Chapter 27: Genitourinary Issues

Questions

Which of the following is associated with overflow incontinence?

A. Urine loss during increased intra-abdominal pressure

B. Loss of moderate to large amounts of urine

C. Inability to delay voiding upon perceiving a full bladder

D. Sense of incomplete bladder emptying following voiding

D. Sense of incomplete bladder emptying following voiding is associated with overflow incontinence due to poor contractility or obstruction around the urethral sphincter.

A. Urine loss during increased intra abdominal pressure is associated with stress incontinence

B. Loss of moderate to large amounts of urine is associated with urge incontinence.

C. Inability to delay voiding after a full bladder is associated with urge incontinence.

Which of the following typically has no identifiable pathology?

A. Stress incontinence

B. Overflow incontinence

C. Mixed incontinence

D. Urge incontinence

D. In most women experiencing urge incontinence there is no underlying pathology.

A. Stress incontinence occurs during periods of elevated intra-abdominal pressure.

B. Overflow incontinence is caused by bladder underactivity and/or outflow obstruction.

C. Mixed incontinence can have a number of different underlying pathologies.

Which of the following pharmacological options is preferred in a woman with stress incontinence?

A. Oral estrogen

B. Anticholinergics

C. Vaginal estrogen

D. Duloxetine

C. Vaginal estrogen is the preferred treatment for stress incontinence. It reduces dysuria and frequency but does not reduce the number of incontinent episodes.

A. Oral estrogen should not be used for stress incontinence. It can exacerbate urinary incontinence and is associated with an increased risk of breast and endometrial cancers.

B. Anticholinergics act in the bladder to reduce bladder contractility and are used for the treatment of urge incontinence. Anticholinergics should not be used in stress incontinence.

D. Duloxetine is not approved for treatment of stress incontinence in Canada or the United States. It is reserved as a second- or third-line option in stress incontinence when patients fail other measures and cannot or will not undergo surgery.

Which of the following has NOT been shown to influence urinary incontinence?