Urinary incontinence simply means involuntary leaking of urine.
Incontinence can range from leaking just a few drops of urine to complete emptying of the bladder.
Social and hygienic problem.
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.
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.
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
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.
URINARY SYSTEM DISORDERS ARE ONE OF THE MOST PREVALENT GROUP OF DISORDERS THAT NEEDS A THOROUGH UNDERSTANDING. THE MOST BASIC OF THEM ARE URINARY RETENTION AND INCONTINENCE. THIS PRESENTATION DEALS WITH A BRIEF OVERVIEW OF THE DESCRIPTION, CAUSES, DIAGNOSIS AND MANAGEMENT OF THESE DISORDERS IN AN ILLUSTRATED MANNER.
In this presentation I have shown the etiology, clinical features and treatment for both Phimosis & Paraphimosis. I have also showed various methods of circumcision for both infants and adults.
Bladder exstrophy is a congenital (present at birth) abnormality of the bladder. It happens when the skin over the lower abdominal wall (bottom part of the tummy) does not form properly, so the bladder is open and exposed on the outside of the abdomen. In epispadias, the urethra does not form properly.
definition of hydronephrosis,
causes and types of hydronephrosis
pathophysiology of hydronephrosis
clinical manifestation and diagnostic test for hydronephrosis
management
The urethra's main job in males and females is to pass urine outside the body. This thin tube also has an important role in ejaculation for men. When a scar from swelling, injury or infection blocks or slows the flow of urine in this tube, it is called a urethral stricture. Some people feel pain with a urethral stricture.
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.
URINARY SYSTEM DISORDERS ARE ONE OF THE MOST PREVALENT GROUP OF DISORDERS THAT NEEDS A THOROUGH UNDERSTANDING. THE MOST BASIC OF THEM ARE URINARY RETENTION AND INCONTINENCE. THIS PRESENTATION DEALS WITH A BRIEF OVERVIEW OF THE DESCRIPTION, CAUSES, DIAGNOSIS AND MANAGEMENT OF THESE DISORDERS IN AN ILLUSTRATED MANNER.
In this presentation I have shown the etiology, clinical features and treatment for both Phimosis & Paraphimosis. I have also showed various methods of circumcision for both infants and adults.
Bladder exstrophy is a congenital (present at birth) abnormality of the bladder. It happens when the skin over the lower abdominal wall (bottom part of the tummy) does not form properly, so the bladder is open and exposed on the outside of the abdomen. In epispadias, the urethra does not form properly.
definition of hydronephrosis,
causes and types of hydronephrosis
pathophysiology of hydronephrosis
clinical manifestation and diagnostic test for hydronephrosis
management
What is the incontinence. Types of incontinence. Pathophysiology of incontinence. Treatment of incontinence. Clinical manifestations of incontinence .8. INCONTINENCE
DEFINITION
Inability of body to control the evacuative functions of urination or defecation is called
incontinence. It may be of following types:
Faecal incontinence: Involuntary excretion of bowel contents.
> Urinary incontinence: Involuntary excretion of urine.
Types
Stress incontinence, also known as effort incontinence, is due essentially to
insufficient
strength of the pelvic floor muscles.
Overflow incontinence: Sometimes people find that they cannot stop their
bladders from constantly dribbling or
continuing to dribble for
some time after
they have passed urine. It is as if their bladders were constantly overflowing,
hence the general name overflow incontinence.
vUrge incontinence is involuntary loss of urine occurring for no apparent
reason while suddenly feeling the need or urge to urinate.
Śtructural incontinence: Rarely, structural problems
can cause incontinence,
usually diagnosed in childhood (for example, an ectopic ureter). Fistulas
caused
by obstetric and gynecologic trauma or injry can lead to incontinence.
functional incontinence occurs when a person recognizes the need to
urinate
but cannot make it to the bathroom. The urine loss may be large. Causes of
functional incontinence include confusion, dementia, poor eyesight, poor
mobility, poor dexterity, unwillingness to toilet because of depression, anxiety
or anger, drunkenness.
Mixed incontinence is common in the elderly fernale population and can
sometimes be complicated by urinary retention, which makes it a treatment
challenge requiring staged multimodal treatment.
- Bedwetting is episodic Ul
while asleep. It is normal in young chiidren.
Fransient
incontinence is a temporary version of incontinence. It can be
triggered by medications, adrenal insufficiency, mental impairment, restricted
mobility, and severe constipation
which can push against
the urinary tract
and obstruct outflow.
Giggle incontinence is an involuntary response to laughter. It usually affects
children.
> Polyuria (excessive urine production).
CAUSES
Caffeine or cola beverages.
> Neurological disorders also interfere with nerve function of bladder, e.g., multiple
sclerosis, spinal bifida, parkinson's disease, strokes, spinal cord injury.
