Urine related things

Question 1

What is used for urinary incontinence?

Answer 1

• oxybutinin - MR prep has fewer side effects
• tolterodine
• solifenicin
• mirabegron - QT prolongation, CI in hypertension

Question 2

What drug treatment can be used for nocturnal enuresis in children?

Answer 2

• oral or sublingual desmopressin
• if there are signs of response, continue treatment for 3 months
• ALTERNATIVE - imipramine (TCA)

Question 3

What is the difference between acute and chronic urinary retention?

Answer 3

• Acute - inability to pass urine over a period of hours

- Chronic - gradual development of the inability to empty the bladder completely

Question 4

What is the most common cause of urinary retention in men?

Answer 4

Benign prostatic hyperplasia

Question 5

How do you treat acute urinary retention?

Answer 5

• Catheter - immediately

- Alpha blocker - doxazosin, alfuzosin, terazosin, tamsulosin, indoramin

Question 6

What are some side effects of alpha blockers?

Answer 6

• hypotension
• postural hypotension
• first dose at bed time

Question 7

How to you treat chronic urinary retention?

Answer 7

• long term catheterisation

- catheters can cause pain and stones

Question 8

What is used for urinary retention in patients with an enlarged prostate?

Answer 8

• finasteride

- ADRs = male breast cancer, suicidal thoughts, depression

Question 9

What are symptoms of renal and ureteric stones?

Answer 9

• abdominal pain radiating to the groin
• nausea
• increased urinary frequency
• dysuria

Question 10

What are risk factors for kidney stones?

Answer 10

• Male aged between 40-60
• excessive dietry intake of sodium, animal protein, oxlate (rhubarb, spinach, nuts, strawberries, soy), urate
• obesity
• fmaily history

Question 11

How do you treat kidney stones?

Answer 11

• natural passing
• surgical - shockwaves, etc
• NSAIDs to manage the pain

Question 12

what advice would you give to patients with recurrent stones?

Answer 12

• limit oxlate, salt and urate intake

Question 13

How would you treat urological pain?

Answer 13

• lidocaine gel to relieve pain of catheter

- potassium citrate - for alkalinisation of urine

Question 14

How do you go about treating a bladder infection?

Answer 14

• Washouts e.g. sodium chloride solution

- chlorhexidine can also be used but isn’t preferred

Question 15

How do you treat blood clot retention?

Answer 15

irrigation with sterile sodium chloride solution

Question 16

How do you treat bladder cancer?

Answer 16

Installations of doxorubicin and mitomycin

Question 17

Which catheters should be changed at least every 6 weeks?

Answer 17

• catheters composed of latex

- if they are to be left for longer periods of time then silicone catheter should be used