20. Uro-Gynaecological Management

Question 1

Incontinence:

Answer 1

Involuntary leakage of oxygen

Question 2

Overactive bladder:

Answer 2

Urgency with or without leakage

Question 3

Pharmacological treatment for OAB:

Answer 3

1st choice: Oxybutynin (immediate release), Tolterodine (immediate release), Darifenacin (once daily)
Abx
Antimuscarinics
Mirabegron (Betmiga 50mg) if antimuscarinics not tolerated
Desmopressin
Duloxetine

Question 4

Contraindications in pharmacological treatment for OAB:

Answer 4

Do not give oxybutynin to frail older women

Question 5

Surgical treatment:

Answer 5

For vaginal wall prolapse colporrhaphy or colpo-perineorrhaphy, uterine prolapse (hysterectomy), SUI (bulking agents, vaginal tapes), OAB botox, PTNS

Question 6

What is PTNS

Answer 6

Percutaneous sacral nerve stimulation

Question 7

Treatment for anterior vaginal wall prolapse?

Answer 7

(cystocele) -> anterior colporrhaphy

Question 8

Treatment for posterior vaginal wall prolapse?

Answer 8

(rectocele) -> posterior colpo-perineorrhaphy