Neurogenic bladder. Neurogenic bladder is a type of dysfunction of the bladder due to neurological disorder.

Size: px
Start display at page:

Download "Neurogenic bladder. Neurogenic bladder is a type of dysfunction of the bladder due to neurological disorder."

Transcription

1 Definition: Neurogenic bladder Neurogenic bladder is a type of dysfunction of the bladder due to neurological disorder. Types: Nervous system diseases: Congenital: like myelodysplasia like meningocele. Acquired: like Parkinson & the spinal cord trauma Metabolic diseases: Like DM that causes peripheral neuropathy especially sympathetic & parasympathetic of the bladder. Detrusal muscle disease: That includes any neuropathy in the detrusal muscle esp. the fibrotic disease or fibrosis due to chronic inflammation. Classification: - Hyperactive or overactive - Hypoactive Manifestations: From the symptoms we have incontinence or urinary retention; these are the main imp. Symptoms. Also there is the Lower urinary tract symptoms like: suprapubic pain, pain in micturation, frequency, urgency, urge incontinence, difficulty in urination, poor stream and nocturia. Sometimes we will have added complications associated with these symptoms like infections due to stasis of the urine.

2 Let us take incontinence as it s the main symptom. Incontinence : Involuntary loss of urine. Types: - Stress incontinence: Due to weakness of the pelvic floor muscles and sometimes intrinsic deficiency of the urethra and not related to neurogenic bladder. (eg: when coughing, sneezing) - Urge incontinence: It's the strong desire to void (eg: when you are outside) It is one of the main symptoms of the neurogenic bladder. We have two types of urge: motor(involuntary contraction of detrusor muscle). sensory (it's a feeling, any inflammatory process can cause it like cystitis) and the two are related to the nervous system. -Mix (stress + Urge) - Overflow incontinence: Sometimes it is related and sometimes it is not. If we take prostate it is due to obstruction (the urine will accumulate in the bladder then there is leaking- not related to neurogenic bladder. Sometimes if there is increasing in the resistance of the flow due to neurogenic bladder then we will have filled bladder and the emptying will be difficult and sometimes it is due to organic disease like strictures, bladder neck contracture or prostatic diseases like BPH or cancer. It can cause acute or chronic retention. - True incontinence: Not related to the neurogenic bladder and it is due to defect in the external sphincter from trauma or iatrogenic then leaking occurs. - Psychogenic incontinence: Also not related it is due to alteration to the psych of the patient.

3 To differentiate between Urgent, Stress, Overflow and True: Urgent not palpable either if it's full or empty. Stress you use cystogram produces dye contrast picture (make patient cough for angle measurement, u will be able to know if the bladder neck is hyper/hypo mobile) Functional study of LUT ( urodynamic study) is better. Overflow always palpable. Any mass in abdomen think of neurogenic bladder. If mass below abdomen think of uterus in female & in male think of bladder. True find the scar, on palpation or percussion the bladder will be empty, cystoscopy enable to see the sphincter. *Mixed: difficult TT, do surgery if not diagnosed early no benefit. Diagnosis: - From the history it is easy to decide the cause of the incontinence, sometimes he had a prostate operation then a trauma may occur to the sphincter so it is true incontinence. So history is very imp from the patient profile to the social history, for example if a child has urine incontinence it is mostly neurogenic bladder. If an old male patient in the 70s it is mostly from the prostate. How to differentiate between hyper and hypo-active, if for example he had a lumbar spine disc prolapsed hypoactive, DM-hypoactive. The history will not lead us exactly to the diagnosis. - From physical examination like feeling the anal tone, feel bladder if full. - Investigations: other than regular urine analysis and urine culture as if we have infection, urodynamic studies specific for function disorder of the LUT. Causes Neurogenic Bladder: - Trauma - Disease - Tumor

4 - Upper motor neuron disease ( hypertonic, hyperreflexia ) *Complications: 1) increase intravesical pressure or overflow incontinence. Both can lead to renal failure. 2) Infections. -Lower motor neuron (atonic) Both can do urge or overflow incontinence Investigation for any incontinence: CBC, LFT, urine culture, urine analysis, ultrasound. These are a group of tests: Ultrasound: Is the simplest one that used to decide if there is any residual volume in the bladder. The normal residual volume in the adults is up to 50 cc (< 10% of bladder capacity). The normal residual volume differ according to the age we have a formula *{age x 30 ± 30}. Uroflowmetry: A device like the bathroom to measure the flow rate. We concerned with the maximum flow rate (Q-max), average flow rate, voiding volume, time of voiding and the shape of the curve. 1) The shape of the uroflowmetry curve, normally it is bell shape. 2) Qmax: normally it is 3-5 sec. more than 5 it is abnormal. Maximum flow rate differ from males and females. Normal value ml/sec in males, ml/sec in females. The critical value is 15 ml/sec. Average flow rate is 2/3 of the maximum flow rate.

5 3) Residual volume: measured by catheter or ultrasound, Normal is <10% (<50cc) If between 10 50% there is significant residual volume. If > 50% chronic retention. 2 to 3 second to initiate urine " if greater its hesitancy" Abnormal uroflowmetry curve shapes like: 1- Intermittent shape that is caused by straining

6 2- Box shape uroflowmetry occur usually in strictures. 3- And in this shape Qmax is lower than normal, poor stream and a big tail "long term "usually seen in benign prostate hyperplasia. 4- detrusor underactivity. Poor contractility of the bladder >> interrupted flow; because the pt is straining. Cystometry Is the more sophisticated one that measure the detrusal pressure and its relation to the volume. It is an invasive procedure and we enter urethral catheter to measure the vesical pressure and enter a rectal catheter to measure the abdominal pressure. Normally, the cystometry is composed of 2 phases: the filling phase and the voiding phase.

