Urinary Incontinence

Question 1

Define “urinary incontinence”

Answer 1

Involuntary leakage of urine

Question 2

List the main urethral forms of incontinence

Answer 2

Overflow incontinence
Urge incontinence
Stress incontinence
Mixed incontinence

Question 3

What happens in overflow incontinence?

Answer 3

Bladder continuously fills up due to obstruction and eventually overflows
Hugely palpable bladder, can cause renal impairment

Question 4

What is meant by urge incontinence?

Answer 4

Urgent desire to pass urine and unable to hold it in

Question 5

What is the main cause of urge incontinence?

Answer 5

Detrusor overactivity during inhibition of voiding, making it impossible not to let it go
https://www.youtube.com/watch?v=0W_SGoBFJxs

Question 6

What is meant by stress incontinence?

Answer 6

Urine leaks during increased abdominal pressure, usually due to pelvic floor damage or urethral dysfunction

Question 7

Give examples of things that can precipitate stress incontinence

Answer 7

Laughing
Coughing
Jumping
Basically anything that increases abdominal pressure

Question 8

List management for overflow incontinence

Answer 8

Assess renal function
Treat obstruction - catheterise
Bladder rehab

Question 9

List conservative management for urge incontinence

Answer 9

Reduce caffeine intake

Bladder training

Question 10

List pharmacotherapy for urge incontinence

Answer 10

Antimuscarinic - oxybutynin, tolterodine

Beta-3-agonist - mirabegron

Question 11

List conservative management for stress incontinence

Answer 11

Reduce caffeine intake
Pelvic floor exercises/physiotherapy
Stop smoking

Question 12

List extraurethral causes of urinary incontinence

Answer 12

Ectopic ureter

Fistula