Voiding Dysfunction Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU.
|
|
- Shauna Booker
- 6 years ago
- Views:
Transcription
1 Voiding Dysfunction 2009 Block lecture, 5 th year student. Choosak Pripatnanont, Department of Surgery, PSU.
2 Objectives Understand and explain physiologic function and dysfunction of lower urinary tract. Evaluation patient with LUTS Primary management /investigation Give primary management of BPH
3
4
5
6
7
8
9 Bladder pressure Micturition cycle Storage phase Emptying phase Storage phase Bladder filling Detrusor relaxes + Urethra contracts + Pelvic floor contracts First First sensation sensation to to void void Detrusor Detrusor relaxes relaxes + Urethra contraction Urethra contraction increases increases + Pelvic Pelvic floor contracts floor contracts Normal desire to void Detrusor contracts + Urethra relaxes + Pelvic floor relaxes Bladder filling Detrusor relaxes + Urethra contracts + Pelvic floor contracts MICTURITION
10
11 Normal voiding Bladder filling and urine storage require: 1. Accommodation of increasing volumes of urine at a low intravesical pressure and with appropriate sensation. 2. A bladder outlet that is closed at rest and during increases in intra-abdominal pressure. 3. Absence of involuntary bladder contractions.
12 Normal voiding Bladder emptying requires: 1. A coordinated contraction of the bladder smooth musculature of adequate magnitude. 2. A concomitant lowering of resistance at the level of the smooth and striated sphincter. 3. Absence of anatomic (as opposed to functional) obstruction.
13 Functional classification of voiding dysfunction Failure to store Because of the bladder Because of the outlet Failure to empty Because of the bladder Because of the outlet
14
15
16 Symptomatology: Irritative bladder symptom: storage symptom Symptom How to measure Causes Frequency Nocturia Urgency Incontinence Pain how many hours between voiding how many times the patient awakes from sleep to urinate Time per day, degree of leakage Time per day, pads per day Stress, total, overflow Suprapubic area functionally reduced bladder capacity, infection, tumor, stone, outlet obstruction, neurogenic bladder, or foreign body Infection, Insomnia, infection, drinking before bed. infection, BOO, or neurogenic bladder. the ultimate sign of storage failure, associated with urgency, frequency, or nocturia
17 Symptomatology: Obstructive symptoms Symptom hesitancy Straining to void Poor stream Dysuria Feeling of incomplete emptying Terminal dribbling Acute urinary retention How to measure Seconds, IPSS Discomfort Flowmetry (instrument) Discomfort,burning in urethra Residual urine (cath, ultrasound) Discomfort Cath.cc. Causes BPH, BOO, CBN, stricture urethra, prostate cancer UTI, urethritis BPH, BOO, CBN, stricture urethra, prostate cancer
18 Different type of incontinence
19 Differential diagnosis of voiding dysfunction Condition Malignant disease Infections Neurologic Medical Iatrogenic Anatomical Behavioral Pharmacological Other Adenocarcinoma of prostate,tcc of Bladder,Squamous cell CA of Penis Prostatitis, Urethritis, STD Spinal cord injury, cauda equina syndrome, Parkinsonism, Diabetic autonomic neuropathy, Multiple sclerosis, Alzheimer disease. Poorly controlled DM, Diabetes Insipidus, CHF, hypercalcemia, Obstructive sleep apnea. Post prostatectomy, Cystectomy, traumatic stricture, radiation cystitis. Ureteral and bladder stone Polydipsia, excessive alcohol or caffeine consumption. Diuretics, sympathomimetics, anticholinergic, decongestants. Overactive bladder dysfunction Cause of LUTS
20 Diseases usually cause voiding dysfunction pediatrics or congenital voiding dysfunction: posterior urethral valve phimosis? meatal stricture fistula ; ectopic ureteral opening, hypospadias,
21 Hypospadias
22 Cystitis disease usually cause voiding dysfunction The most common form of infection found in female. Caused by gram-negative bacteria colonized in vaginal introitus. Symptoms : irritative bladder dysfunction Simple bacterial cystitis is always easy to treat with oral form antibiotic
23 Type of cystitis when investigation needed. simple bacterial cystitis recurrent cystitis unresolved cystitis persistent cystitis honeymoon cystitis complicated cystitis anatomic abnormalities : post RT, contracted bladder, stricture urethra physiologic disorder: neurogenic, DM rare type bacteria; TB, granulamatous interstitial cystitis stone hemorrhagic cystitis
24 Lower UTI in the male less common than female, ascending infection usually end up as : urethritis orchitis epididymo-orchitis prostatitis Cystitis is uncommon in male!!
