NUR 6111 EXAM 3 MALE GU DISORDERS AND MEN’S HEALTH STUDY NOTES
– COMPREHENSIVE LECTURE SUMMARY
1. urinary incontinence: involuntary loss of urine (in an adult patient) from the urethra
major inconvenience
more common in females then males
2. effects of urinary incontinence: increased risk of skin infections: incontinence dermatitis (diaper
rash), bacterial/ fungal infections
activities such as running or other high impact exercises are often avoided or stopped
avoiding social activities, isolation, depression and anxiety
financial: 23% of women take time ott work
3. RF incontinence: increasing age
declining estrogen levels
multiparity
dementia
DM
spinal cord injury/ lesion
prostatic hypertrophy
stroke
medications (ex. diuretics)
immobility
4. Stress urinary incontinence: predictable loss of urine with activities that increase intra abdominal
pressure (sneezing, laughing, exercising)
5. Urge urinary incontinence: urgency as well as increased urinary frequency or nocturia. Patients
typically lose urine on the way to the toilet
6. Mixed urinary incontinence: has both components of stress and urge incontinence
7. Overflow urinary incontinence: urinary retention and subsequent leakage
patients may strain to pass urine or have a sensation of incomplete emptying
8. Functional urinary incontinence: occurs when there are barriers to toileting such as cognitive
impairment, physical frailty or immobility
, NUR 6111 EXAM 3 MALE GU DISORDERS AND MEN’S HEALTH STUDY NOTES
– COMPREHENSIVE LECTURE SUMMARY
9. assessment findings urinary incontinence: involuntary loss of urine
urinary urgency
perineal irritation
pelvic exam: may detect GU pathology
rectal exam: may demonstrate prostatic pathology, fecal impactation
abdomen: may palpate distended bladder
10. urinalysis for urinary incontinence: abnormal: hematuria, pyuria, bacteriuria, glycosuria, pro-
teinuria
order urine culture if bacteria is detected
11. Cystometry urinary incontinence: severe urgency or bladder contractions when <300ml of
bladder volume= urge incontinence
12. BUN, creatinine urinary incontinence: suspected obstruction, noncompliant bladder, urinary
retention
13. FBS and Ca levels urinary incontinence: polyuria and lack of diuretic drugs
14. dx urinary incontinence: urinalysis
cystometry
BUN, creatinine
FBS and Ca levels
voiding diary 203 days indicating when incontinent episodes occur
post voiding residual volume measurement (200-300ml)
15. prevent urinary incontinence: kegel exercises or pelvic floor therapy
treatment of BPH
maintain healthy weight
, NUR 6111 EXAM 3 MALE GU DISORDERS AND MEN’S HEALTH STUDY NOTES
– COMPREHENSIVE LECTURE SUMMARY
adequate oral hydration
avoidance of bladder irritants (catteine, alcohol)
smoking cessation
16. non pharm management stress urinary incontinence: behavioral therapies: timed or
double voiding, smoking cessation, weight loss, pelvic muscle exercises with or without a physical therapist, pessary,
bowel management
surgical: injectables, bladder neck suspensions, slings, artificial sphincters
17. pharm mgt Stress UI: not FDA approved
alpha adrenergic agonist: pseudoephedrine (Sudafed)- increase urethral pressure and outlet resistance, may im-
prove s/s without significant side ettects
tricyclic antidepressant: Imipramine 10-25mg PO up to TID- may be useful in younger patients who have failed other
therapies, alpha agonist and anticholinergic ettects
Estrogen- topical cream (may help improve urethral closure)
18. Urge UI non pharm mgt: behavioral therapies: same as stress UI with bladder training, scheduled
voiding, bladder irritants minimization, and urge suppression
surgical therapy: neurosacral modulation, bladder augmentation, botulinum toxin injection
19. Urge UI pharm mgt: anticholinergic/ antimuscarinics: oxybutynin 2.5-5mg PO BID-TID, tolterodine 2mg
BID (caution with bladder outflow obstruction, caution in OA, sedation, confusion, delirium)
beta adrenergic agonists: mirabegron 25mg PO daily (may increase BP in patients with HTN, not recommended in
severe hepatic or renal impairment)
20. mixed UI management: combination of therapies for stress and urge incontinence
21. overflow UI nonpharm mgt: behavioral therapies: timed or double voiding, clean intermittent
catheterization, pessary
surgery: to relieve urethral obstruction or stricture or to reduce prolapse
