The document discusses urinary incontinence (UI), including its definition, types, risk factors, evaluation, and treatment options. It defines UI as the involuntary leakage of urine and describes its two main types as stress urinary incontinence and urge urinary incontinence. The evaluation of UI involves taking a history, physical examination, and simple tests. Treatment options include lifestyle changes, physical therapy, devices, and surgical procedures depending on the type of UI.
Urinary Incontinence: Types, Causes & Prevention By Unique WellnessUnique Wellness
Adult Incontinence is a problem that affects millions of people around the world, and those that are affected by it are spending thousands a year to help manage their conditions. Incontinence can be divided into various parts and Urinary incontinence is one such part affecting men and women. In order to help you in understanding what is Urinary incontinence, what are the types and causes and is there any way to prevent this condition, We have created this video which will tell you everything about Urinary incontinence. Hope you enjoy and like this. For more information on incontinence problems, visit http://wellnessbriefs.com/
Urinary Incontinence: Types, Causes & Prevention By Unique WellnessUnique Wellness
Adult Incontinence is a problem that affects millions of people around the world, and those that are affected by it are spending thousands a year to help manage their conditions. Incontinence can be divided into various parts and Urinary incontinence is one such part affecting men and women. In order to help you in understanding what is Urinary incontinence, what are the types and causes and is there any way to prevent this condition, We have created this video which will tell you everything about Urinary incontinence. Hope you enjoy and like this. For more information on incontinence problems, visit http://wellnessbriefs.com/
Incontinence pad the solution for urinary incontinenceSanjay Ananda
Incontinence pads are used by the one who is facing urinary incontinence issues. Urinary incontinence is a medical term related to the symptoms of accidental urine loss. This disease condition is found more in women than men though it affects both genders.
describes its definition, causes, clinical manifestations, diagnosis and rx.
feedback and inquiries; gufuabdikadir96@gmail.com
Urinary incontinence affects millions of people.Urinary incontinence is leakage of urine you can’t control. Also referred to as loss of bladder control. No matter what you call it, if you have it, you may feel like you’re the only one because people don’t really talk about it. But you’re not alone.
Urinary incontinence presentation people's health 10 10NeilBaum
Urinary incontinence is a condition that is devastating to men and women who are affected by this problem. Help is available. These slides discuss treatment options for this problem.
Presentation, diagnosis and treatment of urinary incontinence (UI). Includes discussion of Stress, Urge, Mixed, Overflow types of UI, Urodynamic testing, Pelvic floor exercise, and Medical vs Surgery treatment options.
Much of the content is in the notes section beneath each slide, or in embedded videos, which are visible only when the slides are downloaded and opened in powerpoint.
Incontinence pad the solution for urinary incontinenceSanjay Ananda
Incontinence pads are used by the one who is facing urinary incontinence issues. Urinary incontinence is a medical term related to the symptoms of accidental urine loss. This disease condition is found more in women than men though it affects both genders.
describes its definition, causes, clinical manifestations, diagnosis and rx.
feedback and inquiries; gufuabdikadir96@gmail.com
Urinary incontinence affects millions of people.Urinary incontinence is leakage of urine you can’t control. Also referred to as loss of bladder control. No matter what you call it, if you have it, you may feel like you’re the only one because people don’t really talk about it. But you’re not alone.
Urinary incontinence presentation people's health 10 10NeilBaum
Urinary incontinence is a condition that is devastating to men and women who are affected by this problem. Help is available. These slides discuss treatment options for this problem.
Presentation, diagnosis and treatment of urinary incontinence (UI). Includes discussion of Stress, Urge, Mixed, Overflow types of UI, Urodynamic testing, Pelvic floor exercise, and Medical vs Surgery treatment options.
Much of the content is in the notes section beneath each slide, or in embedded videos, which are visible only when the slides are downloaded and opened in powerpoint.
Urinary incontinence and pelvic organ prolapseDR MUKESH SAH
Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) coexist in up to 80 percent of women with pelvic floor dysfunction [1]. While these conditions are often concurrent, one may be mild or asymptomatic, which makes selection of the optimal surgical procedure(s) challenging. Prolapse repair can unmask urinary incontinence in previously continent women or worsen existing SUI symptoms [2].
Urinary Tract Infection with Nursing ManagementSwatilekha Das
Urinary Tract Infection introduction, definition, common microorganisms, classification, predisposing factors, clinical manifestations, pathophysiology, diagnostic studies, medical management and nursing management along with assessment, nursing diagnosis, goal, nursing interventions and expected outcome after the intervention.