7 It has a sensor that measure and records it on a diagram that has four lines: 1- Abdominal pressure. 2- intravesical pressure. 3- Detrusal pressure. 4- Flow rate. Pressure Volume Detrusor P = intravesical P Abdominal P Ex; when u cough a peak appear in P abd and P vesical but has no effect on P detrusor. If u see a peak in flow rate line it means stress incontinence. Another ex; detrusor muscle involuntary contraction leading to peak appearing in intr vesical pressure line. Last ex; if u see peaks in p vesical, p detrusor (involuntary contraction) & flow rate lines this mean urge incontinence.

8 Filling 1) Filling pressure: normal 0-10cm/H2O Cystometry 2 phases: Voiding 1) Q max 2) Volume capacity: ml in adult 3) Sensation -First desire to void 50% from volume capacity. -Normal desire 70% -Strong desire 90% -Urgent >90% For any of this sensation if its lower than this value hypersensitive. But if its greater hyposensitive. 4) Detrusor activity: mostly relax 2)Residual volume 3)Voiding pressure: normal 40-70cm/H2O 5) Compliance = ( V / P) normal greater than 40 END Nobody can go back and start a new beginning, but anyone can start today and make a new ending. Maria Robinson Done By: Arowa Basim Subha & Sirine Beleid from A5

URINARY INCONTINENCE. Urology Division, Surgery Department Medical Faculty, University of Sumatera Utara

URINARY INCONTINENCE. Urology Division, Surgery Department Medical Faculty, University of Sumatera Utara URINARY INCONTINENCE Urology Division, Surgery Department Medical Faculty, University of Sumatera Utara Definition The involuntary loss of urine May denote a symptom, a sign or a condition Symptom the

More information

Lower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist

Lower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist Lower Urinary Tract Symptoms K Kuruvilla Zachariah Associate Specialist Lower Urinary Tract Symptoms Storage Symptoms Frequency, urgency, incontinence, Nocturia Voiding Symptoms Hesitancy, poor flow, intermittency,

More information

Incontinence. When I was given this topic in urology to discuss with you today I

Incontinence. When I was given this topic in urology to discuss with you today I Incontinence When I was given this topic in urology to discuss with you today I was slightly disappointed. I personally see mostly men for problems such as stones, benign prostatic hyperplasia, prostate

More information

Summary. Neuro-urodynamics. The bladder cycle. and voiding. 14/12/2015. Neural control of the LUT Initial assessment Urodynamics

Summary. Neuro-urodynamics. The bladder cycle. and voiding. 14/12/2015. Neural control of the LUT Initial assessment Urodynamics Neuro-urodynamics Summary Neural control of the LUT Initial assessment Urodynamics Marcus Drake, Bristol Urological Institute SAFETY FIRST; renal failure, dysreflexia, latex allergy SYMPTOMS SECOND; storage,

More information

Lower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics. Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital

Lower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics. Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital Lower Urinary Tract Symptoms (LUTS) and Nurse-Led Clinics Sean Diver Urology Advanced Nurse Practitioner candidate Letterkenny University Hospital 01/02/2018 Lower Urinary Tract Symptoms LUTS - one of

More information

Urogynecology in EDS. Joan L. Blomquist, MD Greater Baltimore Medical Center August 2018

Urogynecology in EDS. Joan L. Blomquist, MD Greater Baltimore Medical Center August 2018 Urogynecology in EDS Joan L. Blomquist, MD Greater Baltimore Medical Center August 2018 One in three like me Voiding Issues Frequency/Urgency Urinary Incontinence neurogenic bladder Neurologic supply

More information

MANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH

MANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH MANAGING BENIGN PROSTATIC HYPERTROPHY IN PRIMARY CARE DR GEORGE G MATHEW CONSULTANT FAMILY PHYSICIAN FELLOW IN SEXUAL & REPRODUCTIVE HEALTH INTRODUCTION (1) Part of male sexual reproductive organ Size

More information

What should we consider before surgery? BPH with bladder dysfunction. Inje University Sanggye Paik Hospital Sung Luck Hee

What should we consider before surgery? BPH with bladder dysfunction. Inje University Sanggye Paik Hospital Sung Luck Hee What should we consider before surgery? BPH with bladder dysfunction Inje University Sanggye Paik Hospital Sung Luck Hee Diagnostic tests in three categories Recommendation: there is evidence to support

More information

Neuropathic Bladder. Magda Kujawa Consultant Urologist Stockport NHS Foundation Trust 12/03/2014

Neuropathic Bladder. Magda Kujawa Consultant Urologist Stockport NHS Foundation Trust 12/03/2014 Neuropathic Bladder Magda Kujawa Consultant Urologist Stockport NHS Foundation Trust 12/03/2014 Plan Physiology- bladder and sphincter behaviour in neurological disease Clinical consequences of Symptoms

More information

Urodynamics in Neurological Lower Urinary Tract Dysfunction. Mr Chris Harding Consultant Urologist Freeman Hospital Newcastle-upon-Tyne

Urodynamics in Neurological Lower Urinary Tract Dysfunction. Mr Chris Harding Consultant Urologist Freeman Hospital Newcastle-upon-Tyne Urodynamics in Neurological Lower Urinary Tract Dysfunction Mr Chris Harding Consultant Urologist Freeman Hospital Newcastle-upon-Tyne Learning Objectives Review functional neurology relevant to lower

More information

The Management of Female Urinary Incontinence. Part 1: Aetiology and Investigations

