Urogynae

Question 1

What is the first line treatment for urinary incontinence?

Answer 1

urge incontinence: bladder retraining

stress incontinence: pelvic floor muscle training

Question 2

What is associated with detrussor instability and what are the symptoms?

Answer 2

Caffeine intake is associated. The symptoms are frequency and urgency

Question 3

Concerning stress incontinence, what life style factors can be advised?

Answer 3

Weight loss, no heavy lifting

Question 4

What is a complication of a ring pessary and why?

Answer 4

Occasionally it can be too large and compress the urethra against the pubic bone resulting in a degree of voiding difficulty. If there is a residual volume, overflow incontinence can occur but this is rare. UTI is the most common complication.

Question 5

What is a common complication following child birth, regional anaesthetic, prolonged labour and an instrumental delivery?

Answer 5

Overflow incontinence from urinary retention. A post-catheter void may prevent this. (only passing small amounts of urine after birth = urinary retention)!!!

Question 6

What can be seen in women who have protracted, obstructed labour, commonly seen in the developing world.

Answer 6

Tissue necrosis in the vagina and surrounding area which can then lead to a vesico-vaginal fistulae.