Flashcards in 8 - Gynae - Disorders of the Urinary Tract - Overactive Bladder Deck (9):
urinary Sx - ?, w or w/o urge incont, usually with ? or ?, in absence of proven ?
The Sx combo suggests ? over-activity - but can be other ? ? dysfx
urgency, freq or nocturia
Detrusor overactivity - characterised by ? detrusor ? during the ? phase - may be ? or provoked eg after ?
OAB and DOA can happen ? or ?
OAB = ?% of female incontinence
spont/provoked - coughing
alone or together
Aetiology - mostly what?
-can follow what? (prob due to ? ? obstruction)
-occasionally OAB is due to ??, in presence of underlying ? eg ? or sub cut injury
ops for USI - bladder neck obstruction
Mechanism of incontinence - detrusor contraction normally felt as ?
- if strong enough can cause what? leading to urge incontinence.
-can occur ? or with ? eg ? ? or a running tap
-therefore coughing may give leakage - which is easily confused with ? ?
bladder press > urethral > leakage = urge incontinence
spont or w provocation - incr IAP
Hx points - 4 urinary Sx that are usual?
- what other urinary Sx is common?
-some pts leak at ? or at ?
-Hx of childhood ? common, as is faecal ?
Ex - often normal, incidental ? may be found
urgency, urge incont, freq, nocturia
night or at orgasm
-What will urinary diary show? what may it show?
-with DOA - cystometry shows contractions on ? or ?
- cystometry not gen done until what? (few things)
freq passing of small vol of urine, esp at night, may show high intake of caffeinated drinks
filling or provocation
failure of lifestyle changes and drug management OR if surgery considered
MGMT - conservative - 2 simple pieces of advice? avoid which 2 drugs types?
-what other conservative trt? what is it often in combo with?
avoid caffeine, drink less
diuretics and anti-psychs
MGMT - medical - ? suppress DOA, most widely used.
-they ? the detrusor
-one key SE?
- what to do if this doesnt help Sx?
-2 other medical trts?
refer to specialist
Botulinum Toxin A (BTX)