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Reproduction Year 3 > 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

Describe stress incontinence

A

Urine leakage on effort or exertion
Can be brought on by sneezing/coughing/laughing
(anything that increases intra abdominal pressure)

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3
Q

Describe urge incontinence

A

Urine leakage accompanied/preceded by urgency

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4
Q

Describe mixed incontinence

A

urine leakage associated with urgency and exertion

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5
Q

Risk factors for incontinence

A 
Female
Age 
Obesity 
Parity 
smoking
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6
Q

what is overactive bladder syndrome (OAB)

A

Urgency, with or without incontinence, usually associated with frequency + nocturia in the absence of pathological or metabolic conditions that might explain the symptoms

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7
Q

what is OAB wet

A

where urge incontinence is present

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8
Q

what is OAB dry

A

where incontinence is absent

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9
Q

what is OAB associated with

A

detrusor contractions

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10
Q

what are some lifestyle measures that can improve incontinence

A

bladder retraining
caffeine reduction
weight reduction if BMI >30

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11
Q

investigations for incontinence

A

Urodynamics
Urinalysis
Cystoscopy

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12
Q

physio treatment for incontinence

A

pelvic floor muscle exercises

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13
Q

which types of incontinence are pelvic floor exercises useful in

A

stress and mixed

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14
Q

1st line medical treatment for OAB

A

Oxybutynin (anti-muscarinic)

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15
Q

2nd line medical treatment for OAB

A

mirabegron (beta 3 agonist)

used when anti-muscarinic is contraindicated/ineffective

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16
Q

anti-muscarinic side effects

A

dry mouth
constipation
blurred vision
somnolence

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17
Q

mode of action of mirabegron

A

relaxes bladder smooth muscle through activation of B3 receptor

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18
Q

what drug is given if there is nocturia

A

desmopressin

19
Q

What drug is used in treating stress incontinence

A

duloxetine

20
Q

what class of drug is duloxetine

A

combined noradrenaline + serotonin reuptake inhibitor

21
Q

what does uroflowmetry do

A

measure the volume of urine expelled from the bladder each second

22
Q

indications for investigation with uroflowmetry

A 
hesitance
voiding difficulty 
neuropathy 
History of urine retention 
Post operation follow up
23
Q

what is cystometry used for

A

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

24
Q

what causes overflow incontinence

A

obstruction of urethra

poor contractile bladder muscle

25
Q

what is needed for a diagnosis of overflow incontinence

A

post void residual (PVR)- a urine test that measures the amount of urine left in the bladder after urination

26
Q

what drugs must be stopped in overflow incontinence

A

Anticholinergics- atropine, oxybutynin

TCA’s

27
Q

what are the 3 compartments that can prolapse

A

anterior
middle/apical
posterior

28
Q

Classifications of prolapse

A

1st degree- in the vagina
2nd degree- at vaginal orriface
3rd degree- outside vagina

29
Q

what does procidentia mean

A

entirely outside vagina

30
Q

what is an anterior pelvic prolapse called

A

cystocele

31
Q

symptoms of a cystocele

A

bulging, pressure, “mass”, difficulty voiding/inserting tampon, pain on intercourse

32
Q

what is a middle vaginal prolapse called

A

enterocoele

33
Q

symptoms of enterocoele

A

bulging, pressure, “mass”, difficulty voiding/inserting tampon, pain during sex

34
Q

what is a posterior vaginal prolapse called

A

rectocele

35
Q

symptoms of rectocele

A

bulging, pressure, “mass”, difficulty defecting, incomplete defecation, difficulty inserting tampon

36
Q

what is it called when all compartments prolapse

A

complete eversion

37
Q

what are the types of complete eversion

A

uterine procidentia

Complete uterine prolapse

38
Q

risk factors for prolapse

A

Parity + vaginal delivery
Post menopausal oestrogen deficiency
Obestiy
Neurological condition e.g. spina bifida/muscular dystrophy

39
Q

conservative management of prolapse

A

reassure
avoid heavy lifting
lose weight
stop smoking

40
Q

Non conservative management of prolapse

A

pessary

surgery

41
Q

who might receive a pessary

A

woman unfit for surgery
relief of symptoms whilst waiting for surgery
pregnant ladies
patient request

42
Q

how often do pessaries need changed

A

6 monthly

43
Q

surgical treatment for prolapse

A

vaginal hysterectomy
mesh repair
abdominal sacralcolpopexy

Reproduction Year 3 (36 decks)

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