Flashcards in Urinary Incontinence Deck (8)
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Patient with genuine stress incontinence: physical exam findings? Best initial treatment?
1. Hypermobile urethra
2. Cystocele
3. Loss of ureterovesicular angle
Kegel exercises and timed voiding
1
Each of the following is due to?
1. Genuine stress incontinence?
2. Urge incontinence?
3. Overflow incontinence?
1. Due to sudden increases in intra-abdominal pressure (in the absence of bladder muscle spasm)
2. Uninhibited and sudden bladder detrusor muscle contraction
3. Over distended, hypotonic bladder with absence of detrusor contractions
2
Cystometric evaluation?
Investigation of pressure and volume changes in the bladder with filling of unknown volumes
3
Midurethral sling procedure?
Supporting midurethra with tensionless transvaginal tape or transobturator tape
4
Transvaginal tape procedure used to fix? Type of technique?
Transibturator tape procedure?
Proximal urethra retropubic; blind technique to place synthetic tape under urethra
Originating laterally to avoid bladder/bowel injuries due to transvaginal tape procedure
5
Normal effect of Valsalva on bladder/urethra?
Bladder and proximal urethra are normally intra-abdominal, so Valsalva increases pressure to BOTH the bladder and proximal urethra maintaining continence
6
Pathophysiology genuine stress incontinence?
1.Trauma/Weakness of the pelvic diaphragm (childbearing)
2. Proximal urethra falls below the pelvic diaphragm
3. Increasing abdominal pressure (Valsalva/cough) now exerted on the bladder but not proximal urethra
4. Incontinence without urge to void
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