incontinence and prolapse Flashcards
whats are the two manin causes of urinary incontinence?
overactive bladder
stress incontinence
presentation of overactive bladder?
urgency
frequency
nocturia
presentation of stress incontinence?
cough laugh liefting exercise moving
assessment of incontinence?
Frequency chart
urinalysis
residual urine measurement
what are the things to look for in urinalysis? (MSU)
nitrite–>infection
leukocyte esterase–>infection
microscopic haematuria–> Glomerulonephritis, nephropathy, neoplasia, calculus, infection
proteinuria–> renal disease, cardiac disease
glycosuria–> diabeties, impaired glucose tolerence, reduced rental threshold
what is renal threshold?
the concentration of a substance dissolved in the blood above which the kidneys begin to remove it into the urine
treatment of stress incontinence?
physiotherapy
sugery
treatment of overactive bladder?
bladder drill anticholinergic botox augment bypass
lifestyle changes to treating incontinence?
weight loss
smoking cessation
reduce caffine intake
innervation of bladder (detrusor)?
sympathetic innervation (T11-L2)–> maintain relaxation of the bladder for urine storage
parasympathetic (S2s4) –> they produce bladder contraction and sphincter relaxation
what is the external sphincter?
under voluntary control and innervated by s2-s4.
this sphincter contract in response to coughing, or actively tries to not urinate
detrusor muscle info?
smooth, transitional epithelium
neurotransmitter: acetylcholie
receptor: M2, M3
Antagonsists: Atropine (antimuscrinic)–> oxybutynin, toltetodine
what is muscarine poisoning?
Increased salivation
Excessive sweating & lacrimation
Abdominal pain, severe nausea, diarrhoea, blurred vision & laboured breathing.
Death may result from cardiac or respiratory failure
what is Mirabegron?
Beta-3 adrenergic receptor agonist
Relaxes smooth muscle detrusor
Increases bladder capacity
what is Botulinum toxin
neurotoxic protein produced by the bacterium Clostridium botulinum and related species. It prevents the release of the neurotransmitter acetylcholine from axon endings at the neuromuscular junction and thus causes flaccid paralysis
