FCP III: urinary incontinence (exam 6)

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cotton swab test for incontinence
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What medication that is typically used for depression can also be used to treat off label urinary incontinence?duloxetine (cymbalta)how do bulking agents help to treat urinary incontinence?coats urethral mucosa and increases bladder outlet resistance (inject adjacent to proximal urethra/bladder neck and pt multiple tx may be needed)What role does collagen, graphite, calcium hydroxyapatite, and silicone have in treated urinary incontinence?bulking agents to increase bladder outlet resistanceWhat is an anterior repair for urinary incontinencepubocervical fascia imbricated posteriorly to support bladderMarshal-Marchetti-Krantz (MMK)periurethral suspension (used to treat urinary incontinence)Burch suspension method is periurethral/perivesicularperivesicularSurgical options for urinary stress incontinence (4)anterior repair suspension (MMK or burch) artificial urinary sphincter slingnon invasive stress incontinence treatment optionsbehavioral changes pelvic floor training medication continence devicesminimally invasive stress incontinence treatment optionsbulking agents3 parts to artificial urinary sphinctercuff, reservoir, and pumpYou need to place a catheter into a pt however you notice in her chart she has an artificial urinary sphincter, what additional step do you need to do?always deactivate device (pump and lock into open position) before placing the cathwhen are pts with artificial urinary sphincters at highest risk for infectionfirst 2 monthsartificial urinary sphincter infections are more common if a pt has had...pelvic radiationWhen can artificial urinary sphincter be re-implanted after removal due to erosion and infection>3 mo laterurge incontinenceepisodic involuntary loss of urine, immediately preceded by/associated with urgencyurge incontinence/overactive bladder - noninvasive treatment optionsbehavioral therapy estrogen anticholinergics beta-adrenergicsurge incontinence and overactive bladder - minimally invasive treatment optionsneuromodulation of sacral or tibial nerve botoxurge incontinence and overactive bladder - surgical optionsaugmentation enterocystoplasty autoaugmentation urinary diversionurge incontinence and overactive bladder - behavioral modificationsurge suppression using → breathing exercises, mental imagery, distraction, pelvic floor muscle contractionsWhat can be used for urge incontinence in post-menopausal femalestopical vaginal estrogenHow are anticholinergics helpful in treating urge incontinencedecrease detrusor muscle contractionsbeta adrenergic/anticholinergic medications helps to relax the detrusor musclebeta adrenergicMirabegronbeta 3 agonistPt just started on mirabegron for urge incontinence. What do you need to monitor closely now?BPHow long do effects of botox last for urge incontinence treatment3-12 moSacral neuromodulationelectrical stimulation of S3 afferent nerve to modify voiding reflexposterior tibialis nerve stimulationin OV procedure where electrode is placed superior to and posterior to medial malleolus of either leg → electrical stimulation x 30 min weekly x 12 wksautoaugmentation for urge incontinencedetrusor muscle at dome of bladder incised but the urothelium remains intact → allows bladder capacity to expand (which decreases intravesical pressure)augmentation enterocystoplastybladder dome is opened and tubularized intestinal segment appended to bladder to increase bladder capacityTreatment for extreme/refractory cases of urge incontinenceurinary diversion (urine bypasses bladder, such as via ileal conduit)