alone or together)

Question 8

Overflow incontinence is associated with what condition?

MC in men or women?

Answer 8

BPH

MC in men

Question 9

The following localized/systemic illnesses may result in what?

• Dementia/delirium
• Depression
• Urinary tract infection (cystitis)
• Postmenopausal atrophic urethritis or vaginitis
• Diabetes mellitus
• Neurologic disease (e.g., stroke, Parkinson’s disease, multiple sclerosis, spinal cord injury)
• Pelvic malignancy
• Constipation
• Congenital malformations

Answer 9

Urinary Incontinence