Incontinence, neurogenic bladder, urodynamics Flashcards
name 4 continence theory.
Kelly
Mcguire
Delancey
Petro
AUS components C/I Longterm success rate:_ Cx Revision rate:_ infection rate:_ erosion rate:_
90%
20-30%
5%
5%
management of AUS erosion
6 new tips
what is POP Q
what are the stages
0 to IV
What is urethral pressure profilometry
what is Brown Wickham technique?
2mm/sec
what is OAB
.
what is the normal dopaminegic projections to PMC?
Mechanism of LUTS in Parkinson
3+1
what is FVC
what is bladder diary
.
how common is OAB
EPIC STUDY
what lifestyle measures to suggest for OAB?
what is bladder training?
.
Regarding meta analysis for medications for OAB (anticholinergic, B3 agonist): % reduction in a) incontinence b) urgency c) voids
reduction in nocturia episodes:_
50%
40%
20%
0.5
Muscarinic receptors target organs
M1
M2
M3
neural, salivary glands
cardiac
smooth muscles
CI for anticholinergic
is urinary retention a CI for anticholinergic? why?
.
how would u comment on relationship between anticholinergic and dementia
.
OAB drugs
which 2 are most M3 selective?
how selective is trospium?
.
CI for B3 agonist
relation to HT?
can you use in BOO?
.
advantages of vibegron?
4
what is botulinum toxin A
what is Botox
name 2 other commercially available agents.
dysport
xeomin
what is one unit of Botox?
LD50
what are the expected efficacy for Botox?
improvement
max bladder capacity
max detrusor voiding pressure
70%
180ml
30cmH2O
what is posterior tibial nerve?
L4 to S3
PTNS:
1st done by:_
How?
RCT by:_
Compared to tolterodine by:_
mcguire
finazzi agro
peters
what is sacral neuromodulation?
S3
what is the expected efficacy of sacral neuromodulation?
> 80%
what SNM devices are available?
what are the SE ?
classify
Augmentation cystoplasty
physiology
3
Augmentation cystoplasty
efficacy
7
Augmentation cystoplasty
CI
classify
long term complications of Augmentation cystoplasty
7
Augmentation cystoplasty : cancer risk
incidence
pathology
mechanism
1%
adeno
bacteriuria
augmentation cystoplasty: perforation risk
risk factors
usual location
intraperitoneal
SUI definition
Uncomplicated SUI definition
urodynamic SUI definition
.
SUI prevalence according to EPIC STUDY
46%
proper cough test according to ICS
4
what is Oxford power grip
0 to 5
Bonney test
.
Marshall test
.
Q tip test
.
Pad test
what is
short term:_ hour, _g
longterm:_hour ,_g
1hr 1.4g
24hr 4.4g
when would u do UDS for SUI?
4
when should u not perform UDS for SUI?
VALUE study
what is Blaivas classification
I II III
lifestyle modifications for SUI
efficacy for weight loss
weight loss
PRIDE study
how does duloxetine helps SUI?
SNRI
pudendal nerve
how to choose SUI surgery
patient
disease factors
name examples for bulking agents in SUI
silicone
carbon coated zirconium
calcium hydroxylapatite
what is Burch colposuspension
.
Burch colposuspension
success rate:_
better than MUS in terms of:_
74%
less bladder perforations
what kinds of materials are available for MUS?
autologous
synthetic
types 1 to 4
cure rate of TVT
90% at 11y
Nilsson
name 1 complication that is more favorable in TVT compared to transobturator tapes
less groin pain
name 5 complications that are more favorable in transobturator than in TVT
perf erosion uti hematoma voiding luts
name 2 complications that are more favorable in TVTO than in TOT
vaginal perf
vaginal erosion
what is cumberlege review
high vigilance pause
what is Fowler syndrome?
3
Fowler syndrome
EMG changes
deceler burst underwater whale
complex repetitive discharges machine-gun
characteristic changes
supra pontine
supra sacral
peripheral nerve
T6
VCMG findings of DSD
2
sacral anterior nerve root stimulator
effects
detrusor contraction
colonic contraction
sacral anterior nerve root stimulator
example
Brindley stimulator
dorsal rhizotomy
what spinal levels
S2-3
dorsal rhizotomy
effects
controls DO
better compliance, capacity
loss of reflex erection
how to perform quality control for UDS
.
UDS
Normal resting values for Pves/Pabd/Pdet
Supine 5 - 20 cmH2O
Sitting 15 - 40 cmH2O
Pdet = 0
UDS
What instillation rate
10% of max VV (ml/min)
what is ALPP
Normal range
<60
>90
what is DLPP
40cmH2O
what is BOOI female
Cut-off values
PdetQmax - 2.2xQmax
<0: < 10%
>5: 50%
>18: >90% obstruction
DUA in female
How do you determine in a UDS?
PdetQmax < 30 + Qmax < 10 (Abarbanel)
UDS Risks factors for upper tract deterioration in neurogenic bladder
5
Urinary diverison what are the characteristic metabolic problems? Stomach Jejunum Ileum
.
what is jejunal conduit syndrome?
Loss of salt; gain of H+K+
Feed-forward mechanism
What is Bricker and Wallace anastomosis
Separate end to side ureteroileal
Conjoined end to end
Ureteroileal anastomotic stricture:
__ % on the left side
84%
Continent urinary diversion
4 mechanisms of continence
Kock valve
Flap valve
Ileocecal valve
Pelvic floor external sphincter
what is Mitrofanoff principle and Mitrofanoff procedure?
Flap valve = principle
Procedure = use of appendix
what is Monti procedure?
bowel to construct a catheterisable limb
Orthotopic bladder
Daytime continence rate _
Nighttime continence rate _
92%
51%