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.
here give the knowledge that you should possess to manage acute and chronic urine retention. the lecture is more concerned about practical patient care and ward setting management. you should minimally be aware about following facts regarding urine retention. the multiple causes of retention will be discussed later in detailed manner. Direction of the lecture seems more toward BPH and acute retention management. beware there are many aspects of a patient present with an AUR. do no harm and always try to keep patient satisfaction. Let me know about your comments an Ideas. try to improve the quality. good luck.
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control.
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 Tract Fistulas -(VVF) Etiology, Diagnosis, ManagementVikas V
Urinary Tract Fistulas - Etiology, Diagnosis, Management
Surgical and Relevant Anatomy, Classification, eitiology, VVF in Detail, Examination and Diagnosis, Management of VVF - Both Conservative And Surgical Management - Steps of Surgical Management, Post operative Management.
A benign (not cancer) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hyperplasia and BPH.
Urinary incontinence is defined as any involuntary or uncontrolled loss of urine sufficient to cause a social or hygienic problem.
Urge urinary or “urge”—incontinence is the involuntary leakage accompanied or immediately preceded by a perceived strong imminent need to void
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.
here give the knowledge that you should possess to manage acute and chronic urine retention. the lecture is more concerned about practical patient care and ward setting management. you should minimally be aware about following facts regarding urine retention. the multiple causes of retention will be discussed later in detailed manner. Direction of the lecture seems more toward BPH and acute retention management. beware there are many aspects of a patient present with an AUR. do no harm and always try to keep patient satisfaction. Let me know about your comments an Ideas. try to improve the quality. good luck.
Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control.
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 Tract Fistulas -(VVF) Etiology, Diagnosis, ManagementVikas V
Urinary Tract Fistulas - Etiology, Diagnosis, Management
Surgical and Relevant Anatomy, Classification, eitiology, VVF in Detail, Examination and Diagnosis, Management of VVF - Both Conservative And Surgical Management - Steps of Surgical Management, Post operative Management.
A benign (not cancer) condition in which an overgrowth of prostate tissue pushes against the urethra and the bladder, blocking the flow of urine. Also called benign prostatic hyperplasia and BPH.
Urinary incontinence is defined as any involuntary or uncontrolled loss of urine sufficient to cause a social or hygienic problem.
Urge urinary or “urge”—incontinence is the involuntary leakage accompanied or immediately preceded by a perceived strong imminent need to void
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.
Is Urinary Incontinence Dampening Your Days?Summit Health
This presentation will address the causes and types of urinary incontinence and explain how it is evaluated and can be treated. Learn about effective new approaches to help manage and resolve urinary incontinence in women of all ages!
BPH also called as benign prostate hypertrophy. #nursing #nursinglecture #study #teaching. This includes the nursing care plan and management. share to others. Only for study purpose.
33 million American men suffer from erectile dysfunction or impotence. These slides discuss the evaluation and treatment options for this common medical condition
Most men will experience symptoms of the enlarged prostate gland. These slides will discuss the evaluation and treatment options of the enlarged prostate gland
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
3. Today We Will Discuss:
• Describe how the bladder works
• Definition of urinary incontinence
• Common causes of urinary incontinence
• Treatment of urinary incontinence
8. What Is Urinary Incontinence?
• Urinary incontinence (UI) is the
involuntary loss of urine
9. How Common Is
Urinary Incontinence?
• Over 12 million Americans suffer from
urinary incontinence
• Urinary incontinence is most common in
women and people over the age of 50
10. How Common Is
Urinary Incontinence?
• About one in three people over the age of
60 is incontinent
• 8.5 million do not seek treatment
• Most people with urinary incontinence can
be treated successfully and many can be
cured
11. What Are the Causes of
Urinary Incontinence?
• Aging
• Illness
• Injury
12. Causes of Urinary Incontinence
• Age:
– Physical changes resulting from pregnancy,
childbirth and menopause can cause urinary
incontinence in women
– Men over the age of 40 have a higher risk of
developing prostate cancer – an early sign of
the disease is urinary obstruction, a form of
incontinence
13. Causes of Urinary Incontinence
• Illness:
– Removal of the prostate gland as a treatment for
prostate cancer may cause urinary incontinence
in men
– Urinary tract infections, bladder irritants and
other diseases (such as diabetes) may also cause
urinary incontinence for both men and women
14. Causes of Urinary Incontinence
• Injury:
– Stroke, injury or damage to the nervous system
may cause urinary incontinence
15. The Effects of Daily Habits on
Urinary Incontinence
• Fluid intake
• Bathroom habits
• Bladder irritants
16. The Effects of Daily Habits on
Urinary Incontinence
Potential bladder irritants:
• Milk and milk products
• Citrus fruit and juice
• Tomato-based products
• Spicy foods
• Sugar and carbonated beverages
• Caffeine and Alcohol
18. Stress Incontinence
• “I laughed so hard that the tears were
running down my legs.”
