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gynecology_2.1_urinary incontinence (history (dysuria, hematuria, UTI,…
gynecology_2.1_urinary incontinence
investigations
mid-stream urine
urinary diary
urodynamic study
uroflowmetry
volume
cystometry
vesicle pressure: bladder (detrusor hyperexcitability)
intraabdominal pressure: rectum (abdominal straining)
history
dysuria, hematuria, UTI
hesitancy, straining, intermittency, terminal dribbling, incomplete emptying
obstructive symptoms, voiding symptoms
urgency, frequency, nocturia
irritative symptoms, storage symptoms
stress incontinence
DM, stroke, chronic cough
daily life
a lot of drugs
physical examination
abdominal
vaginal
test any leak in cough, Valsalva maneuvre
neurological
general
behavioral modification
x coffee x drinking
cough (x smoking)
weight reduction
drinking habit, voiding habit
(prophylaxis) pads, pants
(detrusor) medical
anti-cholinergic: oxybutynin
surgical
tension-free transvaginal tape surgery
colposuspension
pelvic floor exercise
definition (involuntary leakage of urine)
overflow incontinence
bladder distension or x detrusor activity
true incontinence
anatomy (e.g. vesicovaginal fistula)
urge incontinence
detrusor hyperexcitability
urgency
stress incontinence (e.g. genuine stress incontinence)
intra-abdominal pressure
cough, sneeze, laugh
reflex incontience
x reflex