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Reproduction SB > Pelvic Floor Disorders > Flashcards

Pelvic Floor Disorders Flashcards

1
Q

what are the types of urinary incontinence

A

Stress Incontinence
Urge Incontinence
Mixed Incontinence
Overflow Incontinence

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2
Q

what are risk factors for urinary incontinence

A

sex [W > M]
age
obesity
smoking

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3
Q

what is urgency

A

complaint of a sudden compelling desire to pass urine which is difficult to defer

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4
Q

what is nocturia

A

having to wake up at night to go to the toilet

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5
Q

what is frequency

A

complaint of having to go to the toilet more often

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6
Q

what is urge incontinence

A

involuntary urine leakage accompanied by or immediately preceded by urgency

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7
Q

what is overactive bladder syndrome [OAB]

A

Urgency, with or without urge urinary incontinence, usually with frequency and nocturia in the absence of pathologic or metabolic conditions that might explain these symptoms

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8
Q

what is OAB wet

A

where urge incontinence is present

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9
Q

what is OAB dry

A

where incontinence is absent

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10
Q

what is the definition of urge incontinence

A

involuntary leakage accompanied by, or immediately preceded by urgency.

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11
Q

Urgency, with or without urge incontinence, usually with frequency and nocturia - what is this?

A

overactive bladder syndrome, or urge syndrome

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12
Q

what is mixed urinary incontinence

A

Involuntary leakage associated with urgency and also with exertion, sneezing, or coughing (SUI)

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13
Q

what is OAB associated with

A

detrusor contractions

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14
Q

what is the definition of stress incontinence

A

Urine leaks during increased intra abdominal pressure, without a detrusor contraction

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15
Q

what are lifestyle measure that can help make incontinence better

A

bladder retraining
caffeine reduction
weight reduction if BMI >30

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16
Q

what are physio Tx for incontinence

A

pelvic floor muscle exercises

[only useful for stress and mixed incontinence]

17
Q

what medical Tx can be given for incontinence

A

1st line = Oxybutymin (anti-muscarinic)

2nd line = Mirabegron (beta3 agonist) [when anti-muscarinic contraindicated or ineffective]

18
Q

what are anti Muscarinic side effects

A

dry mouth
constipation
blurred vision
somnolence

19
Q

what does a uroflowmetry do

A

measure the volume of urine expelled from the bladder each second

20
Q

what are indications of investigation by uroflowmetry

A 
hesitance 
voiding difficulty 
neuropathy 
Hx of urine retention 
post-op follow up
21
Q

what is cystometry used for

A

measure the pressure/volume relationship of the bladder during filling, provocation and during voiding

22
Q

what causes overflow incontinence

A

Obstruction of urethra

Poor contractile bladder muscle

23
Q

what is needed for a diagnosis of overflow incontinence

A

post-void residual (PVR)

- a urine test measures the amount of urine left in the bladder after urination

24
Q

what drug must be stopped in overflow incontinence

A

anti-cholinergics

- atropine, Oxybutynin, TCA drugs

25
Q

pelvic prolapse = what compartments that can prolapse

A

anterior
middle or apical
posterior

26
Q

what is the classification of prolapse

A 
1st degree (in vagina),
2nd degree (at vagina orifice),
3rd degree (outside vagina) 
Procidentia (entirely outside vagina)
27
Q

what is an anterior pelvic prolapse called

A

cystocele

28
Q

what are Sx of cystocele

A 
bulging, pressure "mass"
difficulty voiding
incomplete emptying 
splinting vaginal wall 
difficulty inserting tampon
pain with intercourse.
29
Q

what is a middle/apical prolapse also called

A

enterocele

30
Q

Sx of enterocoele

A

same as cystocele

bulging, pressure "mass"
difficulty voiding
incomplete emptying 
splinting vaginal wall 
difficulty inserting tampon
pain with intercourse.
31
Q

what is a posterior prolapse also called

A

rectocele

32
Q

Sx of rectocele

A 
bulging, pressure, “mass"
difficulty defecation
incomplete defecation
splinting vaginal wall or perineum
difficulty inserting tampon.
33
Q

what is it called when all compartments prolapse

A

complete eversion

34
Q

what are the types of complete eversion

A

Uterine Procidentia

Complete uterine prolapse

35
Q

Mx of prolapse - conservative

A

reassure
avoid heavy lifting
lose weight
stop smoking

vaginal oestrogens = if sx atrophic vaginitis

36
Q

Mx of prolapse

A

Physio
Pessary
Surgery

37
Q

who is suitable to receive pessaries

A

Women unfit for surgery

Relief symptoms whilst awaiting surgery

Further pregnancies planned or pregnant

As diagnostic test for prolapse/ensure correction of large cystourethrocele not cause SUI

Patient request

38
Q

surgical Tx for prolapse

A

vaginal hysterectomy
mesh repair
abdominal sacralcolpopexy

Reproduction SB (30 decks)

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