Urogynae Flashcards Preview

Toni's Obs and Gynae > Urogynae > Flashcards

Flashcards in Urogynae Deck (10):
1

Cystometry

Measures debris or pressures as bladder is filled and provoked with coughing
Transducers in rectum and bladder
Bladder P - abdo P = detrusor activity

2

Pharmacological management of detrusor instability aka urge incontinence

Anticholinergics: oxybutynin, solifenacin, tolteridone
SE: headache, dry mouth
Desmopressin (synthetic ADH) reduces urine production
Useful for nocturia

3

Transvaginal tape

Under general or local
Mid urethral sling inserted to limit urethral descent
Provide support to pubourethral ligaments + reinforce ant vaginal wall

4

Bladder training

For OAB aka detrusor instability
1st line = 6 wks bladder training
Medical
Oxybutynin, warn re anti muscarinic side effects
Botulinum toxin A injections into bladder
(Willing and able to self cath if needed)
Last line: sacral nerve stimulation, cystoplasty

5

Cystocele

Descent of bladder through superior anterior vaginal wall
Urinary sx due to change of uterovesical angle: stress incontinence, freq, urgency, incomplete bladder emptying -> UTI

6

Urethrocele

Descent of first 3-4cm of anterior vaginal wall
Urinary sx
Dragging sensation

7

Prolapse and predisposing factors

Weakened pelvic tissues secondary to pregnancy/ vaginal delivery
+ menopausal oestrogen deficiency -> loss of connective tissue strength
Prev suprapubic surgery
Obesity, cough, constipation, heavy lifting, ascites, large pelvic mass

8

Procidentia

Cervix, uterus and vaginal wall prolapse through introitus

9

Vault prolapse

Prolapse of vagina following hysterectomy

10

Rectocele

Prolapse of rectum into lower posterior vaginal wall
Tenesmus
Rectocele may need to be pushed back in order to defecate