What is stress incontinence?
Leakage on increased intra-abdominal pressure
What is urge incontinence?
Urinary leakage preceded by a strong urge to go
An overactive bladder causes urgency (with / without) incontinence.
'wet' or 'dry' overactive bladder
Incontinence becomes (more / less) common as you have more children.
multiparity is a risk factor
Which body state increases your risk of incontinence?
What happens in the menopause to cause incontinence?
Relaxation of pelvic muscles, endopelvic fascia and pelvic ligaments
Which type of infection can cause urinary incontinence?
Which structure should be felt for in any abdominal/pelvic examination of a woman?
What examinations should you do in a woman complaining of urinary incontinence?
What test should you do in any woman complaining of urinary symptoms?
What is the conservative management of an overactive bladder?
drink less alcohol and caffeine
drink less fluid in general
pelvic floor exercises and/or bladder training
Which muscle do antimuscarinics act on?
Detrusor smooth muscle
Inhibit parasympathetics, reducing contraction
What are some examples of antimuscarinic drugs used for urge incontinence?
What are some side effects of antimuscarinics like oxybutynin and tolterodine?
Which new drug will soon be used instead of antimuscarinics to manage overactive bladder?
B3 adrenoceptor agonist
RELAXES detrusor smooth muscle, reducing urge to void
What agents can be injected into the bladder to paralyse the smooth muscle, reducing incontinence but requiring catheterisation?
How is stress incontinence managed?
Pelvic floor exercises
Incontinence pessaries - like pads, kind of
Anticholinergics e.g duloxetine
Injection of botulinum toxin
How do anticholinergics e.g duloxetine treat stress incontinence?
Constrict urethral smooth muscle
Maintain tone of internal urethral sphincter
If all else fails, urinary incontinence can be treated using ___.
What is a common gynae problem caused by increasing age and obesity?
Pelvic organ prolapse
What are some risk factors for pelvic organ prolapse?
Which three closely related organs, found in the pelvis, can prolapse into one another?
Which conditions, causing hypermobility, predispose women to pelvic organ prolapse?
What sort of symptoms are caused by pelvic organ prolapse?
Sensation of pressure, dragging in the pelvis
Lower GI symptoms
Pain or discomfort during sex
What is an anterior pelvic prolapse also known as?
Cystocele causes ___ symptoms.
incomplete emptying, incontinence
What has prolapsed inferiorly in a woman with dragging sensation, back pain and dyspareunia?
What is a posterior pelvic prolapse also known as?
What has prolapsed in a woman with dragging sensation and difficulty defaecating?
What system is used to figure out what exactly has prolapsed in a woman with pelvic organ prolapse?