25 Overactive bladder (OAB) detrusor overactivity (DO) Urgency with or without incontinence Frequency with low volume of urine Psychological and emotional involvement Normal urine analysis without pyuria and bacteriuria
26 Neurogenic bladder Hyperreflexic bladder dysfunction. CVA, high cord lesion, Pakinsonism etc. voiding with reflex activity irritative bladder dysfunction low residual urine urinary dribbling, wetting Hyporeflexic bladder dysfunction Sacral cord lesion, DM with neuropathy, myelomeningocoel no reflex voiding activity high residual urine, recurrence infection overflow incontinence
27 Drugs to Facilitate Storage Drugs to Facilitate Storage: Decrease Bladder Contractility Propantheline Oxybutynin Tolterodine tartrate Flavoxate (Urispas) Trospium (Sanctura) is a balanced M3/M2 selective anticholinergic. Darifenacin (Enablex) is an M3 selective anticholinergic.. Solifenacin (VESIcare) is an antimuscarinic with smooth muscle relaxing properties. Imipramine : dosage: 25 mg PO tid/qid. Hyoscyamine sulfate Increase Outlet Resistance Ephedrine Estrogens
28 Drugs to Facilitate Emptying Increase Bladder Contractility Bethanechol chloride (Urecholine) Decrease Outlet Resistance Phenoxybenzamine (Dibenzyline) Prazosin (Minipress) Terazosin (Hytrin) Doxazosin (Cardura) Tamsulosin (Flomax) Alfuzosin (Xatral)
29 Bladder outlet obstruction BPH is the most common disease Microscopic BPH : histologic evidence of cellular proliferation of the prostate. Macroscopic BPH : enlargement of the prostate resulting from microscopic BPH. Clinical BPH : the LUTS, bladder dysfunction, hematuria, and UTI resulting from macroscopic BPH. Abrams (1994) has suggested using the more clinically descriptive terms benign prostatic enlargement (BPE), BOO, and LUTS to replace BPH.
30 Histologic BPH
31 Clinical BPH (with LUTS)
32 Not all LUTS is BPH LUTS is not disease specific
33 Diagnostic test: symptom score
34 Digital rectal examination (DRE) Size Consistency: slight pressure over the surface to detect whether: smooth or elastic normal hard or woody may indicate cancer tender suggests prostatitis Mobility: A malignant gland may be fixed to adjacent tissue Anatomical limits: seminal vesicles should be impalpable; induration of these suggests malignancy Kirby R et al (Eds). Shared Care for Prostatic Diseases 1995
35 Lab test urinalysis, should be normal PSA, screen or not screen? -may be unnecessary for pts less than 10 yrs. life expectancy. -must accompany DRE -beware of confounding age range, yrs DRE negative DRE positive DRE suspected < >70
36
37 Objective measure of urine flow rate, Uroflowmetry : Qmax
38
39
40 Primary goals : Treatment goals for LUTS/BPH in clinical practice Fast symptomatic relief of bothering LUTS. Improvement in quality of life (QoL). Potentially an increase of maximum flow rate (Qmax) Secondary goals : Reducing in long-term worsening of symptoms. Preventing serious complication : AUR
41 Treatment of BPH Watchful waitng : suitable for mildly symptomatic not bothersome laboratory test is normal patient choose not to treatment Medical treatment : Moderate symptoms and patient agree to treat. Surgical treatment Severe symptom, failure medical treatment AUR
42 Medical treatment Drug use for possible shrinkage of prostate 5 alpha reductase inhibitor (Finasteride) Drugs use for symptomatic relieve of LUTS alpha 1 blocker Doxazosin, Tamsulosin, Alfuzosin, Terazosin
43
44 BPH a progressive condition Progression of BPH can be defined in increase in prostate volume worsening of LUTS, bother, interference with daily activities and quality of life deterioration in urinary flow rate increased risk of acute urinary retention (AUR) increased risk of surgery
45 Patterns of prostate growth (untreated BPH) (PLESS study) Prostate volume (mean % change from baseline) Baseline Years McConnell JD et al. N Engl J Med 1998; 38:
46 Risk factors for acute urinary retention. J Urol 1997;158:
