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Reproduction > Urinary Incontinence and Prolapse > Flashcards

Urinary Incontinence and Prolapse Flashcards

1
Q

What is stress UI?

A

on effort/ exertion

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2
Q

What is urgency UI?

A

immediately preceded by urgency

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3
Q

What is OAB?

A

urgency that occurs with or iwthout incontinence; usually with freq and nocturia

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4
Q

What is OAB dry?

A

OAB wtihout incontinence

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5
Q

What is the aetiology of urinary incontinence?

A

age; parity; obesity; pregnnacy; obsetric history; menopause; UTI; smoking; FHx

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6
Q

What are “storage” symptoms?

A

frequency; nocturia; urgency; UUI; SUI; constant leak

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7
Q

What does a constant leak of urine suggest?

A

fistula

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8
Q

What are voiding symptoms?

A

hesitancy; straining to void; poor flow

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9
Q

What do voiding symptoms suggest?

A

obstruction

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10
Q

What do postmicturition symptoms?

A

prolapse- urine sitting that is hard to get out

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11
Q

What are postmicturition symptoms?

A

incontinence; incomplete emptying

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12
Q

What should be done for an examination with urinary incontinence?

A

BMI; abdo exam; vaginal exam; PR; cognitive impairment

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13
Q

What causes OAB and UUI?

A

detrusor muscle contracts frequently and involuntarily

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14
Q

What causes SUI?

A

urethral hypermobility; urethral sphincter weakness

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15
Q

What causes urethral sphincter weakness in women?

A

trauma; hypoestrogenism; aging; surgical procedures

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16
Q

What is urethral hypermobility?

A

excessive displacement of the urethra and bldder neck during exertion and increased abdo pressure

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17
Q

What are hte investigations for UI?

A

UA; post void resiudal USS; urodynamics; cystoscopy

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18
Q

What are the lifestyle interventions with UI?

A

caffeine; fluid intake; weight loss

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19
Q

What is the conservative managemnt of urge urinary incontinence?

A

pelvic floor physio; bladder retraining; lifestyle

20
Q

What antimuscarinics are used in urge UI?

A

oxybutynin; tolterodine; darfenicin

21
Q

What is the mechanism of antimuscarinics in urge UI?

A

reduce intra-vesicla pressure; increase compicance; reduce uninhibited contractions

22
Q

What are the SE of antimuscarinics?

A

dry mouth; constipation; blurred vision; somnolence

23
Q

What is the second line drug for urge urinary incontinence?

A

mirabegron

24
Q

What is the action of mirabegron?

A

selective B3 ADR agonist- relaxes bladder smooht muscle

25
Q

When might desmopressin be added in with OAB?

A

nocturia

26
Q

What must patients be able to do to have botulinum toxin injections?

A

intermittent self catheterisation

27
Q

What is the medication for SUI?

A

duloxetine

28
Q

What type of drug is duloxetine?

A

combined noradrenaline and serotonin reuptake inhibitor

29
Q

What is the effect of duloxetine?

A

increased intraurethral closure pressure

30
Q

What surgery is available for SUI?

A

tension free tape; colposuspension; intramural bulking agents; artifical sphincters

31
Q

What is complete vaginal eversion known as?

A

uterine procidentia

32
Q

What are the causes of prolapse?

A

age; parity; pregnancy; oestrogen defiencey; obesity; neuro condition; genetic connective tissue disorder

33
Q

What is POP-Q?

A

whilst striaing 6 sites and 3 sites at rest are measured in relation t othe hymenal ring to look at degree of prolapse

34
Q

What is a stage 1 prolapse?

A

1cm above hymen

35
Q

What is a stage 2 prolapse?

A

1cm around hymen

36
Q

What is a stage 3 prolapse?

A

> 1cm beyond hymen

37
Q

What is stage 4 prolapse?

A

complete vaginal eversion

38
Q

What are the complications with pessaries?

A

discharge; ulcerations (fistula); fibrous bands

39
Q

How often should a pessary be changed?

A

6 monthly

40
Q

What is the surgical option for anterior and posterior prolapse?

A

vaginal repair

41
Q

What are vaginal surgical options for apical prolapse?

A

sacrospinous fixation and colpocliesis

42
Q

What is sacrospinous fixation?

A

cervix/ vagina attached to sacrospinous ligament

43
Q

What is colpocleisis?

A

close up vagina

44
Q

What should be done with colpocleisis if woman still has uterus?

A

2 channels left on either side to see PMB

45
Q

What is a pectopexy?

A

subtotal hysterectomy; cervix bilaterally attached to iliopectineal ligament

46
Q

What is a sacrohysteropexy/sacrocolpopexy?

A

attaching uterus/vagina to anterior longitudinal ligamentwith mesh and coverd with peritoneum

Reproduction (52 decks)

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