Bladder dysfunction in ALD and AMN

Size: px
Start display at page:

Download "Bladder dysfunction in ALD and AMN"

Transcription

1 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 1

2 Bladder dysfunction is unfortunately very common in both men and women! -overactive bladder (urinary urgency, frequency, nocturia and incontinence) MOST COMMON -stress urinary incontinence (involuntary leakage on effort or exertion, or on sneezing or coughing) -low stream Significant impact on quality of life but frequently under-reported and under-treated! Bladder disfunction common in AMN and ALD, because the bladder is controlled by the nervous system, which is heavily affected by this condition. In 2015, London study of 48 people focused on problems with the bladder in people with AMN. The most common problem was an overactive bladder, creating increased urgency and frequency in passing urine as well as nocturia (needing to wake up in the night to urinate) and incontinence caused by weak pelvic floor muscles. These symptoms are quite common in AMN and can have a significant impact on quality of life. They are underreported and undertreated. 2

3 Severity of bladder symptoms in AMN 67% of patients reported symptoms to be of moderate or severe grade and having a significant impact on the quality of life Despite this high figure, only a third of patients receive treatment for managing bladder symptoms 67% of study participants reported moderate to severe bladder symptoms which were having a significant impact on their quality of life. 3

4 What happens during the assessment? Ask a few questions Keep a diary of visits to the toilet Test the urine for an infection See if the bladder is emptying after urination Urodynamics? Talk about treatments There are a lot of options for treatment for these symptoms, as long as the patient is properly referred to uro-neurology departments. Patients are asked to fill out a questionnaire and to complete a bladder diary recording all fluid intake, frequency of urination, nocturia and so on. Checks are carried out to test if the patient can completely empty the bladder, through a bladder scan. In some cases, a urodynamics test is also needed. This helps to understand how the bladder works and to uncover any problems. 4

5 Measuring the post void residual 5

6 Storage symptoms Urgency Frequency Nocturia Incontinence Hesitancy Straining Interrupted stream Double voiding Voiding symptoms The function of the bladder is simple, with just two phases: storage and voiding. Possible issues in the voiding phase include hesitancy, in which patients struggle to begin to pass urine, the need to strain in order to pass urine, and stopping and starting during urination. Double voiding may also be a problem, in which the patient must keep returning to the toilet due to an inability to empty the bladder. Storage phase issues include urgency, frequency, incontinence and nocturia (waking at night to urinate) 6

7 Lifestyle modifications Fluid intake of around 1 2 l a day, although this should be individualized. Drinks that CAN irritate the bladder Caffeinated tea and coffee Green tea Hot chocolate Fizzy drinks, especially Cola Caffeinated energy drinks Fresh acidic drinks Drinks that DON T irritate the bladder Decaffeinated tea and coffee Water All types of diluted fruit juices Non-acidic fresh drinks Herbal tea Red bush tea There are several treatment options available, particularly for issues in the storage function (urgency, frequency, nocturia, etc). Lifestyle modifications are the first course of action: fluid intake should be around 1-2L per day, leaflets are provided explaining which fluids are most and least likely to irritate the bladder. Caffeinated and fizzy drinks, for example, are discouraged. 7

8 Bladder training Bladder training involves training yourself to voluntarily hold on for increasingly longer periods You begin with small delays, such as 30 minutes, and gradually work your way up to urinating every three to four hours. Another simple option is bladder training, in which the patient tries to gradually increase the time between urination. 8

9 Pelvic floor muscles exercises They help strengthen your pelvic floor muscles and urinary sphincter. These strengthened muscles can help you stop the bladder's involuntary contractions. A physiotherapist can help you learn how to do the exercises correctly. Useful especially if you have involuntary leakage on effort or exertion, or on sneezing or coughing. Pelvic floor muscle exercises are helpful if there is stress and incontinence, as this is usually due to weakness in these muscles. These exercises are arranged by physiotherapists. 9

10 Medications that relax the bladder Antimuscarinics (e.g. tolterodine, oxybutinin, trospium, solifenacin, darifenacin, fesoterodine) possible side effects are dry eyes, dry mouth and constipation Mirabegron possible side effects are hypertension and palpitations When these lifestyle changes and exercises are not sufficient, medication can be used to relax the bladder. There are two groups of these medications, which act on different receptors in the bladder wall and so can be used together if needed. Antimuscarinics have different effects and side effects, they can cause dry eyes and dry mouth, and cannot be used on patients with glaucoma. Mirabegron has more cardiovascular side effects such as palpitations. 10