Enlarged prostate.
Abbott Diagnostics
Hematology
Educational Services
Intended Audience
This Learning Guide is intended to serve the basic educational needs of health care
professionals who are involved in the fields of laboratory medicine. Anyone associated with
the testing of the formed elements of the blood will find this monograph of special interest.
The monograph features basic information necessary to understand and appreciate the
importance of hematology testing in the laboratory and is intended for those who use
the hematology laboratory services, including, but not limited to, laboratory technicians,
laboratory technologists, supervisors and managers, nurses, suppliers, and other
physician office and laboratory support personnel.
Blood diseases cover a wide spectrum of illnesses, ranging from the anaemias, leukaemias and congenital coagulation disorders.
Haematological change may occur as a consequence of disease affecting any system and measurement of haematological parameters is an important part of routine clinical assessment.
A myeloprolifrative stem cell disorder resulting in
Proliferation of all haematopoietic lineages but
manifestation Predominantly in the granulocytic series.
The disease occurs chiefly between 30 and 80 years, with
A peak incidence at the 55 years.
*accounts for 20% of all leukaemis.
*found in all races.
*the aetiology is unknown.
Systematic (non-random) error that results in an incorrect estimate of the association between exposure and risk of disease.
Can occur in all stages of a study
Not affected by study sample size
Difficult to adjust for afterwards, but can be reduced by adequate study design.
•Can never be totally avoided, but we must be aware of it and interpret our results accordingly
Tropic = shape response. [from Middle English tropik, Old French tropique, Latin tropicus, Greek tropikos, turn]
Viral tropism = the way the virus responds to external stimulus in order to attach to and infect cells
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.
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Students, digital devices and success - Andreas Schleicher - 27 May 2024..pptxEduSkills OECD
Andreas Schleicher presents at the OECD webinar ‘Digital devices in schools: detrimental distraction or secret to success?’ on 27 May 2024. The presentation was based on findings from PISA 2022 results and the webinar helped launch the PISA in Focus ‘Managing screen time: How to protect and equip students against distraction’ https://www.oecd-ilibrary.org/education/managing-screen-time_7c225af4-en and the OECD Education Policy Perspective ‘Students, digital devices and success’ can be found here - https://oe.cd/il/5yV
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Ethnobotany and Ethnopharmacology:
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Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
2. Definition
• Urinary incontinence simply means
involuntary leaking of urine.
• Incontinence can range from leaking
just a few drops of urine to
complete emptying of the bladder.
• Social and hygienic problem.
3. Prevᵃlence
• Incidence: increases with age: 4-8 %
ultimately seek medical attention.
• One of three women over 60y has bladder
control problems.
4. Mechanism
• Continence and urination involve balance
between urethral closure and detrusor (bladder
smooth muscle) activity.
• Urethral pressure normally exceed bladder
pressure, resulting in urine remaining in the
bladder. Intra-abdominal pressure increases
(coughing, sneezing) normally are transmitted in
both urethra and bladder equally, maintaining
continence. Disruption of this balance leads to
various types of incontinence.
5. causes
• Urinary tract infection (UTI)—UTIs sometimes cause leakage and are
treated with antibiotics.
• Diuretic medications, caffeine, or alcohol—Incontinence may be a side
effect of substances that cause your body to make more urine.
• Pelvic floor disorders—These disorders are caused by
weakening of the muscles and tissues of the pelvic
floor and include urinary incontinence, accidental
bowel leakage, and pelvic organ prolapse.
• Constipation—Long-term constipation often is present in women with
urinary incontinence, especially in older women.
• Neuromuscular problems—When nerve (neurologic) signals from the
brain to the bladder and urethra are disrupted, the muscles that control
those organs can malfunction, allowing urine to leak.
• Anatomical problems—The outlet of the bladder into the urethra can
become blocked by bladder stones or other growths.
6.
7. What other symptoms occur with urinary
incontinence?
It is common for other symptoms to occur along with
urinary incontinence:
• Urgency !! —Having a strong
urge to urinate
• Frequency—Urinating (also
called voiding) more often than
what is usual for the patient
• Dysuria—Painful urination
• Nocturia—Waking from sleep
to urinate
• Nocturnal enuresis—Leaking
urine while sleeping
8. Diagnosis (6 basis components)
▲ History - severity of symptoms, rule out medication cause, stress
correlates with amount of urine loss.
▲ Physical examination;
• General examination
• Neurologic screening examination –reflexes
• Urogynecologic examination: may reveal severe vulvar excoriation from
continual dampness. Vaginal tissue atrophy, stenosis.. The patient is asked
to cough or Valsalva repeatedly with a full bladder in the lithotomy or
standing position to induce urine leakage.
