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| 1 |
How long may detrusor overactivity persist following prostate surgery?
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1 year
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| 2 |
How does bladder neck perservation affect SUI in men post prostatectomy?
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Continence returns sooner (not improved continence); wait at least 6-12 months after RRP before...
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| 3 |
How do you work-up post-prostatectomy incontinence (< 1 year post-op)
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U/A, culture, U/S PVR;
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| 4 |
If elevated PVR working up post-prostatectomy incontinence (< 1 year)?
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Cysto to assess for stricture; if no stricture, then can place catheter x 2-4 weeks;...
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How do you w/u post-prostatectomy incontinence > 1 year?
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U/A, culture, PVR, cysto (to assess stricture).
If no stricture, no UTI, then UDS.
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| 6 |
How do you interpret UDS findings in post-prostatectomy incontinence > 1 year?
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DO or DO+ISD - anticholinergics and behavioral therapy; acontractile bladder - CIC; ISD...
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| 7 |
What are non-surgical options for SUI in males?
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alpha agonists, diapers, pads, condom cath, penile clamp (don't use at night), indwelling /...
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| 8 |
What are behavioral therapy treatments?
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Pelvic floor muscle training, timed voiding, fluid management, dietary management.
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| 9 |
Who are good candidates for male slings?
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SUI from ISD who are not candidates for AUS (cognitive dysfunction, impaired dexterity). ...
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| 10 |
In whom should you use a lower sized reservoir (AUS)?
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Those with pelvic radiation / urethral stricture
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| 11 |
Where do you place an AUS cuff?
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Bulbar urethra for post RRP; all others around bladder neck (also in females). Cuff sizes...
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| 12 |
Contraindications to AUS placement?
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Impaired cognitive function, urethral stricture, BOO, DO, infection. (70-80% dry;...
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| 13 |
What are normal cuff / reservoir sizes?
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4.5 for males. 61-70. 51-60 in post-radiation or stricture surgery pts.
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| 14 |
Can AUS and augmentation cystoplasties be performed at the same time? How about with...
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Yes to both.
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| 15 |
When can the catheter come out post-op for AUS? When can you activate?
General instructions...
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1 day for catheter; 6-8 weeks for activation (pull down daily). Avoid perineal pressure...
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| 16 |
What if small urethral injury intra-op for AUS implantation?
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Repair w/ suture; if satisfactory, may continue w/ AUS implantation w/ cuff around different...
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| 17 |
What is large urethral injury or questionable urethral repair w/ AUS?
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Abandon AUS, leave catheter x 1 week.
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| 18 |
What if rectal injury during AUS?
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Abandon, close in 2 layers, dilate anus.
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| 19 |
What are bugs responsible for infections of AUS; how do you treat?
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E. coli, Staph. Treat w/ AUS removal / Abx.
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| 20 |
How to manage retention following AUS
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CIC w/ small catheter; if can't perform, then SP tube.
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| 21 |
Causes of urinary retention in late post-op period for AUS (after it has been activated)
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BNC, urethral stricture, erosion (rare), malfunction, patient malfunction, impaired detrusor...
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| 22 |
Recurrent incontinence after AUS is d/t?
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Urethral atrophy (most common), erosion, stricture, AUS malfx, UTI, pt malfx, DO
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| 23 |
How do you treat urethral atrophy after AUS placement?
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Increase reservoir pressure, decrease cuff size, reposition cuff, place tandem cuff. ...
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| 24 |
How do you manage pts w/ urethral erosion after AUS?
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Removal AUS. Repair urethra primarily, leave catheter 14-21 days. Can replace AUS...
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| 25 |
How do you eval retention / recurrent incontinence after AUS placement?
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Try cycling, have pt demonstrate, U/A, PVR, uroflow, Cysto. May need UDS if bladder dysfx...
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