11 Percutaneous tibial nerve stimulation to relax the bladder -Treatment option for overactive bladder (frequency, urgency, nocturia, incontinence) -A nerve in the leg called the posterior tibial nerve is stimulated near the ankle -It modulates the nerve that control bladder function -No major safety concerns % of patients benefit from this treatment -12 weeks of treatment When these medications are still not sufficient, nerve stimulation (PTNS) is another option, similar to acupuncture. Stimulating a nerve in the leg can modulate the function of the bladder and improve bladder symptoms, the reasons for this are unclear. This treatment is given once a week for 12 weeks and can also treat bowel disfunction. 11

12 Percutaneous Tibial Nerve Stimulation (PTNS) Courtesy Uroplasty A 34-gauge stainless steel needle is inserted approximately 3 4cm about three fingerbreadths cephalad to the medial malleolus, 9V stimulator (Urgent PC, Uroplasty Inc., US) with an adjustable pulse intensity of 01 10mA, a fixed pulse width of 200 microseconds and a frequency of 20Hz. 12

13 Botulinum toxin injections to relax the bladder Botulinum toxin type A injected into the detrusor muscle under cystoscopic guidance appears to be a highly promising treatment for intractable detrusor overactivity. Duration < 15 minutes Discomfort score 3.4 (0.5 9) Effect lasts 9-13 months Often need to perform catheterisation afterwards. It significantly improves frequency, urgency and nocturia and quality of life. Fewer urinary tract infections and reduced urethral leakage when using an indwelling catheter (catheter bypassing). Another option is botulinum toxin A injections into muscles in the bladder, which can benefit the patient for up to 13 months. This can also be effective for patients with catheters. 13

14 How to manage difficulties in emptying the bladder Complete bladder emptying is important for avoiding recurrent urinary tract infections and maintaining renal function. As there are no effective medications for improving voiding, catheterisation is usually the best option. These options are all used to relax the bladder and treat overactivity. There are no medications for inability to empty the bladder, the only way to manage this is catheterisation. This has a low risk of infection. The patient can use an intermittent catheter or an indwelling catheter- usually a suprapubic catheter, because it is easier to manage. 14

15 Catheterisation Clean intermittent self-catheterisation is preferred as it avoids the long term complications associated with a permanent indwelling catheter. Frequency of catheterization depends on the postvoid residual volume and fluid intake. If the symptoms become refractory to all treatments a long term indwelling catheter may be an option This should be a suprapubic rather than a urethral catheter because of the impact of the latter on urethral integrity, perineal hygiene and sexuality. 15

16 Urine infections -Urine should not be routinely tested unless there are symptoms suggesting infection. -Antibiotics should be limited to symptomatic urinary tract infections. -Unrestricted use of prophylactic antibiotics can lead to drug resistance; however, in individuals with proven recurrent urinary tract infections it is sometimes reasonable to start prophylactic low dose antibiotics; this decision should be taken in consultation with a urology specialist team. -Cranberry extract tablets and D-Mannose may be helpful to prevent infections due to E.Coli Urinal infections can also be a problem. Any symptoms of a urine infection should prompt the patient to go to the GP and have the urine culture tested. Different prophylactic measures can be taken depending on what is causing the infection. Prophylactic antibiotics are not prescribed unless other measure have not worked 16

17 To recap Bladder dysfunction is frequent in ALD/AMN Check to see if the bladder is emptying or not Treatments- Fluids Exercise Tablets Electrical stimulation of nerves (PTNS) Botox 17

18 Get in touch Primary care- community continence team Uro-Neurology department- we are here to help National Hospital for Neurology and Neurosurgery Queen Square, London WC1N 3BG 18

19 Thanks for your attention! Questions? 19

Overactive bladder. Information for patients from Urogynaecology

Overactive bladder. Information for patients from Urogynaecology Overactive bladder Information for patients from Urogynaecology An overactive bladder (OAB) is a very common problem. It can cause distressing symptoms that are difficult to control. These can include

More information

Overactive bladder syndrome (OAB)

