Urinary incontinence Flashcards
What are the types of incontinence?
Stress
Urge
Overflow
Mixed
What is stress incontinence?
Involuntary leakage on effort, exertion, increased intraabdo pressure
What is urge incontience?
Involuntary leakage, accompanied by preceded by urgency
What are the causes of incontinence?
Overactive bladder Constipation Weak pelvic floor Nerve damage Bladder damage More
What is the main risk factor for incontinence?
Parity
What are the risk factors for incontinence?
Parity Age MEnopause Increased intraabdo pressure Pelvic floor trauma Denervation Connective tissue disease Surgery Smoking
What is the presentation of incontinence?
Incontinence URgency Frequency HAematuria Prolapse
What is important to take on history with incontinence?
Parity- mode of delivery and heaviest baby Smoking HRT Medical conditions Previous surgery Previous incontinence treatment QoL
What investigations are done for incontinenec?
3 day urinary diary
Urinalysis
Post void residual volume
Urodynamics if considering surgery
What is in a urinary diary?
Fluid intake Urine output Frequeny Nocturia Average voided volume
What are the principles of management of incontinence?
Lifestyle
Pelvic floor muscle training
Medical
Surgical
What is the management of urge incontinence?
- Bladder retraining
2. Antimuscarinic
What is the management of stress incontinence?
- Pelvic floor uncle training
2. Medication/surgery
What medication is used in stress incontinence?
Duloxetine
What are the indications for medical management of stress incontinence?
Pelvic floor training failure/not appropriate
Doesn’t want/not fit for surgery
Failed surgery
Patient wants more children
