Storage LUTS Flashcards
Give 3 neurological conditions that can cause storage LUTS
Diabetic neuropathy
Multiple sclerosis
Spinal cord injury
Which examinations should be performed in a patient presenting with storage LUTS?
Abdominal exam
Vaginal exam in women
DRE in men
Lower limb neurological exam
Give 2 conditions that can be investigated by CT urogram
Vesicovaginal fistula
Ectopic urethra
What is the pathophysiology of stress incontinence?
Leaking from an incompetent sphincter
Give 6 risk factors for stress incontinence
Increasing age Pregnancy Childbirth Menopause Neurological disorders Iatrogenic (e.g. TURP/HoLEP/prostatectomy)
How does stress incontinence present?
Small but frequent amounts of urine on coughing, sneezing and physical exertion
Give 2 options for conservative management of stress incontinence
Pelvic floor exercises
Pads
Which drug can be used to manage stress incontinence?
Duloxetine (SNRI)
What is the first line surgical management for stress incontinence in women?
Urethral bulking
What is the last resort surgical management of stress incontinence in women?
Artificial urinary sphincter
What is the main surgical management of stress incontinence in men?
Artificial urinary sphincter
Give 6 causes of urgency incontinence
Pelvic radiotherapy or surgery Brain damage Diabetes Atrophic vaginitis Urethritis UTI
Give 4 options for the conservative management of overactive bladder syndrome
Avoid caffeine/alcohol/fizzy drinks
Pads and catheters
Bladder training exercises
Weight loss
Give 2 classes of drug used to treat overactive bladder syndrome
Antimuscarinics e.g. solifenacin and tolterodine
Beta-3 agonists e.g. mirabegron
Give 4 side effects of antimuscarinics
Dry eyes
Dry mouth
Constipation
Urinary retention
Give 1 contraindication of antimuscarinics for overactive bladder syndrome
Untreated bladder outlet obstruction
What medication is used to treat atrophic vaginitis in postmenopausal women?
Topical oestrogen therapy
What is the first line surgical management of overactive bladder syndrome?
Cystoscopy with botox injection (can resolve symptoms for 6-9 months)
Give 4 surgical options for overactive bladder syndrome
Cystoscopy with botox injection
Sacral neuromodulation
Ileocystoplasty
Ileal conduit
Give 3 risks of ileocystoplasty
Mucus production
Stone formation
Metabolic abnormalities