UI Flashcards
How does the following drug class cause OAB symptoms?
opiates
opiates
less awareness of bladder filling, increased sphincter tone, fecal impactions
How does the following drug class cause OAB symtpoms?
sedatives
Sedatives
impaired detrusor contraction
How does the following drug class cause OAB symtpoms?
anti-histamines
potential for decreased contractility
How does the following drug class cause OAB symtpoms?
anti-depressants
anti-depressants
duloxetine, TCAs
increased sphincter tone, decreased bladder contractility
How does the following drug class cause OAB symtpoms?
anti-psychotics
anti-psychotics
clozapine, olansapine, risperidone
CNS stimulation, decreased sphincter tone, decreased contractility
How does the following drug class cause OAB symtpoms?
alpha agonists
alpha agonists
meythl-dopa, clonidine
urinary retention, increased sphincter tone
What is the questionnaire measuring and how is it scored?
IIQ- impact of incontinence
affect of incontinence on daily habits and emotional status
score 0-100
What is the questionnaire measuring and how is it scored?
UDI urogenital distress inventory
which sx are most bothersome?
-frequency/urgency/incomplete emptying
-SUI
-Pain
raw score x 25
What is the questionnaire measuring and how is it scored?
PFDI
all pelvic floor dysfunction (urinary, fecal, prolapse)
0-300, raw score x 25
What is the questionnaire measuring and how is it scored?
PISQ
sexual impact of pelvic floor disorders
multiplying the number of items by the mean of responses
what is the success rate of bulkamid?
improved vs dry
70% improved
40% dry
DDX for UI?
structural vs nonstructural:
ectopic ureter, urethral diverticulum, fistula, UUI, MUI, SUI
GU vs non-GU:
dementia, neurologic conditions, UTI, GSM, stool impaction, limited mobility, DM, medications, SIADH
What percentage of patients will stay on an anticholinergic for more than year?
50%
What percentage of patients will stay on an anticholinergic for more than year?
50-75%
How does desmopressin reduce nocturia?
increases vasopressin which decreases urine output
How likely is it that you don’t see DO on UDS in an OAB patient?
68%
Pros and cons of TLH with SCP
Possibly increased risk of mesh erosion
Higher risk of injury to ureters, bladder or bowel?
Pros:
No need for morcellation
No need for cervical cancer surveillance
Name 2 hemostatic agents that do not contain human blood products.
Surgicel-Cellulose
Arista-Polysaccharide spheres
What is the rate of kinking/injury to the ureter with a USLS procedure?
Vaginal 10%
Laparoscopic 0%
How do you decide to leave a foley in place after urethral prolapse excision?
if the prolapse is large to avoid urethral stricture
You suspect urethral diverticulum, but MRI is not available.
What other imaging study can you order?
retrograde urethrogram using a trattner catheter to occlude both ends of the urethra and fill the urethra with contrast
OR
VCUG
What type of epithelium lines the urethra?
proximal 1/3 - transitional epithelium
distal 2/3 - squamous epithelium
Name some histologic changes commonly found in urethral diverticulua
squamous metaplasia,
adenomatous metaplasia,
cystitis cystica
cystitis glandulari
Malignancy types associated with urethral diverticulum
Adenocarcinoma > transitional cell > squamous cell
most common type of bladder cancer?
> 90 % urothelial (transitional cell) carcinoma US and Europe
Non-urothelial cancer internationally due to schistosomiasis.
hematuria work up and CT is contraindicated.
What other imaging coud you do?
MR urogram or renal US
Microhematuria work up is negative.
what are her next steps
SDM regarding whether or not to test again
Gemtesa drug interaction to be worried about.
digoxin. need to monitor levels before, during, and after use
how does botox work?
prevents binds to the SNAP-25 protein which prevents the release of ACh at the motor neuro synapse.
