W1 - Female Incontinence Flashcards
(19 cards)
what % of women experience incontinence regularly
20%
what are the key risk factors for incontinence
Increase with age, parity, obesity, smoking
what are the key types of incontinence
stress
urge
overflow
mixed
functional
what is the pathophysiology of stress incontinence
Sphincter weakness
what is the pathophysiology of urge incontinence (overactive bladder)
Involuntary bladder contractions
how does stress incontinence present
Involuntary leakage:
Cough
Laugh
Lifting
Exercise
Movement
how does urge incontinence present
Urgency
Frequency
Nocturia
Nocturnal enuresis
‘Key in the door’ and ‘Handwash’
Intercourse
what assessments can be done (non-invasive)
Patient reported outcome measure (ePAQ-PF)
Frequency volume chart (FVC)
Urinalysis (Dipstick and MSU)
Uroflow
Residual urine measurement
what urinalysis results would you see for infection, nephropathy and glomerulonephritis
what is uroflowmetry and what is measured
Uroflowmetry is performed by asking the patient to urinate into the funnel that is placed on top of a collection jug.
measured:
flow rate - ml/sec
time taken to void
what parameters are measured in uroflowmetry
Voided volume (ml)
Average flow rate (ml/sec)
Max Flow rate (ml/sec)
Computed Max Flow rate (ml/sec)
Time to Max Flow rate (seconds)
Voiding time (seconds)
what invasive test can be done for incontinence
urodynamics - cystometry
what are the 3 components of urodynamics
Uroflow and PVR
Filling cystometry
Voiding cystometry
what is the conservative treatment for stress incontinence
(Physiotherapy)
what surgical treatment can be done for stress incontinence
Colposuspension
TVT
Autologous sling
Mesh sling (TVT)
what treatment options can be done for urge incontinence
Bladder drill
Drugs (anticholinergic)
Botox
Augment- nerve stimulation
Bypass
what lifestyle advice should be done for someone with incontinence
Weight loss
Smoking cessation
Reduced caffeine intake
Avoidance of straining and constipation
what drugs can be given for urge incontinence
vaginal oestrogen
anticholiergics:
Oxybutanin
Tolterodine
Propiverine
Trospium
Solifenacin
Fesoterodine
what are the key side effects of anticholinergics
dry mouth
constipation
blurred vision
tachycardia
brain fog - cognition reduced
