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Urinary Incontinence Pathophys I Fall 2012 STUDENT (1)

Bladder overactivity myogenic causes changes in

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(Bladder Overactivity) Myogenic causes Changes in bladder pressure due to changes in the bladder smooth muscle (detrusor muscle) Ex: bladder outlet obstruction Increased pressure causes destruction of the efferent nerve endings → detrusor muscle hyper-excitability
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Overflow Incontinence (Urethral Overactivity/ Bladder  Underactivity) Involuntary loss of urine when the intravesicular pressure exceeds the maximal urethral pressure Over-distention of the bladder without detrusor muscle contraction Loss of small amounts of urine Continual feeling of bladder fullness Straining to void, urinary hesitancy
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Overflow Incontinence Occurs is the presence of Bladder outlet obstruction Ex: prostatic hypertrophy Fecal impaction Blocks the passage of urine through the urethra Bladder paralysis Ex: general anesthesia
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Functional Incontinence Involuntary loss of urine due to the inability to get to the bathroom or the lack of awareness of needing to void Common in elderly patients Due to Dementia Oversedation with medications Physical immobility
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Mixed Incontinence Combination of one of more types of incontinence Most commonly: urge/stress incontinence
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Diagnosis Symptoms UUI Voiding diary Timing Frequency Urgency Amount of voiding Drug history Post-void residual (PVR) How much urine remains in the bladder after voiding
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Questions? [email protected] du
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Bladder Overactivity Myogenic causes Changes in bladder...

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