OB Case Files - Antepartum Flashcards
How can you determine the difference between genuine stress urinary incontinence (GSUI) versus urge urinary incontinence (UUI)?
Cystometric exam
What would you expect to see on PE with genuine stress urinary incontinence?
Cystocele, hypermobile urethra or loss of urethrovesicular angle
What’s the best treatment for genuine stress urinary incontinence? What if these fail?
kegels (pelvic floor strengthening exercises) and timed urination
If these fail - urethroplex or transvaginal fixation surgeries are possible
what’s urine incontinence?
the involuntary loss of urine that is objectibly demonstratable and creates social or hygiene concern
What’s genine stress urinary incontinence?
incontinence through the urethra due to suddent increase in intra-abdominal pressure, in the absence of bladder muscle spasm
What’s urge incontience?
Loss of urine due to uninhibited and sudden bladder detrusor muscle contraction
What’s overflow incontinence? What might it be associated with?
loss of urine assoc w/ overdistended, hypotonic bladder in the absence of detrusor contraction.
Assoc w/ DM, spinal cord injuries, lower motor neuropathies or after pelvic surgery due to urethral edema
what’s a cystometric evaluation?
investigation of pressure and volume changes in the bladder with the filling of known volumes. Use to distinguish between genuine stress urinary incontience and urge urine incontinence
What are midurethral sling procedures?
Supporting the midurethral with tensionless transvaginal tape (TVT), or transobturator tape (TOT)
what’s transvaginal tape procedure?
A minimally invasive procedure to fix the prox urethra retropubic via a blind technique using a special hook to place a synthetic tape under the urethra
what’s transobturator tape procedure?
A minimally invasive procedure beginning laterally to avoid bladder/bowel injuries, otherwise like a transvaginal tape procedure
What would constant wetness after a pelvic operation suggests?
possible fistula such vesicovaginal fistula
