gynecology_2.1_urinary incontinence

investigations

history

physical examination

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surgical

medical

behavioral modification

definition

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involuntary leakage of urine

true incontinence

reflex incontinence

overflow incontinence

urge incontinence

stress incontinence

anatomy

spinal cord

detrusor inactivity bladder distension

detrusor instability

pelvic floor muscles

increase intra-abdominal pressure (cough, sneeze, laugh)

urgency

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general, abdominal, vaginal

mid-stream urine

drugs

diseases

pelvic floor muscles

pelvic organ prolapse

urinary symptoms

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3/4 perineal tear

DM, stroke, lung/smoking

diuretics

obstructive symptoms

incomplete emptying

UTI

terminal dribbling

intermittency

irritating symptoms

nocturia

frequency

uregency

straining

hesitency

hematuria

dysuria

test any leakage when cough, Valsalva maneuvre

neurological

urinary diary

urodynamics study

uroflowmetry

cystometry

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urine volume

(detrusor instability) vesicular pressure

(straining) intra-abdominal pressure

(prophylaxis) pad/trousers

drinking habit, voiding habit

weight reduction

x coffee, x drinking

x smoking (cough)

pelvic floor exercise

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anti-cholinergeic: oxybutynin (detrusor instability)

tension-free transvaginal tape surgery

(colposuspension)