Urinary tract infection and incontinence

Question 1

Commonest causative organism of UTI?

Answer 1

E coli

Question 2

General advice for prevention of recurrent cystitis? (4)

Answer 2

Frequent urination
Increase fluid intake
Double void
Void after intercourse

Question 3

When should vaginal oestrogen be considered?

Answer 3

in post-menopausal women if underlying cause has been investigated, and other measures have been insufficient

Question 4

Options for prophylaxis? (2)

Answer 4

TMP 200mg/Nitrofurantoin 100mg when exposed to trigger;

TMP 100mg/Nitrofurantoin 50mg once daily if above proves ineffective or no identifiable trigger

Question 5

Management of asymptomatic bacteruria in pregnancy?

Answer 5

Offer an immediate antibiotic (usually either nitrofurantoin, amox, cefalexin)

Question 6

Initial assessment of urinary incontinence? (3)

Answer 6

Abdominal/pelvic examination
Intake/output diary
Consider bloods if clinically appropriate

Question 7

Initial management of stress incontinence?

Answer 7

Pelvic floor muscle training for at least 3 months

Question 8

Which medication is licensed for stress incontinence?

Answer 8

Duloxetine

Question 9

Initial management of urge incontinence?

Answer 9

At least 6 weeks bladder re-training

Question 10

Drug treatment of urge incontinence? (2)

Answer 10

Anticholinergic drug e.g. oxybutynin (IR), tolterodine (MR), solifenacin
Mirabegron

Question 11

Common adverse effects of antimuscarinics?

Answer 11

Dry mouth, blurred vision, constipation

Question 12

When is desmopressin an option (off-license)?

Answer 12

Troublesome nocturia

Question 13

After how long should drug treatment with an antimuscarinic be reviewed?

Answer 13

4 weeks