Urine Incontinence Flashcards
Male incontinence:
Why is an enlarged prostate the main cause?
Overflow incontinence: Occurs when the bladder is allowed to become so full that it simply overflows. This happens when bladder weakness or a blocked urethra prevents normal emptying. An enlarged prostate can result in such blockage. For this reason, overflow incontinence is more common in men than in women.
Stress incontinence:
What is it?
What is a common cause?
What sex does it affect more?
What are some risk factors?
What do patients usually say happens that should suggest this diagnosis?
Urine leaks with increased intra-abdo pressure
Cough
Sneeze
Women
Age
Obesity
They pee a little when then coughing or sneezing
Functional incontinence:
What is it?
Functional incontinence occurs when an individual with a normal bladder and urethral function has difficulty getting to the toilet before urination occurs. Those with impaired mobility or mental confusion may have this type of incontinence.
Urge incontinence:
What is it?
What muscle is involved?
What usually precipitates it?
Urge to urinate is quickly followed by uncontrollable and sometimes complete emptying of the bladder as the detrusor muscle contracts.
Detrusor overactivity
Arriving home - a conditioned reflex Cold The sound of running water Caffeine Obesity
History:
How can a patient keep a record of symptoms?
Using a 3-day bladder diary
Investigations:
What can be used to rule out UTI and DM?
What can be done to measure post-void residual volume?
Urine dipstick
Bladder scan or catheterisation
Management:
Lifestyle changes - 1
Stress incontinence:
- What will a physio advise?
- What does pseudoephedrine do?
- What can be put inside a woman to support the bladder?
Surgery can be used to resolve this but if declined, what drug can be offered?
Weight loss
Kegels - pelvic exercises - 8 contractions 3x/day for 3 months
Alpha agonists - cause the sphincter muscles to contract and tighten the bladder neck
Anti-continence pessary
DULOXETINE
Management:
Overactive/urge incontinence:
- What drink should be avoided?
- What meds can be prescribed?
- What can be injected into the bladder wall?
What temporary Rx is there for
Bladder wall botox - causes it to relax
Caffeine
Antimuscarinic - oxybutynin
B3 agonists - mirabegron
Pads and pull-ups
Catheterisation
Oxybutynin:
MOA
Side effects due to anticholinergics?
The antagonist of all muscarinic ACh receptor types, preventing parasympathetic contraction of the detrusor muscle.
Dry mouth Blurred vision Nausea Headache Constipation Diarrhoea and/or abdo pain