Overactive bladder syndrome (OAB) Service: Urology Overactive bladder syndrome (OAB) Exceptional healthcare, personally delivered What is OAB? An overactive bladder or OAB is where a person regularly gets a sudden and compelling need or

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

Intravesical Botox Injections

Intravesical Botox Injections Intravesical Botox Injections Department of Urology Patient Information What What is is Botox? Botox? Botox or Botulinum Type-A is toxin produced by bacteria called Clostridium Botulinum. It is given intravesically

More information

Clean Intermittent Self-Catheterisation (CISC)

Clean Intermittent Self-Catheterisation (CISC) Saint Mary s Hospital & Trafford General Hospital Uro-gynaecology Service Information for Patients Clean Intermittent Self-Catheterisation (CISC) What is catheterisation? Catheterisation involves passing

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

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

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Urinary incontinence in women: the management of urinary incontinence in women 1.1 Short title Urinary incontinence in women

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

Intermittent self-catheterisation (ISC) Information for patients Spinal Injuries

Intermittent self-catheterisation (ISC) Information for patients Spinal Injuries Intermittent self-catheterisation (ISC) Information for patients Spinal Injuries page 2 of 12 What is clean intermittent self-catheterisation (CISC)? Urinary catheterisation is a procedure used to drain

More information

Male Lower Urinary Tract Symptoms: Lifestyle Advice, Bladder Training and Pelvic Floor Exercises

Male Lower Urinary Tract Symptoms: Lifestyle Advice, Bladder Training and Pelvic Floor Exercises MALE LUTS/CUP_11_11 Male Lower Urinary Tract Symptoms: Lifestyle Advice, Bladder Training and Pelvic Floor Exercises Lower urinary tract symptoms (LUTS) include the need to pass water very frequently (frequency)

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

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

Overactive Bladder Syndrome

Overactive Bladder Syndrome Page 1 of 5 Overactive Bladder Syndrome Overactive bladder syndrome is common. Symptoms include an urgent feeling to go to the toilet, going to the toilet frequently, and sometimes leaking urine before

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

Information about your Urodynamics Test

Information about your Urodynamics Test Gynaecology Department Patient Information Information about your Urodynamics Test This information booklet has been given to you to help answer some of the questions you may have about having an urodynamic

More information

Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline.

Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. TARGET POPULATION Eligibility Decidable (Y or N) Inclusion Criterion non-neurogenic OAB Exclusion Criterion

More information

Parkinson s Disease and Multiple System Atrophy

Parkinson s Disease and Multiple System Atrophy Parkinson s Disease and Multiple System Atrophy Jalesh N. Panicker MD, FRCP Department of Uro-Neurology National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology Queen Square, London

More information

THE OVER-ACTIVE BLADDER (OAB)

THE OVER-ACTIVE BLADDER (OAB) THE OVER-ACTIVE BLADDER (OAB) Passage of urine is caused by the bladder muscle contracting coordinated with the relaxation of the sphincter muscles, which is controlled by higher centers in the central

More information

Patient Information Incontinence & Prolapse Self-help

Patient Information Incontinence & Prolapse Self-help Patient Information Incontinence & Prolapse Self-help Urogynaecology Introduction This leaflet is produced as a self-help guide for women of East and North Herts that are experiencing issues with continence.

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

Module 5 Management Of Urinary Incontinence

Module 5 Management Of Urinary Incontinence Management Of Urinary Incontinence V3: Last Reviewed September 2017 Learning Outcomes Outline conservative management options Discover the options available to manage the different types of incontinence

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

Promoting Continence with Physiotherapy

Promoting Continence with Physiotherapy A Common problem for Men and women Promoting Continence with Physiotherapy This leaflet contains information about physiotherapy advice and treatment for anyone with bladder and bowel problems. This may

More information

Managing Female Urinary Incontinence Within Primary Care

Managing Female Urinary Incontinence Within Primary Care Managing Female Urinary Incontinence Within Primary Care Angela Patterson Lead Clinical Nurse Specialist in Bladder and Bowel Dysfunction. South Eastern HSCT Background More than 14 million in the UK affected

More information

UK Consensus on Bladder Management in MS

UK Consensus on Bladder Management in MS Continence Care Forum Annual Conference UK Consensus on Bladder Management in MS Clare J.Fowler National Hospital for Neurology and Neurosurgery & Institute of Neurology, UCL Association of British Neurologists

More information

Drinking fluids and how they affect your bladder

Drinking fluids and how they affect your bladder www.olarts.com Drinking fluids and how they affect your bladder Contact us Patient Advice and Liaison Service (PALS) To make comments or raise concerns about the Trust s services, please contact PALS.

