Urinary Incontinence - Stress, Urge, Overflow: Pathophysiology, Clinical correlation | USMLE | MCQs

In this video, I have explained the anatomy of the urinary bladder and pathologies associated w it.
We will also focus on Benign Prostatic Hyperplasia, Prostate Cancer, Bladder cancer, Diabetic neuropathy and Post menopausal effects on the bladder
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I post quizzes on Instagram / chandran_ish
In case you missed it,
Q1. A sensation of Incomplete emptying of the badder after urination is seen in
A. Overflow inconctnce
B. Urge incentive
C. Stress incontince
Q2. Oxybutin is used to treat ____ incontinence
A. Overflow
B. Urge
Q3. Postmenopausal women are most likely to have have____ incontinence due to decreased oestrogen
A. Overflow
B. Urge
C. None
Q4. Incontinence caused due to diabetic neuropathy can be managed w
A. bethanechol
B. Kegel exercise
C. Oxybutin
D. Diabetic neuropathy cannot cause urinary incontince
Q5. A patient complains of leakage of urine while coughing. What is the underlying cause?
A. detrusor overactivity
B. urethral hypermobility
C. psychological stressors
D. none of the above
Q6. An obstruction to the urethra can result in
A. Overflow
B. urge
Q7. Which of the following is more likely to cause urinary incontinence
A. BPH
B. Prostate cancer
Q8. A 60 year old male presents w gross hematuria. He has had 2 similar episodes in the past month. There is no pain associated w it. Cystoscopy confirms the diagnosis. What is the greatest risk factor for this
A. Recurrent UTIs
B. BPH
C. Alcohol
D. Smoking
Q9. ALS is likely to cause
A. Urge incentive
B. Overflow incontinece
C. None
Q10. Early loss of bladder function is seen in
A. Cauda equina syndrome
B. Conus medullaris syndrome
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👩‍⚕️ I'm a final year medical student, your study partner (:
👩‍💻 I make videos to guide students preparing for the USMLE and share my med experience here on my UA-cam channel
🙋‍♀️Get in touch
Instagram: chandran_ish
📩Business enquiries: [e-mail]

[@aakritdahal302]

I can't express my word... It takes a lot of hard work to present such a complex topic into simple words.. Wow

[@IshwariChandran]

Best compliment ever! Thank you so much for supporting :D

[@prateeksinghal1142]

I have urinary incontinence. Have seen lots of videos for so many months, but this video has classified this urinary information comprehensively and with such simple drawings. It helped me to understand my problem better and where I stand. Thank you so much.

[@IshwariChandran]

Really sorry to hear what you’ve been going through. I’m glad this video was able to help you!

[@mohitsekhon6829]

Amazing video with great explanations! Thank you so much!

[@IshwariChandran]

Happy to help! 😁

[@khowajanima1249]

You’re amazing!!! I loved your teaching

[@IshwariChandran]

Thank you so much! :')

[@MedManiac1]

really great to see indian medicos doing such high quality work.❤️

[@IshwariChandran]

Aw thank you so much! :)

[@Abcdefgfedcb]

Awesome video! Very high yield, thank you for making this!!!

[@IshwariChandran]

😁✌️

[@hafsajabeen5303]

Best video on this topic. Thank you

[@IshwariChandran]

That's really nice of you! ☺️

[@ajithkumarkannan1626]

Really useful Q&A video ish. Your explanations are very good.

[@IshwariChandran]

Thank you :D

[@Taiyella]

This was a great video honestly thank you

[@IshwariChandran]

Extremely glad you liked it! 😁

[@IK_59]

excellent explanation, thank you soo much

[@IshwariChandran]

Happy to hear that :)

[@soggy_teabag]

amazing explanation, the receptors can get very confusing but you dumbed it down for me so well thank you!!

[@IshwariChandran]

So glad to hear that 🙌

[@lina_luay]

This is so helpful, thank you💖

[@IshwariChandran]

Anytime 💞

[@priyankaraina1932]

U Got a new subscriber 💓 In love with your work. Thanks a lot 🥺

[@IshwariChandran]

That's so sweet! Thank you very much, Priyanka ❤️

[@muthusamychandran7297]

Excellent explanation 👍

[@IshwariChandran]

Thank you :)

[@housemd8567]

liked ,subscribed .I rlly liked the way you teach it's fabulous .Thank you

[@IshwariChandran]

Thank you so much 🙌🏻😊

[@neurologymadeeasy988]

Very nicely explained. Good work.😊

[@IshwariChandran]

Thank you so much 😁

[@Ab_cd18]

This lecture was amazing , put more videos

[@IshwariChandran]

Thanks! 😁

[@susheelasunder3386]

Nice video my problem bladder obstruction whether curable.mam. incontinence urine.

[@user-gz6hi6vw5f]

Thanks!

[@IshwariChandran]

😊

[@meme-cl4dh]

Amazing

[@IshwariChandran]

Thank you☺️

[@vijaynagaonkar9087]

Excellent video.....wish could have subscribed yr channel even earlier...

