Wk3 Urinary incontinence/POP Flashcards
Two important pelvic floor muscles for incontinence:
levator ani
bulbocavernosus
Beta (B3) receptor role in urination:
relax bladder dome — allow filling
alpha-1 receptor role in urination:
contract trigone and urethral smooth muscle to prevent urination
Muscarinic (M2, M3) receptor role in urination:
contract bladder (detrusor) muscle during urination
only somatic muscle in the system (voluntary)
external urethral sphincter
M3 receptor specifically:
smooth muscle contraction
M2 receptor specifically:
inhibits bladder relaxation
leakage of SMALL amounts of urine when intraabdominal pressure is increased
STRESS incontinence
leakage of LARGE amounts of urine occurring shortly after a sudden urge to urinate
-mediated by bladder contraction
Urge incontinence
aka:
Detrusor overactivity
overactive bladder
3 causes of stress incont:
pelvic floor weakness
loss of elasticity
hormonal or connective tissue effects
2 causes of urge incont:
“PVC” of the bladder
abnormal nerve signals
caused by blockage of the outlet (ie. BPH) or weak bladder muscle function –> frequent or constant dribbling
Overflow
Transient causes of incont:
Delirium
Infx
Atrophic vaginitis
Pharmaceuticals
Psych
Excessive urine output (ie. DM)
Reduced mobility
Stool impaction
Reversible causes of stress incont:
obesity
smoking (cough)
constipation
occupation (ie. lifting)
**Most common cause of urge incont:
detrusor overactivity
