OAB Flashcards
What are some ailments that can contribute to OAB?
obesity, constipation, pelvic organ prolapse, menopause, poorly controlled DM, OSA, anxiety/depression, tobacco cessation
What are conservative behavioral measures for OAB?
pads, diapering, barrier creams, condom catheters, external catheters
bladder training (voiding diary, frequency/volume charts), fluid management, increased exercise, mindfulness, healthy diet
What are nonsurgical interventions?
PFMT, magnetic stimulation, transcranial electrical stimulation, transcutaneous tibial nerve stimulation, transvaginal electrical stimulation, yoga, hypnosis
What are side effects of anticholinergic medications?
dry mouth, constipation, delirium, hallucinations, urinary retention, blurred vision, palpitations, tachycardia
What about B3 agonist?
primarily HTN, cardiac arrhythmia
thus mybetriq is not to be used in people w/ HTN > 180/110. virbegron does not have this warning
What is anticholinergic chronic use associated with, and how long is chronic use?
> 3 months
dementia vs Alzheimer’s
What are contraindications for anticholinergic use?
narrow angle glaucoma patients, delayed gastric emptying (pts with diabetes, prior abd surgery, narcotic use), urinary retention
How do you manage dry mouth?
oral lubricants, avoid mouthwash, suck on sugar free hard candy, sugar free gum , small sips of water
How soon after do you evaluate for improvement?
4-8 weeks
What are surgical treatment options for OAB?
BTX, PTNS, SNM, augmentation cystoplasty or urinary diversion
what are adverse events for SNM?
implant pain, implant site infection, undesirable change in stimulation, UTI, urinary retention
What is a usual PTNS treatment?
30 minutes for 12 weeks
Which symptom is not that useful for BTX patients?
nocturia
What are AE for BTX?
urinary retention needing catheterization, UTI, hematuria, dysuria
What if 100IU doesn’t work?
Increase to 200 IU, where symptoms do tend to improve, but there is an increase chance for UTI
What must you have prior to BTX?
PVR (need to be careful in > 100-200
When should a patient be checked after BTX?
Two weeks - if symptomatic, need to do UA PVR, may need to start on CIC (PVR 100-300)
PVR is optional afterwards if they are voiding fine
What should you do with pharmacotherapy after minimally invasive procedure?
Stop, but then restart if symptoms recur