[@IshwariChandran]

Thank you so much, Vijay! 😊

[@thisumamarasinghe8171]

Thank u so much

[@IshwariChandran]

My pleasure x

[@dr.himmatsinghrathore2022]

Very good 👏🏽

[@IshwariChandran]

Thank you so much! 😁

[@noorhassan3831]

Thanks🌷🌷

[@IshwariChandran]

You're welcome 😊

[@tessblog3384]

good luck my friend
good job

[@IshwariChandran]

Thank you so much! :)

[@Truelust29]

The answer topostmenopausal estrogen losss incontinence shud be stress incontinence. Due to mucle atrophy and not urge. Plz check

[@IshwariChandran]

Hey! You're right about stress incontinence. Menopause can also cause urge incontinence :)

[@Truelust29]

@@IshwariChandran Noted. Thanks for the response. U r doing an amazing job.

[@IshwariChandran]

@@Truelust29 Thank you so much! 😊

[@rajeshmithun9455]

Thanks Madam

[@IshwariChandran]

My pleasure :)

[@m.saqlainqavi8967]

just wow!!! plz guide about book you studied to explain this much

[@IshwariChandran]

Thank you so much!! It's all covered in the syllabus for the USMLE. Here are the resources I used: ua-cam.com/video/LIlvl-u1VlQ/v-deo.html

[@ishu6203]

Fact is like my name and also Ishwari

[@prithvirajbanerjee1547]

Madame I'm an MBBS passout and I really enjoyed watching this video.
Could you please solve a doubt for me on a topic of ANS? I'm kinda stuck..
I learnt from a source that alpha 1 (Gq subtype) receptors are present on GIT smooth muscle, but adrenergic stimulation causes these muscles to relax dt opening of calcium activated potassium channels. Is this info correct?
[ I previously thought that GIT relaxation was brought about by beta 2 receptors Gs subtype during sympathetic response. But I'm very confused after learning this info from a professor.]

[@IshwariChandran]

Thank you so much!
Alpha 1 is Gq ----> contraction
Beta 2 is Gs ----> relaxation
Adrenergic stimulation can stimulate both of them. The effect depends on which one is predominantly stimulated.
Example:
Noepinephrine stimulates alpha 1 more than beta
Epinephrine stimulates beta more than alpha
I hope this helps!

[@kiran3066]

Can fat below belly button and pubic area cause incontinence? Pls reply 🙏🙏

[@varisthashaw9368]

key concepts
1. overflow incontinence is due to atony of the bladder (think, the bladder muscle is not working so the urine builds up to overflowing)
2. urge incontinence is due to detrusor instability (think, the bladder muscle is overactive, giving you the urge to micturate all the time)
3. stress incontinence is due to urethral hypermobility.
4. diabetes destroys nerves and muscles, bladder muscle fails to contract, so there is overflow incontinence
5. in postmenopausal women, collagen is gone so the bladder has become small in capacity and even a little urine causes urge to micturate all the time
6. bethanechol, a CHOLinergic agent stimulates the bladder muscle to contract. used in atonic bladder or overflow incontinence
(trick: bethaneCHOL forces the GALL out of the atonic bladder)
7. oxybutynin, a muscarinic antagonist, calms the bladder muscle. used in urge incontinence or overactive bladder.
(trick: OXYbutynin. let the term oxy remind you of sexy and hence sexual URGES. oxybutynin then, is used for urge incontinence)
8. incomplete bladder emptying means bladder muscle is not contracting. means atonic/overflow incontinence
9. urethral obstruction causes bladder to fill to overflowing. so there is overflow incontinence.

[@easminbegum7007]

For question #6 ....for obstruction of urthera does that cause urge or overflow incontinence....I would assume if the urine cannot pass thru u would have a over flow of urine accumalte in the bladder ?

[@IshwariChandran]

That's right, it causes overflow incontinence :)

[@chandrashekharrawat1870]

My question to you are
q1. in which sort of incontinence is MIRABEGRON usefuL?
q2. In which subtype of patients of BPH is FLAVOXATE usefuL?

[@IshwariChandran]

Hello Sir!
Mirabegron is a beta 3 receptor agonist.
As mentioned in the video, beta 3 receptor activation causes relaxation of the bladder muscles.
So, I believe Mirabegron can be used to treat urge incontinence.
Flavoxate being an anticholinergic drug, can be used to manage urge incontinence in BPH

[@chandrashekharrawat1870]

@@IshwariChandran Yes both Mirabegron and Flavoxate are used in urge incontinence.
Only those subtypes of BPH are given anticholinergics who have postvoid residue of urine in bladder of LESS than 150 mL. if it is LESS than 150 mL suggests that patient is not having underactive bladder (overflow incontinence).
If PVR is MORE than 150 mL then it is suggestive of underactive bladder and anti-cholinergics will worsen the LUTS.

[@chandrashekharrawat1870]

@@IshwariChandran facebook.com/PharmacologyMCQS/photos/a.114660665287919/3423530871067532/
What is ur answer?

[@susheelasunder3386]

Post menopause 30years over.

[@kristymarie6065]

Thank you!!!! Oh this is horrible. I pee and then I feel like I need to go after and a little comes out. So tired of the urge to pee

[@vashikagowreesunkar1635]

Same!!. So annoying

[@kristymarie6065]

Have you gone to the dr for it?

[@vashikagowreesunkar1635]

@@kristymarie6065 no because i know its temporary. I am doing kegel exercises to have better control and its getting better

[@IshwariChandran]

So sorry to hear that! Must be really frustrating :(

[@vashikagowreesunkar1635]

@@IshwariChandran yes. You cant even imagine. Every 5 or 10 mins.. you feel the urge to go to pee. Its like there is pressure. When you finally go. Very little urine.