More information

Botox (Botulinum Toxin) injections into the bladder

Botox (Botulinum Toxin) injections into the bladder Botox (Botulinum Toxin) injections into the bladder Information for patients, relatives and carers Department of Urology York Teaching Hospital NHS Foundation Trust For more information or advice, please

More information

Patient Information. Basic Information on Overactive Bladder Symptoms. pubic bone. urethra. scrotum. bladder. vaginal canal

Patient Information. Basic Information on Overactive Bladder Symptoms. pubic bone. urethra. scrotum. bladder. vaginal canal Patient Information English Basic Information on Overactive Bladder Symptoms The underlined terms are listed in the glossary. What is the bladder? pubic bone bladder seminal vesicles prostate rectum The

More information

Overactive bladder. Patient Information. Women & Children Obstetrics & Gynaecology

Overactive bladder. Patient Information. Women & Children Obstetrics & Gynaecology 50 Overactive bladder Patient Information Women & Children Obstetrics & Gynaecology Content Introduction How to use this booklet Food Drink Eliminating bladder irritants Avoiding constipation Bladder training

More information

Updates in the nonpharmacological. treatment on overactive bladder

Updates in the nonpharmacological. treatment on overactive bladder Updates in the nonpharmacological treatment on overactive bladder Overactive Bladder Also known as urgency-frequency syndrome Symptoms Urgency Daytime frequency Nocturia Urge urinary incontinence Sudden

More information

Advanced Care for Female Overactive Bladder & Urinary Incontinence. Department of Urology Kaiser Permanente Santa Rosa

Advanced Care for Female Overactive Bladder & Urinary Incontinence. Department of Urology Kaiser Permanente Santa Rosa Advanced Care for Female Overactive Bladder & Urinary Incontinence Department of Urology Kaiser Permanente Santa Rosa Goals Participants will: Review normal urinary tract anatomy and function Understand

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

Using Physiotherapy to Manage Urinary Incontinence in Women

Using Physiotherapy to Manage Urinary Incontinence in Women Using Physiotherapy to Manage Urinary Incontinence in Women Bladder control problems are common, and affect people of all ages, genders and backgrounds. These problems are referred to as urinary incontinence

More information

Urinary Incontinence. Lora Keeling and Byron Neale

Urinary Incontinence. Lora Keeling and Byron Neale Urinary Incontinence Lora Keeling and Byron Neale Not life threatening. Introduction But can have a huge impact on quality of life. Two main types of urinary incontinence (UI). Stress UI leakage on effort,

More information

Primary Care management of Overactive Bladder (OAB)

Primary Care management of Overactive Bladder (OAB) DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) Primary Care management of Overactive Bladder (OAB) Prescribing Tips All medicines for OAB have similar dose-related efficacy. More than one agent (up

More information

Please complete this voiding diary and questionnaire. Bring both of them with you to your next appointment with your provider.

Please complete this voiding diary and questionnaire. Bring both of them with you to your next appointment with your provider. Please complete this voiding diary and questionnaire. Bring both of them with you to your next appointment with your provider. To begin the diary, please choose two days when you will be at home. The two

More information

TREATMENT OF OVERACTIVE BLADDER IN ADULTS FUGA 2016 KGH

TREATMENT OF OVERACTIVE BLADDER IN ADULTS FUGA 2016 KGH TREATMENT OF OVERACTIVE BLADDER IN ADULTS FUGA 2016 KGH CONTENTS Overactive bladder (OAB) Treatment of OAB Beta-3 adrenoceptor agonist (Betmiga ) - Panacea? LASER treatment - a flash in the pan or the

More information

Y0028_2726_0 File&Use Bladder Control Does Matter

Y0028_2726_0 File&Use Bladder Control Does Matter Y0028_2726_0 File&Use 04092012 Bladder Control Does Matter If you suffer from urinary incontinence, you re not alone Don t be afraid to raise your hand if you ve been struggling with the embarrassment

