MEDI7212 Lecture Notes - Lecture 81: Nasal Congestion, Bladder Cancer, Urodynamic Testing
Document Summary
Introduction: an involuntary loss of urine or stool in sufficient amount or frequency to constitute a social and/or health problem. Skin irritation and breakdown: recurrent utis, pressure ulceration. Stress on family, friends, caregivers: predisposition to institutionalization, arrange schedules to be close to toilets. First urge to void is generally between 150-300ml. Incontinence = bladder involuntary contraction: urination, true detrusor pressure (bladder minus intra-abdominal pressure) increases, urethral resistance decreases, urine flow occurs when detrusor pressure > urethral resistance. Lesion below s2 = detrusor areflexia: 4 basic categories of causes for geriatric urinary incontinence, urological (+/- gynaecological, neurological. Iatrogenic/ environmental: age-related changes are not a cause of urinary incontinence but can contribute to its development, bladder capacity declines, residual urine increases & involuntary bladder contractions increase. In women, bladder outlet and urethral resistance pressure declines due to diminished estrogen influence + laxity of pelvic floor from childbirth -> stress incontinence.
