Flashcards in Pelvic Floor Disorders Deck (52)
What are the 3 categories of pelvic floor issues?
Pelvic floor prolapse
What urethral problems cause urinary incontinence?
Urethral sphincter incompetence
Retention with overflow
What Extraurethral problems can cause urinary incontinence?
What are the 4 types of urinary incontinence?
What is the incidence of Urinary Stress Incontinence?
1 in 33 women aged 55 and over
1 in 10 will need surgery
What are risk factors for urinary incontinence?
Sex - women
Age - older
Higher number of children
What is OAB?
Overactive Bladder Syndrome
What is OAB wet?
Urge incontinence is present
What is OAB dry?
Incontinence is absent
Describe urge incontinence
Preceded by an urge to void
Can involve triggers such as running water etc.
Describe Mixed urinary incontinence?
Involuntary leakage associated with urgency and also with exertion, sneezing or coughing (stress)
What physical examinations should be done on a patient with incontinence?
Abdomen - masses, palpable bladder etc.
Pelvis/Perineum - External genitalia, atrophic vaginitis
Vagina - prolapse, malignancy, fistula
Rectal - tone, massesm teach Kegels during exam
Neurological - reflexes, sensory, motor
What bladder specific examinations should be done with someone with incontinence?
Post void residual
Urine analysis (dipstick)
What lifestyle measures can help with incontinence?
Sensible fluid intake
Weight reduction if BMI >30
If a women urinates during penetrative sex, is that stress or urge?
If a women urinates during orgasm, is that stress or urge?
What physical treatments can help with incontinence?
Pelvic floor muscle exercises (PFME) - helps mixed and stress
What help do antimuscarinic agents do for incontinence?
Reduce intra-vesical pressure
Raise volume threshold for micturation
Reduce uninhibited contractions
Give 3 examples of antimuscarinics
What are side effects of anti-muscarinics?
What are Beta3 agonists?
First class selective B3 adrenoceptor agonist
What is the method of action of Beta3 agonists?
Relaxes bladder smooth muscle through activation of the B3 adrenoceptor
Selective agonist for the human B3 adrenoceptor with low intrinsic activity for B1 and B2
How much liquid should be taken in each day?
24ml per kg per 24 hours
What do B3 adrenoceptors do?
Increase the voiding interval and inhibit spontaneous bladder contractions
Give an example of a B3-adrenoceptor agonist?
When would a B3-adrenoceptor agonist be recommended?
When there is contraindications of antimuscarinics or they are ineffective
What are the 3 first choice drugs for women with OAB or mixed UI according to NICE?
(All immediate release)
What are the 3 second choice drugs for women with OAB or mixed UI according to NICE?
What are indications for using Uroflowmetry?
History of urine retention
Post-operative follow up