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

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

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

Overactive Bladder Syndrome

Overactive Bladder Syndrome Overactive Bladder Syndrome behavioural modifications to pharmacological and surgical treatments Dr Jos Jayarajan Urologist Austin Health, Eastern Health Warringal Private, Northpark Private, Epworth Overactive

More information

Percutaneous Tibial Nerve Stimulation for Overactive Bladder Symptoms. Patient Information Leaflet

Percutaneous Tibial Nerve Stimulation for Overactive Bladder Symptoms. Patient Information Leaflet Percutaneous Tibial Nerve Stimulation for Overactive Bladder Symptoms Patient Information Leaflet About this leaflet The information provided in this leaflet should be used as a guide. There may be some

More information

Overactive bladder (OAB) affects approximately 15% of the adult population. Diagnosis is based

Overactive bladder (OAB) affects approximately 15% of the adult population. Diagnosis is based Overactive bladder (OAB) affects approximately 15% of the adult population. Diagnosis is based upon a medical history, and includes a focused physical exam (abdominal, neurological, pelvic in females and

More information

Posterior Tibial Nerve Stimulation

Posterior Tibial Nerve Stimulation Posterior Tibial Nerve Stimulation Policy Number: Original Effective Date: MM.02.025 01/01/2015 Lines of Business: Current Effective Date: HMO; PPO; QUEST Integration 02/01/2015 Section: Medicine Place(s)

More information

A word about incontinence

A word about incontinence A word about incontinence When you re continent, you have control over your urine. You feel the need to urinate, and you can hold it until you get to a bathroom. When you re incontinent, you may urinate

More information

Management, Evaluation, and Treatment of Overactive Bladder and Urinary Incontinence

Management, Evaluation, and Treatment of Overactive Bladder and Urinary Incontinence Management, Evaluation, and Treatment of Overactive Bladder and Urinary Incontinence Arthur Mourtzinos, MD, MBA Co-Vice Chair, Institute of Urology Director, Continence Center Assistant Professor of Urology,

More information

Please read the following information and have the child follow the bladder retraining protocol included.

Please read the following information and have the child follow the bladder retraining protocol included. Urology Clinic Hospital for Sick Children Please read the following information and have the child follow the bladder retraining protocol included. Information on bladder retraining, urinary tract infections

More information

Information for Patients. Overactive bladder syndrome (OAB) English

Information for Patients. Overactive bladder syndrome (OAB) English Information for Patients Overactive bladder syndrome (OAB) English Table of contents What is the bladder?... 3 What are overactive bladder symptoms?... 3 What causes overactive bladder symptoms?... 3 Diagnosis

More information

URODYNAMICS Welcome to Chesapeake Urology s Urodynamics Services. Bladder control problems keep millions of people from enjoying a full life, but today, many treatments are available to help. To assist

More information

University College Hospital at Westmoreland Street. Percutaneous Tibial Nerve Stimulation (PTNS)

University College Hospital at Westmoreland Street. Percutaneous Tibial Nerve Stimulation (PTNS) University College Hospital at Westmoreland Street Percutaneous Tibial Nerve Stimulation (PTNS) Urology Directorate If you need a large print, audio or translated copy of this document, please contact

More information

BEST PRACTICE ADVOCACY CENTRE NEW ZEALAND SCOPE. Urinary incontinence in women: the management of urinary incontinence in women

BEST PRACTICE ADVOCACY CENTRE NEW ZEALAND SCOPE. Urinary incontinence in women: the management of urinary incontinence in women BEST PRACTICE ADVOCACY CENTRE NEW ZEALAND SCOPE 1 Guideline title Urinary incontinence in women: the management of urinary incontinence in women 2 Guideline Contextualisation This is a contextualisation

More information

INCONTINENCE AND OTHER UROLOGICAL DILEMMAS DR. ANNA LAWRENCE UROLOGIST AUCKLAND HOSPITAL 161 UROLOGY

INCONTINENCE AND OTHER UROLOGICAL DILEMMAS DR. ANNA LAWRENCE UROLOGIST AUCKLAND HOSPITAL 161 UROLOGY INCONTINENCE AND OTHER UROLOGICAL DILEMMAS DR. ANNA LAWRENCE UROLOGIST AUCKLAND HOSPITAL 161 UROLOGY COVERING INCONTINENCE BE ON JUST NAPPIES CATHETERS TYPES AVAILABLE AND WHEN TO USE THEM JJ STENTS???

