Urinary Incontinence (Repro)

Question 1

Overactive bladder syndrome is defined as?

Answer 1

Urgency that occurs with or without urgency incontinence and usually with frequency and nocturia

Question 2

Overactive bladder syndrome is defined as?

Answer 2

Urgency that occurs with or without urgency incontinence and usually with frequency and nocturia

Question 3

What is characteristic of OAB?

Answer 3

Urinary frequency

Only small voided volumes

Question 4

What is OAB a form of?

Answer 4

Bladder dysfunction characterized by detrusor contractions during the inhibition of voiding phase

Question 5

Most common cause of urge incontinence and OAB?

Answer 5

Idiopathic detrusor overactivity (in middle aged females)

Question 6

Another common cause of urge incontinence?

Answer 6

Atrophic vaginitis

Question 7

Treatment of atrophic vaginitis?

Answer 7

Topical oestrogens

Question 8

Treatment of urinary incontinence?

Answer 8

• Lifestyle advice
• Bladder drill
• Medication
• Botox
• Neuromodulation
• Reconstructive surgery

Question 9

Medications for treating urinary incontinence?

Answer 9

• Anti-muscarinics

- Beta agonists

Question 10

What do anti-muscarinics do to terat urinary incontinence?

Answer 10

Block PS to stop detrusor contractions

Question 11

Examples of anti-muscarinics?

Answer 11

Solifenacin

Question 12

Beta agonists work by?

Answer 12

Activating sympathetics to increase detrusor relaxation

Question 13

Examples of beta agonists?

Answer 13

Mirabegron

Question 14

What is stress incontinence?

Answer 14

Involuntray leakage of urine of effort, exertion, sneezing or coughing causing increased intra-abdominal pressure without detrsor contraction

Question 15

What is stress incontinence due to?

Answer 15

Damage or weakness of the pelvic floor/urethral function

Question 16

RFs for stress incontinence?

Answer 16

• Pregnancies
• Childbirth
• Menopause
• Increased age
• Obesity
• Smoking (chronic cough)

Question 17

Investigation for stress incontinence?

Answer 17

Standing or supine stress test where you ask the ptnt to cough and look for leakage of urine

Question 18

Treatment of stress incontinence?

Answer 18

Lifestyle advice 
Pelvic floor physio 
Pessaries 
Medication 
Incontinence pads 
Surgery

Question 19

Medications for stress incontinence?

Answer 19

Duloxetine which is a combined NA and SSRI thought to increase intraurethral closure pressure

Question 20

Why does overflow incontinence occur?

Answer 20

Due to bladder not emptying properly when urinating causing urine to leak out later

Question 21

Which incontinence is more common in men?

Answer 21

Overflow incontinence

Due to prostatic obstruction

Question 22

Reasons overflow incontinence can happen in women?

Answer 22

Obstruction of the urethra (caused by prolapse)

Poor contractile bladder muscle

Question 23

Presentation of overflow incontinence?

Answer 23

Painful urinary retention

-Palpable bladder, chronic retention, wet and nigh and renal impairment, mass is due to percussion

Question 24

What must be stopped if someone presents with overflow incontinence/acute retention?

Answer 24

Anti-cholinergics

Anti-muscarinics

Question 25

Patients with overflow incontinence have full recoveries. True or False?

Answer 25

FALSE
Unlikely to ever be able to pass urine spontaneously again
(often people need self-catheterisation)