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Incontinencia imperiosa - Symptom

Nombres alternativos

Vejiga hiperreactiva; Inestabilidad del detrusor; Hiperreflexia del detrusor; Vejiga irritable; Vejiga espasmódica; Vejiga inestable; Incontinencia con tenesmo; Espasmos vesicales

Síntomas:

Pruebas y exámenes:

Durante un examen físico, el médico examinará el abdomen y del recto. A las mujeres también se les practicará un examen pélvico y a los hombres un examen genital. En la mayoría de los casos, el examen físico no revela nada anormal.

Si se presentan causas relacionadas con el sistema nervioso (neurológicas), se pueden encontrar otras anomalías.

Entre los exámenes que se pueden realizar se encuentran:

  • EMG (miografía): raras veces se necesita
  • Inspección de la parte interna de la vejiga (cistoscopia)
  • Prueba con toalla sanitaria (después de colocar una toalla sanitaria previamente pesada, se le pide al paciente que haga ejercicio; después del ejercicio, la toalla se vuelve a pesar para determinar el grado de pérdida de orina)
  • Ecografía abdominal o pélvica
  • Residuo posmiccional para medir la cantidad de orina que queda en la vejiga después de la micción
  • Análisis de orina o urocultivo para descartar una infección urinaria
  • Prueba de esfuerzo urinario (el paciente se para con la vejiga llena y tose)
  • Estudios urodinámicos (medición de la presión y flujo urinarios)
  • Radiografía con medio de contraste

Pueden realizarse otros exámenes para descartar otros tipos de incontinencia. La prueba del hisopo o Q-tip mide el cambio en el ángulo de la uretra cuando está en reposo y cuando está escurriendo orina. Un cambio de ángulo mayor a 30 grados a menudo indica que los músculos que sostienen la vejiga están débiles, lo cual es común en la incontinencia urinaria de esfuerzo.

  • Reviewed last on: 3/5/2010
  • A.D.A.M. Editorial Team: David Zieve, MD, MHA, David R. Eltz. Previously reviewed by Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine (8/30/2009).

Referencias

Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Sauders Elsevier; 2007: chap 3.

Rogers RG. Clinical practice: urinary stress incontinence in women. N Engl J Med. 2008;358:1029-1036.

Shamliyan TA, Kane RL, Wyman J, Wilt TJ. Systematic review: randomized, controlled trials of nonsurgical treatments for urinary incontinence in women. Ann Intern Med. 2008;148:459-473.

van Kerrebroeck PE, van Voskuilen AC, Heesakkers JP, Lycklama a Nijholt AA, Siegel S, Jonas U, et al. Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study. J Urol. 2007;178:2029-2034.

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