Pelvic Floor Disorders Flashcards
What is a normal post-void residual(PVR)?
50-60cc
What PVR is usually found in overflow incontinence?
> 300cc
What are etiologies of overflow incontinence?
underactive detrusor muscle(neurologic disorders, diabetes or multiple sclerosis) or obstruction(postoperative or severe prolapse)
What is physiology of stress incontinence?
bladder pressure is greater than the intra-urethral pressure; overactive detrusor can override urethral pressure which is also known as urge incontinence
What defines urethral hypermobility?
straining Q tip angle>30 degrees from horizon
What has the best success rates for patients with stress incontinence due to hypermobility?
mid-urethral sling such as tension free vaginal tape and other sling procedures have best five year success rate; needle suspension and anterior repairs have lower success rates
What procedures are best for patients with intrinsic sphincteric deficiency?
urethral bulking; have a success rate of 80%
What is colpocleisis?
option to treat uterine prolapse where vagina is obliterated and can be performed quickly without general anesthesia
How is urge incontinence 2/2 detrusor overactivity treated?
beta-3 receptor agonists, such as Mirabegron, cause relaxation of detrusor muscle
Mirabegron should be avoided in patients with ___. Tolterodine should be avoided in ___.
severe hypertension, ESRD, or liver disease.
contraindicated in narrow-angle glaucoma
What are risk factors for pelvic organ prolapse?
obesity, age, parity, chronic constipation, connective tissue disorders
what fascia are repaired in cystocele and rectocele?
pubocervical fascia and rectovaginal fasia
What are symptoms of overflow incontinence?
pressure, fullness, frequency and small amount of continuous leakage
