Pelvic Floor Disorders Flashcards

1
Q

What are the 3 main categories of pelvic floor disorders?

A

Urinary incontinence
Pelvic organ prolapse
Anal incontinence

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2
Q

List the 4 main types of urinary incontinence

A

Stress
Urge
Overflow
Mixed

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3
Q

List risk factors for urinary incontinence

A
Being female
Increasing age
Obesity
Smoking
Kidney disease
Diabetes
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4
Q

What is urinary urgency?

A

Sudden compelling desire to pass urine that is difficult to resist

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5
Q

Does involuntary urine leakage occur in urge incontinence?

A

Yes

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6
Q

How is overactive bladder different from stress incontinence?

A

OAB involves involuntary detrusor contraction; stress can be caused by pressure or urethral hypermotility

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7
Q

How can incontinence be tested for on physical examination?

A

Standing or supine stress test

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8
Q

List the spectrum of treatments for overactive bladder, from least to most invasive

A
Lifestyle improvement
Bladder training
Pelvic floor exercise/physio
Drugs
Botox
Neuromodulation
Reconstructive surgery
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9
Q

Which drug class is the most commonly used for overactive bladder? Name the most used agent

A

Antimuscarinics

Oxybutynin

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10
Q

What drug class can help relax the bladder? Give an example

A

B3 agonist

Mirabegron

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11
Q

What is classified as a normal amount of urine to void a day?

A

Less than 8 times a day

Less than 2800 ml a day

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12
Q

What does cystometry measure?

A

Pressure-volume relationship of the bladder during filling, provocation and voiding

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13
Q

When does stress incontinence occur?

A

Sudden movements or increases in intrabdominal pressure

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14
Q

Which drug can be used for stress incontinence?

A

Duloxetine

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15
Q

What surgical methods can be used for stress incontinence?

A

Low-tension vaginal tape
Colposuspension
Artificial sphincters

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16
Q

When is overactive bladder dry and when is it wet?

A

Wet when urge incontinence is present, dry when it is not

17
Q

What is overflow incontinence?

A

Chronic urinary retention due to bladder outflow obstruction

18
Q

What specific symptom do patients often complain about with overflow incontinence?

A

Nocturia

19
Q

Stress incontinence does not involve urgency. True/False?

A

True

20
Q

List risk factors for pelvic organ prolapse

A
Pelvic surgery
Childbirth
Menopause
Obesity
Chronic constipation/coughing/heavy lifting
Uterine fibroids
Connective tissue disorders
21
Q

Which part of the vaginal wall does a cystocele come from?

A

Anterior

22
Q

Which part of the vaginal wall does a enterocele come from?

A

Middle

23
Q

Which part of the vaginal wall does a rectocele come from?

A

Posterior

24
Q

List some clinical features of pelvic prolapse

A

Bulging pressure
Difficulty voiding, incomplete emptying
Splinting of vaginal wall
Pain with intercourse

25
Q

How are pelvic prolapses classified?

A

1st degree: in vagina
2nd degree: at interiotus
3rd degree: outside vagina
Procidentia: completely outside vagina

26
Q

What is the POP-Q system?

A

Pelvic organ prolapse quantification system

Measure each site of prolapse in relation to hymenal ring: if above hymen, -ve, if below hymen, +ve

27
Q

What should be given if someone has pelvic prolapse with atrophic vaginitis?

A

Oestrogen

28
Q

What are the 2 main management options for pelvic prolapse?

A

Pessary

Surgery