Urinary Incontinence Flashcards
What are three types of female urinary incontinence?
Involuntary, spontaneous urine loss that occurs either with strenuous physical activity (stress incontinence) or is associated with an uncontrollable sense of urgency (urge incontinence), or both (mixed incontinence).
What are the risk factors associated with urinary incontinence?
Increasing Age Parity Menopause Smoking Medical problems Raised intra-abdominal pressure Pelvic floor trauma Denervation Connective tissue disease Surgery Obesity Constipation Dementia/care home
What are increased daytime frequency and nocturia classified as?
Daytime frequency- over 7 times a day
Nocturia- more than once a night
What aspects are included in a urinary incontinence diary?
Fluid intake: Quantity & Quality Urine Out-Put (exclude Nocturnal Polyuria) Daytime Frequency, Nocturia Average voided volume.
What investigations should be done for urinary incontinence?
Urinalysis
Post voiding residual volume assessment (only if related symptoms)
Urodynamics (only if surgery contemplated)
What lifestyle changes can be made to help urinary incontinence?
Stop smoking
Lose weight
Eat more healthily to avoid constipation
Stop drinking alcohol and caffeine
How can pelvic floor exercises help with urinary incontinence?
Reinforcement of cortical awareness of muscle groups
Hypertrophy of existing muscle fibres
General increase in muscle strength and tone
What pharmacological therapy can be used for stress incontinence?
Pseudoephedrine
Imipramine
Duloxetine
What surgical procedure can help with both stress and urge incontinence?
Colposuspension
Sling Procedure
Using either trans vaginal or trans obturater tension free tape
What is overactive bladder syndrome?
A symptom complex usually, but not always, related to urodynamically demonstrable detrusor overactivity (DO)
Symptoms include urgency, frequency and nocturia
What are the risk factors for overactive bladder syndrome?
Advanced age
Diabetes
Urinary tract infections
Smoking
What is the non pharmacological management for overactive bladder syndrome?
Treat the symptoms Normalise fluid intake Reduce caffeine, Fizzy drinks, Chocolate Stop Smoking Weight loss Bladder training programme- timed voiding with gradually increasing intervals
What is the pharmacological management for overactive bladder syndrome?
Anti-muscarinics Anti-cholinergics Tri-cyclic antidepressants Botox Neuromodulation
