Raheela Rizvi

By Raheela M. Rizvi and Mohammad Hammad Ather

The diagnosis and assessment of urinary incontinence (UI) are variable. In general, diagnosis is made in primary care using clinical evaluation (a good history and physical examination), bladder diary and validated symptom scales. Condition-specific diagnosis is made in secondary care, and it often involves interventional tools such as urodynamic studies. The evidence available on the accuracy and acceptability of the assessment of UI is inconsistent and variable. A structured data collection tool was used for initial assessment of UI. Some key questions are required for initial assessment of UI in order to diagnose the type of UI. This chapter includes a gender-specific evaluation based on history and clinical examination. Pelvic organ prolapse (POP) in female patients is associated with UI and POP diagnosis, and staging is made by clinical examination only, while male patients are examined for prostate obstructive urinary symptoms. Basic evaluation includes bladder diary in cases of overactive bladder and stress test, for stress urinary incontinence. Other diagnostic tests include urine analysis, uroflowmetry and measurement of post-void residual volume in cases of neurogenic bladder and benign prostate hypertrophy. Patients referred to specialist require further assessment of UI using urodynamic testing, electrophysiological test and imaging.

Part of the book: Synopsis in the Management of Urinary Incontinence

By Raheela Mohsin Rizvi and Sanam Imtiaz

Throughout the world, animal models are being used as simulators of human anatomy and pathophysiology with most of the investigations and treatments first tested on them. Double incontinence (DI) includes both urinary and anal incontinence. This chapter is focused on the use of animals as models to understand pathogenesis, diagnosis and management of double incontinence (DI). DI is a complex disease with variant prevalence around the world which has a severe impact on quality of life (Qol). Many studies are designed to employ rodent and rabbit models to understand the pathogenesis of urinary and fecal incontinence. Urodynamic studies including leak point pressure (LPP) and urethral pressure profilometry (UPP) are used in establishing diagnosis of stress urinary incontinence. Rats have also been used to study fecal incontinence using neurophysiological and sacral nerve stimulation tests. The surgical treatment of double incontinence involves use of mesh, which was initially tested on animals. Animal models have also been used to train surgeons for perineal tear repair surgery. We conclude that the use of animal models provides best approach to learn these specialized surgical skills for medical practitioners and researchers.

Part of the book: Experimental Animal Models of Human Diseases

By Raheela M. Rizvi

Part of the book: Pelvic Floor Disorders