1.9 Urine leaks, urodynamics Flashcards
Urine leaks, urodynamics definition?
Incontinence is an involuntary leakage of urine through the urethra
types of incontinence?
Stress incontinence
Urge incontinence
Mixed incontinence
Overflow incontinence
Overactive bladder syndrome
what is stress incontinence?>
- It is Mechanical problem
- related to weak Pelvic floor muscles or sphincter
- Upon coughing, laughing, physical activity –> increased
intraabdominal pressure –> push on the bladder –> leakage.
stress incontenece risk factors?
- Age
- multiple childbirths
- COPD
- diabetes
- gender: Female are more often affected
Male are more affected if they have undergone a radical prostatectomy.
what is Urge incontinence?
- detrusor m overactivity - Sudden contraction of the bladder
- the patient will feel urge
seen in UTI and overactive bladder
Urge incontinence risk factors?
- Age
- obesity
- disability
- gender: Male will experience more urge incontinence
what is overflow incontinence?
Bladder outlet obstruction –> cannot void, bladder will become too full –> sudden overflow.
what is Overactive bladder syndrome?
related to Frequency, urgency with or without incontinence
diagnosis of urine leaks and urodynamics?
- history of Voiding and bladder diaries
(for 3 days write down all fluid intake and outlet with accurate time) - Urine examination; to exclude UTIs and bladder cancer (if hematuria is found)
- Vaginal and rectal examination; look for prolapse
- Uroflowmetry
- Residual volume;(normal PVR volume of <50 mL, 50-100 in elderly)
if >150-250ml –> need intervention - Ultrasound: for overflow incontinence
- Urodynamical measurement( pelvic floor EMG, uroflowmetry, cystometry, pressure flow studies, urethral pressure profile)
- Endoscopy
- Radiology
- Neurological exam
Urodynamics definition?
is a study that assesses how the bladder and urethra are
performing their job of storing and releasing urine
( pelvic floor EMG, uroflowmetry, cystometry, pressure flow studies, urethral pressure profile)
what is post-void resifual volume?
- insertion of a urinary catheter/transducer following complete bladder emptying by the patient
- The urine volume is measured (this
shows how efficiently the bladder empties) - High volumes (180 ml) may be associated with UTIs.
- High levels can be associated with overflow incontinence
what is Uroflowmetry?
- Free uroflowmetry measures how fast the patient can empty his/her bladder
what is Pressure uroflowmetry?
- measures the rate of voiding, but with simultaneous assessment of bladder and rectal pressures.
- It helps demonstrate the reasons for
difficulty in voiding. for example bladder muscle weakness or obstruction of the bladder outflow.
what is Multichannel cystometry?
Measures the pressure in the rectum and in the bladder, using two pressure catheters, to deduce the presence of contractions of the bladder wall, during bladder filling, or during other provocative maneuvers.
The strength of the urethra can also be tested during this phase, using a cough or Valsalva maneuver, to confirm genuine stress incontinence.
what is Urethral pressure profilometry?
Measures strength of sphincter contraction.
