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Repro > 7 - Female Urinary Incontinence > Flashcards

7 - Female Urinary Incontinence Flashcards

1
Q

which is the upper part of the urinary tract?

A

kidneys

ureters

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2
Q

which is the lower part of the urinary tract?

A

bladder

urethra

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3
Q

@ which rate does the bladder fill?

A

0.5-5 ml/ min

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4
Q

describe the pressure of the lower urinary tract?

A

low-pressure storage of urine

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5
Q

describe the transportation of urine via the upper urinary tract?

A

from nephrons via ureters to the bladder

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6
Q

what does the vesico-ureteric mechanism do?

A

protects nephrons from damage 2y to retrograde transmission of back pressure/ infection from the bladder

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7
Q

function of bladder filling?

A

accomodate increasing volume at constantly low pressure

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8
Q

how does the bladder inhibit contractions?

A

gradual awareness of filling

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9
Q

describe cortical activity?

A

Activates a reciprocal guarding reflex by Rhabdosphincter contraction; increase sphincter contraction & resistance

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10
Q

describe the 4 actions which contribute to bladder emptying?

A

Detrusor contraction

Urethral Relaxation

Sphincter co-ordination

Absence of Obstruction

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11
Q

define urinary incontinence?

A

any involuntary leakage of urine

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12
Q

define stress urinary incontinence?

A

involuntary leakage on effort/ exertion, on sneezing/ coughing

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13
Q

define urge urinary incontinence?

A

involuntary leakage accompanied by/ immediately preceded by urgency

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14
Q

define mixed urinary incontinence?

A

involuntary leakage accompanied by/ immediately preceded by urgency and on effort/exertion, or by sneezing/coughing

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15
Q

relationship of age and UI?

A

risk increases with age

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16
Q

name 4 impacts of UI?

A

Reduce social relationships and activities

Impair emotional and psychological well- being

Impair sexual relationships

Embarrassment and reduced self- esteem

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17
Q

what is the greatest risk factor for UI?

A

pregnancy/ childbirth

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18
Q

name 5 other risk factors for UI?

A

age

menopause

smoking

connective tissue disease

pelvic floor trauma

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19
Q

4 factors of patient assessment?

A

History
Examination
Investigations
Management

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20
Q

3 important questions during history?

A

mode of past deliveries

weight of heaviest baby

HRT

21
Q

4 important questions during history - PMH, D+A?

A

glaucoma

anti-HTN meds

cognitive problems

previous surgeries for SUI/POP

22
Q

5 irritation symptoms from patient’s complaint?

A

Urgency

Increased daytime frequency (>7)

Nocturia (>1)

Dysuria

Haematuria

23
Q

name 3 incontinence symptoms?

A

Stress UI

Urgency UI

Coital Incontinence

24
Q

3 voiding symptoms?

A

Straining to void

Interrupted flow

Recurrent UTI

25
Q

2 prolapse symptoms?

A

Vaginal Lump

Dragging sensation in vagina

26
Q

4 bowel symptoms?

A

Anal Incontinence

Constipation

faecal evacuation dysfunction

IBS

27
Q

2 methods of measuring UI?

A

3 days urinary diary

urine dipstick

28
Q

5 examinations to be carried out for women with bladder issues?

A 
General
Abdominal
Neurological
Gynaecological
Pelvic floor assessment
29
Q

How is pelvic floor assessed?

A

Oxford Scale

30
Q

3 investigations of UI?

A

urinalysis

post voiding residual volume assessment

urodynamics

31
Q

4 methods of management for UI?

A

lifestyle changes

medical treatments

physiotherapy

surgery

32
Q

describe 4 lifestyle changes to help UI?

A

smoking cessation

Lose weight

Eat more healthily to avoid constipation

Stop drinking alcohol and caffeine

33
Q

describe 3 benefits of PFMT - pelvic floor muscle training?

A

reinforcement of cortical awareness

hypertrophy of existing muscle fibres

general increase in muscle tone and strength

34
Q

which drug is used for moderate to severe stress incontinence?

A

Duloxetine

35
Q

who should recieve duloxetine in 1y care?

A

if PFMT needs improving or has not worked at all

36
Q

who should recieve duloxetine in 2y care?

A

those who -

  • do not wish surgery
  • are not fit for surgery
  • have had failed surgery
37
Q

TVT - what is this used for?

A

Tension-free Vaginal Tape - used as a minimally invasive procedure

38
Q

what does TVT depend on?

A

the hammock theory for continence

39
Q

which is 1st line surgical treatment for SUI - TVT or colposuspension?

A

TVT

40
Q

3 complications of TVT?

A

bladder perforation

vaginal and urethral erosions

vascular injuries

41
Q

define Overactive Bladder Syndrome (OBS)?

A

A symptom complex usually, but not always, related to urodynamically demonstrable detrusor overactivity (DO)

42
Q

defining symptoms for OBS?

A

urgency
frequency
nocturia

43
Q

define urgency?

A

The complaint of a sudden, compelling desire to pass urine that is difficult to defer

44
Q

define urge incontinence?

A

The complaint of involuntary leakage of urine accompanied or immediately preceded by urgency

45
Q

define frequency?

A

Usually accompanies urgency with or without urge incontinence and is the complaint by the patient who considers that he/she voids too often by day

46
Q

define nocturia?

A

Usually accompanies urgency with or without urge incontinence and is the complaint that the individual has to wake at night one or more times to void

47
Q

name 3 antimuscarinic oral drugs to treat OBS?

A

Solifenacin

Fesoteridine

Trospium Chloride

48
Q

name a antimuscarinic transdermal drug to treat OBS?

A

kentera patches

49
Q

name a tri-cyclic antidepressant to treat OBS?

A

imipramine

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