_of urinary incontinence in adults成人尿失禁概述课件

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1、OverviewofUrinaryIncontinenceinAdultsChristinaM.Bordeau,D.O.InternalMedicine,PGY-3October28,2012GoalsandObjectivesProvidetheclinicianwithabasic,yetcomprehensive,overviewofurinaryincontinencepathophysiologyEquipthephysicianwithabasicunderstandingofproperevaluationandassessmentofpatientswithuri

2、narycomplaintswithintheadult♀populationEstablishtheindicationsforandproceduresinvolvedinurodynamictestingNocommercialinvestments,endorsements,norbias’UrinaryIncontinence:DefinitionInternationalContinenceSocietyThe“involuntaryleakageofurine”StressUrinaryIncontinenceis“involuntaryleakageoneffor

3、torexertion,oronsneezingorcoughing”UrinaryUrgencyis“thecomplaintofasuddencompellingdesiretopassurinewhichisdifficulttodefer”UrgencyIncontinenceis“thecomplaintofinvoluntaryleakageaccompaniedbyorimmediatelyprecededbyurgency”OveractiveBladderSyndromeis“urgencywithorwithouturgencyincontinence,usu

4、allyincreaseddaytimefrequencyandnocturia”.UrinaryDisordersThreecategories:StorageVoidingPostmicturitionVoidingSymptomsSlowurinarystreamSplittingorsprayingIntermittencyorhesitancywithflowStrainingtovoidIncompleteemptyingPostmicturitiondribbleCaseReportMrs.M.A.isan84-year-oldfemaleAlzheimer’sDe

5、mentia87-year-oldhusbandreportsherurinaryincontinenceisworseningandiscausingincreasedcaregiverstressOccasionalincontinence>5yrsPast6monthshashadatleast3episodesofurinelossdaily,atleast1oftheseduringthenightDoingmorelaundryandrestrictingsocialactivitiestominimizeembarrassmentCaseReport2Shemini

6、mizestheconcernReportsonlyoccasionalurinelossIndependentinself-carebutneedsassistancewithshoppingandcomplexmealpreparationMedications:Donepezil10mgdaily,7monthsagoNifedipineXR30mgdailyHCTZ25mgdailyforHTNASA81mgdailyOxazepam30mgQHSPRNsleepCaseReport3Describessmall-volumeurinelosswithcoughingor

7、laughingLossofmoderatevolumesofurine(enoughtodripdownherleg)ifshe“doesn’tgettothebathroomrightaway”(withintwominutes)uponurgeOccasionallywakesupwetandneedstogotothetoiletimmediatelyuponawakeningCoffeeintheAM3cupsofteabetweenlunchandbedtimeDen