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December 2009   both) prolapse, the urethra can be kinked or compressed,
November 2009   obstructing urine outflow and mak...
Stress Urinary Incontinence = "Exert and

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Urogynics an obstructed bladder is a cranky bladder


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Urogynics an obstructed bladder is a cranky bladder

  1. 1. Dr. Romanzi Dedicated to Your Quality of Life Home Vaginal Rejuvenation Sex & Health Cosmetic Reconstructive Surgery Press About Us/About You Patient Forms PAGES An obstructed bladder is a cranky About Dr. Romanzi bladder – the story of prolapse and the badly behaved bladder Post a question for Dr. R. by admin DR. ROMANZI HOME DELIVERY LATEST POSTS (C) Lauri Romanzi 2010 Enter your email address: Three (Unhappy) Musketeers Pelvic floor disorders include problems with urinary – Prolapse, Bladder Outlet Obstruction and Overactive incontinence, pelvic organ prolapse, fecal incontinence, Subscribe Bladder fistula, urinary tract infections, and mechanical sexual Delivered by FeedBurner Ask Dr R: overactive bladder, dysfunction. Who wants to think about this stuff?  Well, for  interstitial cystitis, and starters, women who suffer these disastrous conditions. ulcerative colitis An obstructed bladder is a Pelvic organ prolapse, on which I’ve written aplenty, can SEARCH cranky bladder – the story of sometimes induce a rather nasty condition called To search, type and hit enter prolapse and the badly behaved bladder overactive bladder. Overactive bladder happens when your bladder muscle (yes, the bladder is a muscle, an Dr R Talks About Prolapse, BLOGROLL Part 1 automatic muscle, like the muscles in your intestines or your heart) decides to EVACUATE, any time it wants to, Heal India e-Newsletter Does Betty need hysterectomy for prolapse? whether you’re on the toilet or riding the bus. Women with Seek Wellness We think not. Dr R guest overactive bladder often report a compelling, sometimes Womens Voices for Change blog on Women’s Voices for sudden urge to void (urinate) that is difficult or impossible Change to defer. She may find her bladder waking her from deep sleep many times at night with this same horrible urgency. LINKS CATEGORIES When this urgency control is “difficult”, she’s Kegeling her Health Guru legs off, squeezing her thighs together and sweating Ask Dr. R. JonasWeb – Webmaster bullets trying to make that horrible urge feeling stop so she Blog can uncross her legs and dash to the nearest powder SearchTROOP Breaking News and room. When the urge to void is “impossible” to defer, she Seek Wellness Research Reviews wets her pants. It’s messy, horrifying, and terribly unsexy. Fistula and Childbirth Injury GOOGLE CONNECT Hysterectomy and Alternatives to Hysterectomy Pelvic Organ Prolapse Urinary Incontinence LOGIN Uterine Prolapse Register Vaginal Laxity Log in Vaginal Prolapse Entries RSS Vaginal Rejuvenation Comments RSS WordPress.org ARCHIVES Urge Incontinence from Overactive July 2010 Bladder June 2010 While most cases of overactive  bladder are idiopathic  May 2010 (medicalese for “no apparent cause”), some cases are April 2010 caused by prolapse.  When the bladder or uterus (or 
  2. 2. December 2009 both) prolapse, the urethra can be kinked or compressed, November 2009 obstructing urine outflow and making it difficult for the bladder to empty completely. Obstructed bladders are October 2009 cranky bladders, often becoming overactive in response to August 2009 this interference with emptying. A recent multicenter European study published in Neurourology and Urodynamics showed a distinct correlation between severe pelvic organ prolapse, bladder outlet obstuction, and overactive bladder. Prolapse can obstruct bladder outflow and if it does, the bladder tends to become overactive, reminiscent of that vaudeville song, “The head bone’s connected to the … neck bone…”.  In this timely review, they also found that successful prolapse surgery often, but not always, calmed down bladder overactivity by un-blocking the urethra and normalizing bladder outflow. The connection between prolapse, bladder outlet obstruction and overactive bladder Women with prolapse and bladder problems often want to know if surgery will fix both. This study helps us understand that it indeed may help fix both the prolapse and the obstructed/overactive bladder disorders in a large portion of women with this unhappy combination. For years, I’ve used pessaries (vaginal widgets that comfortably hold prolapse in place) to help predict whether or not prolapse surgery might also stop obstructed voiding and overactive bladder, and most of the time it correlates well to surgical outcome. And sometimes, the patient is so pleased with the pessary that she cancels the operation. For a detailed case report on women with prolapse, obstructed voiding and overactive bladder, click on this MedScape review: Dr R for MedScape- prolapse, overactive bladder, stress incontinence, obstructed bladder http://cme.medscape.com/viewarticle/700135 One last note for women with prolapse and bladder problems – there is another urinary incontinence condition, called stress incontinence, that may actually increase with pessary use or prolapse surgery, because a stress – incontinent urethra may actually seal better with the kinking and compression caused by prolapse, and may therefore increase when the prolapse and kinking are mechanically corrected. Stress incontinence is caused by poor urethral closure that allows urine to leak out with strenuous physical exertion, like sneezing or coughing or opening a window or lifting heavy grocery bags. No urgency, just “exert and squirt”.
  3. 3. Stress Urinary Incontinence = "Exert and Squirt" If you have prolapse and stress incontinence, your problems require therapies for prolapse and therapies for stress incontinence. Prolapse therapy options usually involve pessary use or reconstructive surgery. Stress incontinence options include Kegel exercises with pelvic floor physical therapy, medications, or procedures such as urethral bulking injections or minimally invasive sling operations. You can do prolapse reconstruction and urethral sling in one operation, for instance, taking care of both your plumbing and your renovation problems at the same time (on Plumbing and Renovations). Prolapse or no prolapse, urge incontinence from overactive bladder and stress incontinence from a weak urethral seal can plague any woman at any age. About 13% of women with overactive bladder are under the age of 35, and up to 30% college female athletes report regular urinary incontinence of one sort or another during training and competition. It comes with the territory, and it increases in prevalence as women age. 1/3 of incontinent women suffer only stress incontinence, 1/3 only urge (overactive bladder) incontinence and 1/3 suffer a mixture of both overactive bladder / urge incontinence AND stress incontinence. If you have incontinence, or prolapse and bladder problems, make sure you don’t undertake any therapeutic measures without first understanding if you have overactive bladder, bladder outlet obstruction, and/or stress urinary incontinence. It is absolutely possible, and not at all uncommon, to have all three conditions if you suffer severe prolapse. Take the time to sort it all out, make sure it’s clear in your mind, then work with your doctor to set a common-sense course of action to restore your core to normal anatomic and physiologic function. Share: 0 comments
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