Pelvic organ prolapse Flashcards
How does the parasympathetic nervous system cause urinary voiding?
Causes detrusor to contract,and relaxes the internal urethral sphincter
How can continence be maintained voluntarily?
Voluntary contraction of the external urethral sphincter via the pudendal nerve
How do parasympathetic nerves reach the bladder walls?
Via the pelvic splanchic nerves, arising from the sacral spine
Main types of urinary incontinence
Stress
Urge/overactive bladder
Mixed
Other types of urinary incontinence
Overflow (outflow obstruction)
Fistulae
Neurological (e.g. diabetes, MS)
Urinary symptoms to ask about in history
Stress Urgency Frequency Dysuria Nocturia Incomplete voiding Hesitancy Poor stream
Reason for carrying out urinalysis in UI
?UTI
Investigations in UI
bladder diary/chart
Pad test
Urodynamics
What does cystometry do?
Visualises relationships between urinary flow, bladder pressure and volume
Lifestyle measures in treating UI
Fluid restriction; consume less caffeine; lose weight
Drug therapy for stress incontinence
Duloexetine- noradrenaline and serotonin re-uptake inhibitor
Surgical treatment of stress incontinence
Low tension vaginal tape
Colposuspension
Intraurethral injection
Drug treatment of overactive bladder
Oxybutyinin (antimuscarinic)
B3 receptor agonists e.g. mirabegron
Degrees of uterine prolapse
1st degree- in vagina
2nd- at interoitus
3rd- outside vagina
Definition of enterocele
Prolapse of pouch of douglas containing small bowel into posterior vaginal wall
