Urinary incontinence evaluation

TABLE 50-2. Items Which Should Be Addressed During Diagnostic Evaluation of Urinary Incontinence (Ul)... 

Payne CK (1998) Epidemiology, pathophysiology and evaluation of urinary incontinence and over-active bladder. Urology 51 3-10... 

From a clinical perspective, some of these PCO classes have attracted initial attention. Diazoxide and minoxidil have been evaluated as antihypertensive agents. These PCOs open K+ channels in the plasma membranes of vascular smooth muscle cells, causing vascular vasodilation, thereby lowering blood pressure. Cromakalim has been investigated as a smooth muscle bronchodilator for the treatment of human asthma. Nicorandil was launched in Japan in 1984 for the treatment of angina because of its perceived ability to promote vasodilation of coronary arteries. Developmental work on these and other PCOs is continuing for indications ranging from hypertension, asthma, urinary incontinence, psychosis, epilepsy, pain, and alopecia (hair loss). 

Neurokinins comprise a group of peptides involved in nerve transmission. Specific members of this class of mediators control such diverse functions as visceral regulation and CNS function. The nonpeptide neurokinin antagonist talnetant (32-6), for example, has been evaluated for its effect on irritable bowel syndrome and urinary incontinence as well as depression and schizophrenia [36]. The quinoline portion of this compound is prepared by base-catalyzed Pfitzinger condensation of isatin (32-1) with the methoxy acetophenone (32-2). The methoxy ether in the product (32-3) is next cleaved by means of hydrogen bromide (32-4). Amide formation with the chiral a-phenylpropylamine (32-5) affords the neurokinin antagonist talnetant (32-6) [37]. 

Musselman DM, Ford APDW, Gennevois DJ, et al. A randomized crossover study to evaluate Ro 115-1240, a selective a1A/L-adrenoceptor partial agonist in women with stress urinary incontinence. BJU Int 2004 93 78-83. 

In evaluating urinary incontinence, drug-induced or drug-aggravated etiologies must be ruled out. 

Blaivas JG, Heritz DM. Qassification, diagnostic evaluation and treatment overview. In Blaivas JG, ed. Topics in Qinical Urology— Evaluation and Treatment of Urinary Incontinence. New York, Igaku-Shoin, 1996 22-45. 

Thom DH, van den Eeden SK, Brown JS. Evaluation of parturition and other reproduchve variables as risk factors for urinary incontinence in later hfe. Obstet Gynecol 1997 90 983-989. 

Neurokinines comprise of a group of peptides involved in nerve transmission. The nonpeptidic neurokinin antagonist talnetant has been evaluated for its effect on irritable bowel syndrome (IBS) and urinary incontinence as well as depression and schizophrenia. The quinoline portion of this compound has been prepared through a Pfitzinger condensation of isatin with methoxy acetophenone. Methoxy ether cleavage and amide... 

A novel series of 1-aryl-3-(thiophen-2-yl)-1 H-1,2,4-triazol-5(4H)-one derivatives was synthesized and evaluated as detrusor muscle relaxants for the treatment of urinary incontinence. The effects of these compounds on bladder contractile function were determined in vitro by using isolated rat bladder strips from male Sprague-Dawley rats that were pre-contracted with carbachol. The results of the SAR studies in this series led to the identification of several potent smooth muscle relaxants. The design, synthesis, and SAR of the series will be presented. 

Patients with urinary frequency and urinary retention do benefit from urodynamical evaluation to determine the voiding pressures, the volume that triggers the void, the effect of abdominal pressure, and the volume of void. A urology nurse or a physician can prescribe appropriate medications to address the above issues. Urodynamics may be performed at the bedside by a trained nurse and can provide prompt information to assist with a plan to address incontinence. This examination will prevent unnecessary wetness and improve the continence outcomes. 

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