| Show Learning Points most relevant to Phase 1: |
Urinary incontinence in women
| Clinical Discipline(s)/Organ System(s) Genitourinary System, Obstetrics & Gynaecology, Urology | Progress Test Topic(s) Women's health |
Description
A 53 year old NZ European woman presents to her GP with a 2 year history of losing control of her bladder. She had three vaginal births. She has to wear urinary incontinence pads daily. This has had a negative impact on her work and mood.
Progress Test-Type Questions: Question 1 | Question 2Applied Science for Medicine
- Anatomy and function of the lower urinary tract and pelvic floor
- Normal micturition cycle, including autonomic and conscious controls of continence
- Risk factors for urinary incontinence
- Pharmacology of anticholinergic medications and local oestrogens
- Anatomy and function of the lower urinary tract and pelvic floor
- Normal micturition cycle, including autonomic and conscious controls of continence
- Risk factors for urinary incontinence
- Pharmacology of anticholinergic medications and local oestrogens
Clinical and Communication Skills
- History from a woman with urinary incontinence; differentiate stress, urge, mixed and neurological
- Gynaecological examination including abdominal, vaginal and speculum examinations when indicated (including stress test and pelvic floor tone)
- List the local and systemic causes of urinary incontinence
- Interpret midstream urine and urinary diary
- Knowledge of specific urogynaecological investigations such as cystometry, urodynamics, post void residual
- Management of urinary incontinence: conservative, bladder retraining, medical, use of adjuncts (pessary, hormone therapy, continence aids), surgery
- Recognise the common presenting features of a neurodegenerative condition
- Preventative strategies for avoiding future urinary incontinence
- History from a woman with urinary incontinence; differentiate stress, urge, mixed and neurological
- Gynaecological examination including abdominal, vaginal and speculum examinations when indicated (including stress test and pelvic floor tone)
- List the local and systemic causes of urinary incontinence
- Interpret midstream urine and urinary diary
- Knowledge of specific urogynaecological investigations such as cystometry, urodynamics, post void residual
- Management of urinary incontinence: conservative, bladder retraining, medical, use of adjuncts (pessary, hormone therapy, continence aids), surgery
- Recognise the common presenting features of a neurodegenerative condition
- Preventative strategies for avoiding future urinary incontinence
Personal and Professional Skills
- Appreciate the role of the continence specialist nurse and physiotherapist for pelvic floor strengthening
- Discussions around personal topics
- The possible social isolation, loss of employment and wider psychological consequences of incontinence
- Intimate examinations and use of a chaperone
- Appreciate the role of the continence specialist nurse and physiotherapist for pelvic floor strengthening
- Discussions around personal topics
- The possible social isolation, loss of employment and wider psychological consequences of incontinence
- Intimate examinations and use of a chaperone
Population Health
- Epidemiology of urinary incontinence
- Service provision for incontinence
- Epidemiology of urinary incontinence
- Service provision for incontinence
Conditions to be considered relating to this scenario
Common
stress incontinence, urge incontinence, urinary tract infection, urogenital atrophy, urethritis/vaginitis, drugs (e.g. diuretics), diabetes mellitus, decreased mobility, lifestyle factors (e.g. caffeine intake)
stress incontinence, urge incontinence, urinary tract infection, urogenital atrophy, urethritis/vaginitis, drugs (e.g. diuretics), diabetes mellitus, decreased mobility, lifestyle factors (e.g. caffeine intake)
Less common but 'important not to miss'
multiple sclerosis, tetra/paraplegia
multiple sclerosis, tetra/paraplegia
Uncommon
psychological, metabolic (e.g. hypercalaemia), diabetes insipidus, cauda-equina syndrome
psychological, metabolic (e.g. hypercalaemia), diabetes insipidus, cauda-equina syndrome
