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Stress Urinary Incontinence

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Stress Urinary Incontinence Dr. Ali Abd El-Monsif Thabet * Types of female urinary Incontinence True incontinence Urge incontinence False incontinence (retention with ... – PowerPoint PPT presentation

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Title: Stress Urinary Incontinence


1
Stress Urinary Incontinence
  • Dr. Ali Abd El-Monsif Thabet

2
Types of female urinary Incontinence
  • True incontinence
  • Urge incontinence
  • False incontinence (retention with over flow)
  • Nocturnal enuresis

3
Stress incontinence
  • It is involuntary leakage of urine, from the
    urethra and such leakage occurs on sudden rise of
    intraabdominal pressure, as in coughing,
    laughing, sneezing, straining, or any other
    physical activities, when the intravesical
    pressure exceeds the maximum urethral pressure in
    the absence of detrusor contraction.

4
Psychological impact
  • It has a profound psychosocial impact not only on
    patients but also on their families and
    caregivers, resulting in

5
  • Pathophysiology of stress incontinence

6
The effect of intra-abdominal pressure on the
urethra (a) normal (B) bladder neck descended
7
Grades of stress incontinence
  • Grade I. Incontinence only with severe stress,
    such as coughing, sneezing, or jogging
  • Grade II. Incontinence with moderate stress,
    such as rapid movement or walking up and down
    stairs.
  • Grade III Incontinence with mild stress, such
    as standing. The patient is continent in the
    supine position.

8
  • Incidence of stress incontinence

9
Aetiology
  • 1. Congenital
  • 2. Traumatic
  • 3. Hormonal dysfunction
  • 4. Infections

10
Factors that provoke or aggravate incontinence
  • Excess body weight
  • Chronic coughing
  • Smoking
  • Drugs

11
Evaluation
  • Diagnostic Tests
  • Stress Test
  • Bonney's test
  • One-Hour office Pad Test
  • Perineometer
  • Electromyography

12
Treatment
  • 1. Prophylaxis
  • 2. Curative Treatment

13
Surgical Treatment
  • Collagen injection
  • Sling operations
  • Artificial sphincters

14
Physiotherapy For Pre and Post operative cases
  • Pre-operative education
  • 1- Breathing exercises
  • 2- Circulatory exercises
  • 3- Pelvic floor exercises
  • 4- Abdominal exercises
  • 5- Postural education .

15
Urge incontinence
  • By using acute maximal stimulation through a
    vaginal and an anal electrode with current
    frequency from 5-10 Hz for 20 minutes. The
    current intensity varied from 5-80 mA on the
    rectal electrode and from 15-100 mA on the
    vaginal electrode. For 6 to 14 treatments are
    given with 2-3 sessions a week.
  • The maximal electrical stimulation may inhibit
    spontaneous detrusor contractions by normalizing
    the disturbed balance between cholinergic and
    adrenergic neurotransmission.

16
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