▲ Urinalysis and urine culture. To rule out inf before further
evaluation.
▲ Residual urine volume after voiding. Catheterization
▲ Frecuency – volume bladder chart.,,,
▲ Urodynamics: Cystometry, Uroflowmetry, Complex urodynamic tests.
9. Urodynamics
– Simple cystometry involves placing a catheter and gradually
filling the bladder with sterile water. Involuntary “detrusor”
contractions are demonstrated by a rise in water level during
filling due to back-pressure. Normally, the first sensation to
void occurs at 150 mL and bladder capacity is typically 400–
600 mL.
– Uroflowmetry is used to determine the urinary flow rate and
flow time to screen for the presence of outflow obstruction
and abnormal detrusor contractility. Normally, women
achieve a peak flow rate of 15–20 mL/s with a voided volume
of 150–200 mL.
– Complex urodynamic testing requires placement of an
intravesical catheter to measure detrusor pressures and a
vaginal or rectal catheter to indirectly measure
intraabdominal pressures.
11. Stress urinary incontinence
(SUI)
• Patients have loss of small amounts of urine with
coughing, laughing, sneezing, exercising, or other
movements that increase intra-abdominal pressure and
thus increase pressure on the bladder.
Etiology
• Physical changes resulting from pregnancy, childbirth,
and menopause often result in weaknesses in the
pelvic floor, and urethral support structures and nerve
damage
12. Stress urinary incontinence
(SUI)
• Mechanism. If the fascial support is weakened, the
urethra can move downward at times of increased
abdominal pressure, causing bladder pressure to
exceed urethral sphincter closure pressure (hyper-
mobile urethra). Incomplete urethral closure may be
due to scarring or neuromuscular damage, and cause a
more severe form of stress urinary incontinence –
intrinsic sphincter deficiency.
• Diagnosis. SUI is suggested by history, physical
examination, and a positive stress test (demonstrable
loss of urine while the patient is being examined).
13. Non-surgical treatment.
• lifestyle changes
Weight Loss; fluid intake Management; Limiting
alcohol and caffeine; Bladder training.
• pelvic muscle (Kegel) exercises
• biofeed-back (pressure measurement device notifies the patient
when correct muscle contraction is performed and reinforces correct
technique)
• pessaries
14. pelvic muscle (Kegel) exercises
• Find the right muscles. To identify your pelvic floor muscles, stop
urination in midstream. If you succeed, you've got the right
muscles. Once you've identified your pelvic floor muscles you can
do the exercises in any position, although you might find it easiest
to do them lying down at first.
• Perfect your technique. Tighten your pelvic floor muscles, hold the
contraction for five seconds, and then relax for five seconds. Try it
four or five times in a row. Work up to keeping the muscles
contracted for 10 seconds at a time, relaxing for 10 seconds
between contractions.
• Maintain your focus. For best results, focus on tightening only your
pelvic floor muscles. Be careful not to flex the muscles in your
abdomen, thighs or buttocks. Avoid holding your breath. Instead,
breathe freely during the exercises.
• Repeat three times a day. Aim for at least three sets of 10
repetitions a day.
15. Surgical treatment
• Tension-free transvaginal tape (TVT) or
transobturator tape (TOT) are minimally invasive
suburethral sling procedures that are rapidly
becoming the “gold standard”
• Burch colposuspension
• Anterior colporrhaphy
• Collagen periurethral
16.
17.
18. Urge incontinence
• Patients experience involuntary leakage for no apparent
reason while suddenly feeling an urgent need to urinate.
This may be accompanied by urinary frequency and
nocturia, and patients often describe their bladder as
“spastic” or “overactive”.
• Etiology. Involuntary detrusor muscle contractions.
Detrusor hyperactivity can be due to loss of central nervous
system (CNS) inhibitory pathways, local irritants, or bladder
outlet obstruction.
• Mechanism. Frequently idiopathic, but results from
damage to the nerves of the bladder, the nervous system
(spinal cord and brain), or the muscles themselves.
19. Urge incontinence
• Treatment. Behavior modification (bladder
drills, biofeedback) and/or pharmacologic
therapy (oxybutynin chloride, imipramine,
mirabegron), injection of the detrusor muscle
with botulinum toxin A, neuromodulation.
20. Overflow incontinence
• Patients experience continuous, unstoppable
dribbling of urine, or continuing to dribble for
some time after they have passed urine.
• Etiology. The bladder is always full and
overflows, resulting in frequent or continuous
urine leakage.
21. Overflow incontinence
• Mechanism. Weak bladder detrusor muscles,
resulting in incomplete emptying, or a blocked
urethra (outflow obstruction) due to pelvic
organ prolapse, or after an anti-incontinence
procedure that has overcorrected the problem.