47 Current indications for surgery Fail medical treatment AUR Problems with compliance Side effect from medication Progressive enlargement of prostate Hematuria
48 Objectives, Do you copy? Understand and explain physiologic function and dysfunction of lower urinary tract. Evaluation patient with LUTS Primary management /investigation Give primary management of BPH
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 informationLower 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 informationMANAGING 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 informationManagement 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 informationDr. 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 informationBenign Prostatic Hyperplasia. Jay Lee, MD, FRCSC Clinical Associate Professor University of Calgary
Benign Prostatic Hyperplasia Jay Lee, MD, FRCSC Clinical Associate Professor University of Calgary Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied,
More informationDiagnostic 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 informationVictoria Sharp, MD, MBA, FAAFP. Clinical Professor of Urology and Family Medicine
Victoria Sharp, MD, MBA, FAAFP Clinical Professor of Urology and Family Medicine Victoria Sharp, MD, MBA, FAAFP Market Chief Medial Officer AmeriHealth Caritas Family of Companies Office phone: (515) 330-3740
More informationNeurogenic bladder. Neurogenic bladder is a type of dysfunction of the bladder due to neurological disorder.
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.
More informationBenign Prostatic Hyperplasia (BPH):
Benign Prostatic Hyperplasia (BPH): Evidence Based Guidelines for Primary Care Providers Jeanne Martin, DNP, ANP-BC Objectives 1. Understand the pathophysiology and prevalence of BPH 2. Select the appropriate
More informationAll about the Prostate
MEN S HEALTH Dr Nick Pendleton January 16 th 2018 All about the Prostate 1 What does it do? Functions of the Prostate 1. Secretes Prostatic Fluid slightly alkaline fluid, 30% of volume of seminal fluid,
More informationUrinary 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 informationURINARY 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 informationWhat 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 informationOveractive 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 informationLUTS 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 informationVarious 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 informationDisclosures. Geriatric Incontinence and Voiding Dysfunction. Agenda. Agenda. UI: a Geriatric Syndrome. Geriatric Syndromes 9/7/2018.
Disclosures Geriatric Incontinence and Voiding Dysfunction None Shachi Tyagi MD, MS Assistant Professor Division of Geriatric Medicine University of Pittsburgh Medical Center UI: a Geriatric Syndrome Geriatric
More informationLUTS & Cancer pathway. Mr Francis Thomas Urology Consultant DRI &BDGH
LUTS & Cancer pathway Mr Francis Thomas Urology Consultant DRI &BDGH Topics Male and female LUTS Urinary retention Post void Residual urine Referral pathway LUTS Raised PSA Hematuria Services in community
More informationProstate Disease. Chad Baxter, MD
Prostate Disease Chad Baxter, MD Managing BPH and LUTS Chad Baxter, MD Department of Urology cbaxter@mednet.ucla.edu 33 nd Annual UCLA Intensive Course in Geriatric Medicine & Board Review Prevalence of
More informationMale Lower Urinary Tract Symptoms: Management in primary care and beyond. Daniel Cohen PhD FRCS(Urol) Consultant Urological Surgeon
Male Lower Urinary Tract Symptoms: Management in primary care and beyond Daniel Cohen PhD FRCS(Urol) Consultant Urological Surgeon 1 LUTS Very common: 1/3 men over age of 50 have moderate to severe LUTS
More informationURGE MOTOR INCONTINENCE
URGE MOTOR INCONTINENCE URGE INCONTINENCE COMMONEST TYPE IN ELDERLY WOMEN Causes: 1 - Defects in CNS regulation Stroke Parkinson s disease Dementia (Alzheimer s and other types) Normopressure hydrocephalus
