This web-based module for third-year medical students reviews acute and established forms of urinary incontinence, clinical features, and the importance of history and exam in evaluating this geriatric syndrome. Nonpharmacologic, pharmacologic, and invasive treatments are presented in appropriate detail for a student learner. Faculty-led small group discussions focus on the cases for application of the content. One of several goals of the cases is to increase the learner’s sensitivity to the social and emotional consequences of urinary incontinence.
- Relate potential social and emotional consequences of incontinence.
- List at least 5 potential etiologies for acute (transient) urinary incontinence.
- Describe features of the 4 types of chronic (established) physiologic urinary incontinence.
- Identify age-related changes that may predispose older adults to develop incontinence.
- Describe the complex physiology involved in normal micturition.
- Discuss potential pathophysiologic causes of incontinence.
- Discuss important features of history, exam and testing in evaluating a patient with UI.
- Identify various nonpharmacologic treatments with appropriate conditions/situations for their use.
- Cite examples of pharmacologic treatment for SUI, OAB/UUI, and Overflow UI.
- Relate specific concerns of antimuscarinic agents in older adults, and examples of choices to minimize risk.
- Explain the IFIS risk for patients who have used alpha-adrenergic antagonists as a class, and tamsulosin in particular.
- Discuss urology referral for various invasive treatment interventions.
This product is reviewed internally each year by the program core faculty.
DeMaagd, G., & Geibing, J. D. (2006). An overview of overactive bladder and its pharmacological management with a focus on anticholinergic drugs. P&T; 31(8); 462-474. Available online at: http://www.ptcommunity.com/ptjournal/fulltext/31/8/PTJ3108462.pdf
[Note: the student is directed to the excellent discussion of anticholinergic and antimuscarinic pharmacology in this Pharmacy and Therapeutics article.]
DeMaagd, G. (2007). Urinary incontinence: Treatment update with a focus on pharmacological management. U. S. Pharmacist; 32(6):34-44. Available online at: http://www.uspharmacist.com/content/t/urology/c/10310/
Haas, P. (2008, July 2). Consider cataracts before prescribing alpha blockers for your patients. AAFP News Now. Available online at: http://www.aafp.org/online/en/home/publications/news/news-now/clinical-care-research/20080702alpha-cataract.html
Ellsworth, P., & Kirshenbaum, E. (2010). Update on the pharmacologic management of overactive bladder: The present and the future. Available online at: http://www.medscape.com/viewarticle/718789 (posted April 7, 2010)