Urinary Incontinence & Prolapse Flashcards
what are causes of a weakened pelvic floor?
increased intra-abdominal pressure (chronic cough, obesity, constipation, intra-abdominal mass)
pelvic floor muscle trauma & denervation (obstetric trauma, pelvic fracture/surgery, congenital)
connective tissue disorder (age-related, oestrogen deficiency, congential or acquired, drug related)
what is urinary incontinence?
involuntary leakage of urine
what types of urinary incontinence are there?
stress, urge, overflow
what is stress incontinence?
involuntary leakage of urine when there is increased intra-abdominal pressure
absence of detrusor muscle contraction
when is stress incontinence seen?
after childbirth, pelvic surgery, oestrogen deficiency
may be triggered by coughing, sneezing, exercise
what lifestyle changes can help stress incontinence?
weight loss, smoking cessation, avoid constipation, caffeine reduction, avoid heavy lifting
what is urge incontinence?
when an individual has increased urgency & frequency to void urine
which incontinence has larger and smaller volumes of leakage?
larger volumes - urge
smaller volumes - stress
what incontinence has over-activity of the detrusor muscle?
urge
what is overflow incontinence?
leakage of urine from a full urinary bladder, often with no urge to urinate
what are some causes of overflow incontinence?
inactive detrusor muscle
involuntary bladder spasms
cystocele or uterine prolapse
what are risk factors of urogenital prolapse?
increasing age
multiparity, vaginal deliveries
obesity
spina bifida
what are signs/symptoms of prolapse?
sensation of pressure, heaviness, ‘bearing down’
urinary incontinence, frequency, urgency
how would a prolapse be treated?
depends on degree of prolapse
- lifestyle
- pelvic floor
- pessary
- surgery
what antibiotics is a pregnant woman with a UTI given?
if 1st/2nd trimester then Nitrofurantoin
if 3rd trimester then Trimethoprim