The Management of Female Urinary Incontinence. Part 1: Aetiology and Investigations The Management of Female Urinary Incontinence Part 1: Aetiology and Investigations Dr Oseka Onuma Gynaecologist and Pelvic Reconstructive Surgeon 4 Robe Terrace Medindie SA 5081 Urinary incontinence has

More information

ATLAS OF URODYNAMICS. Bladder. Pure. Pves. Pabd. Pdet EMG. Bladder. volume. Cough Strain IDC. Filling. Pure. Pves. Pabd. Pdet EMG

ATLAS OF URODYNAMICS. Bladder. Pure. Pves. Pabd. Pdet EMG. Bladder. volume. Cough Strain IDC. Filling. Pure. Pves. Pabd. Pdet EMG 2 Normal Micturition The micturition cycle (urine storage and voiding) is a nearly subconscious process that is under complete voluntary control. Bladder filling is accomplished without sensation and without

More information

Overactive Bladder: Diagnosis and Approaches to Treatment

Overactive Bladder: Diagnosis and Approaches to Treatment Overactive Bladder: Diagnosis and Approaches to Treatment A Hidden Condition* Many Many patients self-manage by voiding frequently, reducing fluid intake, and wearing pads Nearly Nearly two-thirds thirds

More information

Pelvic Floor Therapy for the Neurologic Client Carina Siracusa, PT, DPT, WCS

Pelvic Floor Therapy for the Neurologic Client Carina Siracusa, PT, DPT, WCS Pelvic Floor Therapy for the Neurologic Client Carina Siracusa, PT, DPT, WCS OhioHealth, Columbus Ohio Disclosures I have nothing to disclose Objectives Describe the role of a pelvic floor therapist in

More information

Tools for Evaluation. Urodynamics Case Studies. Case 1. Evaluation. Case 1. Bladder Diary SUI 19/01/2018

Tools for Evaluation. Urodynamics Case Studies. Case 1. Evaluation. Case 1. Bladder Diary SUI 19/01/2018 Urodynamics Case Studies Christopher K. Payne, MD Vista Urology & Pelvic Pain Partners Emeritus Professor of Urology, Stanford University Tools for Evaluation Ears, Eyes, and Brain Bladder diary Stress

More information

Practical urodynamics What PA s need to know. Gary E. Lemack, MD Professor of Urology and Neurology

Practical urodynamics What PA s need to know. Gary E. Lemack, MD Professor of Urology and Neurology Practical urodynamics What PA s need to know Gary E. Lemack, MD Professor of Urology and Neurology Urodynamics essential elements Urethral catheter Fill rate Catheter size Intravesical pressure measurements

More information

Dr. Aso Urinary Symptoms

Dr. Aso Urinary Symptoms Haematuria The presence of blood in the urine (haematuria) is always abnormal and may be the only indication of pathology in the urinary tract. False positive stick tests and the discolored urine caused

More information

NEUROGENIC BLADDER. Dr Harriet Grubb Dr Alison Seymour Dr Alexander Joseph

NEUROGENIC BLADDER. Dr Harriet Grubb Dr Alison Seymour Dr Alexander Joseph NEUROGENIC BLADDER Dr Harriet Grubb Dr Alison Seymour Dr Alexander Joseph OUTLINE Definition Anatomy and physiology of bladder function Types of neurogenic bladder Assessment and management Complications

More information

The Neurogenic Bladder

The Neurogenic Bladder The Neurogenic Bladder Outline Brandon Haynes, MD Resident Physician Department of Urology Jelena Svircev, MD Assistant Professor Department of Rehabilitation Medicine Anatomy and Bladder Physiology Bladder

More information

Video-urodynamics. P J R Shah Institute of Urology and UCH

Video-urodynamics. P J R Shah Institute of Urology and UCH Video-urodynamics P J R Shah Institute of Urology and UCH Bladder Function Storage Capacity and Pressure Emptying Pressure/flow/emptying URODYNAMIC INVESTIGATIONS Free urine flow rate Urethral pressure

More information

Diagnostic approach to LUTS in men. Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center

Diagnostic approach to LUTS in men. Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center Diagnostic approach to LUTS in men Prof Dato Dr. Zulkifli Md Zainuddin Consultant Urologist / Head Of Urology Unit UKM Medical Center Classification of LUTS Storage symptoms Voiding symptoms Post micturition

More information

THE ACONTRACTILE BLADDER - FACT OR FICTION?

THE ACONTRACTILE BLADDER - FACT OR FICTION? THE ACONTRACTILE BLADDER - FACT OR FICTION? Jacob Golomb Department of Urology Chaim Sheba Medical Center Tel Hashomer NEUROGENIC UNDERACTIVE DETRUSOR Central (complete/incomplete): Spinal cord injury-

More information

GUIDELINES ON NEUROGENIC LOWER URINARY TRACT DYSFUNCTION

GUIDELINES ON NEUROGENIC LOWER URINARY TRACT DYSFUNCTION GUIDELINES ON NEUROGENIC LOWER URINARY TRACT DYSFUNCTION M. Stöhrer (chairman), D. Castro-Diaz, E. Chartier-Kastler, G. Kramer, A. Mattiasson, J-J. Wyndaele Introduction NLUTD (neurogenic lower urinary

More information

Various Types. Ralph Boling, DO, FACOG

Various Types. Ralph Boling, DO, FACOG Various Types Ralph Boling, DO, FACOG The goal of this lecture is to increase assessment and treatment abilities for physicians managing urinary incontinence (UI) patients. 1. Effectively communicate with

