Storage LUTS Flashcards

1
Q

Give 3 neurological conditions that can cause storage LUTS

A

Diabetic neuropathy
Multiple sclerosis
Spinal cord injury

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2
Q

Which examinations should be performed in a patient presenting with storage LUTS?

A

Abdominal exam
Vaginal exam in women
DRE in men
Lower limb neurological exam

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3
Q

Give 2 conditions that can be investigated by CT urogram

A

Vesicovaginal fistula

Ectopic urethra

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4
Q

What is the pathophysiology of stress incontinence?

A

Leaking from an incompetent sphincter

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5
Q

Give 6 risk factors for stress incontinence

A
Increasing age
Pregnancy
Childbirth
Menopause
Neurological disorders
Iatrogenic (e.g. TURP/HoLEP/prostatectomy)
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6
Q

How does stress incontinence present?

A

Small but frequent amounts of urine on coughing, sneezing and physical exertion

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7
Q

Give 2 options for conservative management of stress incontinence

A

Pelvic floor exercises

Pads

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8
Q

Which drug can be used to manage stress incontinence?

A

Duloxetine (SNRI)

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9
Q

What is the first line surgical management for stress incontinence in women?

A

Urethral bulking

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10
Q

What is the last resort surgical management of stress incontinence in women?

A

Artificial urinary sphincter

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11
Q

What is the main surgical management of stress incontinence in men?

A

Artificial urinary sphincter

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12
Q

Give 6 causes of urgency incontinence

A
Pelvic radiotherapy or surgery
Brain damage
Diabetes
Atrophic vaginitis
Urethritis
UTI
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13
Q

Give 4 options for the conservative management of overactive bladder syndrome

A

Avoid caffeine/alcohol/fizzy drinks
Pads and catheters
Bladder training exercises
Weight loss

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14
Q

Give 2 classes of drug used to treat overactive bladder syndrome

A

Antimuscarinics e.g. solifenacin and tolterodine

Beta-3 agonists e.g. mirabegron

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15
Q

Give 4 side effects of antimuscarinics

A

Dry eyes
Dry mouth
Constipation
Urinary retention

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16
Q

Give 1 contraindication of antimuscarinics for overactive bladder syndrome

A

Untreated bladder outlet obstruction

17
Q

What medication is used to treat atrophic vaginitis in postmenopausal women?

A

Topical oestrogen therapy

18
Q

What is the first line surgical management of overactive bladder syndrome?

A

Cystoscopy with botox injection (can resolve symptoms for 6-9 months)

19
Q

Give 4 surgical options for overactive bladder syndrome

A

Cystoscopy with botox injection
Sacral neuromodulation
Ileocystoplasty
Ileal conduit

20
Q

Give 3 risks of ileocystoplasty

A

Mucus production
Stone formation
Metabolic abnormalities