Patient of Dr. Baum
19.
20. Types of Urinary Incontinence
• Stress Incontinence:
– Involuntary relaxation of the muscles
supporting the bladder and urethra
– Involuntary loss of small volumes of urine
– Occurs during activities like coughing,
sneezing, laughing, lifting heavy items or
exercising
– Occurs most frequently in women
22. Types Of Urinary Incontinence
• Urge Incontinence or Overactive Bladder:
– Urgent need to urinate and the inability to
control it – a sudden bladder contraction is
followed by the involuntary loss of urine
– Involuntary loss of large volumes of urine
23. Types of Urinary Incontinence
• Urge Incontinence:
– Frequent urination, >8 times within a 24 hour
period
– Getting up >2 times during the night to urinate
24. Types of Urinary Incontinence
• Overflow Incontinence:
– Inability to empty bladder, causing the bladder
to become overfilled and leak
– Prostate enlargement in men over age 40 may
cause this type of incontinence
25. Types of Urinary Incontinence
• Mixed incontinence:
– A combination of two different types of urinary
incontinence
– Usually affects older women
26. Incontinence in Men
• Nerve problems
Diabetes, Stroke, OAB
• Prostate disorders
Enlarged prostate gland
Prostate cancer – surgery, radiation
27. How Is Incontinence Diagnosed?
• Medical history and physical examination
• Screening tests
• Urologic evaluations
32. Treatment of
Urinary Incontinence
• Behavior therapy:
– Bladder retraining
– Pelvic muscle exercises
• Kegel exercises (for men and women) –
contracting the pelvic floor muscles
• Vaginal cones – used in conjunction with
Kegel technique to enhance the performance
of the exercises in women
33. Treatment of
Urinary Incontinence
• Behavior therapy:
– Advantages
• Inexpensive
• Useful for mild stress incontinence
– Disadvantages
• Requires high levels of motivation
• Requires three to six months for results
• May require life-long continuation of therapy
35. Treatment of Incontinence in
Men
• Drugs:
alpha blockers, drugs to shrink the prostate
bladder relaxants
36. Treatment of
Urinary Incontinence
• Drug therapy:
– Advantages
• Simple to use
• Inexpensive
• Most effective for urge incontinence or overactive
bladder
– Disadvantages
• Requires continuous use
• Side effects
37. Treatment of
Urinary Incontinence
• Drug Therapy:
– Side effects of bladder relaxants:
• Dry mouth
• Constipation (rare)
• Blurred vision (rare)
– If you take medication for other conditions,
such as glaucoma or diabetes, talk to your
doctor about the possible risks of drug
interactions
38. Treatment of
Urinary Incontinence
• Drug therapy:
– Estrogen therapy:
• For stress and urge incontinence in post-menopausal
women
• Restores blood supply to the lining of the vagina
and urethra
• Premarin cream and tablets
39. Treatment of
Urinary Incontinence
• Mechanical devices:
– Pessary (for women)
– Bladder neck support device – a prosthesis used
to restore the normal anatomic relationship
between the bladder and urethra
– Urethral insert – a small plug inserted into the
urethra and removed for urination
41. Treatment of
Urinary Incontinence
• Surgery:
– For mixed and stress incontinence
– Returns bladder and urethra to normal
anatomical position
42. Treatment of
Incontinence in Women
• Types of surgical procedures:
– Open surgery
– Needle bladder neck suspension
– Tension free vaginal tape (sling)
43. Treatment of
Urinary Incontinence
• Types of surgical procedures:
– Tension free vaginal tape:
• Advantages:
– Most effective treatment for stress and mixed
incontinence
– Procedure can be performed using local or
general anesthesia (in 20 to 30 minutes)
– Immediate results
44. Treatment of
Incontinence in Women
• Types of surgical procedures:
– Tension free vaginal tape:
• Advantages:
– Most women require no pain medication
– 85 percent success rate
• Disadvantages
– Recovery period is one to two days
– Six weeks to return to normal activities
45. Take Home Message
• There is no such thing as an average
women. Each woman is unique and
requires her own special attention.
48. Summary
• Urinary incontinence is not a normal part of
aging, it is a symptom of something else
• Talk to your doctor
• Evaluation of urinary incontinence is easily
accomplished by your doctor
• Medication, exercises and surgery can help
restore bladder control
We will learn the definition of urinary incontinence; common causes of urinary incontinence; what you can do to find out if you have urinary incontinence; and ways to treat it.
