Pelvic Floor Disorders Flashcards Preview

Repro > Pelvic Floor Disorders > Flashcards

Flashcards in Pelvic Floor Disorders Deck (52)
Loading flashcards...
1

What are the 3 categories of pelvic floor issues?

Urinary Incontinence
Pelvic floor prolapse
Anal incontinence

2

What urethral problems cause urinary incontinence?

Urethral sphincter incompetence
Detrusor instability
Retention with overflow
Functional

3

What Extraurethral problems can cause urinary incontinence?

Congenital
Fistula

4

What are the 4 types of urinary incontinence?

Stress
Urge
Mixed
Overflow

5

What is the incidence of Urinary Stress Incontinence?

1 in 33 women aged 55 and over
1 in 10 will need surgery

6

What are risk factors for urinary incontinence?

Sex - women
Age - older
Obesity
Smoking
Kidney disease
Diabetes
Higher number of children

7

What is OAB?

Overactive Bladder Syndrome

8

What is OAB wet?

Urge incontinence is present

9

What is OAB dry?

Incontinence is absent

10

Describe urge incontinence

Preceded by an urge to void
Can involve triggers such as running water etc.

11

Describe Mixed urinary incontinence?

Involuntary leakage associated with urgency and also with exertion, sneezing or coughing (stress)

12

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

13

What bladder specific examinations should be done with someone with incontinence?

Stress test
Post void residual
Urine analysis (dipstick)
Bladder diary

14

What lifestyle measures can help with incontinence?

Bladder retraining
Sensible fluid intake
Caffeine reduction
Weight reduction if BMI >30

15

If a women urinates during penetrative sex, is that stress or urge?

Stress

16

If a women urinates during orgasm, is that stress or urge?

Urge

17

What physical treatments can help with incontinence?

Pelvic floor muscle exercises (PFME) - helps mixed and stress

18

What help do antimuscarinic agents do for incontinence?

Reduce intra-vesical pressure
Increase compliance
Raise volume threshold for micturation
Reduce uninhibited contractions

19

Give 3 examples of antimuscarinics

Oxybutynin
Solifenacin
Tolterodine

20

What are side effects of anti-muscarinics?

Dry mouth
Constipation
Blurred vision
Somnolence

21

What are Beta3 agonists?

First class selective B3 adrenoceptor agonist

22

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

23

How much liquid should be taken in each day?

24ml per kg per 24 hours

24

What do B3 adrenoceptors do?

Increase the voiding interval and inhibit spontaneous bladder contractions

25

Give an example of a B3-adrenoceptor agonist?

Mirabegron

26

When would a B3-adrenoceptor agonist be recommended?

When there is contraindications of antimuscarinics or they are ineffective

27

What are the 3 first choice drugs for women with OAB or mixed UI according to NICE?

Oxybutynin
Tolterodine
Propiverine
(All immediate release)

28

What are the 3 second choice drugs for women with OAB or mixed UI according to NICE?

Trospium (immediate)
Oxybutynin (extended)
Darifenacin

29

What are indications for using Uroflowmetry?

Hesitancy
Voiding difficulty
Neuropathy
History of urine retention
Post-operative follow up

30

What are indications for Multichannel Urodynamics?

Uncertain diagnosis
Fail to respond to treatment
Prior surgery