More information

Incontinence; Lets talk about it. Karanvir Virk M.D. Minimally Invasive and Pelvic Reconstructive Surgery

Incontinence; Lets talk about it. Karanvir Virk M.D. Minimally Invasive and Pelvic Reconstructive Surgery Incontinence; Lets talk about it Karanvir Virk M.D. Minimally Invasive and Pelvic Reconstructive Surgery Select the most appropriate subtitle for this talk A: Bladders gone wild! B: There s no such thing

More information

Recommandations de prise en charge des vessies neurogènes EAU 2006

Recommandations de prise en charge des vessies neurogènes EAU 2006 Annexe 4-1 Recommandations de prise en charge des vessies neurogènes EAU 2006 (Version courte) 685 686 GUIDELINES ON NEUROGENIC LOWER URINARY TRACT DYSFUNCTION M. Stöhrer (chairman), D. Castro-Diaz, E.

More information

Module 3 Causes Of Urinary Incontinence

Module 3 Causes Of Urinary Incontinence Causes Of Urinary Incontinence V4: Last Reviewed September 2017 Learning Outcomes Appreciate the numerous requirements and skills necessary for the person to achieve and maintain urinary continence Discuss

More information

Voiding Dysfunction Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU.

Voiding Dysfunction Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU. Voiding Dysfunction 2009 Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU. Objectives Understand and explain physiologic function and dysfunction of lower urinary tract.

More information

Urodynamics in women. Aims of Urodynamics in women. Why do Urodynamics?

Urodynamics in women. Aims of Urodynamics in women. Why do Urodynamics? Urodynamics in women Chendrimada Madhu MD, MA, MRCOG Subspecialty Trainee in Urogynaecology Southmead Hospital 2013 Aims of Urodynamics in women n Confirmation of incontinence and its cause n Definition

More information

Disease Management. Incontinence Care. Chan Sau Kuen Continence Nurse Consultant United Christian Hospital 14/11/09

Disease Management. Incontinence Care. Chan Sau Kuen Continence Nurse Consultant United Christian Hospital 14/11/09 Disease Management in Incontinence Care Chan Sau Kuen Continence Nurse Consultant United Christian Hospital 14/11/09 What is incontinence? Definition of Incontinence - Is the compliant of any involuntary

More information

Glossary of terms Urinary Incontinence

Glossary of terms Urinary Incontinence Patient Information English Glossary of terms Urinary Incontinence Anaesthesia (general, spinal, or local) Before a procedure you will get medication to make sure that you don t feel pain. Under general

More information

Guidelines on Neurogenic Lower Urinary Tract Dysfunction

Guidelines on Neurogenic Lower Urinary Tract Dysfunction Guidelines on Neurogenic Lower Urinary Tract Dysfunction (Text update March 2009) M. Stöhrer (chairman), B. Blok, D. Castro-Diaz, E. Chartier- Kastler, P. Denys, G. Kramer, J. Pannek, G. del Popolo, P.

More information

Management of Female Stress Incontinence

Management of Female Stress Incontinence Management of Female Stress Incontinence Dr. Arvind Goyal Associate Professor (Urology& Renal Transplant) Dayanand Medical College & Hospital, Ludhiana, Punjab, India Stress Incontinence Involuntary loss

More information

Overactive bladder can result from one or more of the following causes:

Overactive bladder can result from one or more of the following causes: Overactive bladder can affect people of any age; however, it is more common in older people. Effective treatments are available and seeing your doctor for symptoms of overactive bladder often results in

More information

Male LUTS. Dr. Brian Ho. Division of Urology Department of Surgery Queen Mary Hospital

Male LUTS. Dr. Brian Ho. Division of Urology Department of Surgery Queen Mary Hospital Male LUTS Dr. Brian Ho Division of Urology Department of Surgery Queen Mary Hospital Mr. Siu M/78 Known to have HT & DM since 2008 on follow up with General ut-patient Clinic (GPC) Noticed to have worsening

More information

Mr. GIT KAH ANN. Pakar Klinikal Urologi Hospital Kuala Lumpur.

Mr. GIT KAH ANN. Pakar Klinikal Urologi Hospital Kuala Lumpur. Mr. GIT KAH ANN Pakar Klinikal Urologi Hospital Kuala Lumpur drgitka@yahoo.com 25 Jan 2007 HIGHLIGHTS Introduction ICS Definition Making a Diagnosis Voiding Chart Investigation Urodynamics Ancillary Investigations

More information

What neurologists need to understa

What neurologists need to understa 98 PRACTICAL NEUROLOGY INTRODUCTION Urodynamics has been used in the investigation of bladder dysfunction since the 1950s, although the first report describing bladder pressure measurement dates from 1882

More information

Prolapse and Urogynae. By Sarah Rangan & Daniel Warrell

Prolapse and Urogynae. By Sarah Rangan & Daniel Warrell Prolapse and Urogynae By Sarah Rangan & Daniel Warrell Anatomy and physiology of the pelvic supports The pelvic floor supports the pelvic viscera and vaginal, urethral and rectal openings Endopelvic fascial

More information

Adult Urodynamics: American Urological Association (AUA)/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Guideline

Adult Urodynamics: American Urological Association (AUA)/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Guideline Adult Urodynamics: American Urological Association (AUA)/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Guideline TARGET POPULATION Eligibility Decidable (Y or N) Inclusion

More information

2 Voiding Dysfunction

2 Voiding Dysfunction 2 Voiding Dysfunction Diagnostic Evaluation Victor W. Nitti, MD and Michael Ficazzola, MD Contents Introduction Classification of Voiding Dysfunction History Physical Examination Laboratory Testing Simple

More information

URODYNAMICS IN MALE LUTS: NECESSARY OR WASTE OF TIME?

