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stress_incontinence

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urinary stress incontinence

Introduction

  • involuntary loss of control of urine is a common problem and if it is recurrent becomes a major impact on a person's life and socialisation
  • urinary continence requires:
    • a functional autonomic bladder sphincter
    • a functional voluntary sphincter
      • this not only relies upon neural inputs but pelvic floor muscle tone and control

Aetiology

  • post-TURP
  • sphincter injury - pelvic fractures, iatrogenic from surgery, radiation therapy, obstetric injury /mutiple vaginal deliveries
  • vascular disease
  • pelvic floor insufficiency, age, obesity, frailty

Mx

  • avoid or reduce:
    • chronic coughs - cease smoking (nicotine itself can increase incontinence)
    • exertion / heavy lifting
    • excessive caffeine
    • alcohol
    • obesity
    • straining - constipation Mx
    • hormonal deficiencies (eg. oestrogen replacement Rx])
    • overly full bladder - timed voids, avoid excessive fluid intake
  • pelvic floor muscle training
  • consider trial of pseudoephedrine
  • consider surgical treatments such as urethral slings
stress_incontinence.txt · Last modified: 2019/07/16 20:25 (external edit)