Incontinence + other Flashcards
What is urge incontinence?
detrusor overactivity and nocturnal Sx
Urge incontinence
MC?
common in?
2nd mc
younger F, UTIs, dm, during pregnancy, constipation
Sx of urge incontinence?
key in door syndrome
hand-washing trigger
Dx of urge incontinence?
urine dip, mc+s
bladder diary - nocturnal Sx
urodynamic studies
ePAQ (QoL effect based on Sx -LUTs, Bowel Sx, Sex)
Tx for urge incontinence?
Bladder retraining 6 weeks
then try OXYBUTYNIN (M3 Ach-i)
Then cyctoplasty/botox injections
What is a Ddx for urge incontinence>
overactive bladder (same but ND INCONTINENCE)
What is stress incontinence?
MC?
Sudden increase pressure in bladder = weak sphincter muscles = leak
no nocturnal Sx
MC
Typical Stress incontinence Px?
older Px, surgery, multiple births, weight lifting, obese
Sx of stress incontinence?
incontinence with valsalva
Dx of stress incontinence?
urine dip, mc+s
bladder diary
urodynamic studies and POSITIVE Q tiptest (>30^)
+ ePAQ
Tx for stress incontinence?
Kegel exercises first
Then try duloxetine
last line = surgery
(mesh sling, colposuspension, autologous sling, tension free vaginal tape)
What is overflow incontinence?
total detrusor voluntary control loss + nocturnal leakage
(unable to completely empty bladder = overflow = leaks out unexpectedly)
What typically causes overflow incontinence?
post traumatic surgery
S2-4
Sx of overflow incontinence?
poor stream, incomplete emptying
Tx for overflow incontinence?
catheterise
Dx of overflow incontinence?
urine dip mc+s
bladder diary + nocturnal Sx
urodynamic studies (>50ml PVR Post residual volume - urine left in bladder after wee)
+ ePAQ
What is asherman syndrome?
caused by?
scar tissue inside uterus +/- cervix
uterine adhesions, post surgery
Sx of asherman syndrome?
2^ amenorrhoea
infertility
Dx of asherman syndrome?
1st = TV USS
GS = Laparoscopy
Tx for asherman syndrome?
adhesiolysis (hysteroscopic guided)
what is a bartholin cyst?
unilateral blockage of a bartholin gland resulting in build up of mucus + secretions at labia major
Sx and bacterial causes of a bartholin cyst?
tender, erythematous, may increase in size
s.aureus, E.Coli, STI
Tx for a bartholin cyst?
incision and drainage (antibiotics if abscess)