URODYNAMICS IN MALE LUTS: NECESSARY OR WASTE OF TIME? URODYNAMICS IN MALE LUTS: NECESSARY OR WASTE OF TIME? Andrea Tubaro, MD, FEBU Chairman Department of Urology Sant Andrea Hospital Sapienza University of Rome, Italy Disclosures Consultant, paid speaker,

More information

TREATMENT METHODS FOR DISORDERS OF SMALL ANIMAL BLADDER FUNCTION

TREATMENT METHODS FOR DISORDERS OF SMALL ANIMAL BLADDER FUNCTION Vet Times The website for the veterinary profession https://www.vettimes.co.uk TREATMENT METHODS FOR DISORDERS OF SMALL ANIMAL BLADDER FUNCTION Author : SIMONA T RADAELLI Categories : Vets Date : July

More information

Dysfunctional voiding

Dysfunctional voiding Dysfunctional voiding The importance of assessment, diagnosis and treatment of dysfunctional voiding and its role in recurrent UTI Dr Dean Wallace Consultant Paediatric Nephrologist RMCH Objectives Development

More information

INCONTINENCE. Continence and Pelvic Floor Rehabilitation TYPES OF INCONTINENCE STRESS INCONTINENCE STRESS INCONTINENCE STRESS INCONTINENCE 11/08/2015

INCONTINENCE. Continence and Pelvic Floor Rehabilitation TYPES OF INCONTINENCE STRESS INCONTINENCE STRESS INCONTINENCE STRESS INCONTINENCE 11/08/2015 INCONTINENCE Continence and Pelvic Floor Rehabilitation Dr Irmina Nahon PhD Pelvic Floor Physiotherapist www.nahonpfed.com.au Defined as the accidental and inappropriate passage of urine or faeces (ICI

More information

Ben Herbert Alex Wojtowicz

Ben Herbert Alex Wojtowicz Ben Herbert Alex Wojtowicz 54 year old female presenting with: Dragging sensation Urinary incontinence Some faecal incontinence HPC Since May 14 had noticed a mass protruding from the vagina when going

More information

Diane K. Newman DNP, ANP-BC, PCB-PMD, FAAN

Diane K. Newman DNP, ANP-BC, PCB-PMD, FAAN Diane K. Newman DNP, ANP-BC, PCB-PMD, FAAN Diane K. Newman, DNP is a Biofeedback Certified Continence Specialist. With over 35-years experience, she is an expert in the assessment and management of pelvic-floor

More information

Objectives. Prevalence of Urinary Incontinence URINARY INCONTINENCE: EVALUATION AND CURRENT TREATMENT OPTIONS

Objectives. Prevalence of Urinary Incontinence URINARY INCONTINENCE: EVALUATION AND CURRENT TREATMENT OPTIONS URINARY INCONTINENCE: EVALUATION AND CURRENT TREATMENT OPTIONS Lisa S Pair, MSN, CRNP Division of Urogynecology and Pelvic Reconstructive Surgery Department of Obstetrics and Gynecology University of Alabama

More information

I am certain readers will find Voiding Dysfunction: Diagnosis and Treatment informative, practical, and clinically relevant. Rodney A.

I am certain readers will find Voiding Dysfunction: Diagnosis and Treatment informative, practical, and clinically relevant. Rodney A. PREFACE The purpose of Voiding Dysfunction: Diagnosis and Treatment is to bring the reader up-to-date on all clinical apsects of voiding dysfunction, not just urodynamic and other evaluative techniques,

More information

P R E S E N T S Dr. Mufa T. Ghadiali is skilled in all aspects of General Surgery. His General Surgery Services include: General Surgery Advanced Laparoscopic Surgery Surgical Oncology Gastrointestinal

More information

Appendix F: Continence Care and Bowel Management Program Training Presentation. Audience: For Front-line Staff Release Date: December 22, 2010

Appendix F: Continence Care and Bowel Management Program Training Presentation. Audience: For Front-line Staff Release Date: December 22, 2010 Appendix F: Continence Care and Bowel Management Program Training Presentation Audience: For Front-line Staff Release Date: December 22, 2010 Objectives Address individual needs and preferences with respect

More information

Bladder Dysfunction in Multiple Sclerosis. by Nancy J. Holland, EdD, RN and Nancy C. Reitman, MA, RN

Bladder Dysfunction in Multiple Sclerosis. by Nancy J. Holland, EdD, RN and Nancy C. Reitman, MA, RN Clinical Bulletin Information for Health Professionals Bladder Dysfunction in Multiple Sclerosis by Nancy J. Holland, EdD, RN and Nancy C. Reitman, MA, RN Effective bladder management strategies make it

More information

4. Know how to examine and name relevant test performed on patients

4. Know how to examine and name relevant test performed on patients Chapter 18 Female Urinary lncontinence Dr Zeelha Abdool Ed ucational Objectives : After completion of this chapter you should be able to: 1. Understand the pathophysiology of incontinence 2. Define and

More information

Urinary incontinence. Urology Department. Patient Information Leaflet

Urinary incontinence. Urology Department. Patient Information Leaflet Urinary incontinence Urology Department Patient Information Leaflet Introduction This leaflet is for people who have been diagnosed with urinary incontinence. It contains information about the bladder,

More information

Urodynamic study before and after radical porstatectomy 가톨릭의대성바오로병원김현우

Urodynamic study before and after radical porstatectomy 가톨릭의대성바오로병원김현우 Urodynamic study before and after radical porstatectomy 가톨릭의대성바오로병원김현우 Introduction Radical prostatectomy - treatment of choice for patients with localized prostate cancer. Urinary incontinence and/or

