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REPRO TEST 3 > Urinary Incontinance and POP > Flashcards

Urinary Incontinance and POP Flashcards

1
Q

6 common causes of pelvic organ prolapse

A
  1. childbirth
  2. chronic heavy lifting
  3. prior surgery
  4. obesity
  5. aging
  6. menopayse
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2
Q

sx of prolapse

A 
bulge or lump in vagina 
painful/difficult sex  
delayed or slow urinary stream 
incontinence  
BM difficulty
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3
Q

cystocele

A

bladder fall into vagina

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4
Q

enterocele

A

small bowel into vagina

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5
Q

rectocele

A

rectum into vagina

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6
Q

uterine prolapse

A

uterus into vagina

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7
Q

vaginal vault prolapse

A

vaginal vault occurs when the upper portion of vagina (apex) descends into canal

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8
Q

POP 3 steps to PE

A
  1. speculum exam
  2. bimanual exam
  3. dorsal lithotomy position
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9
Q

POP grade 0

A

no prolapse

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10
Q

POP grade 1

A

mild defect, not visible without speculum

descent halfway to hymen

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11
Q

POP grade 2

A

prolapse into hymen

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12
Q

POP grade 3

A

prolapse beyond hymen (halfway past)

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13
Q

POP grade 4

A

complete prolapse

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14
Q

procidentia

A

aka complete prolapse

grade 4

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15
Q

GH

A

gnital hiatus

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16
Q

PB

A

perineal body

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17
Q

TVL

A

total vaginal length

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18
Q

POP Q scale 1-4

A

0 no pop
1 most distal prolapse is over 1 cm above hymen

2 most distal prolapse is between 1cm above to 1cm below hymen

3 most distal prolapse is over 1 cm belwo hymen but under 2 cm less than TVL

4: complete procidentia (more than 2 cm TVL)

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19
Q

2 ways to strengthen pelvic floor

A

kegel exercises

vaginal cone weights

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20
Q

besides exercises other POP tx option

A

pessaries with adjunctive vaginal estrogen therapy

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21
Q

pessary complications

A

irritation, erosion, discharge, odor

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22
Q

colporrhaphy

A

surgical repair of vaginal laxity

23
Q

4 reasons when to start tx POP

A
  1. s/s bother pt
    2/ prolapse lead to tissue trauma or other effects
  2. urinary incontinence
  3. key! don’t discriminate against age
24
Q

experiencing overwhelming need to urinate, even if just went or cant hold it to make it the bathroom

A

urge inctontinence

25
Q

urge incontinence aka

A

overactive bladder

26
Q

causes of urge incontinence

A

Idiopathic detrusor instability

neuropathic detrusor hyperreflexia

27
Q

urine loss during episodes of increased abdominal pressure,

A

stress urinary incontinence

28
Q

causes of stress incontinence

A
  1. urethral hypermobility

2. intrinsic sphincter deficiency (ISD)

29
Q

storage sx of incontinence

A

frequency
urgency
interruption of sleep

30
Q

voiding sx of incotinence

A

slow stream
dribbling
incomplete emptying
hesitancy

31
Q

average functional bladder capacity

A

largest vl voided in normal life

avg 400-600mL

32
Q

average # voids / day

A

7-8

about 250 ml

33
Q

what is q tip test?

A

about 1 cm in urethra then cough

more than 30 degress of mvmt = positive test

34
Q

urodynamics

A

assessment of bladder function

35
Q

3 urodynamic tests

A
  1. cystometry
  2. urethral profile pressure
  3. leak point pressure
36
Q

pressure flow study

A

cystometry

37
Q

urethral closure pressure

A

urethral profile pressure

38
Q

lowest pressure at which leakage occurs w/ straining

A

leak point pressure

39
Q

occurs when nerve passages from bladder to brain are damaged.. causes sudden bladder contraction

A

detrusor contractions

sudden onset, larger volum

40
Q

tx for urge incontinence

A

conservative- time voids, diary
meds: muscarinic receptor antagonists
neural stim: sacral neuromodulation interstim

41
Q

sacral neuromodulation interstim is used to tx..

A

urge incontinence

42
Q

tx stress incontinence

A

kegel exercises

pessary divices

43
Q

pessary devices do what?

A

strengthen and support the levator ani muscles

compressive effect on urethra

44
Q

strengthening the levator ani muscles help with

A

improving support or proximal urethra

45
Q

strengthening the striated urogenital sphincter leads to

A

increases urethral closure force

46
Q

surgical opt for stress incontinence

A

sling shaped material placed below urethra

compresses urethral lumen at level of bladder neck as well as urethral support

success 90% of time

47
Q

3 ex of old stress incontinence surg options

A

anterior colporrhaphy
retropubic bladder neck surgery
needle suspensioun

48
Q

bulking agents tx what?

A

stress incontinence

into bladder neck via injection

49
Q

t/f there is currently no meds to treat stress urinary incontinence (SUI)

A

true

50
Q

incontinence occurring without urgency or stress

A

unconscious or overflow

51
Q

urethral hypermobility and/or instrinsic sphincter deficiency can cause..

A

stress or genuine stress urinary incontinence

52
Q

what 6 meds can make incontinence sx worse?

A
  1. anticholinergics
  2. alpha blockers
  3. calcium channel blockers
  4. sedatives
  5. alcohol
53
Q

contents of void diary

A 
24 hr log 
measure UOP (urine output), intake, leage times and amounts
54
Q

UOP

A

urine output

REPRO TEST 3 (7 decks)

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