Urinary_Incontinence_Flashcards

Question 1

What is stress incontinence?

Answer 1

Stress incontinence is the involuntary leakage of small amounts of urine when there is increased intra-abdominal pressure, such as coughing or laughing.

Question 2

What is urge incontinence?

Answer 2

Urge incontinence is the involuntary leakage of urine which is accompanied or preceded by an ‘urge’ to pass urine.

Question 3

What is overactive bladder syndrome?

Answer 3

Overactive bladder syndrome is characterized by increased frequency and nocturia, not necessarily with incontinence (if incontinent, classed as urge incontinence).

Question 4

What is mixed incontinence?

Answer 4

Mixed incontinence involves both urge and stress incontinence.

Question 5

What is overflow incontinence?

Answer 5

Overflow incontinence can be due to detrusor underactivity or bladder outlet obstruction causing urinary retention and leakage of urine.

Question 6

What can continuous incontinence indicate?

Answer 6

Continuous incontinence can either indicate severity or be due to a fistula.

Question 7

What is the cause of stress incontinence?

Answer 7

Stress incontinence is due to pelvic floor weakness or intrinsic sphincter deficiency.

Question 8

What are the conservative management steps for stress incontinence?

Answer 8

Conservative management for stress incontinence includes avoiding caffeinated drinks, avoiding drinking either excessive or reduced amounts of fluids daily, weight loss if BMI > 30kg/m2, smoking cessation if applicable, and local MDT involvement.

Question 9

What is the first line treatment for stress incontinence?

Answer 9

The first line treatment for stress incontinence is pelvic floor muscle training.

Question 10

What are the second line surgical procedures for stress incontinence?

Answer 10

Second line surgical procedures for stress incontinence include colposuspension, autologous rectus fascial sling, retropubic mid-urethral mesh sling, and intramural urethral bulking agents.

Question 11

What is the follow-up period for all surgeries related to stress incontinence?

Answer 11

The follow-up period for all surgeries related to stress incontinence should happen within 6 months.

Question 12

What is the third line treatment for stress incontinence?

Answer 12

The third line treatment for stress incontinence is duloxetine (enhances sphincter contraction) with review in 2-4 weeks if unsuitable for surgery or prefer pharmacological to surgical treatment.

Question 13

What are the conservative management steps for urge incontinence?

Answer 13

Conservative management for urge incontinence includes avoiding caffeinated drinks, avoiding drinking either excessive or reduced amounts of fluids daily, and weight loss if BMI > 30kg/m2.

Question 14

What is the first line treatment for urge incontinence?

Answer 14

The first line treatment for urge incontinence is bladder retraining for 6 weeks.

Question 15

What is the aim of bladder retraining for urge incontinence?

Answer 15

The aim of bladder retraining for urge incontinence is to gradually increase the intervals between voiding.

Question 16

What are the second line bladder stabilising drugs for urge incontinence?

Answer 16

Second line bladder stabilising drugs for urge incontinence include antimuscarinics like oxybutynin (immediate release), tolterodine (immediate release), or darifenacin (once daily preparation). Immediate release oxybutynin should be avoided in ‘frail older women’.

Question 17

What is the third line treatment for urge incontinence?

Answer 17

The third line treatment for urge incontinence is mirabegron (beta-3 agonist).

Question 18

What are the fourth line surgical procedures for urge incontinence?

Answer 18

Fourth line surgical procedures for urge incontinence include Botox injection, percutaneous tibial nerve stimulation (PTNS), or sacral nerve stimulation (SNS).

Question 19

What are the risk factors for stress incontinence?

Answer 19

Risk factors for stress incontinence include age, traumatic delivery (forceps), obesity, and previous pelvic surgery.

Question 20

What are the risk factors for urge incontinence?

Answer 20

Risk factors for urge incontinence include age, obesity, smoking, family history, and diabetes mellitus.

Question 21

What lifestyle measures should be explained to patients with incontinence?

Answer 21

Lifestyle measures for patients with incontinence include controlling fluid intake, avoiding caffeine, losing weight, and bladder retraining or pelvic floor training depending on the type of incontinence.

Question 22

What should be explained to patients regarding the treatment of urge incontinence?

Answer 22

Patients with urge incontinence should be explained that bladder retraining for 6 weeks involves trying to gradually increase the time in between going to the toilet.

Question 23

What should be explained to patients regarding the treatment of stress incontinence?

Answer 23

Patients with stress incontinence should be explained that pelvic floor training for 3 months involves supervised training with at least 8 contractions performed 3 times per day.

Question 24

What medical and surgical options should be explained to patients with incontinence?

Answer 24

Patients with incontinence should be explained the medical and surgical options, including conservative measures, first line treatments, and potential surgeries.