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You are covering for a long term care facility and a nurse asks you to assess a 86 year old man who is presenting with urinary incontinence.
Name 3 types/classifications of urinary incontinence.
Describe 4 transient, short term or modifiable causes of incontinence.
Name 4 conservative management strategies to advise patients who are presenting with urinary incontinence.
Name 2 medications that can be used for patients presenting with urge incontinence/over active bladder.
- Urge incontinence
- Stress incontinence
- Mixed, functional
Use mnemonic DIAPERS:
Pharmaceuticals (anticholinergics, sedatives, hypnotics)
Retention (BPH)/Reduced mobility
Stool impaction (constipation)
Others to consider: excessive alcohol or caffeine intake
- Prompted/scheduled voiding
- Urge suppression/delayed voiding
- Kegel exercises (although evidence for this is very limited)
- Pelvic physiotherapy
- Weight loss
- Limit caffeine intake
- Limit alcohol intake
- Bowel regimen
- Limit fluids after supper
- Anti-muscarinic drugs (oxybutynin, tolterodine, fesoterodine, darifenacin, solifenacin)
- Beta-adrenergic agonists (mirabegron)
- For women; intravaginal estrogen
- TCA (nortriptyline, imipramine)
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