LIGHT BLADDER LEAKAGE AND OTHER PROPAGANDA DR ANNA LAWRENCE - - PowerPoint PPT Presentation

LIGHT BLADDER LEAKAGE AND OTHER PROPAGANDA

DR ANNA LAWRENCE UROLOGIST 161 UROLOGY AUCKLAND

 Is the complaint of any involuntary leakage of urine  Approximately 24 to 35% of New Zealanders suffer Urinary Incontinence  Estimated 8 billion dollars a year

URINARY INCONTINENCE

 If we are to believe the advertising propaganda the urinary incontinence is…

 “NORMAL” TENA

 “COMFORTABLE” POISE  “DISCREET” DEPENDS

LIGHT BLADDER LEAKAGE

 It is not a normal part of a woman's aging process to develop uncomfortable, troublesome symptoms of incontinence or

• prolapse. Women need not ‘learn to live with

it.’ American Urogynaecology Society

URINARY INCONTINENCE

 PSYCHO-SOCIAL  substantial stress, depression, social limitation, increased institutionalization, financial strain  SKIN BREAKDOWN  dermatitis, skin breakdown, vulvar folliculitis, pruritus ani

COMPLICATIONS OF URINARY INCONTINENCE

 FALLS AND FRACTURES:  Urge incontinence independently INCREASES FALLS by 26%  and INCREASES FRACTURES by 34%

COMPLICATIONS OF URINARY INCONTINENCE

 URGE  STRESS  OVERFLOW  CONTINUOUS

TYPES OF INCONTINENCE

 Long term anti-cholinergic use increases / causes cognitive decline BOTOX TIBIAL NERVE STIMULATION SACRAL NERVE MODULATION

NEW IN MANAGEMENT OF INCONTINENCE: URGE

 Grave concern regarding Mesh use in Stress Incontinence:  FDA warnings refer to transvaginally placed mesh for prolapse repair surgeries  Transvaginal midurethral slings are still considered safe in TRAINED HANDS

NEW IN MANAGEMENT OF INCONTINENCE: STRESS

 Overflow represents a bladder that is unable to empty due to

 1. bladder failure / hypotonic or atonic detrusor  2. obstruction of emptying with resultant overflow  Often symptomatically difficult to dx  USS with Post void residual is helpful  Vaginal examination to ensure no pelvic masses

NEW IN MANAGEMENT OF INCONTINENCE: OVERFLOW

 Female SHOULD NOT be left with long term indwelling URETHRAL catheters due to the real risk of Urethral EROSION

 Intermittent catheterisation  Supra-pubic catheter

CATHETERS

 Urinary Incontinence is NOT a normal part of the aging process

 It has SERIOUS health consequences  It can and SHOULD BE TREATED

TAKE HOME MESSAGE