#53: Urinary Incontinence: Tips and strategies to stay dry.
Published August 21, 2017
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58 min
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    Get control of urinary incontinence with tips from Internist and Women’s Health Specialist, Dr. Molly Heublein, Assistant Clinical Professor of Medicine at UCSF. This is a must listen if you’re still uncomfortable managing urinary incontinence. We learn nonpharmacologic strategies like pelvic floor muscle therapy, bladder training, timed voiding, foods to avoid, and run through the available medical therapies, their efficacy and side effects. Plus, a brief review of next line therapies like percutaneous tibial nerve stimulation, and botox injections for overactive bladder.

    Full show notes available at http://thecurbsiders.com/podcast

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    Case: 79 yo F with at least 10 years of urinary urgency with occasional loss of small amounts of urine and rare full bladder emptying. She drinks 1 cup of coffee every morning and about 2-3 glasses of water per day. She tries to minimize liquids due to her incontinence. She has HTN and takes HCTZ. Has been on oxybutynin for 10 years and wants to try something else.

    Time Stamps

    00:00 Intro

    01:06 Listener feedback

    02:43 Announcements

    03:43 Picks of the week

    09:07 Getting to know our guest

    14:27 Case of urinary incontinence (UI)

    15:30 Epidemiology of UI

    16:34 Screening for UI

    17:30 The 3IQ Questionnaire

    18:44 Additional testing in UI

    21:23 Classifying UI

    24:00 Nonpharmacologic therapy for UI

    32:42 Effectiveness of pharmacologic versus nonpharmacologic therapy

    34:50 Case continued. Changing medications

    37:42 Mirabegron as an alternative to anticholinergics

    40:18 More options for stress UI management

    41:40 Next line therapies for urge UI, overactive bladder

    44:38 Surgery for stress urinary incontinence

    45:50 Botox therapy for urge UI, overactive bladder

    48:30 Do we need any more fancy diagnostic tests?

    50:30 Take home points

    55:05 Stuart schools us on urinary incontinence in men and timing of BPH meds

    56:40 Outro

    Tags: urinary, urine, incontinence, urge, stress, mixed, bladder, training, kegels, pelvic, floor, muscle, therapy, anticholinergic, botox, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student

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