1 / 14

When Your Patients Gotta Go!!!!!

When Your Patients Gotta Go!!!!!. Raji Gill, D.O., M.Sc. Clinical Assistant Professor of Surgery Division of Urology Oklahoma State University. Incontinence. Types Overflow / retention Stress / overactive. History. Urgency, frequency, nocturia Incomplete bladder emptying

madison
Download Presentation

When Your Patients Gotta Go!!!!!

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. When Your Patients Gotta Go!!!!! Raji Gill, D.O., M.Sc. Clinical Assistant Professor of Surgery Division of Urology Oklahoma State University

  2. Incontinence • Types • Overflow / retention • Stress / overactive

  3. History • Urgency, frequency, nocturia • Incomplete bladder emptying • Leak when straining • Weak stream, post void dribbling

  4. Past Medical Conditions • Multiple sclerosis, spinal cord injury • Diabetes • Parkinsons Disease

  5. Medications • Worsen overflow • Ephedrine (Rynatuss), pseudoephidrine, imiprimine (Tofranil) Worsen stress • Clonidine (Catapress), phenoxybenzamine

  6. Physical • Check post void residual (PVR) • Normal less than 50cc • Abnormal more than 200cc • Digital rectal exam • Larger prostate (more than • 40 gms)

  7. Treatment • Overflow / retention • If PVR 50 – 200cc, timed voids, double voids • If PVR > 200cc, straight cath or foley • Stress / overactive • Do not hold urine

  8. Medical Therapy • Overflow • Alpha blockers act on smooth muscle receptors in the prostate (Hytrin, Cardura, Flomax) • 5 alpha reductase inhibitor lowers dihydrotestosterone levels (Proscar, Avodart) • Stress / overactive • Anticholinergics for involuntary detrusor contraction (Ditropan, Detrol) • Tricyclic anidepressants (Imipramine, Tofranil)

  9. Surgical Therapy • TURP, microwave therapy, thermotherapy for enlarged prostates • Periurethral injections • Urethral suspensions • Sphincter prosthesis • Sacral nerve stimulation

  10. The End

More Related