More information

NEUROPATHIC BLADDER DISORDERS

NEUROPATHIC BLADDER DISORDERS NEUROPATHIC BLADDER DISORDERS ANATOMY & PHYSIOLOGY The Bladder Unit The functional features of the bladder include (1) a normal capacity of 400 500 ml, (2) a sensation of fullness, (3) the ability to accommodate

More information

giovanni.montini@aosp.bo.it VD: definition Voiding dysfunction refers to daytime voiding disorders in children who do not have neurologic, anatomic, obstructive, or infectious abnormalities of the urinary

More information

Urogynaecology. Colm McAlinden

Urogynaecology. Colm McAlinden Urogynaecology Colm McAlinden Definitions Urinary incontinence compliant of any involuntary leakage of urine with many different causes Two main types: Stress Urge Definitions Nocturia: More than a single

More information

EXPERIMENTAL AND THERAPEUTIC MEDICINE 4: , 2012

EXPERIMENTAL AND THERAPEUTIC MEDICINE 4: , 2012 1112 Usefulness of total bladder capacity and post void residual urine volume as a predictor of detrusor overactivity with impaired contractility in stroke patients SANG HYUB LEE, JOONG GEUN LEE, GYEONG

More information

Management of LUTS after TURP and MIT

Management of LUTS after TURP and MIT Management of LUTS after TURP and MIT Hong Sup Kim Konkuk University TURP & MIT TURP : Gold standard MIT TUIP TUNA TUMT HIFU LASER Nd:YAG, ILC, HoLRP, KTP LUTS after TURP and MIT Improved : about 70% Persistent

More information

Management of Voiding Problems in Older Men. Dr. John Fenn Consultant, QEH 10 th October, 2005

Management of Voiding Problems in Older Men. Dr. John Fenn Consultant, QEH 10 th October, 2005 Management of Voiding Problems in Older Men Dr. John Fenn Consultant, QEH 10 th October, 2005 Voiding Problems Poor stream Hesitancy Straining Incomplete emptying Intermittent micturition Terminal dribbling

More information

This report presents definitions of the symptoms,

This report presents definitions of the symptoms, UPDATE THE STANDARDISATION OF TERMINOLOGY IN LOWER URINARY TRACT FUNCTION: REPORT FROM THE STANDARDISATION SUB-COMMITTEE OF THE INTERNATIONAL CONTINENCE SOCIETY PAUL ABRAMS, LINDA CARDOZO, MAGNUS FALL,

More information

ICD-10 Common Codes for Pelvic Rehab Providers

ICD-10 Common Codes for Pelvic Rehab Providers ICD-10 Common Codes for Pelvic Rehab Providers With ICD-10 changes taking place in 2015, we thought it would be helpful to put together a bit of a cheat sheet for our pelvic health providers. Keep in mind

More information

Urogynecology ICD-9 to ICD-10 Crosswalks

Urogynecology ICD-9 to ICD-10 Crosswalks 1100 Wayne Ave, Suite 825 Silver Spring, MD 20910 301.273.0570 Fax 301.273.0778 info@augs.org www.augs.org Urogynecology ICD-9 to ICD-10 Crosswalks ICD 9 ICD 9 Description ICD 10 Code ICD 10 Description

More information

Dysfunctional Voiding Patients: When Do you Give Medication and Why (A Practical approach)

Dysfunctional Voiding Patients: When Do you Give Medication and Why (A Practical approach) Dysfunctional Voiding Patients: When Do you Give Medication and Why (A Practical approach) Andrew Combs, PA-C Director, Pediatric Urodynamics Division of Pediatric Urology New York Presbyterian-Weill Cornell

More information

National Kidney and Urologic Diseases Information Clearinghouse

National Kidney and Urologic Diseases Information Clearinghouse Urodynamic Testing National Kidney and Urologic Diseases Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What is the urinary tract? The urinary tract

More information

Urodynamic Testing National Kidney and Urologic Diseases Information Clearinghouse

Urodynamic Testing National Kidney and Urologic Diseases Information Clearinghouse Urodynamic Testing National Kidney and Urologic Diseases Information Clearinghouse National Institute of Diabetes and Digestive and Kidney Diseases NATIONAL INSTITUTES OF HEALTH U.S. Department of Health

More information

Incontinence. Anatomy The human body has two kidneys. The kidneys continuously filter the blood and make urine.

Incontinence. Anatomy The human body has two kidneys. The kidneys continuously filter the blood and make urine. Incontinence Introduction Urinary incontinence occurs when a person cannot control the emptying of his or her urinary bladder. It can happen to anyone, but is very common in older people. Urinary incontinence

More information

Incontinence. Urinary. In Adults. THIS PUBLICATION IS OUT OF DATE. For most current information:

Incontinence. Urinary. In Adults.  THIS PUBLICATION IS OUT OF DATE. For most current information: Urinary Incontinence In Adults A Patient's Guide r I When you eat and drink, your body absorbs the liquid. The kidneys filter out waste products from the body fluids and make urine. Urine travels down

More information

Incontinence: Risks, Causes and Care

Incontinence: Risks, Causes and Care Welcome To Incontinence: Risks, Causes and Care Presented by Kamal Masaki, MD Professor and Chair Department of Geriatric Medicine John A. Burns School of Medicine, UH Manoa September 5, 2018 10:00 11:00

