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Flashcards in GYN- Incontinence Deck (11)
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1
Q

Descibe the innv needed for continence

A

INVOLUNTARY
sympatetic: via hypogastric N –> detrusser relaxation + internal sphincter constriction (HOLDS PEE)

Parasympathetic: via pelvic splanchnic N –> MAch R –> detrussor contraction and internal sphincter relaxation (EXPELS PEE)

VOLUNTARY:::
SOMATIC CONTROL of external anal sphincter via pudental N

2
Q

First step when pt comes in for incontinence

A

get UA/UCx to r/o UTI

3
Q

urine leakage with exertion or straining =

Tx?

A

stress incontinence

surg to stabalize hypermobile urethra (best) > kegek, pessaries

4
Q

urine leakage due to detrussor overactivity/involuntary bladder contractions

Tx?

A

urge incontience

anti-cholinergics (oxybutinin)
TCAs (imipramine)

5
Q

urine leakage with urine retantion and over distention

Tx?

A

overflow incontinence`

intermittent self cath 
cholinergics (inc bladder contractility)
a1 blockers (inc urethral resistance)
6
Q

urine leakage due to fistula following pelvic surgery or pelvic radiation

A

bypass incontinence

7
Q

urine leakage due to physcial or psych issues, common in nursing homes

A

functional incontinence

8
Q

old age causes what kind of incontinence

A

stress and functionlal

9
Q

UTIs cause what kind of incontinence

A

urge (detrussor overactivity/involuntary bladder contractions)

10
Q

bladder stones or cancer cause what kind of incontinence

A

urge (detrussor overactivity/involuntary bladder contractions)

11
Q

how to diagnose bypass incontinence

A

methylene blue or indigo carmine dye