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3. Y5 Zero to finals: O&G > Urinary Incontinence > Flashcards

Urinary Incontinence Flashcards

1
Q

What is Urinary Incontinence?

A

Involuntary leakage of urine

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2
Q

What are the 2 types of Urinary Incontinence?

A
  1. Urge
  2. Stress
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3
Q

What is Mixed Incontinence?

A

Pt with features of both types of incontinence (most common)

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4
Q

What is the definition of Stress Incontinence?

A

Involuntary urine leakage @ increased intra-abd pressure

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5
Q

When is Stress Incontinence typically seen?

A

After childbirth (aka most common causative factor)

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6
Q

What is Stress Incontinence due to?

A

Weakness of pelvic floor + sphincter muscles

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7
Q

What occasions does urine leak out with Stress Incontinence? (4 things)

A
  1. Laughing
  2. Coughing
  3. Sneezing
  4. Surprised
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8
Q

What is Urge incontinence caused by?

A

Overactivity of detrusor muscle

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9
Q

What is another name for Urge incontinence?

A

Overactive bladder

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10
Q

What are the RF for Urinary Incontinence? (8 things)

A
  1. Age
  2. BMI
  3. Postmenopausal
  4. Vaginal delivery
  5. Pelvic organ prolapse
  6. Pelvic floor surgery
  7. Neurological conditions (e.g MS)
  8. Cogn impairment / Dementia
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11
Q

What are the CF of Stress Incontinence? (3 things)

A
  1. Leakage @ exertion (ask pt to cough)
  2. SMALL volume leakage
  3. Prolapse of urethra + ant vaginal wall (@ exam)
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12
Q

What are the CF of Urge Incontinence? (4 things)

A
  1. Urgency
  2. Frequency
  3. Nocturia
  4. LARGE volume leakage
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13
Q

What are some triggers for urgency in Urge Incontinence? (2 things)

A
  1. Hearing running water
  2. Cold weather
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14
Q

What is the aim of the primary investigation for sus Incontinence?

A

Excluding UTI

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15
Q

What are the 2 main investigations for Incontinence?

A
  1. Frequency / volume charts
  2. Urodynamic studies
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16
Q

How do you distinguish between Stress vs Urge with Frequency / volume charts?

A
  • Stress = Normal frequency
  • Urge = Increased frequency
17
Q

What is the point of doing Urodynamic Studies? (2 points)

A
  1. Done for Stress incontinence when considering surgery
  2. Used to confirm Dx + rule out detrusor over-activity
18
Q

What is important a pt does before Urodynamic Studies are done?

A

Stop taking anticholinergic meds 5 days before

19
Q

What are some important Modifiable lifestyle factors you should ask about in the Hx of sus Incontinence? (3 things)

A
  1. Caffeine / Alcohol consumption
  2. Meds
  3. BMI
20
Q

What are you checking for @ examination of sus Incontinence? (5 things)

A
  1. Pelvic tone
  2. Pelvic organ prolapse
  3. Atrophic vaginitis
  4. Urethral diverticulum
  5. Pelvic mass
21
Q

What are the CONSERVATIVE Mx options for Stress Incontinence? (4 things)

A
  1. X caffeine / alcohol / overfilling bladder
  2. Weight Loss
  3. TUC (e.g chronic cough)
  4. Pelvic floor exercises (supervised)
22
Q

How long should Pelvic floor exercises be done for before considering Surgery?

A

3 months

23
Q

What are the SURGICAL Mx options for Stress Incontinence? (2 things)

A
  1. Tension Free Vaginal Tape (TVT) (most common)
  2. Laparoscopic colposuspension
24
Q

What does Tension Free Vaginal Tape (TVT) involve?

A

Tape placed under mid-urethra via small vaginal incision

25
Q

When should someone have MEDICAL Mx for Stress Incontinence?

A

Woman doesn’t want / not suitable for surgery

26
Q

What is the Medical Mx of Stress Incontinence?

A

Duloxetine (SNRI antidepressant)

27
Q

What are the CONSERVATIVE Mx options for Urge Incontinence? (2 things)

A
  1. X caffeine / alcohol / overfilling bladder
  2. Bladder retraining
28
Q

What are the MEDICAL Mx options for Urge Incontinence? (2 things)

A
  1. Anticholinergics (e.g oxybutynin)
  2. Mirabegron (alternative to anticholinergics)
29
Q

What are the Side fx of using Anticholinergics for Urge Incontinence? (5 things)

A
  1. Confusion
  2. Dry eyes / mouth
  3. Blurred vision
  4. Arrhythmias
  5. Constipation
30
Q

What are the CI for taking Anticholinergics for Urge Incontinence? (3 things)

A
  1. Acute angle glaucoma
  2. Myasthenia gravis
  3. GI obst
31
Q

What are the CI for taking Mirabegron for Urge Incontinence?

A

Uncontrolled HTN

32
Q

Who is SURGICAL Mx of Urge Incontinence reserved for?

A

Only those with debilitating symptoms

33
Q

What is the SURGICAL Mx option for Urge Incontinence?

A

Detrusor myomectomy + Augmentation Cystoplasty

(using bowel tissue to enlarge bladder)

34
Q

Which Incontinence type is SURGICAL BEFORE MEDICAL Mx?

A

Stress Incontinence

(doc gets STRESSED n instantly does da Surgery)

3. Y5 Zero to finals: O&G (27 decks)

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