Urinary Incontinence Flashcards
1
Q
What is UI?
A
- Involuntary leakage of urine
2
Q
What are the different types of UI?
*7 types
*FUSMOOT
A
- Functional Incontinence
- Stress Incontinence
- Urge Incontinence
- Mixed Incontinence
- Overactive Bladder Syndrome
- Overflow Incontinence
- True Incontinence
3
Q
What is functional incontinence?
A
- patient is unable to reach the toilet in time
- poor mobility or unfamiliar surroundings
4
Q
What is stress incontinecne?
A
- involuntary leakage of urine on effort or exertion
- incompetent sphincter
5
Q
What is urge incontinence?
A
- involuntary urine leakage accompanied by, or immediately preceded by, urgency of micturition
- detrusor instability or hyperreflexia
- involuntary detrusor contraction
- detrusor instability or hyperreflexia
6
Q
What is mixed incontinence?
A
- involuntary leakage of urine associated with both urgency and exertion
7
Q
What is overactive bladder syndrome?
A
- urgency that occurs with or without urge incontinence and usually with frequency and nocturia
8
Q
What is overflow incontinence?
A
- due to chronic bladder outflow obstruction
- prostatic disease in men
9
Q
What is true incontinence?
A
- Continuous leakage of urine
- fistulous track between the vagina and the ureter, or bladder, or urethra
10
Q
What are the RF of UI?
A
- Women
- Pregnancy, parity
- Vaginal delivery
- Vaginal hysterectomy
- UTI
- Neurological disease
- stroke, dementia, parkinsons
- Enlarged protsate
- Stool impaction
11
Q
What questions will you enquire to assess the type of incontinence?
A
- Stress incontinence: leakage of urine on sneezing, coughing, exercise, rising from sitting, or lifting.
- Urge incontinence: urgency and failure to reach a toilet in time.
- Frequency of urine during the day/at night.
- Dribbling of urine after leaving the toilet.
- Loss of bladder control.
- Feeling of incomplete bladder emptying.
- Dysuria: pain or burning sensation on passing urine.
- Bladder spasms
12
Q
What other questions would you ask to enquire more about the incontinence?
A
- consider neurological causes - hand co-ordination, cognitive function
- A full obstetric history
- The patient should be asked to complete a bladder chart for a minimum of three days.
- Enquire about sexual dysfunction and quality of life.
- Assess functional status and access to toilet.
- Establish whether any medication contributes to symptoms.
- Enquire about bowel habit.
- Enquire about desire for treatment
13
Q
What examination would you perform for UI?
*list both women and men
A
women
- Digital assessment of pelvic floor contraction
- vaginal examination - assess for prolapse
- signs of vaginal atrophy
- abdo, pelvic and neuro examination
men
- DRE - prostate and anal strength
- abdo, pelvic and neuro examination
14
Q
WHat ix would you order for UI?
A
- urinary dipstick testing - infection or haematuria
- MSU for MCS if UTI +
- Post-void bladder scan
- urodynamic assessment
- outflow urodynamics
- cystoscopy
- IV urogram
- MRI
15
Q
When is urodynamic testing only considered?
A
- suspected detrusor over-activity
- symptoms suggestive of voiding dysfunction
- have had previous surgery for stress UI
