Urinary incontinence

Question 1

What is occult stress incontinence?

Answer 1

stress incontinence that is only observed after reduction of co-existent pelvic organ prolapse

Question 2

What is microscopic hematuria

Answer 2

3+RB per high power field

Question 3

How do anti-muscarinic agents work?

Answer 3

block parasympathetic muscarinic receptors and act on bladder M2 and m3 receptors to inhibit involuntary detrusor contractions
Ex: oxybutynin, solifenacin, tolterodine, trospium, fesoterodine

Question 4

How do beta-agonists work?

Answer 4

activate Beta-3 adrenergic receptor in detrusor muscle, incr muscle relaxation and bladder capacity.
se: tachycardia, HA, diarrhea, HTN, ESRD/liver dz
Mirabegron

Question 5

How does Botox work?

Answer 5

muscle paralytic inhibits presynaptic release of acetylcholine.
SE: UTI, voiding dysfunction

Question 6

Side effects or retropubic vs transobturator sling

Answer 6

Retropubic (TVT): Voiding dysfunction, bladder perforation , vascular injury, blood loss
Transobturator: groin pain

Question 7

What is a cysturethrocele?

Answer 7

AKA paravaginal defect
- majority of anterior vaginal wall prolapse is thought to be caused by paravaginal defects
- occurs w/ detachment of the pubocervical fascia from the arcus tendineus fascia pelvis (ATFP). This defect was associated with descent of the lateral part of the anterior wall, resulting in a cystourethrocele