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Obs and Gynae > Pelvic Prolapse and Urinary Incontinence > Flashcards

Pelvic Prolapse and Urinary Incontinence Flashcards

1
Q

What are risk factors for pelvic prolapse?

A 
obesity 
age
parity and vaginal delivery 
post menopause 
connective tissue disease 
neuro condition
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2
Q

What is complete uterine collapse?

A

there are 3 compartments - this is prolapse of all 3

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3
Q

What is a cystocele?

A

bladder prolapse - drops into vagina

anterior compartment

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4
Q

What are the symptoms of a cystocele and enterocele?

A

incomplete emptying, pressure, bulging, difficulty voiding
painful or difficult intercourse, tampon insertion
dragging sensation

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5
Q

What is an enterocoele?

A

vaginal vault

middle compartment

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6
Q

What is a rectocele?

A

prolapse of front wall of bowel into vagina

posterior compartment

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7
Q

What are the symptoms of a rectocele?

A 
difficulty pooping
incomplete pooping
bulging 
pressure 
mass 
splinting vaginal wall
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8
Q

How are pelvic prolapses investigated?

A

examination
history - sexual dysfunction, urinary and bowel symptoms, pressure, dragging sensation
USS, MRI

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9
Q

What is the treatment of pelvic prolapses?

A

pessaries - for mild to moderate, families incomplete, frail patients
surgery

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10
Q

What are the complications of pessaries for pelvic prolapse?

A

fibrous band formation

ulcerations

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11
Q

How often should pessaries for pelvic prolapse be changed?

A

every 6 months

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12
Q

What is urinary incontinence?

A

any involuntary leakage of urine

can be stress, urge, mixed, overactive bladder

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13
Q

What is stress incontinence?

A

leakage on effort

e.g. sneezing, cough, laughing

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14
Q

What is urge incontinence?

A

leakage preceded by urgency

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15
Q

What is mixed incontinence?

A

urgency and on exertion/sneezing etc

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16
Q

What are the investigations of incontinence?

A 
examination 
history 
urinalysis 
post void residual 
cystoscopy 
urodynamics 
imaging
17
Q

What may you find on examination in incontincence?

A 
cognitive impairment 
masses
prolapse 
fistula
atrophy
PR exam - loss of tone, masses
18
Q

What is the conservative treatment for stress incontinence?

A

pelvic floor exercises 3 months

19
Q

What is the conservative treatment for urge incontinence?

A

bladder retraining 6 weeks

20
Q

What are some drugs used in urinary incontinence?

A

antimuscarinic agents e.g. oxybutyin, tolterodine
B3 agonists e.g. mirabegron
desmopressin

21
Q

What are some other treatments of urinary incontinence?

A

botox

surgery e.g. tension free tape

Obs and Gynae (27 decks)

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