We like to counsel our patients extensively and empower them to make the best informed decision to restore their quality of life, Every woman deserves to receive the highest quality of care, most technologically advanced and the least invasive treatment. Our team is proud to offer cutting-edge novel treatments by being highly specialized in the field of female pelvic medicine and reconstructive surgery.
THE URINARY INCONTINENCE AND IT'S MANAGEMENT DETAILS WITH APPROPRIATE EXPLANATION
Introduction of urinary incontinence,
Etiology of urinary incontinence,
Risk factors associated with urinary incontinence,
Types of urinary incontinence,
Pathophysiology of Urinary incontinence,
Clinical manifestations of urinary incontinence,
Diagnostic evaluations of urinary incontinence,
Management of urinary incontinence- Behavioural techniques, Drug therapy, surgical management, medical devices and Physiotherapy assessment and management in details with appropriate explanation with the help of the SlideShare .
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Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Good morning, everyone. I’m Dr HONG shunjia from dept of O& G, Memorial hospital of this university. About twenty years ago, I was a student as you sitting in the classroom, listening to the professor and taking the lecture notes. At that time, we don’t have microsoft powerponit or windows media player. It is not easy for our professor to present all the things and explain clearly to us. But they done it. So, today, when I stand here, I have my responsibility to present to you what we need to know.
The prevalence of incontinence appears to increase gradually during young adult life (Fig. 23-1). A broad peak is noted at middle age and then steadily increases after age 65 (Hannestad, 2000). The type of incontinence may differ by age, with some studies suggesting a higher prevalence of stress incontinence in women younger than 60 years and urge incontinence in older women (Hannestad, 2000). Not all studies confirm this finding, and the causes of these age-related trends are not clearly understood (Rortveit, 2003).
Physiology of Micturition The bladder is a complex organ that has a relatively simple function: to store urine effortlessly, painlessly, and without leakage and to discharge urine voluntarily, effortlessly, completely, and painlessly. To meet these demands, the bladder must have normal anatomic support as well as normal neurophysiologic function.
The bladder is a bag of smooth muscle that stores urine and contracts to expel urine under voluntary control. It is a low-pressure system that expands to accommodate increasing volumes of urine without an appreciable rise in pressure. This function appears to be mediated primarily by the sympathetic nervous system. During bladder filling, there is an accompanying increase in outlet resistance. The bladder muscle (the detrusor) should remain inactive during bladder filling, without involuntary contractions. When the bladder has filled to a certain volume, fullness is registered by tension-stretch receptors, which signal the brain to initiate a micturition reflex. This reflex is permitted or not permitted by cortical control mechanisms, depending on the social circumstances and the state of the patient's nervous system. Normal voiding is accomplished by voluntary relaxation of the pelvic floor and urethra, accompanied by sustained contraction of the detrusor muscle, leading to complete bladder emptying.
Normal urethral closure is maintained by a combination of intrinsic and extrinsic factors. The extrinsic factors include the levator ani muscles, the endopelvic fascia, and their attachments to the pelvic sidewalls and the urethra. This structure forms a hammock beneath the urethra that responds to increases in intra-abdominal pressure by tensing, allowing the urethra to be closed against the posterior supporting shelf (Fig 23.1). When this supportive mechanism becomes faulty for some reason—the endopelvic fascia has detached from its normal points of fixation, muscular support has weakened, or a combination of these two processes—normal support is lost, and anatomic hypermobility of the urethra and bladder neck develops. For many women, this loss of support is severe enough to cause loss of closure during periods of increased intra–abdominal pressure, resulting in stress incontinence. However, many women remain continent in spite of loss of urethral support (1)
The intrinsic factors contributing to urethral closure include the striated muscle of the urethral wall, vascular congestion of the submucosal venous plexus, the smooth muscle of the urethral wall and associated blood vessels, the epithelial coaptation of the folds of the urethral lining, urethral elasticity, and the tone of the urethra as mediated by α adrenergic receptors of the sympathetic nervous system.
Micturition is triggered by the peripheral nervous system under the control of the central nervous system. It is useful to consider this event as occurring at a micturition threshold, a bladder volume at which reflex detrusor contractions occur. The threshold volume is not fixed; rather, it is variable and can be altered depending on the contributions made by sensory afferents from the perineum, bladder, colon, and rectum as well as input from the higher centers of the nervous system. The micturition threshold is, therefore, a floating threshold that can be altered or reset by various influences.
