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

URINARY INCONTINENCE  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

LIGHT BLADDER LEAKAGE  If we are to believe the advertising propaganda the urinary incontinence is…  “NORMAL” TENA  “COMFORTABLE” POISE  “DISCREET” DEPENDS

URINARY INCONTINENCE  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

COMPLICATIONS OF 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%

TYPES OF INCONTINENCE  URGE  STRESS  OVERFLOW  CONTINUOUS

NEW IN MANAGEMENT OF INCONTINENCE: URGE  Long term anti-cholinergic use increases / causes cognitive decline  BOTOX  TIBIAL NERVE STIMULATION  SACRAL NERVE MODULATION

NEW IN MANAGEMENT OF INCONTINENCE: STRESS  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: OVERFLOW  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

CATHETERS  Female SHOULD NOT be left with long term indwelling URETHRAL catheters due to the real risk of Urethral EROSION  Intermittent catheterisation  Supra-pubic catheter

TAKE HOME MESSAGE  Urinary Incontinence is NOT a normal part of the aging process  It has SERIOUS health consequences  It can and SHOULD BE TREATED