More information

GUIDELINES ON NEURO-UROLOGY

GUIDELINES ON NEURO-UROLOGY GUIDELINES ON NEURO-UROLOGY (Text update pril 2014) J. Pannek (co-chair), B. Blok (co-chair), D. Castro-Diaz, G. del Popolo, J. Groen, G. Karsenty, T.M. Kessler, G. Kramer, M. Stöhrer Eur Urol 2009 Jul;56(1):81-8

More information

Report from the Standardisation Sub-committee of the International Continence Society

Report from the Standardisation Sub-committee of the International Continence Society THE STANDARDISATION OF TERMINOLOGY IN LOWER URINARY TRACT FUNCTION Report from the Standardisation Sub-committee of the International Continence Society Committee: Paul Abrams, Linda Cardozo, Magnus Fall,

More information

Guidelines on Urinary Incontinence

Guidelines on Urinary Incontinence Guidelines on Urinary Incontinence J. Thüroff (chairman), P. Abrams, K.E. Andersson, W. Artibani, E. Chartier-Kastler, C. Hampel, Ph. van Kerrebroeck European Association of Urology 2006 TABLE OF CONTENTS

More information

Spinal Cord Injury. R Hamid Consultant Neuro-Urologist London Spinal Injuries Unit, Stanmore & National Hospital for Neurology & Neurosurgery, UCLH

Spinal Cord Injury. R Hamid Consultant Neuro-Urologist London Spinal Injuries Unit, Stanmore & National Hospital for Neurology & Neurosurgery, UCLH Spinal Cord Injury R Hamid Consultant Neuro-Urologist London Spinal Injuries Unit, Stanmore & National Hospital for Neurology & Neurosurgery, UCLH SCI 800 1000 new cases per year in UK Car accidents 35%

More information

This Special Report supplement

This Special Report supplement ...INTRODUCTION... Overactive Bladder: Defining the Disease Alan J. Wein, MD This Special Report supplement to The American Journal of Managed Care features proceedings from the workshop, Overactive Bladder:

More information

URINARY INCONTINENCE

URINARY INCONTINENCE Center for Continence Care and Pelvic Medicine What is urinary incontinence? URINARY INCONTINENCE Urinary incontinence is the uncontrollable loss of urine. The amount of urine leaked can vary from only

More information

Physiology & Neurophysiology of lower U.T.

Physiology & Neurophysiology of lower U.T. Physiology & Neurophysiology of lower U.T. Classification of voiding dysfunction Evaluation of a child with voiding dysfunction Management Storage Ø Adequate volume of urine Ø At LOW pressure Ø With NO

More information

Renal Physiology: Filling of the Urinary Bladder, Micturition, Physiologic Basis of some Renal Function Tests. Amelyn R.

Renal Physiology: Filling of the Urinary Bladder, Micturition, Physiologic Basis of some Renal Function Tests. Amelyn R. Renal Physiology: Filling of the Urinary Bladder, Micturition, Physiologic Basis of some Renal Function Tests Amelyn R. Rafael, MD 1 Functions of the Urinary Bladder 1. storage of urine 150 cc 1 st urge

More information

Urodynamic Patterns of the Idiopathic Overactive Bladder

Urodynamic Patterns of the Idiopathic Overactive Bladder Science Journal of Clinical Medicine 2017; 6(5): 74-79 http://www.sciencepublishinggroup.com/j/sjcm doi: 10.11648/j.sjcm.20170605.12 ISSN: 2327-2724 (Print); ISSN: 2327-2732 (Online) Urodynamic Patterns

More information

Case Based Urology Learning Program

Case Based Urology Learning Program Case Based Urology Learning Program Resident s Corner: UROLOGY Case Number 23 CBULP 2011 077 Case Based Urology Learning Program Editor: Associate Editors: Manager: Case Contributors: Steven C. Campbell,

More information

THE vesical dysfunction which follows injury or disease of the spinal cord

THE vesical dysfunction which follows injury or disease of the spinal cord VESICAL NECK RESECTION FOR NEUROGENIC BLADDER WILLIAM J. ENGEL, M.D. Department of Urology THE vesical dysfunction which follows injury or disease of the spinal cord or cauda equina has always presented

More information

Table 1. International Consultation on Incontinence recommendations for frail older adults

Table 1. International Consultation on Incontinence recommendations for frail older adults Table 1. International Consultation on Incontinence recommendations for frail older adults Clinicians need to assess and manage co-existing co morbid conditions which are known to have an impact on continence

More information

Prolapse and Urogynae Incontinence. Lucy Tiffin and Hannah Wheldon-Holmes

Prolapse and Urogynae Incontinence. Lucy Tiffin and Hannah Wheldon-Holmes Prolapse and Urogynae Incontinence Lucy Tiffin and Hannah Wheldon-Holmes 66 year old woman with incontinence PC: 7 year Hx of urgency, frequency, nocturia (incl. incontinence at night), and stress incontinence

More information

Bladder dysfunction in ALD and AMN

Bladder dysfunction in ALD and AMN Bladder dysfunction in ALD and AMN Sara Simeoni, MD Department of Uro-Neurology National Hospital for Neurology and Neurosurgery Queen Square, London 10:15 Dr Sara Simeoni- Bladder issues for AMN patients

More information

Standard terminology and good urodynamic practices. International Continence Society Adrian Wagg, Hong Kong Continence Society 2014

Standard terminology and good urodynamic practices. International Continence Society Adrian Wagg, Hong Kong Continence Society 2014 Standard terminology and good urodynamic practices International Continence Society Adrian Wagg, Hong Kong Continence Society 2014 The Standardisation of Terminology of Lower Urinary Tract Function: Report

