Urinary Incontinence

17 important questions on Urinary Incontinence

What causes stress urinary incontinence (SUI)?

Pelvic floor relaxation causes an inefficient internal urethral sphincter.

What happens to the bladder in overflow urinary incontinence?

The bladder gets massively distended, filled with urine.

What is the patient unable to do in overflow urinary incontinence?

The patient loses the urge or ability to void.
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During which phase does the detrusor muscle not contract?

The detrusor does not contract during the filling phase.

What will physical exam/POCUS identify in overflow urinary incontinence?

A distended bladder.

What system keeps the detrusor muscle quiescent during filling?

The sympathetic nervous system keeps it quiescent via activation of β₃ GPCRs.

What is the surgical option for stress urinary incontinence?

Tension-free midurethral sling (with mesh).

What does cystometry demonstrate in overflow urinary incontinence?

Absent detrusor contractions and large urine volumes.

What is the role of the internal urethral sphincter during filling?

It contracts due to activation of α₁ GPCRs.

What is a characteristic of urge urinary incontinence (UUI)?

Random detrusor muscle contractions occur at any time and all volumes.

What medications can facilitate voiding in overflow urinary incontinence?

Bethanechol.

What medication can be used to treat urge urinary incontinence?

Oxybutynin or mirabegron.

What is required for permanently hypotonic bladders?

Regularly scheduled in-and-out catheterization.

What is the function of the sphincter urethrae?

The sphincter urethrae runs the entire length of the urethra.

What does the guarding reflex stimulate?

The guarding reflex stimulates the sympathetic nervous system.

What happens when the cortex disinhibits the PMC?

It relaxes the external urethral sphincter and may increase intra-abdominal pressure.

What is the result of a bladder fistula?

A constant and continuous leak of urine day and night.

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