incontinence’ ‘Overflow Alpha blockers such as relax smooth muscle at neck of bladder so aid voiding. terazosin Prostate cancer can also lead to overflow incontinence, so also look for weight loss UTI Very very common Elderly women Frequency, urgency and fever Can also present insidiously, NO URINARY SYMPTOMS….sepsis UTI is an example of urge incontinence Stress Incontinence Leak of urine when intra-abdominal pressure rises. Event in the past has weakened the pelvic muscles Child birth Pelvic surgery Summary of Incontinence Overflow BPH and Spinal Cord Compression – Urge Idiopathic in Women. Treat with anticholinergics – Stress Increase in abdominal pressure. Treat with pelvic floor exercises/bladder retraining – Functional dementia, poor mobility – Polycystic kidney disease = 1/1000. Adults. Mutation in PKD1 or PKD2. Bilateral ballotable masses +/- abdo pain + —ADPKD haematuria, infections, calculi, progressive renal failure. Associated risk berry aneurysms -> SAH. = RARE (1/40,000). Infancy. Mutation PKHD1 gene. Causes CKD, HTn, hepatic fibrosis. —ARPKD Scrotal Swellings 4 questions Can you get above the swelling Can you identify the testis and epididymis Is the swelling translucent Is the swelling painful Swellings NOT confined to the scrotum Hernia you CANNOT get above it! – –
‘Overflow incontinence’ Alpha blockers such as terazosin relax smooth muscle at neck of bladder so aid voiding. Prostate cancer can also lead to overflow incontinence, so also look for weight loss UTI Very very common Elderly women Frequency, urgency and fever Can also present insidiously, NO URINARY SYMPTOMS….sepsis UTI is an example of urge incontinence Stress Incontinence Leak of urine when intra-abdominal pressure rises. Event in the past has weakened the pelvic muscles Child birth Pelvic surgery Summary of Incontinence Overflow – BPH and Spinal Cord Compression Urge – Idiopathic in Women. Treat with anticholinergics Stress – Increase in abdominal pressure. Treat with pelvic floor exercises/bladder retraining Functional – dementia, poor mobility Polycystic kidney disease —ADPKD = 1/1000. Adults. Mutation in PKD1 or PKD2. Bilateral ballotable masses +/- abdo pain + haematuria, infections, calculi, progressive renal failure. Associated risk berry aneurysms -> SAH. —ARPKD = RARE (1/40,000). Infancy. Mutation PKHD1 gene. Causes CKD, HTn, hepatic fibrosis. Scrotal Swellings 4 questions Can you get above the swelling Can you identify the testis and epididymis Is the swelling translucent Is the swelling painful Swellings NOT confined to the scrotum Hernia – you CANNOT get above it! –