Incontinence

Urethral hypermobility test

• Place a swab in the urethra so the tip sits at the vesico-urethral
junction
• The location is measured at rest and during straining
• Hypermobility is defined as excursion >30 degrees
• However almost all women stage II and above prolapse have urethral
mobility making the test unnecessary in concurrent prolapse
Urodynamic testing
• Put a catheter in vagina , urethra and rectum
• Can test intravesicular pressure vs. intraabdominal
• Evaluates the STORAGE and VOIDING function of the bladder
• It is an invasive procedure
• In women with uncomplicated stress incontinence demonstrated on
office test no need for urodynamic testing
• Post-void is a must
Urge Incontinence management
• Timed Voiding
• Anticholinergics
• Intravesicular Botulinum
• Percutaneous tibial nerve stimulation
• Sacral neuromodulation