Effective urethral closure is maintained by the interaction of extrinsic urethral support and intrinsic urethral integrity, each of which is influenced by several factors (muscle tone and strength, innervation, fascial integrity, urethral elasticity, coaptation of urothelial folds, urethral vascularity). In the clinical setting, damaged urethral support is manifested clinically by urethral hypermobility, which often results in incompetent urethral closure during physical activity and presents as stress urinary incontinence. Clinical appreciation of the importance of extrinsic support and intrinsic urethral function led to the separation of stress incontinence into two broad types: Incontinence caused by anatomic hypermobility of the urethra Incontinence caused by intrinsic sphincteric weakness or deficiency
Defining urinary incontinence would seem an easy task: women that leak urine must be “incontinent”. The International Continence Society, an organization charged with defining the various disorders of pelvic floor dysfunction, recently defined incontinence as “the complaint of any involuntary leakage of urine”. Unfortunately, this definition does not take into account the wide variation in this symptom and the disruption it causes. For example, half of young nulliparous women report occasional minor urine leakage; for most this is not neither a bother nor a symptom for which they would seek treatment. At the other extreme, 5% to 10% of adult women have severe leakage daily.
Risk Factors for Urinary Incontinence Most of the data about risk factors for urinary incontinence come from clinical trials or cross–sectional studies using survey design. Some risk factors have been more rigorously studied than others. Thus, the information available is limited in its general applicability and one cannot infer causality from it. Despite these limitations, there is some evidence that age, pregnancy, childbirth, obesity, functional impairment, and cognitive impairment are associated with increased rates of incontinence or incontinence severity (15,22). Some factors pertain more to certain age groups than others. For example, in studies of older women, childbirth no longer increases the risk of incontinence, possibly because of the presence of comorbidities and other factors that promote incontinence. Medical diagnoses that generally have been associated with urinary incontinence include diabetes, strokes, and spinal cord injuries. Other factors about which less is known or findings are contradictory include hysterectomy, constipation, occupational stressors, smoking, and genetics.
The initial evaluation of patients with incontinence requires a systematic approach to consider possible causes. The basic evaluation should include the following items: history (including assessment of quality of life and degree of bother from symptoms), physical examination, and simple primary care level tests. Most women can begin nonsurgical treatment after this basic evaluation.
A thorough medical history should be obtained from every incontinent patient. The history should include a review of symptoms, general medical history, review of past surgery, and current medications. The woman's most troubling symptoms must be ascertained—how often she leaks urine, how much urine she leaks, what provokes urine loss, what improves or worsens the problem, and what treatment (if any) she has had in the past.
Physicians caring for incontinent women should ask them about how the incontinence specifically affects their lives and to what degree the incontinence bothers them. Physicians who have a large number of incontinence patients or who wish to evaluate patients in a more standardized fashion before and after treatment may choose to use one of several well-designed, validated quality-of-life measures available.
The physical examination of the patient with incontinence should focus on both general medical conditions that may affect the lower urinary tract as well as problems related to urinary incontinence. Such conditions include cardiovascular insufficiency, pulmonary disease, occult neurologic processes (e.g., multiple sclerosis, stroke, Parkinson's disease, and anomalies of the spine and lower back), abdominal masses, and mobility.
A frequency/volume bladder chart (often termed a “bladder diaryâ€) is an invaluable aid in the evaluation of patients with urinary incontinence. A frequency/volume chart is a voiding record kept by the patient for several days. Patients are instructed to write down the time of every void on the chart and measure the amount of urine voided. The time of any incontinent episodes, as well as the specific activities associated with urine loss, should be recorded. If desired, the patient can also be instructed to keep a record of fluid intake. Although the type of intake may guide management suggestions, in most cases volume of intake can be estimated with some accuracy from the amount of urine produced. A frequency/volume bladder chart provides vital information about bladder function that is not provided by formal urodynamics studies:
Examination of the urine by dipstick testing and microscopy is done to exclude infection, hematuria, and metabolic abnormalities. Hematuria cannot be diagnosed on the results of a dipstick test alone; confirmation by microscopic evaluation is mandatory. If a urinary tract infection is documented by microscopy or culture, it is reasonable to see whether urinary tract symptoms improved with eradication of bacteriuria.
