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Urinary Incontinence

Clinical Medicine II

Involuntary leakage of urine urine incontinence
Who are at risk or who should we ask for UI women who have had kids, individuals w/ comorbid conditions, >65
Sudden and compelling desire to pass urine that is difficult to defer urgency
Involuntary leakage accompanied by urgency (drops of urine to soaking thru pants) urge incontinence
What are things that can precipitate urge incontinence running water, hand washing, going out into the cold
What is stress incontinence involuntary leakage w/ effort: exertion, sneezing, coughing
What determines immediate and delayed leakage I: failure of sphincter, D: difficult to stop uninhibited detrusor
What is mixed incontinence involuntary leakage w/ urgency and stress
Urgency, frequency, nocturia, w/w/o urge incontinence overactive bladder (symptom and syndrome)
Continuous leakage, usually dribbling of sm amounts of urine continuous urinary incontinence
Complaint of needing to void too often during the day daytime frequency
Waking at night oneor more times to void nocturia
Same as above w/ incontinence nocturnal enuresis
Perception of reduced urine flow, compared to previous performance slow stream
Urine flow which stops and starts on one or more occasions during voiding intermittent
Difficulty in initiating voiding hesitancy
Muscular effort used to initiate, maintain, or improve urinary stream straining to void
Sensation that the bladder is not empty after voiding incomplete empyting: obstruction?
In men, sx associated w/ leakage post-void dribbling
What causes overactive bladder syndrome role of afferent sensory n. pathway of the bladder, detrusor hyperactivity w/ impaired contractility
When does stress leakage occur an increase in intraabdominal pressure overcomes sphincter closure in the absence of a bladder contraction. MC in younger women
Combination of urge and stress incontinenc e mixed incontinence
Mechanisms of mixed incontinence detrusor overactivity, impared urethral sphincter tone (surgery, birth)
Overflow incontinenc e d/t incomplete bladder emptying
Is incomplete emptying common in women no.
What can cause obstruction in women scarring from previous surgery, pelvic organ prolapse, suprasacral spinal injury
Causes of incomplete emptying detrusor underactivity
What is DHIC detrusor hyperactivity impaired contractility: urgency w/ ↑ postvoid residual vol in absence of obstruction
Neurogenic bladder unspecific term for a dx of areflexia d/t a neruo d/o
What is functional incontinence related to potentially reversible conditions, cognition, mobility, medications
Uncommon causes of UI Vesico-Vaginal fistula (UC or CD), impaired detrusor compliance
Causes for sudden onset of incontinence UTI, neuologic, neoplastic
Hy do we check SCa+, glucose, VIt B12 for UI
When do we do a urine cytology if hematuria and pelvic pain
Stress test for UI have pt cough w/ a pad Instant: stress incontinence, delayed: cough-induced detrusor overactivity, -: less useful
When do we do postvoid vol test women sig pelvic organ prolapse, nero dz’s or recurrent UTI, DM and PN
What is adequate emptying <50 PRV, >200 suggestive of detrusor weakness or obstruction
What is the UI test gold standard Urodynamic Testing Look up
Tx of UI Behavior! diet, fluid intake, bladder training, timed voiding, (voiding diary, ↑ gradually voiding trails)
Dx of UI clinically establish cause (Urge, stress, mixed, incomplete voiding), kegel exercises,
Do we practice kegels during voiding no., during the URGE to urinate
Refer when when you think, is right,
What are some medications for UI urethral bulking agents: collagen, silicone
Surgical Tx in women restore urethral support: midurethral sling support
Surgical Tx in men artificial urinary sphincter
Created by: becker15
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