Urinary Incontinence and Pelvic Floor Disorders Flashcards
definition of urinary incontinence
involuntary loss of urine that causes physical and/or emotional distress to pt
sex predilection for urinary incontinence
women
what is stress urinary incontinence?
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.
What is urge urinary incontinence?
involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate (UTI, bladder irritants)
What is overflow incontinence
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.
What is functional incontinence?
due to physical impairment = a person recognizes the need to urinate but cannot make it to the bathroom
type of incontinence common in menopause
stress
type of incontinence common in prostate disease
overflow
type of incontinence common in pregnancy
stress
type of incontinence common in parkinson’s
urge
type of incontinence common in DM
overflow
type of incontinence common in alzheimers
urge
What are risk factors for urinary incontinence
female DM increase abd pressure (obesitY, chronic cough, chronic constipation) childbirth menopause altered cognition or neuro dz smoking collagen disorders
What specifics are needed in HPI for assessment of incontience
FINISHED PUBS Freq and volume #Incontinent episodes Nocturia Incomplete emptying Stream Hematuria Hesitancy Euresis Dysuria Post void dribble Urgency Burning Strain to empty
What should be included in a voiding diary
fluid consumption, type, and volume voiding episodes and volume leaking episodes urgency any assc symptoms
relevant PMH
parity birth trauma and assc repairs length of labor (esp 2nd phase) previous incontinence or gyn surgery back problems DM, MS, stroke, parkinsosn
what type of drugs are given to prevent voiding?
↑symp and ↓para = alpha adrengergic and anti-cholinergic
what type of drugs are given to promote voiding?
↓ symp and ↑para = alpha blocker and cholinergic
what foods are assc with incontinence
caffeine, spicy food, alcohol, citrus foods and drinks
what do you look for in a gyn exam that could explain incontience
sings of infection: erythema and excoriation of external genitalia atrophy of the vaginal walls uretheal diverticulum prolapse caruncle
What nerve (spinal cord segs?) needs to be checked when assessing incontience? how is this done?
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
WHat does the Q tip test assess?
baldder neck mobility
What type of incontience often has hypermobility?
stress
**but hypermobility does not necessarily mean SUI
