Urinary Incontinence Flashcards
what is definition of Transient UI
Arises suddenly, lasts < 6 months, and can be reversed
what are the 4 subtypes of Chronic UI
Stress UI
Urge UI
Mixed UI
Overflow UI
what is a stress UI
leakage of urine with coughing, sneezing, or physical exertion (women)
what is a urge UI
Urine leakage with sudden compelling desire to void (OAB) (women and men)
what is a mixed UI
Coexistence of stress and urgency (commonly co-exist)
what is an overflow UI
Urinary retention from detrusor underactivity or outflow obstruction
-more common in men, from prostate enlargement
what is a Functional UI
Incontinence in the setting of physical or cognitive impairment which limits mobility or abillity to process information about bladder fullness
Common risk factors and risk factors for men and women for Urinary incontinence
Common:
- age
- obesity
- smoking, pulmonary disease
- family history
- Other diseases - DM, neuro conditions, injuries
- previous pelvic surgery
- medications
- NH admission
- Dementia
Women:
- Parity
- Menopause
Men:
-Benign prostate hypertrophy (BPH)
Pathophysiology of stress UI
problems with the pelvic floor, external sphincter, urethra, and endopelvic fascia
Pathophysiology of Urge Incontienece
Detrusor muscle
-over stimulation
pathophysiology of overflow incontinence
Blocked urethra bladder weakness -diabetes -alcohol -decreased nerve function Enlarged prostate
what is one medication that can lead to an Urinary incontienence
lithium
what are three physical exams to perform for presentation of UI
Functional assessment (mental status, mobility BMI)
Abdominal exam (asses for masses, palpable bladder, CVA tenderness)
Urogenital exam:
-inspection
-palpation
-consider rectal exam
-provocation: cough stress test
what are some urological tests for UI
UA with calometric reagent test + microscopy
Urine culture recommended with positive symptoms or dip
+/-Post void residual volume (PVR) - measures completeness of emptying
Voiding diaries
Pad testing worn for 24 hours >g increase in weight is positive test
what is the conservative management for stress UI
- appropriate fluid intake
- constipation management
- electrical stimulation (home electrode-stimulation therapy of the vagina or anus)
- Mechanical devices (vaginal inserts, urethral plugs)
- Pelvic floor muscle strengthening (kegel exercises, pelvic floor muscle training)
- smoking cessation
- weight loss
