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infertility and assoc pregnancy stuff > incontinence > Flashcards

incontinence Flashcards

1
Q

supply of detrusor and para or symp?

A

parasympathetic S2,3,4

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2
Q

what supplys the urethral smooth muscle? symp or para

A

sympathetic T10- L2

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3
Q

what is stress incontinence

A

leakage of urine when increased abdo pressure

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4
Q

does the detrusor contract in stress incontinence

A

no

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5
Q

when is stress incontinence seen

A

after childbirth, pelvic surgery, oestrogen deficiency

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6
Q

triggers for stress incontinence

A

coughing , sneezing , exercise

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7
Q

what shoudl be excluded when investigating stress incontinence

A

UTI

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8
Q

investigations for stress incontinence

A

frequency/vol charts done- should show norm results

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9
Q

management of stress incontinence- conservative

A

wgt loss, smoking cessation, avoid constipation, avoid heavy lifting and caffeine
then pelvic floor exercises for 3 months

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10
Q

management of stress incontinence - medical

A

duloxetine (side effects counselling) or vaginal oestrogen
surgery - bulking agents
fascial sling
colposuspension

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11
Q

describe urge incontinence

A

overactive bladder - increased. urgency and frequency may experience nocturia

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12
Q

triggers for urge incontinence

A

hearing water and cold weather

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13
Q

what produces larger volumes stress or urge incontinence

A

urge

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14
Q

causes of urge incontinence

A

idiopathic, pelvic surgery, MS , spina bifida

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15
Q

Investigatiosn of urge incontinence

A

fre/vol charts show increased frequency

urodynamics show increased detrusor activity

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16
Q

management of urge incontinence - conservative

A

lifestyle - reduce fluids, minimise caffeine adn alcohol, pads
bladder retraining

17
Q

management of urge incontinence - medical

A 
oxybutynin - anti cholinergic 
mirabegron - b3 agonist
intravaginal OE
consider desmopressin if nocturia 
suregry - botox, sacrak nerve stim
18
Q

why might oxybutynin be avoided in elderly ahd what shoudl be used instead

A

can casue confusion, tolterodine or solifenanic

mirabegron

19
Q

what is overflow incontinence

A

leakage of urine from full bladder as no urge to go

20
Q

causes of overflow incontinence

A

inactive detrusor eg MS

involuntary bladder spasm eg CV or diabetes

21
Q

what should you give to a pregnant women with a UTI in 1st /2nd and 3rd trimester. does a urine culture need to be done

A

1st and 2nd - nitrofurantoin
3rd - trimethoprime

yes if pregnant , >65 or haematuria

infertility and assoc pregnancy stuff (5 decks)

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