Urinary Incontinence Flashcards
1
Q
types of urinary incontinence?
A
- urge
- stress
- mixed
- overflow
2
Q
describe urge
A
- suddenly feeling urge to pass urine, but urinating before able to get to bathroom
- caused by detrusor overactivity aka overactive bladder
3
Q
describe stress
A
caused by weakness in pelvic floor & sphincter muscles when increase in pressure ie cough, laughing
4
Q
describe mixed
A
both stress and urge
5
Q
aetiology of overflow incontinence?
A
chronic urinary retention
6
Q
risk factors?
A
- increased age
- increased BMI
- post-menopausal
- previous pregnancies & vaginal birth
- POP
- previous pelvic floor surgery
- neurological condition
- cognitive impairment
7
Q
assessment?
A
- history
- important to assess how severe symptoms are
- examination
- bimanual vaginal exam- strength of pelvic muscle contractions
8
Q
Ix?
A
- urine dipstick
- post void residual bladder volume
- urodynamic testing
9
Q
when would you do urodynamic testing?
A
if 1st line medical treatment failed for pts w urge
10
Q
Mx of Stress
A
- conservative
- Pelvic floor muscle training
- Duloxetine
- Surgery
- Tension free vaginal tape (TFVT)
- autologous sling procedures
- colposuspension
- intramural urethral bulking
11
Q
Mx of urge
A
- bladder retraining
- anticholinergics or mirabegron
- surgical- botox injections into detrusor to prevent it contracting
12
Q
contraindication to mirabegron?
A
uncontrolled HT as it is a beta-agonist therefore stimulates sympathetic system
13
Q
outline the innervation of the bladder
A
- Pees–> Parasympathetic
- Storage –> Sympathetic
- Voluntary–> Pudendal nerve
