Urinary Incontinence and Pelvic Floor Disorders

Question 1

definition of urinary incontinence

Answer 1

involuntary loss of urine that causes physical and/or emotional distress to pt

Question 2

sex predilection for urinary incontinence

Answer 2

women

Question 3

what is stress urinary incontinence?

Answer 3

insufficient strength of the pelvic floor muscles to prevent the passage of urine, especially during activities that increase intra-abdominal pressure, such as coughing, sneezing, or bearing down.

Question 4

What is urge urinary incontinence?

Answer 4

involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate (UTI, bladder irritants)

Question 5

What is overflow incontinence

Answer 5

cannot stop their bladders from constantly dribbling or continuing to dribble for some time after they have passed urine. It is as if their bladders were constantly overflowing, hence the general name overflow incontinence.

Question 6

What is functional incontinence?

Answer 6

due to physical impairment = a person recognizes the need to urinate but cannot make it to the bathroom

Question 7

type of incontinence common in menopause

Answer 7

stress

Question 8

type of incontinence common in prostate disease

Answer 8

overflow

Question 9

type of incontinence common in pregnancy

Answer 9

stress

Question 10

type of incontinence common in parkinson’s

Answer 10

urge

Question 11

type of incontinence common in DM

Answer 11

overflow

Question 12

type of incontinence common in alzheimers

Answer 12

urge

Question 13

What are risk factors for urinary incontinence

Answer 13

female
DM
increase abd pressure (obesitY, chronic cough, chronic constipation)
childbirth
menopause
altered cognition or neuro dz 
smoking 
collagen disorders

Question 14

What specifics are needed in HPI for assessment of incontience

Answer 14

FINISHED PUBS
Freq and volume
#Incontinent episodes
Nocturia
Incomplete emptying 
Stream
Hematuria
Hesitancy
Euresis
Dysuria
Post void dribble
Urgency
Burning
Strain to empty

Question 15

What should be included in a voiding diary

Answer 15

fluid consumption, type, and volume
voiding episodes and volume
leaking episodes
urgency
any assc symptoms

Question 16

relevant PMH

Answer 16

parity
birth trauma and assc repairs
length of labor (esp 2nd phase)
previous incontinence or gyn surgery
back problems
DM, MS, stroke, parkinsosn

Question 17

what type of drugs are given to prevent voiding?

Answer 17

↑symp and ↓para = alpha adrengergic and anti-cholinergic

Question 18

what type of drugs are given to promote voiding?

Answer 18

↓ symp and ↑para = alpha blocker and cholinergic

Question 19

what foods are assc with incontinence

Answer 19

caffeine, spicy food, alcohol, citrus foods and drinks

Question 20

what do you look for in a gyn exam that could explain incontience

Answer 20

sings of infection: erythema and excoriation of external genitalia 
atrophy of the vaginal walls
uretheal diverticulum 
prolapse
caruncle

Question 21

What nerve (spinal cord segs?) needs to be checked when assessing incontience? how is this done?

Answer 21

S2-S4 Pudental N (innv clitoris and ext genitalia + sphincters of bladder and rectum)

sharp and dull touch to perineum and buttocks
reflexes: anal wink and bulbocavernosus

Question 22

WHat does the Q tip test assess?

Answer 22

baldder neck mobility

Question 23

What type of incontience often has hypermobility?

Answer 23

stress

**but hypermobility does not necessarily mean SUI