More information

Priorities Forum Statement GUIDANCE

Priorities Forum Statement GUIDANCE Priorities Forum Statement Number 61 Subject The management of female incontinence Date of decision May 2016 Date refreshed May 2017 Date of review May 2019 Introduction: GUIDANCE Urinary incontinence

More information

Urinary Incontinence. a problem for many

Urinary Incontinence. a problem for many Urinary Incontinence a problem for many This leaflet gives information on urinary incontinence and the problems arising from the various types of urinary incontinence. It also gives advice on how to relieve

More information

Second-line Treatment for OAB

Second-line Treatment for OAB Patient Information English 35 Second-line Treatment for OAB The underlined terms are listed in the glossary. Sometimes the drugs your doctor prescribed do not improve your overactive symptoms (OAB). In

More information

Voiding Diary. Begin recording upon rising in the morning and continue for a full 24 hours.

Voiding Diary. Begin recording upon rising in the morning and continue for a full 24 hours. Urodvnamics Your physician has scheduled you for a test called URODYNAMICS. This test is a series of different measurements of bladder function and can be used to determine the cause of a variety of bladder

More information

Urinary Incontinence for the Primary Care Provider

Urinary Incontinence for the Primary Care Provider Urinary Incontinence for the Primary Care Provider Diana J Scott FNP-BC https://youtu.be/gmzaue1ojn4 1 Assessment of Urinary Incontinence Urge Stress Mixed Other overflow, postural, continuous, insensible,

More information

Urinary Incontinence

Urinary Incontinence Urinary Incontinence Q: What is urinary incontinence and what causes it? A: When you are not able to hold your urine until you can get to a bathroom, you have what s called urinary incontinence (also called

More information

Urodynamic Tests. Department of Gynaecology. Patient Information

Urodynamic Tests. Department of Gynaecology. Patient Information Urodynamic Tests Department of Gynaecology Patient Information What are urodynamic tests? Urodynamic tests assess the dynamic function of the lower urinary tract. The tests assess 3 functions; The ability

More information

Women s & Children s Directorate The TVT Operation - a guide for patients

Women s & Children s Directorate The TVT Operation - a guide for patients Women s & Children s Directorate The TVT Operation - a guide for patients This leaflet was written for women who are considering having a TVT operation. If you have any questions that aren't answered by

More information

Faecal Incontinence Information Leaflet THE DIGESTIVE SYSTEM

Faecal Incontinence Information Leaflet THE DIGESTIVE SYSTEM THE DIGESTIVE SYSTEM This factsheet is about faecal incontinence Faecal (or anal) incontinence is the loss of stool, liquid or gas from the bowel at an undesirable time. Males and females of any age may

More information

Coping with urges and leaks?

Coping with urges and leaks? OAB AND YOU Coping with urges and leaks? Let me help you learn more about overactive bladder (OAB) symptoms and ways to help manage them 1 HOW DOES THE BLADDER WORK? Within the urinary tract, the kidneys

More information

Uterus (Womb) Rectum. Another problem could be the sensation of something coming down at the birth canal or back passage (prolapse).

Uterus (Womb) Rectum. Another problem could be the sensation of something coming down at the birth canal or back passage (prolapse). Pelvic Floor Exercises for Women Physiotherapy Department Continence Service Introduction This leaflet tells you how to exercise and strengthen your pelvic floor muscles. These muscles form a broad sling

More information

IF YOU VE GOT TO GO, WE VE GOT SOLUTIONS.

IF YOU VE GOT TO GO, WE VE GOT SOLUTIONS. IF YOU VE GOT TO GO, WE VE GOT SOLUTIONS. Get the facts about urinary incontinence and get real solutions. HENRY FORD PELVIC HEALTH & CONTINENCE CENTER HENRY FORD WOMEN S HEALTH SERVICES INCONVENIENCE?

More information

Trans urethral resection of prostate (TURP)

Trans urethral resection of prostate (TURP) Trans urethral resection of prostate (TURP) Information for patients Urology PROUD TO MAKE A DIFFERENCE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST What is the prostate? Only men have a prostate

More information

Urinary dysfunction assessment tool (care home)

Urinary dysfunction assessment tool (care home) Addressograph label CHI:... Name:... Address:...... Urinary dysfunction assessment tool (care home) Past medical history: Is the patient on medications which can affect bladder function? If, please list

More information

Information about your operation: Sacral nerve stimulation (SNS)

Information about your operation: Sacral nerve stimulation (SNS) Information about your operation: Sacral nerve stimulation (SNS) Urogynaecology Unit Information for Patients i Important supplementary information What is an overactive bladder? Women with an overactive

More information

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic.

