Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Reproduction and sexual health > Incontinence and prolapse > Flashcards

Incontinence and prolapse Flashcards

1
Q

define urinary incontinence

A

involuntary leakage of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

define stress urinary incontinence

A

involuntary leakage of urine after physical exertion e.g. coughing, sneezing, sports

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

define urge urinary incontinence

A

overactive bladder
feeling of urgency
trying to make it to the toilet on time causing leakage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

define mixed urinary incontinence

A

features of both stress and urge urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

RF for incontinence

A 
age 
BMI 
parity
menopause 
oestrogen deficiency 
hysterectomy 
UTI 
smoking 
FH 
caffeine
alcohol (diuretic)
DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

urinary symptoms can be categorised into what?

A

storage symptoms

voiding symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

list storage symptoms of UI

A 
frequency 
nocturia 
urgency 
incontinence 
constant leakage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

list voiding symptoms of UI

A 
difficulty getting started
dribbling 
hesitancy 
poor flow 
dysuria 
haematuria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

examination for UI

A

BMI
abdominal exam
PV exam
neuro (S2-4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

investigations for UI

A 
urinalysis 
post void bladder scanning 
bladder diary
cystoscopy 
urodynamics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

management of stress UI

A 
Conservative:
weight loss 
smoking cessation 
pelvic floor exercises 
incontinence ring 
Medical: vaginal oestrogen, (duloxetine)
Surgical:
bulking agents, fascial slings, colposuspension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

mechanism of action of duloxetine

A

5HT and NA reuptake inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Management of overactive bladder

A

Conservative:
weight loss, reduce caffeine, smoking cessation, bladder retraining
Medical: vaginal oestrogen, anti-cholinergics, B3-agonist, desmopressin
Surgical: botox, PPTNS, augmentation cytoplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

examples of anti-cholinergics used in OAB

A

tolterodine
solifenacin
oxybutynin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

side effects of anti-cholinergics

A

dry mouth and eyes
tachycardia
urinary retention
constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

example of B3 agonist used in OAB

A

mirabegron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is Pelvic Organ Prolapse POP?

A

herniation of pelvic or abdominal organs through the vaginal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

examples of POP

A

cystocele - anterior wall
rectocele - posterior wall
uterine prolapse
vaginal vault proplapse = top of the vagina post hysterectomy

19
Q

RF of POP

A

age
high parity
post menopausal - oestrogen deficiency
BMI
smoker - chronic cough
neurological conditions - spina bifida, muscular dystrophy
collagen disorders - Marfans, Ehler-Danlos

20
Q

symptoms of POP

A 
heaviness 
sensation of dragging 
urinary frequency, urgency, incomplete voiding
manual reduction of prolapse 
faecal incontinence 
straining 
sexual dysfunction
21
Q

examination for POP

A

abdo and PV exam

22
Q

system to classify POP

A

POP-Q classification system

23
Q

management of POP

A

conservative: lifestyle advice, pelvic floor exercises, vaginal oestrogen
Pessaries
surgery

24
Q

describe the POP-Q classification

A

uses the hymen as a landmark reference and defines 6 points (2 in each vaginal compartment - ant/superior/post)

25
Q

describe stage 0 prolapse

A

no prolapse demonstrated

26
Q

describe stage 1 prolapse

A

leading edge is -1cm or above

mild protrusion

27
Q

describe stage 2 prolapse

A

leading edge is between -1cm and +1cm

present at introitus

28
Q

describe stage 3 prolapse

A

leading edge is +1cm or below but without complete eversion

protruding outside introitus

29
Q

describe stage 4 prolapse

A

complete vaginal eversion
aka procidentia
complete prolapse

30
Q

complications of longterm use of vaginal pessaries

A

vaginal discharge
ulceration –> fistulae
fibrous band formation

31
Q

how often should pessaries be changed and why

A

every 6 months with the additional use of topical oestrogen

to prevent fistula formation

32
Q

side effects of duloxetine

A 
difficulty sleeping 
headaches 
dizziness 
blurred vision 
CIBH 
N+V 
dry mouth 
sweating 
decreased appetite 
decreased libido
33
Q

bladder diary features

A 
number of pads 
volume of urine passed 
w = wet 
x = bowel motion 
p = changed a pad 
nocturia
34
Q

indication for urodynamics

A

prior to surgical options

to ensure correct diagnosis

35
Q

in stress incontinence, forget medical management, true or false

A

true

duloxetine is reserved as a very last line option

36
Q

___ is harvested for fascial slings in surgical management of stress UI

A

rectus sheath

37
Q

OAB vs urge UI

A

urge UI - they actually leak

OAB - don’t know if they are actually incontinent

38
Q

why is oxybutynin not used as commonly

A

can worsen cognitive function

oxybutynin is the worst anticholinergic for this

39
Q

side effects of mirabegron that need monitoring

A

BP

40
Q

for overactive bladder, you can forget about surgical management, true or false

A

true

botox is the only thing

41
Q

what is bladder pain syndrome

A

diagnosis of exclusion

chronic pain syndrome

42
Q

long term definitive management of POP

A 
surgery:
anterior/posterior repair 
sacrospinous fixation 
colpoplexy 
colpocleisis - vaginal closing procedure (not fully in case of PMB)
43
Q

management of POP

A

conservative - lifestyle advice, pelvic floor exercises, vaginal oestrogen
pessaries
surgery -

44
Q

can you have sexual intercourse with pessaries

A

no, except for 1 type - self managed cube pessary

Reproduction and sexual health (46 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions