Master Urge Incontinence with Picmonic for Physician Assistant

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Urge Incontinence

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Urge Incontinence

Urgent Alarm with Urine In-continents
Picmonic
11 KEY FACTS
SYMPTOMS
Strong Urge To Void
Strong-arms Urgently squeezing knees

Urge incontinence is characterized by an intense urge to void, whether or not the bladder is full.

Unable To Void Quickly Enough
Peeing in pants

Patients often are unable to reach a restroom facility quickly enough after a getting a strong urge or sensation to void. Because the urge to urinate comes frequently and intensely the patients are often incontinent.

Nocturia
Nocturnal-moon-urine

Patients with urge incontinence will often wake up at night to void. This is common in any patient who experiences frequency.

Increased Frequency
Up-arrow Frequency-wave

Urinating more than 8 times in 24 hours is a symptom of urge incontinence.

Small Volume Voids
Smaller Urinals

During urination, the patient will void only a small amount, even if they feel the sensation of having a full bladder.

PATHOPHYSIOLOGY
Increased Detrusor Muscle Activity
Up-arrow D-trousers

The detrusor muscle is in the wall of the bladder that allows the bladder contract when voiding to release urine. Increase in muscle activity or spasms cause a constant urge to urinate. This may be associated with inflammatory nervous disorders or disorders of the spinal cord or CNS, causing contractile dysfunction of the bladder. Spinal cord lesions such as bladder stones, tumors or cystitis may also cause bladder irritation, resulting in uncontrollable bladder contractions and incontinence.

TREATMENT
Avoid Caffeine & Alcohol
Avoid-sign Caffeinated-coffee and Alcoholic-martini

Certain lifestyle modifications can be made to manage urge incontinence. A patient should avoid foods and liquids that irritate the bladder, in addition to avoiding caffeine and alcohol, managing fluid intake throughout the day, and planning timed voiding to reduce the frequency urination.

Anticholinergics
Ant-tie-cola

Anticholinergic agents, such as oxybutynin, are often used to treat urge incontinence. These medications inhibit the binding of acetylcholine to the cholinergic receptor, resulting in suppression involuntary bladder contraction.

Mirabegron
Mirror-bed

Mirabegron is used as a second line treatment for urge incontinence when antimuscarinics cannot be taken or are ineffective. This medication acts on the beta 3 adrenergic receptors to relax the detrusor muscle.

Botox
Bow-tux

Injecting neurotoxin from Clostridium botulinum in the detrusor muscle prevents ACh release from presynaptic membrane. This treatment is indicated for urinary incontinence in patients with neurologic conditions or for patients who do not respond adequately to medication.

Sacral Neuromodulation
Nerve-mode-dial stimulating Sacral-area

Sacral neuromodulation is a form of electrical stimulation therapy that controls symptoms of urinary incontinence through direct modulation of the nerve activity. In this procedure, a generator device is usually placed through the sacral foramen to stimulate the S3 sacral nerve to decrease detrusor muscle contractions. Percutaneous tibial nerve stimulation (PTNS) is another treatment option for patients exhibiting urge incontinence symptoms.

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