Question | Answer |
As many as __% of women will have urinary incontinence at some point in their lifetime | 45 |
Hypermobility, intrinsic sphincter deficiency | Stress incontinence |
Detrusor overactivity, overactive bladder | Urge incontinence (hyper-irritable, unstable, detrusor contractions) |
Urge incontinence, think __ | Neurologic problem |
Overflow incontinence, think __ | Inability to void |
Increased abdominal pressure, coughing or straining, not associated with urge | Stress incontinence |
Often large volume, associated with strong desire to void, may be precipitated by sounds | Urge incontinence |
Pinpoints the site of urinary incontinence by assessing the bladder, urethra and pelvic support | Urodynamic testing (considered gold standard)(although has poor neg predictive value) |
__ has proven ineffective for the treatment of stress incontinence | Pharmacotherapy |
Premise of the suburethral sling | Support the urethra and bladder neck with hammock that provides stabilization of urethra at rest and dynamic compression of urethra with increased intraabdominal pressure |
Intrinsic Sphincter Deficiency, think: | stress incontinence |
Contributors to intra-abdominal pressure (may lead to incontinence) | Childbirth, obesity, asthma, smoking, chronic heavy lifting |
MOA of pelvic floor damage | Mx disruption; Peripheral nerve damage; Connective tissue damage (inc lacerations of perineal body) |
the most commonly associated inciting factor for incontinence. | Childbirth |
Causes of stress UI | Childbirth; PF mx weakness; decreased collagen synthesis; previous pelvic surgery (eg, hysterectomy); Smoking, chronic constipation; Aging, estrogen deficiency |
Extraurethral incontinence: | fistulas |
Goal of urodynamic testing | reproduce symptoms of leakage in order to direct therapy |
Effective tx for SUI | Behavioral (mx exercises, biofeedback); Pessary; surg |
Tx for urge incontinence | Behavioral Tx; Meds (Anticholinergics); Peripheral neuromodulation (inter-stim); Botox Injections |