Female urinary incontinence and urodynamics

Question 1

Indications of multichannel filling and voiding cystometry Ix

Answer 1

Question 2

What should be done before cystometry?

Answer 2

Question 3

During cystometry, the bladder should be filled with (———) at a rate of (—-) ml/min during filling cystometery.

Answer 3

During cystometry, the bladder should be filled with sterile warm water at a rate of 80ml/min during filling cystometery.

Question 4

What should be recorded during cystometry?

Answer 4

Question 5

What should be done after filling cystometry?

Answer 5

Question 6

Answer 6

Question 7

Answer 7

Question 8

How should voiding cystometry be done?

Answer 8

Question 9

What does a typical uroflowmetry look like?

Answer 9

Normally resembles bell-shape

Only meaningful if the voided volume is > 150mL

Question 10

Answer 10

Question 11

What will be seen in the filling cystometry and voiding cystometry of a patient with atonic bladder?

Answer 11

Question 12

Hx taking for urinary incontinence

Answer 12

• How long has it lasted?
• When are you most affected by this?
• How often does the incontinence occur?
• Do you need to use pads?
• How many cups of water do you drink? Do you drink coffee?
• Any incontinence when you cough or run?
• Any dribbling or incomplete emptying?
• Any heaviness in introitus?
• Is your defecation normal?
• What is your occupation?
• Have you seen any other doctors and are you on long-term medication?
• Drug/food allergy?
• G?P? Method of delivery? How heavy was your heaviest baby?
• Did doctor tell you if you had pelvic muscle injury?
• Have you menopaused? Any post-menopausal bleeding?

Question 13

Stress incontinence RF

Answer 13

Loosened pelvic muscles
* Menopause
* 3 vaginal delivery
* Repairing of vagina after delivery may have loosened muscles
* Constant straining (carrying heavy things)

Question 14

How is stress incontinence managed?

Answer 14

Lifestyle modifications:
- Don’t drink caffienated drinks
- Don’t carry heavy things
- Physiotherapy for pelvic floor exercise
- Follow-up
- Surgical management (90% of patients see improvement) = place suture in middle of urinary tract

Question 15

How is urge incontinence managed?

Answer 15

Lifestyle modifications:
- Drink less water (1.5-2L of water is enough)
- Don’t drink caffienated drinks
- Do bladder training (when you feel the urge to pee, don’t release right away, slowly increased the duration)
- Follow-up

Medications
- Anticholinergics (S/E: dry mouth, eyes, constipation / GLAUCOMA IS CONTRAINDICATION)