Urinary Incontinence and Prolapse

Question 1

What is stress UI?

Answer 1

on effort/ exertion

Question 2

What is urgency UI?

Answer 2

immediately preceded by urgency

Question 3

What is OAB?

Answer 3

urgency that occurs with or iwthout incontinence; usually with freq and nocturia

Question 4

What is OAB dry?

Answer 4

OAB wtihout incontinence

Question 5

What is the aetiology of urinary incontinence?

Answer 5

age; parity; obesity; pregnnacy; obsetric history; menopause; UTI; smoking; FHx

Question 6

What are “storage” symptoms?

Answer 6

frequency; nocturia; urgency; UUI; SUI; constant leak

Question 7

What does a constant leak of urine suggest?

Answer 7

fistula

Question 8

What are voiding symptoms?

Answer 8

hesitancy; straining to void; poor flow

Question 9

What do voiding symptoms suggest?

Answer 9

obstruction

Question 10

What do postmicturition symptoms?

Answer 10

prolapse- urine sitting that is hard to get out

Question 11

What are postmicturition symptoms?

Answer 11

incontinence; incomplete emptying

Question 12

What should be done for an examination with urinary incontinence?

Answer 12

BMI; abdo exam; vaginal exam; PR; cognitive impairment

Question 13

What causes OAB and UUI?

Answer 13

detrusor muscle contracts frequently and involuntarily

Question 14

What causes SUI?

Answer 14

urethral hypermobility; urethral sphincter weakness

Question 15

What causes urethral sphincter weakness in women?

Answer 15

trauma; hypoestrogenism; aging; surgical procedures

Question 16

What is urethral hypermobility?

Answer 16

excessive displacement of the urethra and bldder neck during exertion and increased abdo pressure

Question 17

What are hte investigations for UI?

Answer 17

UA; post void resiudal USS; urodynamics; cystoscopy

Question 18

What are the lifestyle interventions with UI?

Answer 18

caffeine; fluid intake; weight loss

Question 19

What is the conservative managemnt of urge urinary incontinence?

Answer 19

pelvic floor physio; bladder retraining; lifestyle

Question 20

What antimuscarinics are used in urge UI?

Answer 20

oxybutynin; tolterodine; darfenicin

Question 21

What is the mechanism of antimuscarinics in urge UI?

Answer 21

reduce intra-vesicla pressure; increase compicance; reduce uninhibited contractions

Question 22

What are the SE of antimuscarinics?

Answer 22

dry mouth; constipation; blurred vision; somnolence

Question 23

What is the second line drug for urge urinary incontinence?

Answer 23

mirabegron

Question 24

What is the action of mirabegron?

Answer 24

selective B3 ADR agonist- relaxes bladder smooht muscle

Question 25

When might desmopressin be added in with OAB?

Answer 25

nocturia

Question 26

What must patients be able to do to have botulinum toxin injections?

Answer 26

intermittent self catheterisation

Question 27

What is the medication for SUI?

Answer 27

duloxetine

Question 28

What type of drug is duloxetine?

Answer 28

combined noradrenaline and serotonin reuptake inhibitor

Question 29

What is the effect of duloxetine?

Answer 29

increased intraurethral closure pressure

Question 30

What surgery is available for SUI?

Answer 30

tension free tape; colposuspension; intramural bulking agents; artifical sphincters

Question 31

What is complete vaginal eversion known as?

Answer 31

uterine procidentia

Question 32

What are the causes of prolapse?

Answer 32

age; parity; pregnancy; oestrogen defiencey; obesity; neuro condition; genetic connective tissue disorder

Question 33

What is POP-Q?

Answer 33

whilst striaing 6 sites and 3 sites at rest are measured in relation t othe hymenal ring to look at degree of prolapse

Question 34

What is a stage 1 prolapse?

Answer 34

1cm above hymen

Question 35

What is a stage 2 prolapse?

Answer 35

1cm around hymen

Question 36

What is a stage 3 prolapse?

Answer 36

>1cm beyond hymen

Question 37

What is stage 4 prolapse?

Answer 37

complete vaginal eversion

Question 38

What are the complications with pessaries?

Answer 38

discharge; ulcerations (fistula); fibrous bands

Question 39

How often should a pessary be changed?

Answer 39

6 monthly

Question 40

What is the surgical option for anterior and posterior prolapse?

Answer 40

vaginal repair

Question 41

What are vaginal surgical options for apical prolapse?

Answer 41

sacrospinous fixation and colpocliesis

Question 42

What is sacrospinous fixation?

Answer 42

cervix/ vagina attached to sacrospinous ligament

Question 43

What is colpocleisis?

Answer 43

close up vagina

Question 44

What should be done with colpocleisis if woman still has uterus?

Answer 44

2 channels left on either side to see PMB

Question 45

What is a pectopexy?

Answer 45

subtotal hysterectomy; cervix bilaterally attached to iliopectineal ligament

Question 46

What is a sacrohysteropexy/sacrocolpopexy?

Answer 46

attaching uterus/vagina to anterior longitudinal ligamentwith mesh and coverd with peritoneum