Fowlers syndrome symptoms
- Retention
- Can be painful or painless
- No urge to void
- Large residual volume >1000ml
Triggers for Fowlers syndrome
- Surgery - urology/gynae/obs
Can be other surgeries
Treatment for fowlers syndrome
- Sacral neuromodulation
Risk of vault prolapse after hysterecotmy for prolapse
6x more than hyst for benign conditions
Pelvic floor exercises
Duration for
1. Prolapse
2. SUI
- 4 months for prolapse
- 3 months for SUI
Most significant lifestyle change for OAB
- Caffeine reduction
When to perform urodynamics
- Mixed incont
- Beofre surgery for urge - if diagnosis unclear
Definition of recurrent UTI
- 3 in 1 year
- 2 in 6 months
Treatment for rUTI
Pre-menopause:
- glycosaminoglycan (GAG)
- Can try D Mannose
Abx:
Trimethoprim/ Nitrofurantoin/ amox/cefalexin ON
Post- menopause
- Vaginal estrogen
Consider GAG
RCOG DONT advise
Cranberry
Mx of PN retention
- Pass urine within 6h of SVD or after TWOC
- Conservative- Running water, warm shower
- Bladder scan- if <150ml, think hydration
- 150-700ml- reinsert catheter if unable to PU
Re- TWOC in 24h - > 700ml- catheter for 2 weeks
UAE reintervetnion
- 33% in 5 years
- 80-90% asymptomatic in 1 year
% of women with PCO and PCOS
- PCO- 20-30%
- PCOS- 10-18% of repro age
Risks of metabolic syndrome
- CVS 3-6 fold inc
- T2DM 5 fold inc
- 30 fold in OSP
Anaemia in HMB
- 27%
RF for anaemia
- Obesity- inc hepcidin levels, lowers iron absorption
- Prev anaemia in preg- if preg again in 1year, inc risk
TOA- how many P0
- 60%
% of TOA thats polymicrobial
30-40%
% of PID thats TOA
15-35%
Chronic pelvic pain after TOA
- After 1 episode- 12%
- After 2 episodes- 30%
- After 3- 67%
Fertility after TOA
- Abx alone- 4-15% fertility
- Surgery- 32-63%