NICE Pathways bring together all NICE guidance, quality standards and other NICE information on a specific topic. bring together all NICE guidance, quality standards and other NICE information on a specific topic. are interactive and designed to be used online. They are updated regularly as new NICE guidance is published.

More information

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

Keep high, stay dry. Pelvic floor exercises for men

Keep high, stay dry. Pelvic floor exercises for men Keep high, stay dry Pelvic floor exercises for men What is the pelvic floor? Layers of muscle stretch like a hammock from your pubic bone in the front to the bottom of your backbone (see diagram). These

More information

Indwelling Urinary Catheters And Drainage systems

Indwelling Urinary Catheters And Drainage systems If you require this leaflet in any other format, e.g., large print, please telephone 01935 384256 Indwelling Urinary Catheters And Drainage systems Useful organisations Ms Society Helpline Tel: 0808 800

More information

Information for men considering a male sling procedure UHB is a no smoking Trust

Information for men considering a male sling procedure UHB is a no smoking Trust Information for men considering a male sling procedure UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm Introduction

More information

It is possible to manage the bladder problems of MSA even if they cannot be cured.

It is possible to manage the bladder problems of MSA even if they cannot be cured. How the bladder works What goes wrong? What investigations need to be done? Who can help? Advice Medication Equipment Other help Useful contacts Continence in MSA It is possible to manage the bladder problems

More information

Indwelling urinary catheter

Indwelling urinary catheter Indwelling urinary catheter Information for patients and carers RDaSH leading the way with care What is a catheter? A catheter is a hollow flexible tube designed to drain urine from the bladder. Following

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

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

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

Evaluation & Management of Overactive Bladder

Evaluation & Management of Overactive Bladder Evaluation & Management of Overactive Bladder Disclosures/Conflict of Interest/Bias I have no financial relationship with any of the companies that produce the products I m about to discuss I have no conflicts

More information

Urodynamics Clinic. Patient Information

Urodynamics Clinic. Patient Information Patient Information Urodynamics Clinic Author: Gynaecology Produced and designed by the Communications Team Issue date May 2017 - Review date May 2020 Version 3 Ref no. PILCOM1433 Urodynamics Clinic An

More information

Dr Jonathan Evans Paediatric Nephrologist

Dr Jonathan Evans Paediatric Nephrologist How do I manage a patient with intractable daytime wetting: Dr Jonathan Evans Paediatric Nephrologist Of 107 children aged 11-12 with day-wetting 91 (85%) were dry at 15-16 yr Swithinbank et al BJU 1998

More information

Tension Free vaginal tape. Mrs Ami Shukla, Consultant Urogynaecologist Northampton General Hospital Northampton NN1 5BD

Tension Free vaginal tape. Mrs Ami Shukla, Consultant Urogynaecologist Northampton General Hospital Northampton NN1 5BD Tension Free vaginal tape Mrs Ami Shukla, Consultant Urogynaecologist Northampton General Hospital Northampton NN1 5BD What is a TVT procedure? A TVT (Tension Free Vaginal Tape) procedure is an operation

More information

Urinary Aspects of Multiple Sclerosis chronic condition with innovative treatment strategies. Dr. Boris Friedman May 2, 2012 OBJECTIVES

Urinary Aspects of Multiple Sclerosis chronic condition with innovative treatment strategies. Dr. Boris Friedman May 2, 2012 OBJECTIVES Urinary Aspects of Multiple Sclerosis chronic condition with innovative treatment strategies Dr. Boris Friedman May 2, 2012 OBJECTIVES 1) Definition and classification of MS 2) Interventional radiology

More information

Urinary dysfunction assessment tool (community)

Urinary dysfunction assessment tool (community) Addressograph label CHI:... Name:... Address:...... Urinary dysfunction assessment tool (community) Past medical history: Is the patient on medications which can affect bladder function? If, please list

More information

The Management of Overactive Bladder Syndrome with Antimuscarinic Drugs

The Management of Overactive Bladder Syndrome with Antimuscarinic Drugs The Management of Overactive Bladder Syndrome with Antimuscarinic Drugs Author Version Date Consultation Date of Ratification By JPG Shaista Hussain Joint Formulary Pharmacist V2 16.09.2014 Homerton University

More information

Uroformation. Instillation of Botox. The Uroformation series is a co-operative venture in patient centered urological information.

