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Reproduction > Urinary Incontinence and Prolapse > Flashcards

Urinary Incontinence and Prolapse Flashcards

1
Q

What is stress incontinence?

A

Involuntary urine leakage on effort/exertion

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2
Q

What is urge incontinence?

A

Involuntary urine leakage accompanied/immediately preceded by urgency to urinate

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3
Q

What is mixed incontinence?

A

Involuntary urine leakage associated with both urgency and exertion

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4
Q

What is overactive bladder?

A

Urgency with/without incontinence and is usually accompanied by nocturia and frequency

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5
Q

Give some potential risk factors for incontinence

A 
Age
Parity
Obesity
Pregnancy
Menopause
UTI
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6
Q

What is clinical evaluation of a patient with incontinence focused on?

A 
Storage symptoms (frequency/nocturia/urgency/incontinence)
Incontinence
Voiding symptoms
Postmicturition symptoms
Prolapse
Diet
Medication – particularly psychoactive medications 
Sex
Obstetric history
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7
Q

What examinations should be carried out on a patient with incontinence?

A

Abdominal exam
Vaginal exam
PR exam

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8
Q

Give some investigations that may be used for stress incontinence

A

Urinalysis
Urodynamics
Cystoscopy
Imaging

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9
Q

Give some conservative management that may be used for incontinence

A

Lifestyle interventions (reduce caffeine/fluid/weight)
Pelvic floor exercises
Bladder retraining

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10
Q

What medication may be used to treat urge incontinence?

A 
Antimuscarinic agents (oxybutynin/tolterodine)
Beta-3 adrenoceptor agonists (mirebegron)
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11
Q

What is the effect of antimuscarinic agents on the bladder?

A

Reduce intra-vesical pressure

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12
Q

Give some common side effects of antimuscarinics

A

Dry mouth
Constipation
Blurred vision
Somnolence

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13
Q

What is the effect of beta-3 adrenoceptor agonists?

A

Relaxes bladder smooth muscle by activating beta-3 adrenoceptor

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14
Q

What other ways may be used to manage an overactive bladder?

A 
Desmopressin
Topical oestrogen
Botox
Percutaneous sacral nerve stimulator
Augmentation cystoplasty
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15
Q

How can stress incontinence be managed?

A 
Weight loss
Physiotherapy
Incontinence therapy
Surgery
Duloxetine
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16
Q

What are the three compartments of prolapse?

A

Anterior (uterus)
Middle/apical
Posterior (bowel)

17
Q

Give some symptoms associated with a cystocele (anterior)

A

Bulge
Pressure
Incomplete bladder emptying
Incontinence

18
Q

Give some symptoms associated with uterine prolapse

A 
Dragging
Back pain
Mass present
Difficulty inserting/retaining tampon
Dyspareunia
19
Q

Give some symptoms associated with rectocele (posterior)

A

Bulging
Pressure
Difficulty defaecating

20
Q

What investigations may be used in prolapse?

A

USS (masses present)

MRI (complex surgery)

21
Q

What conservative management may be done for prolapse?

A

Weight loss
Pelvic floor exercises
Vaginal pessaries

22
Q

Young women can manage their own pessaries. True/false?

A

True

23
Q

What surgery may be done for prolapse?

A

Sacrospinous fixation
Colpoclesis
Sacrohysteropexy

24
Q

What is involved in sacrohysteropexy?

A

Resuspension of the prolapsed uterus to lift the uterus and hold it in place

Reproduction (33 decks)

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