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Urinary incontinence Flashcards

1
Q

What is stress urinary incontinence?

A

Involuntary leakage on effort or exertion, on sneezing or coughing

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2
Q

What is urge urinary incontinence?

A

Involuntary leakage accompanied by or preceded by urgency

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3
Q

What can cause incontinence?

A 
Overactive bladder
Weakened pelvic floor
Nerve damage
Bladder condions
Other- e.g. constipation
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4
Q

What are the risk factors for incontinence?

A 
Parity
Increasing age
Menopause
Smoking
Increase intra abdominal pressure
Pelvic floor trauma
Denervation
Connective tissue disease
Surgery
Medical problems
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5
Q

What are the irritation symptoms that can come with incontinence?

A 
Irgency
Frequency >7x a day
Nocturia
Dysuria
HAmoaturia
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6
Q

What are the possible voiding symptoms with incontinence?

A

Straining to void
Interupted flow
Recurrent UTI

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7
Q

What are the possible prolapse symptoms that can come with incontinence?

A

Vaginal lump

Dragging sensation in vagina

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8
Q

What are the possible bowel symptoms that may come with incontinence?

A

Anal incontinence
Consiptaion
Faecal evacuation dysfunction
IBS

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9
Q

What history should be taken in urinary incontinence?

A

Parity- mode of delivery, weight of biggest baby
Smoking
HRT
Medical conditions
Previos pelvic floor muscle training, surgical treatment of incontinence or prolapse
Quality of life

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10
Q

What medical conditions should be enquired about with incontinence?

A 
DM
Anti HTN medications
Glaucoma
Heart, kidney, liver
Cognitive
Anti-depressants/anti-psychotics
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11
Q

What is recommended to be done for anyone with incontinence?

A

3 day urinary diary

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12
Q

What is looked at in a urinary diary?

A 
Fluid intake
Urine output
Daytime frequency
Nocturia
Average voided volume
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13
Q

What examinations should be done with incontinence?

A 
General
Abdo
Neuro
Gynae
Pelvic floor assessment
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14
Q

What investigations should be done for incontinence?

A

Urine dipstick and MSSU
Post ovoidal residual volume assessment
Urodynamics- if surgical treatment considered

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15
Q

What can be done for lifestyle management of incntinence?

A

Smoking cessation
Weight loss
Healthy diet- avoid constipation
Stop drinking alcohol and caffeine

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16
Q

What are the medical treatment options for stress incontinence?

A

Duloxetine

17
Q

What are the indications to use duloxetine in stress incontinence?

A

Pelvic floor training failed or would be enhanced by duloxetine
Doesn’t want/ not fit for surgery
Failed surgery
Patient wishes to have more children

18
Q

What are the medical options for treatment of urge incontinence?

A

Anti-muscarinic
Tricyclic antidepressants
Botox
Neuromodulin

19
Q

What are the physiotherapy options for treatment of incontinence?

A

Pelvic floor muscle training

20
Q

What are the surgical options for management?

A

Tension free vaginal tape

Colposuspension

21
Q

What is overactive bladder syndrome?

A

symptom complex usually, but not always, related to urodynamically demonstrable detrusor overactivity

22
Q

What are the risk factors for overactive bladder syndrome?

A

Advanced age
DM
UTI
Smoking

23
Q

What are the signs and symptoms of overactive bladder syndrome?

A

Urgency, with or without urge incontinence
Frequency
Nocturia

24
Q

What is the management of overactive bladder syndrome?

A 
Treat symptoms
Normalise fluid intake
Reduce caffeine, fizzy drinks, chocolate
Smoking cessation
Weight loss
Bladder training programme
Pharm
25
Q

What is a bladder training programme?

A

Timed voiding with gradually increasing intervals

Reproduction (29 decks)

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