• Treatment. Catheter drainage, followed by
treatment of the underlying condition.
22. pelvic organ prolapse
• Descent of one or more pelvic organs (uterine
cervix, vaginal apex, anterior vagina, posterior
vagina, or cul de sac peritoneum) through the
pelvic flor into the vaginal canal.
• ½ of parous women have prolapse on
examination
• 10% will undergo surgery for prolapse or urinary
incontinence in their lifetime
• Prolapse is the most common indication for
hysterectomy in women after age 55.
23.
24. Cystocele
• Surgical options
• Anterior colporrhaphy involves vaginally plicating
the endopelvic fascia in the midline to provide
support and raise the bladder to correct its
anatomic position.
• Paravaginal repair replaces the anterolateral
vaginal wall to its anatomic position.
• The McCall culdoplasty shortens the uterosacral
ligaments and reattaches them to the vaginal
apex.
25. Rectocele
• Surgical options
• Posterior colporrhaphy mimics the anterior procedure with a
midline plication of endopelvic fascia. Perineorrhaphy is commonly
required due to an attenuated perineal body or widened genital
hiatus.
• Enterocele
• Surgical options
• As an enterocele is a true herniation of the peritoneal cavity at the
pouch of Douglas which bulges into the rectovaginal septum, repair
is usually performed at the same time as posterior colporrhaphy.
The hernia sac is visualized as the vagina is separated from the
rectum and it must be dissected free of underlying tissue. The neck
of the hernia is then isolated and sutured. Fixing the uterosacral
ligaments to the sac will help prevent recurrence.
26. Uterine procidentia
(Prolapse)
Surgical options
• TVH is common, but anterior and posterior colporrhaphy
generally do not provide sufficient long-term apical support
• Sacrospinous ligament suspension (SSLS) may be
concomitantly performed vaginally by suspending the fascia
of the apex to one or both ligaments.
• Abdominal sacrocolpopexy with total abdominal
hysterectomy (TAH) is another reasonable option that has less
apical failure, post- operative dyspareunia, and stress
incontinence than SSLS, but is associated with longer surgical
time, longer patient recovery, and more short- and long-term
complications. Laparoscopic and robotic-assisted techniques
are the preferred option due to reduced recovery times.
• Colpocleisis (Lefort procedure
In overweight women, losing even a small amount of weight (less than 10% of total body weight) may decrease urine leakage.
If the patient has leakage in the early morning or at night, sche may want to limit her intake of fluids several hours before bedtime. Limiting the amount of fluids she drinks also may be useful (no more than 2 liters total a day).
The goal of bladder training is to learn how to control the urge to empty the bladder and increase the time span between urinating to normal intervals (every 3–4 hours during the day and every 4–8 hours at night).
Biofeedback is a training technique that may help the patient locate the correct muscles. In one type of biofeedback, sensors are placed inside or outside the vagina that measure the force of pelvic muscle contraction. When she contracts the right muscles, the measurement will appear on a monitor.
A pessary is a device that is inserted into the vagina to treat pelvic support problems and SUI. Pessaries support the walls of the vagina to lift the bladder and urethra. They come in many shapes and sizes. Usually the patient can insert and remove a support pessary herself. Pessaries may provide relief of symptoms without surgery. An over-the-counter tampon-like device also is available that is designed specifically to help prevent bladder leaks.
Burch colposuspension involves suture placement at the Cooper ligament. The Marshall–Marchetti–Krantz (MMK) variation has sutures going through the periosteum of the pubic symphysis.
Anterior colporrhaphy has a poor long-term success rate.
Collagen periurethral injections (Coaptite, Macroplastique) are designed as a treatment for SUI resulting from intrinsic sphincter deficiency.
Drugs that control muscle spasms or unwanted bladder contractions can help prevent leakage from urgency urinary incontinence and relieve the symptoms of urgency and frequency.
Mirabegron is a drug that relaxes the bladder muscle and allows the bladder to store more urine. This drug is used to treat urgency urinary incontinence and relieve the symptoms of urgency and frequency.
Injection of a drug called onabotulinumtoxinA into the muscle of the bladder helps stop unwanted bladder muscle contractions. The effects last for about 3–9 months.
Sacral neuromodulation—This is a technique in which a thin wire is placed under the skin of the low back and close to the nerve that controls the bladder. The wire is attached to a battery device placed under the skin nearby. The device sends a mild electrical signal along the wire to improve bladder function.
Percutaneous tibial nerve stimulation (PTNS)—PTNS is a procedure that is similar to acupuncture. In PTNS, a slender needle is inserted near a nerve in the ankle and connected to a special machine. A signal is sent through the needle to the nerve, which sends the signal to the pelvic floor. PTNS usually involves weekly 30-minute office sessions for a few months.