– COMPREHENSIVE LECTURE SUMMARY
1. urinary incontinence: involuntary loss of urine (in an adult patient) from the urethra
major inconvenience
more common in females then males
2. effects of urinary incontinence: increased risk of skin infections: incontinence dermatitis (diaper
rash), bacterial/ fungal infections
activities such as running or other high impact exercises are often avoided or stopped
avoiding social activities, isolation, depression and anxiety
financial: 23% of women take time ott work
3. RF incontinence: increasing age
declining estrogen levels
multiparity
dementia
DM
spinal cord injury/ lesion
prostatic hypertrophy
stroke
medications (ex. diuretics)
immobility
4. Stress urinary incontinence: predictable loss of urine with activities that increase intra abdominal
pressure (sneezing, laughing, exercising)
5. Urge urinary incontinence: urgency as well as increased urinary frequency or nocturia. Patients
typically lose urine on the way to the toilet
6. Mixed urinary incontinence: has both components of stress and urge incontinence
7. Overflow urinary incontinence: urinary retention and subsequent leakage
patients may strain to pass urine or have a sensation of incomplete emptying
8. Functional urinary incontinence: occurs when there are barriers to toileting such as cognitive
impairment, physical frailty or immobility
, NUR 6111 EXAM 3 MALE GU DISORDERS AND MEN’S HEALTH STUDY NOTES
– COMPREHENSIVE LECTURE SUMMARY
9. assessment findings urinary incontinence: involuntary loss of urine
urinary urgency
perineal irritation
pelvic exam: may detect GU pathology
rectal exam: may demonstrate prostatic pathology, fecal impactation
abdomen: may palpate distended bladder
10. urinalysis for urinary incontinence: abnormal: hematuria, pyuria, bacteriuria, glycosuria, pro-
teinuria
order urine culture if bacteria is detected
11. Cystometry urinary incontinence: severe urgency or bladder contractions when <300ml of
bladder volume= urge incontinence
12. BUN, creatinine urinary incontinence: suspected obstruction, noncompliant bladder, urinary
retention
13. FBS and Ca levels urinary incontinence: polyuria and lack of diuretic drugs
14. dx urinary incontinence: urinalysis
cystometry
BUN, creatinine
FBS and Ca levels
voiding diary 203 days indicating when incontinent episodes occur
post voiding residual volume measurement (200-300ml)
15. prevent urinary incontinence: kegel exercises or pelvic floor therapy
treatment of BPH
maintain healthy weight
, NUR 6111 EXAM 3 MALE GU DISORDERS AND MEN’S HEALTH STUDY NOTES
– COMPREHENSIVE LECTURE SUMMARY
adequate oral hydration
avoidance of bladder irritants (catteine, alcohol)
smoking cessation
16. non pharm management stress urinary incontinence: behavioral therapies: timed or
double voiding, smoking cessation, weight loss, pelvic muscle exercises with or without a physical therapist, pessary,
bowel management
surgical: injectables, bladder neck suspensions, slings, artificial sphincters
17. pharm mgt Stress UI: not FDA approved
alpha adrenergic agonist: pseudoephedrine (Sudafed)- increase urethral pressure and outlet resistance, may im-
prove s/s without significant side ettects
tricyclic antidepressant: Imipramine 10-25mg PO up to TID- may be useful in younger patients who have failed other
therapies, alpha agonist and anticholinergic ettects
Estrogen- topical cream (may help improve urethral closure)
18. Urge UI non pharm mgt: behavioral therapies: same as stress UI with bladder training, scheduled
voiding, bladder irritants minimization, and urge suppression
surgical therapy: neurosacral modulation, bladder augmentation, botulinum toxin injection
19. Urge UI pharm mgt: anticholinergic/ antimuscarinics: oxybutynin 2.5-5mg PO BID-TID, tolterodine 2mg
BID (caution with bladder outflow obstruction, caution in OA, sedation, confusion, delirium)
beta adrenergic agonists: mirabegron 25mg PO daily (may increase BP in patients with HTN, not recommended in
severe hepatic or renal impairment)
20. mixed UI management: combination of therapies for stress and urge incontinence
21. overflow UI nonpharm mgt: behavioral therapies: timed or double voiding, clean intermittent
catheterization, pessary
surgery: to relieve urethral obstruction or stricture or to reduce prolapse