You have urinary incontinence when you are not able to keep urine from leaking from your urethra. The urethra is the tube that carries urine out of your body from your bladder. The bladder stores urine until you are ready to go to the bathroom to empty it. The bladder is a round organ that swells like a balloon when full, and shrinks to a smaller size when empty. The opening of the bladder contains circular muscles called sphincters, which keep urine from leaking out. The sphincter relaxes to allow the flow of urine when you go to the bathroom.
Urinary incontinence, also referred to as UI, is the involuntary loss of urine. Your bladder leaks and you cannot control it. The bladder normally stores urine until you want to empty it. But if you leak urine when you do not intend to, you may have urinary incontinence.
Over 12 million Americans suffer from various types of urinary incontinence. Although anyone can be affected, women are twice as likely as men to suffer from urinary incontinence and it is most common in people over the age of 50.
The loss of bladder control is a common problem that affects both men and women at any age. It can be embarrassing and distressing to a person, which is why the problem often remains unreported to doctors. The severity of incontinence ranges from occasionally leaking urine, to a sudden and strong urge that leaves no time to get to the bathroom.
About one in three people over the age of 60 is incontinent. Due to the embarrassment of the condition, 8.5 million people do not seek treatment. Many people learn to live with the symptoms of urinary incontinence and avoid situations where they may have an accident. Fortunately, most people with urinary incontinence can be successfully treated and many can be cured.
Urinary incontinence is usually caused by aging, illness or injury.
Urinary incontinence is not a normal part of aging, it is a symptom of another issue. As women age, the physical stress and changes from pregnancy, childbirth and menopause can cause urinary incontinence. As men age, they have a higher risk of developing prostate cancer. Urinary incontinence in men may be an early symptom of the disease.
Urinary incontinence may be caused by the removal of the prostate gland in men being treated for prostate cancer. It may also be caused by other illnesses such as, urinary tract infections or diabetes for both men and women.
Stroke, injury or damage to the nervous system may also cause urinary incontinence.
Bladder function can also be influenced by many aspects of daily life. Fluid intake can affect bladder function. Adequate fluids are vital to normal function of the urinary tract, inadequate fluid intake can result in concentrated urine that is irritating to the bladder. Good bathroom (toileting) habits can also make a difference. Chronic holding of urine can over-stretch the bladder. However, going too often may lead to the bladder’s inability to hold normal amounts of urine. Certain foods can also be irritating to the bladder and cause urinary incontinence.
Potential bladder irritants include milk, milk products, citrus fruits and juices (grapefruit, orange, lemon and lime), tomato-based products, spicy foods, sugar, artificial sweeteners, carbonated beverages and alcohol. If you think you may be having a problem with bladder irritants, remove certain foods from your diet for a week to see if your urinary incontinence symptoms improve. You may not have to eliminate these foods entirely, just eat them less frequently in smaller amounts.
Incontinence can be a short-term or long-term problem. Two types of incontinence, stress and urge, are related to the body’s failure to store urine. Overflow incontinence is a result of the body’s inability to empty urine. Some people may have symptoms of both stress and urge incontinence simultaneously – this is called mixed incontinence.
Stress incontinence is the involuntary relaxation of the muscles supporting the bladder and urethra, releasing small volumes of urine. This type of incontinence normally occurs during exercise, coughing, sneezing, laughing or any movement that puts pressure on the bladder. It occurs most often in women and is often thought to be the result of pelvic relaxation of tissues from childbirth or aging.
Urge incontinence or overactive bladder is characterized by a strong, urgent need to urinate followed by instant bladder contraction and the involuntary loss of urine. Once you realize you need to urinate, you don’t have enough time to exercise any control before you actually urinate. Urge incontinence or overactive bladder involves the involuntary loss of large volumes of urine.
Urge incontinence is also characterized by frequent urination, such as using the bathroom eight times within a 24 hour period. If you find yourself getting out of bed more than twice during the night to use the bathroom, you may have this type of incontinence
Overflow incontinence occurs when a person cannot completely empty their bladder. The bladder then becomes overfilled and leaks. Those suffering with overflow incontinence find they constantly have a full bladder requiring frequent urination, a constant dribbling of urine – or both. An enlarged prostate in men over age 40 may cause this type of incontinence.
Mixed urinary incontinence is having the symptoms of two types of incontinence, usually stress incontinence and urge incontinence, at the same time. It tends to occur in older women.
A comprehensive medical history and physical examination are necessary to diagnose incontinence. Your doctor needs to find out about the circumstances associated with the onset of your incontinence and determine any medical conditions that may affect urinary tract function. A physical exam is performed to assess any abnormalities. To determine the type and severity of incontinence, a number of screenings and urologic evaluations are used.
There are several screening tests used to assess urinary incontinence. A urination diary can help determine if you have UI. It records the timing, symptoms and associated factors of incontinence. A urinalysis can evaluate how well the urinary tract functions and test for infection. Blood, glucose and calcium tests are also conducted to make an accurate diagnosis.
