Urinery Incontinence

Question 1

what is the treatment of stress incontinence?

Answer 1

Lifestyle (loose weight, stop smoking, avoid caffeinated drinks, avoid excessive fluid intake)

Physiotherapy: pelvic floor muscle retraining, biofeedback, electrical stimulation, pessaries

Drugs: Duloexetine : combined noradrenaline and serotonin reuptake inhibitor (increase intraurethral closure pressure)

Surgical

Low tension vaginal tape

Intraurethral injection

Artificial sphincters

Question 2

what is the treatment of an overactive bladder?

Answer 2

Lifestyle: avoid caffeinated drinks

Physiotherapy:bladder training

Drugs: antimuscarinic drugs (oxybutynin) block detrusor muscarinic receptors and decrease the ablility of detrusor muscles to contract

B-3 receptor agonists

Question 3

describe the different degrees of uterine descent

Answer 3

• 1st degree (in vagina),
• 2nd degree (at interiotus),
• 3rd degree (outside vagina)
• Procidentia (entirely outside vagina)

Question 4

What is an enterocele prolapse?

Answer 4

prolapse of pouch of douglas containing small intestine

Question 5

what are the symptoms of pelvic organ prolapse

Answer 5

Any prolapse:

• asymptomatic,
• feeling SCD
• coital difficulties

Cystourethrocele:

• stress urinary incontinence
• urinary retention,
• recurrent UTI

Uterine/vault prolapse

• backache
• ulceration if procidentia /everted

Rectocele:

• constipation
• dyschezia

Question 6

what is the treatment of POP?

Answer 6

pessaries

Surgery