Incontinence + other

Question 1

What is urge incontinence?

Answer 1

detrusor overactivity and nocturnal Sx

Question 2

Urge incontinence
MC?
common in?

Answer 2

2nd mc
younger F, UTIs, dm, during pregnancy, constipation

Question 3

Sx of urge incontinence?

Answer 3

key in door syndrome
hand-washing trigger

Question 4

Dx of urge incontinence?

Answer 4

urine dip, mc+s
bladder diary - nocturnal Sx
urodynamic studies

ePAQ (QoL effect based on Sx -LUTs, Bowel Sx, Sex)

Question 5

Tx for urge incontinence?

Answer 5

Bladder retraining 6 weeks
then try OXYBUTYNIN (M3 Ach-i)
Then cyctoplasty/botox injections

Question 6

What is a Ddx for urge incontinence>

Answer 6

overactive bladder (same but ND INCONTINENCE)

Question 7

What is stress incontinence?
MC?

Answer 7

Sudden increase pressure in bladder = weak sphincter muscles = leak
no nocturnal Sx
MC

Question 8

Typical Stress incontinence Px?

Answer 8

older Px, surgery, multiple births, weight lifting, obese

Question 9

Sx of stress incontinence?

Answer 9

incontinence with valsalva

Question 10

Dx of stress incontinence?

Answer 10

urine dip, mc+s
bladder diary
urodynamic studies and POSITIVE Q tiptest (>30^)
+ ePAQ

Question 11

Tx for stress incontinence?

Answer 11

Kegel exercises first
Then try duloxetine
last line = surgery
(mesh sling, colposuspension, autologous sling, tension free vaginal tape)

Question 12

What is overflow incontinence?

Answer 12

total detrusor voluntary control loss + nocturnal leakage
(unable to completely empty bladder = overflow = leaks out unexpectedly)

Question 13

What typically causes overflow incontinence?

Answer 13

post traumatic surgery
S2-4

Question 14

Sx of overflow incontinence?

Answer 14

poor stream, incomplete emptying

Question 15

Tx for overflow incontinence?

Answer 15

catheterise

Question 16

Dx of overflow incontinence?

Answer 16

urine dip mc+s
bladder diary + nocturnal Sx
urodynamic studies (>50ml PVR Post residual volume - urine left in bladder after wee)
+ ePAQ

Question 17

What is asherman syndrome?
caused by?

Answer 17

scar tissue inside uterus +/- cervix
uterine adhesions, post surgery

Question 18

Sx of asherman syndrome?

Answer 18

2^ amenorrhoea
infertility

Question 19

Dx of asherman syndrome?

Answer 19

1st = TV USS
GS = Laparoscopy

Question 20

Tx for asherman syndrome?

Answer 20

adhesiolysis (hysteroscopic guided)

Question 21

what is a bartholin cyst?

Answer 21

unilateral blockage of a bartholin gland resulting in build up of mucus + secretions at labia major

Question 22

Sx and bacterial causes of a bartholin cyst?

Answer 22

tender, erythematous, may increase in size
s.aureus, E.Coli, STI

Question 23

Tx for a bartholin cyst?

Answer 23

incision and drainage (antibiotics if abscess)