Urologic evaluations examine the bladder more closely. A cystoscopy inspects the inside of the lower urinary tract (including the bladder, urethra and prostate gland) in search of abnormalities. A cystometrogram measures bladder activity, pressure and sensation. X-rays and sonograms take computerized pictures that can reveal detailed information about the bladder, such as size, thickness, the presence of blockages or any abnormalities.
Because urinary incontinence is a symptom and not a disease, the method of treatment depends on the diagnosis. Sometimes urinary incontinence can be cured by changes in diet or fluid intake. Sometimes other types of treatments are needed. These treatments include: behavior techniques, drug therapies and mechanical devices that may be used alone or together to treat incontinence. Surgery may be considered when other options fail.
Behavior therapy involves using a few different techniques. Bladder retraining helps prevent accidents by going to the bathroom on a schedule, with the length of time between bathrooms trips gradually increased. Pelvic muscle exercises help strengthen weak muscles around the bladder to prevent leakage. Doing simple pelvic exercises, like the Kegel technique, several times daily will strengthen your pelvic floor muscles. Vaginal cones are used in conjunction with Kegel exercises to enhance the performance of these exercises in women.
There are some advantages and disadvantages with behavior therapy. The advantages are that behavior therapy is inexpensive and useful for mild incontinence. The disadvantages of behavior therapy is that it requires a high level of motivation, it takes three to six months to see results and it may require life-long behavior changes.
Certain medications can be prescribed to improve incontinence. Drug treatment for urge incontinence helps calm the overactive bladder by suppressing urges and contractions, therefore helping the bladder hold larger amounts of urine. Bladder relaxants block certain receptors in the bladder and reduce symptoms, such as frequent urination and sudden urges. Your doctor may prescribe Detrol® LA, Ditropan XL® (generic name oxybutynin ER) or Flavoxate to help with these symptoms. For women who are postmenopausal, hormone replacement therapy with estrogen may help reduce symptoms.
The advantages of bladder relaxants are that they are simple to use, inexpensive and are the most effective treatment option for urge incontinence or overactive bladder. However, the disadvantages of bladder relaxants are that they require continuous use and have side effects.
The side effects of bladder relaxants are: dry mouth, constipation (rare) and blurred vision (rare). It is very important to inform your doctor if you are taking medications for other conditions, such as glaucoma or diabetes, because of possible drug interactions.
Estrogen drug therapy may be used for stress and urge incontinence in post-menopausal women to restore the blood supply to the lining of the vagina and urethra. Hormone replacement therapy is available in oral preparations, such as Premarin tablets, as well as vaginal creams, such as Premarin cream.
There are a few mechanical devices used to treat urinary incontinence. One is a mechanical device called the pessary, which is inserted in the vagina to hold up the bladder and prevent leakage. It helps reduce leakage by pressing against the wall of the vagina and nearby urethra. Other devices include: the bladder neck support device (a prosthesis used to restore the normal anatomic relationship between the bladder and urethra) and the urethral insert (a small plug that is inserted into the urethra and removed for urination).
The advantages of using mechanical devices to treat UI is that they are inexpensive and painless, however they must be worn continuously which is viewed as a disadvantage.
If incontinence does not respond to lifestyle changes or medication, surgery may be needed. The type of surgery performed will depend on the type and cause of incontinence. Surgical procedures are most often performed for mixed and stress incontinence to remove blockages or return the bladder and urethra to a normal anatomical position.
There are a few types of surgical procedures for mixed or stress incontinence. Open surgery is the traditional method in which a surgeon makes an incision through the abdomen and uses special instruments to perform a procedure that corrects or eases urinary incontinence. Urinary surgery includes a variety of procedures depending on the diagnosis. Needle bladder neck suspension surgery supports the urethra by stitching it to tissues on the pelvic floor. A new surgical approach uses tension free vaginal tape (also called OB-tape) to help support the urethra.
Tension free vaginal tape supports a sagging urethra with a mesh-like tape that acts as a sling or hammock to hold the urethra in its normal position. When you cough or move vigorously, the urethra will remain closed and there will be no accidental leaking of urine. The advantages of tension free vaginal tape are: it is the most effective treatment for stress and mixed incontinence, the procedure can be performed using general anesthesia (in 20 to 30 minutes) and it has immediate results.
More advantages of tension free vaginal tape are that most women require no pain medication and there is an 85 percent success rate. The disadvantages of tension free vaginal tape are a recovery period of one to two days, six weeks to return to normal activities and possible catheterization (rare).
Thank you for joining us today. Please remember that urinary incontinence is not a normal part of aging, it is a symptom of something else. Don’t just learn to live with UI, talk to your doctor. Evaluation of urinary incontinence is easily accomplished by your doctor and there are many effective treatments that can help restore bladder control.