Female Urinary Incontinence Flashcards Preview

Hugh's MD3 Women's > Female Urinary Incontinence > Flashcards

Flashcards in Female Urinary Incontinence Deck (18)
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1
Q

What proportion of women experience incontinence post partum?

A

30-40%

2
Q

What is stress incontinence?

A

Leakage associated with some form of stress

3
Q

What is retention with overflow?

A

Overfilling and voiding without feeling need

4
Q

What are the mechanisms of stress incontinence?

A

Defects in pelvic floor

Urethral sphincter deficiency

5
Q

What is healthy bladder activity?

A

Holds 300-500ml
Voids 8x per day
Up to once at night

6
Q

What medical condition do you screen for in incontinence?

A

Narrow-angle glaucoma

7
Q

Which medications interact with incontinence particularly?

A

Anti-cholinergics
Diuretics
Anti-hypertensives

8
Q

What do you do on exam?

A
Mobility, MSE, Manual dexterity, Neurological, BMI
Abdominal and bimanual exam
Vulval and vaginal skin: atrophy
Cough test 
Pelvic floor muscle strength
9
Q

How does menopause contribute to incontinence?

A

Lowered oestrogen exacerbates but does not cause the incontinence so replacement helps

10
Q

How do you investigate incontinence?

A
MSU
Post-void residual
Bladder diary/QoL questionnaires 
Urodynamics: uroflowmetry, cystometry, urethral pressure profilometry 
Videourodynamics
Cystourethroscopy
11
Q

Rate modes of delivery by risk of incontinence

A

Forceps
Vaginal
Caesarean

12
Q

What is the conservative management of SI?

A
Pelvic floor exercises
Biofeedback
Electrical stimulations
Pads, tampons 
Pessary
13
Q

When are pelvic floor exercises effective?

A

Stress incontinence due to weakness at bladder neck (not sphincter)
Urge incontinence

14
Q

What are the operations for SI?

A

Vaginal Sling procedure

Periurethral bulking agent

15
Q

What is the conservative mx in UI?

A

1.5L per day of fluids
Avoid alcohol and caffeine
Pelvic floor exercises
Bladder retraining - distraction during urgency to gradually in the time between voids

16
Q

What is the pharmacological mx of UI?

A

Anticholinergics - oxybutinin
Beta-3 agonists - mirabegron
TCAs - imipramine
Oestrogen

17
Q

What is the surgical mx options of UI?

A

Cystoscopy and hydrodistension
Cystoscopy with intravesical injection of botox
Sacral nerve stimulation for intractable OAB

18
Q

When there is mixed incontinence what do you treat first?

A

The urgency as the voids are larger

Decks in Hugh's MD3 Women's Class (68):