URINARY INCONTINENCE A LESSON IN LEAKAGE ASHLEY N

LETS START BY TALKING A BIT ABOUT THE BLADDER • MADE UP OF A

SO LEAKING URINE ISN’T NORMAL, EVEN AS WE AGE… • 25 MILLION PEOPLE IN

THERE ARE DIFFERE NT KINDS OF LEAKAGE ? There are 4 common kinds of

URINARY URGE INCONTINENCE • CAUSED BY A BLADDER SPASM • NEUROLOGICAL ISSUE • TRAUMA

URGE SYMPTOMS • NOT MAKING IT TO THE BATHROOM IN TIME • KNOWING WHERE

TREATMENTS FOR URGE 1 st Line 2 nd Line Lifestyle Modification Medications 3 rd

STRESS URINARY INCONTINEN CE • CAUSED BY TOO MUCH MOVEMENT • HYPERMOBILITY OF URETHRA

STRESS SYMPTOMS • LEAKAGE • LAUGHING • COUGHING • SNEEZING • EXERCISE • BENDING

THERE ARE TREATME NT OPTIONS! Kegels • Quick flicks • Long holds Pessary •

PELVIC FLOOR PT, IT IS MORE THAN JUST KEGELS

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URINARY INCONTINENCE: A LESSON IN LEAKAGE ASHLEY N. QUINTANA, MSN, BSN, NP-C, RN DEPARTMENT OF UROGYNECOLOGY UNM SANDOVAL REGIONAL MEDICAL CENTER

LETS START BY TALKING A BIT ABOUT THE BLADDER • MADE UP OF A GIANT MUSCLE • HOLDING AREA FOR URINE • SIZE OF A PEAR WHEN EMPTY • HOLDS ~2 CUPS • VERY SENSITIVE • EASILY IRRITATED • ACTS OUT

SO LEAKING URINE ISN’T NORMAL, EVEN AS WE AGE… • 25 MILLION PEOPLE IN THE US • 75% WOMEN • 1 IN EVERY 3 WOMEN HAS STRESS URINARY INCONTINENCE (SUI) • 1. 5 IN EVERY 10 WOMEN HAS OVERACTIVE BLADDER (OAB) • 25% MEN • 1 IN EVERY 10 MAN OVER AGE 65 • OAB > SUI

THERE ARE DIFFERE NT KINDS OF LEAKAGE ? There are 4 common kinds of urinary incontinence • • Stress Urge Overflow Functional Today we are only focusing on 2 kinds • Stress • Urge

LETS START WITH URGE!

URINARY URGE INCONTINENCE • CAUSED BY A BLADDER SPASM • NEUROLOGICAL ISSUE • TRAUMA • SURGERY • MISPLACED • IRRITATION

URGE SYMPTOMS • NOT MAKING IT TO THE BATHROOM IN TIME • KNOWING WHERE ALL THE BATHROOMS ARE, EVERYWHERE YOU GO • LEAKING IF YOU DON’T MAKE IT IN TIME • WAKING UP MORE THAN 2 TIMES AT NIGHT • GOING MORE THAN 6 TIMES DURING THE DAY • LIMITING FLUIDS • GOING JUST A LITTLE BIT

TREATMENTS FOR URGE 1 st Line 2 nd Line Lifestyle Modification Medications 3 rd Line Cutting down/out irritations Anticholinergics Botox Drinking enough water Beta agonists Sacro Neuromodulation Timed voiding Post Tibial Nerve Stimulation

THIRD LINE TREATMENTS

LET’S TALK ABOUT STRESS, BABY!

JUST A LITTLE HUMOR!

STRESS URINARY INCONTINEN CE • CAUSED BY TOO MUCH MOVEMENT • HYPERMOBILITY OF URETHRA • WEAK PELVIC FLOOR MUSCLES • KEGELS • TRAUMA • SURGERY

STRESS SYMPTOMS • LEAKAGE • LAUGHING • COUGHING • SNEEZING • EXERCISE • BENDING OVER • MOVEMENT

THERE ARE TREATME NT OPTIONS! Kegels • Quick flicks • Long holds Pessary • Self care • Assisted care Pelvic Floor PT Surgery • Midurethral sling • Pubovaginal sling • Burch • Urethral bulking

HOW TO DO A KEGEL

PELVIC FLOOR PT, IT IS MORE THAN JUST KEGELS

PESSARI ES

THE MIDURETHRAL SLING GOLD STANDARD

QUESTIONS?