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Flashcards in Urinary Problems Deck (14)
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1
Q

Urinary symptoms

A

Rarely solely stress or urge incontinence, most people will also have some frequency or urgency or nocturia (mix of wet and dry symptoms) Hard to predict detrusor instability based on symptoms alone

2
Q

Urinary diary

A

Intended to measure intake and output of fluid to estimate functional capacity, frequency of voiding and frequency of incontience

3
Q

Investigations of urinary symptoms

A

Urodynamics - flow rate (~15mls/s), urinary residual, bladder capacity and detrusor function
Exclude UTI

4
Q

Treatment of incontinence

A

Conservative - pregnancy, unfit for surgery or only mild problems
lifestyle changes - reduce fluid intake, exclude UTI, improve mobility and sleep

5
Q

Treatments of Overactive bladder (OAB) or Detrusor instability (DI)

A

Pathology not understood but symptomatic treatment possible

Variety of treatments including drugs, bladder training, psychotherapy, acupuncture, hypnotherapy or surgery

6
Q

Overactive bladder (OAB) or Detrusor instability (DI)

A

Starts with incontience and moves to frequency
Nocturia is common in older women anyway
sexual dysfunction affects 1/3 of women with DI

7
Q

Drug treatments for Overactive bladder (OAB) or Detrusor instability (DI)

A

Anticholinergics (Propiverine)
Musculotropic relaxants (oxybutynin)
Antimuscarinics (Toterodine/detrusitol)

8
Q

Imipramine

A

Useful for nocturia and works synergistically with other drugs
Also useful for intercourse incontinence

9
Q

Estrogen replacement

A

No evidence it cures DI
but is good for atrophic vaginitis or urethritis
Reduces the frequency of UTIs
can improve sensory urgency

10
Q

DDAVP

A

Demopressin - used to treat nocturia but care should be taken if the patient has heart failure

11
Q

Stress incontience

A

If mild treat with pelvic floor training or vaginal devices, if more severe use fluid restriction or void before stress events

12
Q

Vaginal delivery and the pelvic floor

A

14% will have long standing dyspareunia after SVD

35% have sonographic evidence of anal sphincter damage

13
Q

Prevalence of urinary problems

A

14-20% of women effected - under recognised and under treated
Mainly OAB and stress incontinence
Majority treated conservatively

14
Q

Treatment of Isolated idiopathic urinary frequency

A

Fluid restriction is often effective on its own.