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Gynecology > Urogyne > Flashcards

Urogyne Flashcards

0
Q

Define urodynamics

A

Dynamic study of the transport, storage and evacuation of urine by urinary tract

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1
Q

What are the components of urodynamics?

A 
Uroflowmetry
Cystometrics
Cystometrography
Urethral pressure profile
Pressure flowmetry
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2
Q

Name 3 indications for urodynamics

A

Inconclusive dx after simpler tests
Poor response to empiric therapy
Neuro condition
When a proposed test has significant risks
Women w sx of mixed incontinence who have difficulty characterizing their incontinence, who have previously undergone surgical procedures for incontin or in whom neuro dz is suspected

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3
Q

What do cystometrics measure?

A

Pressure volume relationship within bladder during bladder filling

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4
Q

What does uroflowmetry measure?

A

Urine flow rate over time (max flow rate, voided volume, time to max flow, avg flow rate

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5
Q

What is the benefit of measuring urethral mobility during preop assessment of stress incontin?

A

Pts w/ stress incontin and normal urethral mobility are harder to fix than pts w urethral hyper mobility

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6
Q

Name two findings on cystoscopy that may indicate interstitial cystitis

A

Hunner’s ulcers

Glomerulations

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7
Q

What are first line tx options for interstitial cystitis?

A 
Pt education
Behavior modification
Pyridium
CystoPlus (sodium citrate)
Pelvic floor muscle relaxation
Bladder training
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8
Q

What are some second line tx options for interstitial cystitis?

A 
Manual physical therapy
Amytriptyline
Cimetidine
Hydroxyzine
Pentozoan poly sulfate (Elmiron)
Intravesical distillation of DMSO, heparin or lidocaine
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9
Q

What are some third line tx options for interstitial cystitis?

A

Hydrodistension

Tx Hunner’s lesions

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10
Q

How do you define recurrent UTI?

A

> =2 UTIs within 6 mnths

Or >=3 + cultures w/in preceding 12 mnths

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11
Q

What is the difference b/w a relapsed UTI and a reinfection?

A

Relapse = recurrent infxn w/ same organism despite adequate tx

Reinfxn = recurrent UYI caused by diff bacteria or same bacteria after negative intervening culture or >=2 wks b/w infxns

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12
Q

In the presence of dysuria, frequency and hematuria w/o vag d/c, what is the probability of a culture + UTI?

A

81%

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13
Q

Risk factors for recurrent UTIs

A 
Pregnancy
Poor hygiene
Frequent intercourse
Multiple sexual partners
Spermicide
Post menopausal
Prolapse
Diabetes
Incontinence
High PVR...
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14
Q

Which pts w/ recurrent UTIs should have cystoscopy +- imaging upper urinary tract?

A

Pts w/ persistent hematuria or persistent growth of bacteria other than E. coli

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15
Q

Using a urine culture, what is the dx cutoff for a UTI?

A

> 100 000 CFU/HPF

Or >1000 CFU/HPF in a sx woman

Gynecology (7 decks)

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