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CONTINUING PROFESSIONAL DEVELOPMENT
1. Which ONE of the following
most accurately describes stress
a) Leaking of small amounts of urine
during activities that increase pressure
inside the abdomen and push down on
b) Occurs mainly in men when the bladder
(detrusor muscle) develops instability.
c) Is accompanied by a strong, sudden
need to urinate.
d) Is an unwillingness to go to the toilet
because of stress or anxiety.
2. Regarding hormone replacement
therapy and incontinence, which
ONE of the following is correct?
a) Hormone therapy has only proven
effective for functional incontinence.
b) Intravaginal oestrogen has been
found to be ineffective for improving
incontinence in postmenopausal
c) Oral hormone therapy is not
recommended since evidence suggests
this may worsen urinary incontinence.
d) Topical hormone therapy is known
to irritate and exacerbate urinary
3. Which ONE of the following
statements most appropriately
describes urinary incontinence
exacerbated by antipsychotics?
a) Antipsychotics increase bladder
contractions, causing urge
b) Antipsychotics cause diarrhoea,
exacerbating urge incontinence.
c) Antipsychotics reduce bladder
contractions and can cause urinary
d) Antipsychotics relax the bladder outlet,
causing stress incontinence.
4. Which ONE of the following
statements is the most appropriate
regarding risk factors for urinary
incontinence in women?
a) Women who deliver a baby via
C-section are very unlikely to have
problems with stress incontinence.
b) Hysterectomy can protect women
against urinary incontinence due to
reduced risk of prolapse.
c) In older woman, atrophic vaginitis
contributes to urge incontinence because
of thinning and irritation of the urethra.
d) Menopause can reduce the risk of
urinary incontinence, since oestrogen is
known to exacerbate incontinence.
5. Which ONE of the following statements
is the most appropriate regarding
urinary incontinence in men?
a) Prostate surgery is a common cause of
functional incontinence in men.
b) The prevalence of urinary incontinence
is equal to that in women, but men are
half as likely to seek help compared with
c) Benign prostatic hypertrophy (BPH) is
the most common cause of overflow
incontinence in men.
d) Men having symptoms including
leakage, weak urinary stream, dribbling,
hesitancy, frequency and nocturia are
likely suffering stress incontinence.
that constipation could be making her
urinary incontinence worse. She agrees
to increase her fluid intake, gradually
increase gentle exercise, increase the fibre
in her diet and reduce her caffeine intake.
She is not currently drinking any alcohol.
You ask Martha about contraception to
determine if hormone therapy could
be worsening her symptoms. Martha
advises that, as she is still very early post-
partum, she is breastfeeding exclusively
and not using any contraception. She
intends going on the minipill in a few
weeks, as she used this previously
without a problem. This progesterone-
only pill should not exacerbate her
urinary incontinence, as it is mainly oral
oestrogens which are problematic.
Martha thanks you for your care and
thoughtfulness and is especially grateful
that you counselled her in a separate
room to discuss sensitive matters. She
purchases the recommended pads, takes
her PSA Self Care Fact Cards, agrees to
make an appointment with her GP today
and finally tells you she will pop in next
week to update you with her progress.
People suffering from urinary
incontinence are often embarrassed
and reluctant to seek help. Consumers
may not be aware that urinary
incontinence can be treated, better
managed and, in many cases, cured.
Knowledgeable pharmacists are
ideally placed and highly accessible
primary healthcare professionals
who can provide timely, sensitive
and appropriate advice and referral,
improving the care and management of
this often disabling “hidden” problem.
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16. Urinary incontinence in women: management. NICE
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Newborn Health Service. King Edward Memorial Hospital
Physiotherapy Department. 2009. At: www.kemh.health.
18. Urinary incontinence in adults. BPACNZ Guidelines. BPJ
2013;55:28–41 . At: www.bpac.org.nz/BPJ/2013/October/
COUNSELLING IN PRACTICE
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