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BPH & INCONTINENCE- PREOPERATIVE ASSESSMENT AND MANAGEMENT Dr.Anil Haripriya
INTRODUCTION ,[object Object],[object Object],[object Object],[object Object]
WHY PREOPERATIVE ASSESSMENT? ,[object Object],[object Object],[object Object]
CONTINENCE ,[object Object],[object Object],[object Object]
URINARY SPHINCTER ,[object Object],[object Object],[object Object],[object Object]
URINARY SPHINCTER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
INCONTINENCE IN BPH ,[object Object],[object Object],[object Object],[object Object]
URGE INCONTINENCE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
OVERFLOW INCONTINENCE ,[object Object],[object Object]
POSTPROSTECTOMY INCONTINENCE ,[object Object],[object Object],[object Object],[object Object]
POSTPROSTECTOMY INCONTINENCE contd.. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
POSTPROSTECTOMY INCONTINENCE contd.. ,[object Object],[object Object],[object Object],[object Object]
POSTPROSTECTOMY INCONTINENCE contd.. ,[object Object],[object Object],[object Object],[object Object],[object Object]
EVALUATION  ,[object Object],[object Object],[object Object],[object Object]
EVALUATION contd.. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HISTORY TAKING ,[object Object],[object Object],[object Object],[object Object],[object Object]
CLINICAL EXAMINATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LABORATORY TESTS ,[object Object],[object Object],[object Object],[object Object],[object Object]
ULTRASONOGRAPHY ,[object Object],[object Object],[object Object]
POST VOID RESIDUAL URINE ,[object Object],[object Object],[object Object],[object Object],[object Object]
UROFLOWMETRY ,[object Object],[object Object],[object Object]
UROFLOWMETRY ,[object Object],[object Object],[object Object],[object Object]
Urine flow rate curves:  Note how the pattern of the curve is a useful adjunct to making a diagnosis. (a) Normal flow rate, (b) high-pressure low flow rate caused by bladder neck obstuction, (c) urethral stricture, (d,e) low-pressure low flow rates differing patterns, (f) straining to void. W, voided volume) URINARY FLOW RATE CURVES Normal and abnormal flow traces
URODYNAMIC STUDIES ,[object Object],[object Object],[object Object],[object Object]
URODYNAMIC STUDIES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MULTICHANNEL VIDEO URODYNAMICS ,[object Object],[object Object]
URODYNAMIC STUDIES Poor compliance during later part of filling Phasic detrusor unstability during filling Urodynamic studies:  Schematic representation of (left top) moderately poor compliance during the latter stages of filling and (left bottom) phasic detrusor instability during filling. In both cases high-pressure low-flow voiding also occurs, which indicates bladder outflow obstruction
Low – pressure low-flow voiding caused by a poorly contracting detrusor.  P abd  abdominal pressure, P det  detrusor pressure, P ves  intravesical pressure, RU, residual urine; W, voided volume
CYSTOURETHROSCOPY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TREATMENT ,[object Object],[object Object],[object Object]
TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TREATMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CONCLUSION ,[object Object],[object Object],[object Object],[object Object]
THANK YOU

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Assess BPH Incontinence Causes

  • 1. BPH & INCONTINENCE- PREOPERATIVE ASSESSMENT AND MANAGEMENT Dr.Anil Haripriya
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  • 24. Urine flow rate curves: Note how the pattern of the curve is a useful adjunct to making a diagnosis. (a) Normal flow rate, (b) high-pressure low flow rate caused by bladder neck obstuction, (c) urethral stricture, (d,e) low-pressure low flow rates differing patterns, (f) straining to void. W, voided volume) URINARY FLOW RATE CURVES Normal and abnormal flow traces
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  • 28. URODYNAMIC STUDIES Poor compliance during later part of filling Phasic detrusor unstability during filling Urodynamic studies: Schematic representation of (left top) moderately poor compliance during the latter stages of filling and (left bottom) phasic detrusor instability during filling. In both cases high-pressure low-flow voiding also occurs, which indicates bladder outflow obstruction
  • 29. Low – pressure low-flow voiding caused by a poorly contracting detrusor. P abd abdominal pressure, P det detrusor pressure, P ves intravesical pressure, RU, residual urine; W, voided volume
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