M7: 2

Question 1

Stress incontinence is directly related to

Answer 1

Underactive PFMs

Question 2

Urge incontinence is related to

Answer 2

Visceral dysfunction

Question 3

Overflow incontinence is related to

Answer 3

Failure to empty urine

Question 4

These types of incontinence are generally not related to underactive PFMs

Answer 4

• overflow

- functional

Question 5

Symptoms: stress incontinence

Answer 5

Small leak with

• cough
• sneeze
• exercise

Question 6

Symptoms: urge

Answer 6

Mod-large leak with strong urge

Question 7

Symptoms: mixed incontinence

Answer 7

Mix of stress and urge

Question 8

Dx classifications: stress incontinence

Answer 8

• underactive PFM

- PFM weakness

Question 9

Dx classifications: urge incontinence

Answer 9

• visceral dysfunction

- may have PFM weakness

Question 10

Dx classifications: mixed incontinence

Answer 10

• underactive PFM
• PFM weakness
• visceral dysfunction

Question 11

Questions to include in a brief pelvic floor screen

Answer 11

1. Do you ever leak urine or feces?
2. Do you ever wear a pad because of leaking urine?
3. Do you have pain during intercourse?

Question 12

Levator ani syndrome

Answer 12

• constant/freq spasm of PFMs

- spasm and TrPs in pelvic diaphragm

Question 13

Coccygodynia

Answer 13

• pain in coccyx

- related to TrPs of PFMs, obturatur, g max, piriformis

Question 14

Vulvodynia

Answer 14

• pain of external genitalia, perineum
• often idiopathic
• provoked or unprovoked
• “stabbing” pain in vagina, less commonly in rectum

Question 15

Vaginisimus

Answer 15

Spasm of muscle around the vagina (superficial mm or pelvic diaphragm)

Question 16

Anisimus

Answer 16

Failure of PFMs to relax during defecation

Question 17

Dyspareunia

Answer 17

• painful intercourse

- common sx of vaginisimus

Question 18

2 categories of dyspareunia

Answer 18

• pain at initial penetration

- pain at deep penetration

Question 19

Dyspareunia: pain at initial penetration

Answer 19

• superficial mm spasm

- skin irritation or adherence, painful episiotomy

Question 20

Dyspareunia: pain with deep penetration

Answer 20

• spasm of PFM

- organ prolapse with visceral adhesion

Question 21

Stress incontinence questions

Answer 21

1. Do you leak urine when you cough, laugh, or sneeze
2. Do you lose urine when you lift heavy things?
3. Do you lose urine when you run, jump, or exercise?

Question 22

Urge incontinence questions

Answer 22

1. Do you ever have such an uncomfortable strong need to urinate that you leak if you don’t reach the toilet?
2. Do you develop an urgent need to urinate when you hear running water?
3. Do you develop an urgent need to urinate when you are nervous, under stress, or in a hurry?

Question 23

Questions for organ prolapse

Answer 23

1. Do you ever feel as though you are sitting on a ball or that there is something in the way when you are sitting?
2. Do you ever feel as though something is falling out of your perineal area?

Question 24

Questions for obstruction

Answer 24

1. Do you find it hard to begin urination?
2. Do you have a slow stream?
3. Do you strain to pass urine?

Question 25

What are 2 typical pt responses to UI that may actually worsen the problem?

Answer 25

• stop exercising entirely
• limit ADLs to reduce risk of leaking
• not drinking as much water » shrinks bladder