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My2 renal > BOO and urinary incontinence > Flashcards

BOO and urinary incontinence Flashcards

1
Q

what is bladder outflow obstruction (BOO)

A

blockage at base/ neck of bladder that stops/ reduces urine flow

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2
Q

what are causes of bladder outflow obstruction

A

BPH, prostate cancer, urethral stricture/ scar tissue, prostate cancer, bladder stones

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3
Q

what are symptoms of BOO

A

increased frequency, increased urgency, nocturia, hesitancy passing, poor flow, incomplete emptying, dribbling, bed wetting

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4
Q

what are red flags for bladder cancer

A

haematuria, suprapubic pain, recurrent UTIs

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5
Q

what investigations can be done for BOO

A

IPSS questionnaire, frequency chart, urinalysis, renal USS, cystoscopy, USS

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6
Q

what management is given to relax the prostate

A

alpha blockers eg tamsulin

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7
Q

what management is given to shrink the prostate

A

5-alpha reductase inhibitors

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8
Q

what muscle relaxants are given to inhibit smooth muscle contraction of the bladder

A

anti-cholinergics and beta blockers

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9
Q

what pressures act on the bladder (4)

A

intrvesical pressure, abdo pressure, urethral pressure and atmospheric pressure

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10
Q

what happens in the voiding stage of micturition

A

detrusor contracts (increases intravesicle pressure) urethra relaxes

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11
Q

what are symptoms of urge incontinence

A

desperate, urgent need to go to the toilet, daytime frequency, can cause involuntary enuresis (small volumes)

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12
Q

what can trigger urge incontinence

A

knowing you are close eg putting key in the door

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13
Q

what causes urge incontinence

A

detrusor contracting when it shouldnt - UTIs, diabetes, stress, neurological damage to S2,3 eg pelvic surgery

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14
Q

what is seen in urodynamics of urge incontinence

A

detrusor pressure and intravesical pressure increase - detrusor overactivity (coughing does not cause)

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15
Q

what is overactive bladder syndrome

A

urgency +/- incontinence

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16
Q

what are symptoms of overactive bladder syndrome

A

nocturia, urge and polyuria

17
Q

what non-medical management can be done for urge incontinence

A

diet: avoid caffeine, bladder rehab

18
Q

what medical management can be done for urge incontinence

A

antimuscarinics eg oxybutyin, B3 agonists eg mirabegron, bladder pacemaker, surgery

19
Q

what is stress incontinence

A

leaking of urine due to increases intra-abdo pressure and failure of pelvic floor

20
Q

what are the symptoms of stress incontinence

A

wet when coughing, exercise or sneezing, small leakage

21
Q

how do you diagnose stress incontinence

A

urodynamic studies

22
Q

what can cause stress incontinence

A

damage to pelvic floor/ urethral function eg childbirth, surgery, obesity, diabetes

23
Q

what non-medical management can be done for stress incontinence

A

weight loss, no smoking, pelvic floor exercises

24
Q

what medical management can be done for stress incontinence

A

SNRI eg duloxetine

25
Q

what medical management can be done for stress incontinence

A

surgery eg minimally invase tape procedures

26
Q

what is overflow incontinence

A

leakage of full bladder without the need to urinate

27
Q

what is a common presentation of overflow incontinence

A

men, huge palpable bladder, bed wetting, leaking of urine, signs of chronic retention

28
Q

what is seen on urodynamics of overflow incontinence

A

underactive detrusor

29
Q

how do you manage overflow incontinence

A

treat underlying cause (may be BOO), catheterise

30
Q

name 2 types of extra-urethral incontinence

A

ectopic ureter, vesico-vaginal fistula

31
Q

what is an ectopic ureter

A

rare congenital disorder where ureter joins straight to urethra and bypasses the bladder

32
Q

what is the presentation of an ectopic ureter

A

a child who is constantly wet

33
Q

what is a vesico-vaginal fistula

A

fistula between bladder and vagina where urine is passed via the vagina

34
Q

what is the cause of vesico-vaginal fistulas in the developed world

A

surgery

35
Q

what is the cause of vesico-vaginal fistulas in the developing world

A

prolonged labour - babies head damages pubic and pelvic area, baby also dies

My2 renal (27 decks)

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