Urinary Incontinence and Prolapse Flashcards Preview

Reproduction > Urinary Incontinence and Prolapse > Flashcards

Flashcards in Urinary Incontinence and Prolapse Deck (46):
1

What is stress UI?

on effort/ exertion

2

What is urgency UI?

immediately preceded by urgency

3

What is OAB?

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

4

What is OAB dry?

OAB wtihout incontinence

5

What is the aetiology of urinary incontinence?

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

6

What are "storage" symptoms?

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

7

What does a constant leak of urine suggest?

fistula

8

What are voiding symptoms?

hesitancy; straining to void; poor flow

9

What do voiding symptoms suggest?

obstruction

10

What do postmicturition symptoms?

prolapse- urine sitting that is hard to get out

11

What are postmicturition symptoms?

incontinence; incomplete emptying

12

What should be done for an examination with urinary incontinence?

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

13

What causes OAB and UUI?

detrusor muscle contracts frequently and involuntarily

14

What causes SUI?

urethral hypermobility; urethral sphincter weakness

15

What causes urethral sphincter weakness in women?

trauma; hypoestrogenism; aging; surgical procedures

16

What is urethral hypermobility?

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

17

What are hte investigations for UI?

UA; post void resiudal USS; urodynamics; cystoscopy

18

What are the lifestyle interventions with UI?

caffeine; fluid intake; weight loss

19

What is the conservative managemnt of urge urinary incontinence?

pelvic floor physio; bladder retraining; lifestyle

20

What antimuscarinics are used in urge UI?

oxybutynin; tolterodine; darfenicin

21

What is the mechanism of antimuscarinics in urge UI?

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

22

What are the SE of antimuscarinics?

dry mouth; constipation; blurred vision; somnolence

23

What is the second line drug for urge urinary incontinence?

mirabegron

24

What is the action of mirabegron?

selective B3 ADR agonist- relaxes bladder smooht muscle

25

When might desmopressin be added in with OAB?

nocturia

26

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

intermittent self catheterisation

27

What is the medication for SUI?

duloxetine

28

What type of drug is duloxetine?

combined noradrenaline and serotonin reuptake inhibitor

29

What is the effect of duloxetine?

increased intraurethral closure pressure

30

What surgery is available for SUI?

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

31

What is complete vaginal eversion known as?

uterine procidentia

32

What are the causes of prolapse?

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

33

What is POP-Q?

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

34

What is a stage 1 prolapse?

1cm above hymen

35

What is a stage 2 prolapse?

1cm around hymen

36

What is a stage 3 prolapse?

>1cm beyond hymen

37

What is stage 4 prolapse?

complete vaginal eversion

38

What are the complications with pessaries?

discharge; ulcerations (fistula); fibrous bands

39

How often should a pessary be changed?

6 monthly

40

What is the surgical option for anterior and posterior prolapse?

vaginal repair

41

What are vaginal surgical options for apical prolapse?

sacrospinous fixation and colpocliesis

42

What is sacrospinous fixation?

cervix/ vagina attached to sacrospinous ligament

43

What is colpocleisis?

close up vagina

44

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

2 channels left on either side to see PMB

45

What is a pectopexy?

subtotal hysterectomy; cervix bilaterally attached to iliopectineal ligament

46

What is a sacrohysteropexy/sacrocolpopexy?

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