Incontinence and Prolapse Flashcards
types of incontinence
stress
overactive (can be wet or dry)
overflow
RF for incontinence
women pregnancy age smoking chronic cough
examinations in incontinence
abdo
vaginal
DRE
neuro for S2-4
diagnosis of incontinence
urinalysis bladder diary (W is wet, X is bowel movement and P is pad) bladder scan stress test urodynamic studies
lifestyle advice for incontinence
fluid
caffeine
weight
bladder training
management of OAB
physio for minimum of 3 months pharmacological= tolterodine, solifenacin, fesoterodine (2nd line is mirabegron) desmopressin for nocturia vaginal oestrogens surgery
surgical options in OAB
botox
posterior tibial nerve stimulation
cystoplasty
management of stress incontinence
pessaries pads duloxetine vaginal oestrogen surgery
surgical options in stress incontinence
bulkamide
fascial slings
colosuspension
staging of prolapse
- Stage 0= no prolapse
- Stage 1= leading edge is -1cm or above
- Stage 2= leading edge is +1 to -1cm
- Stage 3= leading edge is +1cm or below but without complete eversion
- Stage 4= complete eversion (procidentia)
why is oxybutynin not used in incontinence in the elderly?
risks cognitive impairment
what is a vaginal vault prolapse?
top of vagina falls post-hysterectomy
presentation of prolapse
heaviness/dragging pressure mass difficulty voiding incomplete emptying pain in intercourse back pain incontinence
diagnosis of prolapse
POP-Q
RF for prolapse
age surgery menopause loss of muscle tone births obesity chronic cough lifting connective tissue neurological
conservative management of prolapse
lifestyle
pelvic floor exercises
vaginal oestrogen
pessaries
surgical management of prolapse
vaginal hysterectomy
Manchester repair
sacrospinous fixation
mesh