More information

NEUROMODULATION FOR UROGYNAECOLOGISTS

NEUROMODULATION FOR UROGYNAECOLOGISTS NEUROMODULATION FOR UROGYNAECOLOGISTS Introduction The pelvic floor is highly complex structure made up of skeletal and striated muscle, support and suspensory ligaments, fascial coverings and an intricate

More information

SUPRAPUBIC PUNCTURE IN THE TREATMENT OF NEUROGENIC BLADDER

SUPRAPUBIC PUNCTURE IN THE TREATMENT OF NEUROGENIC BLADDER SUPRAPUBIC PUNCTURE IN THE TREATMENT OF NEUROGENIC BLADDER CHARLES C. HIGGINS, M.D. W. JAMES GARDNER, M.D. WM. A. NOSIK, M.D. The treatment of "cord bladder", a disturbance of bladder function from disease

More information

URODYNAMICS. Your urodynamic study is scheduled at the Ambulatory Procedure Center. This is located at 4-South waiting room at the Altru Main Clinic.

URODYNAMICS. Your urodynamic study is scheduled at the Ambulatory Procedure Center. This is located at 4-South waiting room at the Altru Main Clinic. Altru HEALTH SYSTEM URODYNAMICS Your urodynamic study is scheduled at the Ambulatory Procedure Center. This is located at 4-South waiting room at the Altru Main Clinic. Arrival Time: Appointment Date:

More information

John Laughlin 4 th year Cardiff University Medical Student

John Laughlin 4 th year Cardiff University Medical Student John Laughlin 4 th year Cardiff University Medical Student Prolapse/incontinence You need to know: Pelvic floor anatomy in relation to uterovaginal support and continence The classification of uterovaginal

More information

GUIDELINES ON NEURO-UROLOGY

GUIDELINES ON NEURO-UROLOGY GUIDELINES ON NEURO-UROLOGY (Limited text update March 2015) B. Blok (Co-chair), J. Pannek (Co-chair), D. Castro Diaz, G. del Popolo, J. Groen, T. Gross (Guidelines ssociate), R. Hamid, G. Karsenty, T.M.

More information

Overactive Bladder. When to see a doctor. Normal bladder function

Overactive Bladder. When to see a doctor. Normal bladder function Overactive Bladder Overactive bladder is a problem with bladder-storage function that causes a sudden urge to urinate. The urge may be difficult to stop, and overactive bladder may lead to the involuntary

More information

Urodynamics Assessment & Urotherapy in Children

Urodynamics Assessment & Urotherapy in Children Urodynamics Assessment & Urotherapy in Children APN Ng Wai Hing Department of Surgery QEH Nursing Management in Children with Nocturnal Enuresis Assessment Investigations Urotherapy Program Support Urodynamic

More information

Objectives. Key Outlines:

Objectives. Key Outlines: Objectives! Iden8fy and describe the Func8onal Anatomy of Urinary Bladder! Describe the mechanism of filling and emptying of the urinary bladder! Cystometrogram! Appreciate neurogenic control of the mechanism

More information

Management of OAB. Lynsey McHugh. Consultant Urological Surgeon. Lancashire Teaching Hospitals

Management of OAB. Lynsey McHugh. Consultant Urological Surgeon. Lancashire Teaching Hospitals Management of OAB Lynsey McHugh Consultant Urological Surgeon Lancashire Teaching Hospitals Summary Physiology Epidemiology Definitions NICE guidelines Evaluation Conservative management Medical management

More information

LUTS A plea for a holistic approach. HUBERT GALLAGHER, MCh; FRCSI, FRCSI(Urol) Head of Urology Beacon Hospital

LUTS A plea for a holistic approach. HUBERT GALLAGHER, MCh; FRCSI, FRCSI(Urol) Head of Urology Beacon Hospital LUTS A plea for a holistic approach. HUBERT GALLAGHER, MCh; FRCSI, FRCSI(Urol) Head of Urology Beacon Hospital LUTS- Classification Men LUTS can be divided into: Storage Voiding Frequency Nocturia Urgency

More information

Neural control of the lower urinary tract

Neural control of the lower urinary tract Neural control of the lower urinary tract Jalesh N. Panicker Consultant Neurologist and Honorary Senior Lecturer The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology Queen

More information

Definitions of IC: U.S. perspective. Edward Stanford MD MS FACOG FACS Western Colorado

Definitions of IC: U.S. perspective. Edward Stanford MD MS FACOG FACS Western Colorado Definitions of IC: U.S. perspective Edward Stanford MD MS FACOG FACS Western Colorado PURPOSE OF A DEFINITION? Identifies with specificity those patients who are most likely to have the disease. Identifies

More information

Management of Voiding Dysfunction after Prostate Radiotherapy

Management of Voiding Dysfunction after Prostate Radiotherapy Management of Voiding Dysfunction after Prostate Radiotherapy Up to Date Symposium on Uro-Oncology December 7, 2012 Belo Horizonte, Brazil Jaspreet S. Sandhu, MD Department of Surgery/Urology Memorial

More information

Loss of Bladder Control

Loss of Bladder Control BLADDER HEALTH: Bladder Prolapse Loss of Bladder Control Bladder Prolapse Don t Let Bladder Prolapse Keep You from Enjoying Life. What is the Bladder? The bladder is a hollow, balloon-like organ made mostly

More information

The Enlarged Prostate Symptoms, Diagnosis and Treatment

The Enlarged Prostate Symptoms, Diagnosis and Treatment The Enlarged Prostate Symptoms, Diagnosis and Treatment MAC00031-01 Rev G Financial support for this seminar has been provided by NeoTract, Inc., the manufacturer of the UroLift System. 1 Today s Agenda

More information