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12 Cards in this Set

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2RF for urinary incontinence
(& mult rf for one)
1. OLD AGE
2. PELVIC RELAXATION:
OBSTRUCTED LABOR
TRAUMATIC DELIVERY
MENOPAUSE (hormone Δ->dec tissue resiliency)
(inc abd press): cough
straining
ascites
lg pelvic tumors
age, pelvis
2 types of urinary incontinence
1. stress incont
2. urge incont
*hx dif b/w stress and urge
1. amts
1. stress sm amt, urge lg
sm or lg
hx dif b/w stress and urge
2. situation
2. stress w/ exertion or strain (cough, laugh),
urge unpredictable
cough, laugh, or unpredict
*hx dif b/w stress and urge*
3. time of day
3. stress: none when supine or asleep
urge: day or night urge/freq
awake or asleep
PE dif b/w stress and urge
stress: nml or may show cystocele or urethrocele
urge: normal
RF for stress incont
pelvic relaxation
chronic inc abd press
weakened urethral closing mech (ie estrogen deficiency, meds)
structural
RF for urge incont
neuro dz (Alzheimers, Park)
DM
bladder ca
bladder stone
UTI
neuro
Dx for stress incont
r/o urge: nml UA/cult, neuro exam, cystometrogram
show leakage w/ stress
positive "Q-tip test" (angle of cotton swab shows >30 deg change when pt strain)
r/o urge, special test
Dx for urge incont
cystometrogram: invol blad ctx assoc w/ ur leakage,
nml residual vol & sensation
diagnostic tool
Tx stress incont
pelvic exercises (kegel), estrogen,
pessaries,
+/- surg
Tx urge incont
beta-adrenergics (metaproterenol)
antichol (oxybutynin)
behav mod
+/- surg denervation