Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan...
-
Upload
sabina-hancock -
Category
Documents
-
view
218 -
download
0
Transcript of Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan...
![Page 1: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/1.jpg)
Tjahjodjati
Subdivision Urology Surgery Department, Medical Faculty
Padjadjaran University / Hasan Sadikin Hospital
![Page 2: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/2.jpg)
DEFINITIONDEFINITION
URINARY INCONTINENCE IS DEFINED AS THE INVOLUNTARY LEAKAGE OF URINE,PERCEIVED BY THE SUFFERER , AS A SOCIAL OR HYGIENE PROBLEM.
![Page 3: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/3.jpg)
1. Urge Urinary Incontinence
The involuntary leakage of urine accompanied by or immediately proceeded by urgency
![Page 4: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/4.jpg)
2. Stress Urinary Incontinence
The complaint of involuntary leakage of urine on effort or exertion, or sneezing or coughing
![Page 5: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/5.jpg)
3. Overflow Urinary Incontinence
The complaint of involuntary leakage of urine due to overdistention of bladder. It is usually caused by infravesical obstruction or flaccid bladder.
![Page 6: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/6.jpg)
4. Reflex Urinary Incontinence The complaint of leakage of urine due to detrusor involuntary
![Page 7: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/7.jpg)
5. Continous Urinary Incontinence : The complaint of continous urine leakage. It is caused
usually by urinary fistula ,ex: vesicovaginal fistula,ureterovaginal fistula, extopic ureter, extrophia bladder.
6. Nocturnal Enuresis : The complaint of involuntary loss of urine that occurs
during sleep
7. Mixed Urinary Incontinence : is mixed of urge and stress urinary incontinence
![Page 8: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/8.jpg)
NEURAL CONTROL OF MICTURITION
![Page 9: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/9.jpg)
MICTURITION AND URINE STORAGE
![Page 10: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/10.jpg)
Bladder Filling & Bladder Filling & Emptying CycleEmptying Cycle
1. Bladder fills
2. First desire tourinate (bladderhalf full)
3. Urinationvoluntarily inhibiteduntil time and placeare right
The cycle ofbladder fillingand emptying
Urination
Detrusor musclecontracts
Urethralsphincterrelaxes
Urethralsphinctercontracts
Detrusor muscle relaxes
![Page 11: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/11.jpg)
History
How long symptoms exist, any correlation with strainning (coughing or laughing), voiding sensation
History of Surgery : Urology or Gynecology Patient Mobility : Handicap to go to the toilet Mental Status : Dementia, Psychologycal Problem Medication/Drugs : Sedative Hypnosis, Diuretic,
Antidepresant Concomitant Disease : Asthma Brochiale, COPD Obstretrical History : Pregnancy, Delivery, High
Birth Weight
![Page 12: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/12.jpg)
Impact of Incontinence to the person’s Quality of Life :
Severity of Symptoms : Voiding Diary chart
![Page 13: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/13.jpg)
![Page 14: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/14.jpg)
Physical Examination General Status Supra pubic : full bladder or not ,pain External genital : Perineum : skin rash,
eritema, uterine prolaps, cystocele, rectocele, strictur, stone
Neurologic : sensation, reflex bulbocavernosus
Rectal : prostat, feces consistency, sphincter tone
![Page 15: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/15.jpg)
Laboratory Examination
Urinalysis : UTI, Hematuria Post void Residual Urine Uroflowmetri PAD Test Urodynamic Imaging : BNO-IVP, USG
![Page 16: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/16.jpg)
![Page 17: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/17.jpg)
![Page 18: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/18.jpg)
STRESS INCONTINENCESTRESS INCONTINENCE
![Page 19: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/19.jpg)
Directed to the Etiology : Stress U.I
Pelvis Floor Excercises Weighted Vaginal Cone Electro Stimulation Surgery : - TVT
- Kolposuspension
![Page 20: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/20.jpg)
Urge U.I Bladder Retraining Medication : anti muscarinic agent Surgery
Overflow U.I : Relief the obstruction (surgery)
Continous U.I: Treat the Etiology/ close the fistula/defect (surgery)
![Page 21: Tjahjodjati Subdivision Urology Surgery Department, Medical Faculty Padjadjaran University / Hasan Sadikin Hospital.](https://reader035.fdocuments.in/reader035/viewer/2022062320/56649d965503460f94a7fcb1/html5/thumbnails/21.jpg)
THANK YOU FOR YOUR THANK YOU FOR YOUR ATTENTIONATTENTION