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LUTS: Slides 1-34
Corresponding to lecture 17
Terms in this set (35)
What does incontinence mean?
The inability to control excretory functions
any involuntary loss of urine
Lower urinary tract dysfunction
Define BPH in simplest terms
Benign prostatic hyperplasia. Non-malignant enlargement of the prostate that occurs thanks to excessive cell growth
What does a patient experiencing Nocturia experience?
Excessive urination at night
What does OAB mean
What does PVR measure?
Post void residual
Mike has a urinary frequency issue. What is occuring with Mike?
urination at short intervals without an increase in daily volume of urinary output
What does urinary urgency mean?
the sudden compelling urge to urinate
Gio is urinating in Banff when a bear pops up. Predict what will happen regarding his urine
Sympathetic will act (retention): sphincters will tighten and he cant urinate now
What does the parasympathetic nervous system play a role in regarding urination?
urination will occur, bladder contracts and sphincters relax
What are storage symptoms regarding LUTS
urgency, inconteince, frequency, nocturia
What are some voiding symptoms regarding LUTS and define them
intermittent stream (start, stop, go)
hesitancy (you think you g2g but cant)
Terminal Dribble: urination keeps on dribbling
What are some post micturition symptoms of LUTS?
feeling on incomplete empyting, post micturtion dribble: think your done but you are still leaking
What are some other symptoms of LUTS?
leakage with sex
symptoms associated with pelvic organ prolapse
What is overactive bladder syndrome?
urgency, you may have or not have urge incontinence. Accompanied with frequency and nocturia.
After Manpreets results, his LUTS suggest bladder outlet obstruction. How do you interpret this?
voiding symptoms in men in the absence of infection or other causes of outlet obstruction
How many types of incontinence are there? Define each (UI)
Stress: when there is abdominal pressure, caused by laughing, sneeze
Urgency: Cant postpone or make it to toilet
Mixed: A combination of stress and urgency
Overflow: bladder not emptying so its always spilling, 1-1.5 L in bladder remains
Functional: A problem NOT pertaining to the bladder. Ex: Walking is very hard, dementia,
What is enuresis
Passive loss of urine
What is nocturnal enuresis?
Releasing urine during the night (bed-wetting)
The prevalence of UI is overreported. t or f
According to the Alberta Pharmacy study, what was the general conclusion with LUTS?
Majority of people had some issue with LUTS and 75% of these guys find it bothersome. They tend to not report this to HCPs
What are the ratios of males who have BPH evidence at age 60? Age 85?
Age 60: more than 50%
Age 85: 90%
What are 5 co-morbid complications that present with LUTS?
incontinence dermatits: skin damage
infections regarding chronic retention
increased falls risk, impaired attention and slow gait
if they never get check out, they will overuse absorbent pads
What are 5 requirements for continence?
cognitive ability intact: need to sequence the method of going to the washroom
manual dexterity: need to unzipper pants
balance and coordination
motivation to stay dry, have some goals for intervention
As we age, what do we decrease in regarding our physiology that make us more prone for LUTS?
tougher to postpone voiding
urethral, bladder compliance
maximal urethral closure pressure
urinary flow rate
As we age, what in our body increases regarding LUTS ?
uninhibited bladder contractions
nocturnal urine excretion
concomitant disease states
What does an enlarged prostate do regarding voiding? Why does it effect voiding?
It narrows and squeezes on the urethra which makes it harder to void
What is the enzyme that converts T into DHT
5 alpha reductase
Explain the mechanism by which T effects the prostate
T is converted to DHT. DHT acts on DNA androgenic receptors. The result is an overexpression of prostate growth factors.
What are the 5 risk factors for LUTS
associated causalities (constipation, menopause)
What are the risk factors for incontinence? Think DIPPERS
D delirium, dementia
P pharmaceuticals P psychological/psychiatric
E excessive urine output/endocrine R restricted mobility
S stool impaction, stroke, spinal cord injury
There are drugs that increases the chances for incontinence by decreasing awareness and sensation. What are they?
There are drugs that increase the chances for incontinence by causing retention. What are they?
calcium channel blockers
What are 5 classes of drugs that increase urine loss?
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