Uroformation. Instillation of Botox. The Uroformation series is a co-operative venture in patient centered urological information. Uroformation Instillation of Botox The Uroformation series is a co-operative venture in patient centered urological information. June 2014 What is Botox? Botox or botulinum toxin, is a purified toxin

More information

Urinary Incontinence? - gør dig ikke skakmat...

Urinary Incontinence? - gør dig ikke skakmat... Urinary Incontinence? - gør dig ikke skakmat... The International Continence Society (ICS) have defined urinary incontinence as invo- luntary loss of urine to such an extent that it constitutes a social

More information

21/03/2016. The urogynaecologist approach. Urinary continence management in women: a multidisciplinary approach. Dr Anna Rosamillia

21/03/2016. The urogynaecologist approach. Urinary continence management in women: a multidisciplinary approach. Dr Anna Rosamillia Urinary continence management in women: a multidisciplinary approach The urogynaecologist approach Dr Anna Rosamillia What is normal bladder function? Incontinence is not normal Normal voiding is 7-8 times

More information

Botulinum Toxin Injection for OAB: Indications & Technique

Botulinum Toxin Injection for OAB: Indications & Technique Classification of LUTS Botulinum Toxin Injection for OAB: Indications & Technique Sherif Mourad, MD Professor of Urology, Ain Shams University General Secretary of International Continence President of

More information

Patient Urinary Catheter Passport

Patient Urinary Catheter Passport Useful contact details: Continence Service (Community) 01724 298325 Continence Service (Goole) 01482 336951 Continence Service (SGH) 01724 282282 Ext 2823 Continence Service (DPOW) 01472 874111 Infection

More information

Self -Managing Your Urinary Symptoms

Self -Managing Your Urinary Symptoms Information for Men Self -Managing Your Urinary Symptoms SPHERE Bladder and Bowel Service Supporting Pelvic Health through Empowerment Rehabilitation and Education 2 Index Self-managing your urinary symptoms

More information

Incontinence Patient Information Form

Incontinence Patient Information Form Incontinence Patient Information Form (To be completed by patient) Before talking with you, the doctor would like some information about your urine leakage. These questions are important for finding out

More information

IMPROVING URINARY INCONTINENCE

IMPROVING URINARY INCONTINENCE IMPROVING URINARY INCONTINENCE INFORMATION FOR OLDER ADULTS, FAMILIES, AND CAREGIVERS READ THIS PAMPHLET TO LEARN: What Urinary Incontinence is. How to Manage Urinary Incontinence. What Pelvic Floor Exercises

More information

Bladder retraining - treatment for urgency and urge incontinence

Bladder retraining - treatment for urgency and urge incontinence Bladder retraining - treatment for urgency and urge incontinence This leaflet explains what urge incontinence is and how we can help to reduce and relieve your symptoms. If you have any questions or concerns,

More information

Self -Managing Your Urinary Symptoms

Self -Managing Your Urinary Symptoms Information for Women Self -Managing Your Urinary Symptoms SPHERE Bladder and Bowel Service Supporting Pelvic Health through Empowerment Rehabilitation and Education 2 Index Self-managing your urinary

More information

Tension-free Vaginal Tape (TVT)

Tension-free Vaginal Tape (TVT) Page 1 of 7 Tension-free Vaginal Tape (TVT) Introduction This leaflet will provide you with basic information about the Tension--free Vaginal Tape (TVT) procedure. What is a TVT? TVT is an operation to

More information

Continence in MSA. How the bladder works

Continence in MSA. How the bladder works How the bladder works What goes wrong? What investigations need to be done? Who can help? Advice Medication Equipment Other help Useful contacts Continence in MSA Bladder problems are very common in people

More information

Urinary Catheter Passport

Urinary Catheter Passport Urinary Catheter Passport Catheter Change Record and Looking After Your Urinary Catheter Please take this booklet with you if you are admitted to hospital or have an appointment Patient details Name Address

More information