By Kate Moore
ISBN-10: 1846281679
ISBN-13: 9781846281679
This absolutely revised and up-to-date 2d version accommodates new facts within the parts of continence tactics, prolapse administration, mesh utilization and issues; as well as new insights into Sacral Nerve Stimulation for refractory detrusor overactivity.
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Additional resources for Urogynecology Evidence-Based Clinical Practice
Example text
The risk of iatrogenic bacterial cystitis is about 2%. Recent studies have suggested that urodynamic testing is not cost effective in all patients with urinary leakage, because it does not always affect management. On the other hand, it is fair to say that performing incontinence surgery without having a urodynamic diagnosis of stress incontinence, excluding detrusor overactivity, and checking for voiding difficulty, is not good medical practice at all. Several studies have shown that simply having a main complaint of stress incontinence does not equate to the patient having urodynamic stress incontinence (USI).
If a short patient stands up from the table, her pubic bone may drop to well below its original site when she was lying on the couch; Pabdo then becomes negative. 18 given as part of the case history at end of this chapter). What Is “Sensory Urgency”? For many years, patients who suffered from frequency, urgency, and nocturia, in whom urodynamic testing revealed a stable bladder, but a very early First Desire to Void (less than 100– 150 ml) and a small Maximum Cystometric Capacity (less than 400 ml) were diagnosed as having sensory urgency (Jarvis9).
2C. Although the POPQ system may seem a little cumbersome to begin with, it is easy to pick up after a few practice attempts. Over the next decade, most gynecologists and all urogynecologists will inevitably take it up, because it is objective and allows for scientific research as to the outcome of prolapse surgery that has never been possible before (as shown in Chapter 9). 2D. Perform a Bimanual Examination Again, examine for pelvic masses that may press on the bladder to cause frequency, urgency, or incontinence.
Urogynecology Evidence-Based Clinical Practice by Kate Moore
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