Incomplete bladder emptying may cause incontinence. Patients with a large postvoid residual urine volume (PVR) have a diminished functional bladder capacity because of the dead space occupied in the bladder by retained urine. This stagnant pool of urine also is a source of urinary tract infections because the major defense of the bladder against infection is frequent, nearly complete emptying. A large PVR can contribute to urinary incontinence in two ways. If the bladder is overdistended, increases in intra–abdominal pressure can force urine past the urethral sphincter, causing stress incontinence. In some cases, bladder overdistention may provoke an uninhibited contraction of the detrusor muscle, leading to incontinence. These conditions may coexist, further complicating the problem. The PVR can be assessed by either direct catheterization or ultrasonography. It is generally agreed that a PVR level less than 50 mL is normal and greater than 200 mL is abnormal
Patients should be examined with a full bladder, particularly if stress incontinence is a consideration. Urine egress from the urethra at the time of a cough documents stress incontinence. If leakage is not observed when the woman is supine, she should stand with her feet separated to shoulder width and cough several times.
Lifestyle interventions can decrease stress urinary incontinence in many women (44). Weight loss in both morbidly and moderately obese women decreases leakage, and ways to incorporate this intervention in a management plan are being investigated. Postural changes (such as crossing the legs during periods of increased intra–abdominal pressure) often prevent stress urinary incontinence. There is some evidence that decreasing caffeine intake improves continence; however, fluid intake in general seems to play a minor role in the pathogenesis of incontinence. Although smokers are at greater risk for incontinence, no data have been reported on whether smoking cessation resolves incontinence. The Cochrane Incontinence Group concluded that pelvic floor muscle training is consistently better than no treatment or placebo treatment for stress incontinence and should be offered as first–line conservative management to women. Intensive training sessions that include personal contact with a health care professional to teach and supervise pelvic floor muscle training may be more beneficial than standard care. Several factors improve the likelihood that pelvic muscle training will relieve stress urinary incontinence. The woman must do the exercises correctly, regularly, and for an adequate duration. Based on exercise training of skeletal muscles elsewhere in the body, many physical therapists recommend training sessions three to four times per week, with three repetitions of eight to ten sustained contractions each time. Bladder training focuses on modifying bladder function by changing voiding habits. Behavioral therapy focuses on improving voluntary control rather than bladder function (50). The key component to bladder training is a scheduled toileting program. After reviewing the patient's voiding diary, an initial voiding interval is chosen that represents the longest interval between voiding that is comfortable.
A. Urethral insert used for continence. (Courtesy of Rochester Medical.) The device consists of a short silicone tube that is covered by a mineral oil–containing sheath. The proximal end of the conformable sheath expands to a bulbous tip. At the device's distal end, a soft flange prevents migration of the entire tube into the bladder. B. For insertion, an applicator is used to aid placement. With insertion, mineral oil within the sheath is evenly distributed along its length, and the bulbous tip is collapsed. When properly placed, the tip enters the bladder and the mineral oil preferentially flows to the device's bulbous tip. The applicator is then removed. As a result, the bulbous tip occludes the urethra to improve continence. When voiding is desired, the flange is grasped and the entire single-use device is gently removed.
In 1996, Falconer et al. described the tension-free vaginal tape (TVT) for correcting stress urinary incontinence (120). In this technique, polypropylene mesh is placed under the midurethra with minimal tension (Fig. 23.12, A and B). A report of the 2-year follow-up of 344 women with urodynamic stress incontinence enrolled from 14 centers in a multicenter randomized clinical trial compared TVT and open Burch colposuspension. The objective cure rates (defined as a negative 1-hour pad test) ranged from 63% to 85% for the TVT procedure and 51% to 87% for open colposuspension, depending on how missing data were handled, leading the authors to conclude that “TVT may be better, worse, or the same as open colposuspension in the cure of stress incontinence”. Subjectively, only 43% of women in the TVT group and 37% of women in the open colposuspension group reported cure of their stress leakage.
With the increase in demand of treatment of pelvic floor dysfunction, a new sub-specialty called urogynecology and pelvic reconstructive surgery has been established and developed very rapidly in recent years. Here is a hospital episode statistics from Brazil. You can see colposuspension decreased but TVT procedure increased sharply resulting in a increase in total No of procedures. In US, for the year 2000-2004, more than 600000 cases of hysterectomy were done per year. For these cases, the three most common indications are uterine fibroid, endometriosis and uterine prolapse.