More informationObjectives. 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 informationThe 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 informationCase studies: LUTS. Case 1 history. Case 1 - questions. Case 1 - outcome. Case 2 - history. Case 1 learning point 14/07/2015 DR JON REES
Case 1 history Case studies: LUTS DR JON REES A 49 year old male comes to see you he has had gradual deterioration of his flow over the last few years- he saw a colleague of yours 6 weeks ago who recorded
More informationOveractive 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 informationManagement of LUTS. Simon Woodhams February 2012
Management of LUTS Simon Woodhams February 2012 The management of lower urinary tract symptoms (LUTS) in men Implementing NICE guidance May 2010 NICE clinical guideline 97 Background Lower urinary tract
More informationCanadian Undergraduate Urology Curriculum (CanUUC): Prostate Diseases
Canadian Undergraduate Urology Curriculum (CanUUC): Prostate Diseases LUTS/Benign Prostate Hyperplasia Objectives 1. List the lower urinary tract symptoms (LUTS) found in men with BPH. 2. List the differential
More informationUBC Department of Urologic Sciences Lecture Series. Voiding Dysfunction & BPH
UBC Department of Urologic Sciences Lecture Series Voiding Dysfunction & BPH Objectives Today 1. Anatomy of the lower urinary tract A) Innervation of the bladder B) Normal voiding 2. Classify Neurogenic
More informationWhat is Nocturia? What are the Consequences of Nocturia? 23/10/12. Dr. Tam Cheuk Kwan Consultant, Dept. of M&G Tuen Mun Hospital
Survival 23/10/12 Dr. Tam Cheuk Kwan Consultant, Dept. of M&G Tuen Mun Hospital What is Nocturia? Nocturia is the complaint that the individual has to wake at night one or more times to void. (ICS definition
More informationNeuropathic 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 informationUrogynecology 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 informationBenign Prostatic Hyperplasia (BPH)
Benign Prostatic Hyperplasia (BPH) Definition Prostate gland enlargement is a common condition as men get older. Also called benign prostatic hyperplasia (BPH), prostate gland enlargement can cause bothersome
More informationModule 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 informationAUCKLAND REGIONAL UROLOGY GUIDELINES AND REFERRAL RECOMMENDATIONS
AUCKLAND REGIONAL UROLOGY GUIDELINES AND REFERRAL RECOMMENDATIONS This document outlines the urological conditions currently funded at Auckland District Health Board (ADHB), Counties Manukau District Health
More informationPelvic 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 informationDiagnosis and Mangement of Nocturia in Adults
Diagnosis and Mangement of Nocturia in Adults Christopher Chapple Professor of Urology Sheffield Teaching Hospitals University of Sheffield Sheffield Hallam University UK 23 rd October 2015 Terminology
More informationMODULE 3: BENIGN PROSTATIC HYPERTROPHY
MODULE 3: BENIGN PROSTATIC HYPERTROPHY KEYWORDS: Prostatic hypertrophy, prostatic hyperplasia, PSA, voiding dysfunction, lower urinary tract symptoms (LUTS) At the end of this clerkship, the medical student
More informationLUTS after TURP: How come and how to manage? Matthias Oelke
LUTS after TURP: How come and how to manage? Matthias Oelke Department of Urology Global Congress on LUTD, Rome, 26 th June 2015 Disclosures Consultant, speaker, trial participant and/or research grants
More informationPolicy for Prostatism/Lower Urinary Tract Symptoms in men
NHS Halton Clinical Commissioning Group NHS Liverpool Clinical Commissioning Group NHS St Helens Clinical Commissioning Group NHS South Sefton Clinical Commissioning Group NHS Southport and Formby Clinical
More informationIncontinence: 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 informationGeriatric Urinary Incontinence
Geriatric Urinary Incontinence Neil M. Resnick, MD Thomas Detre Professor of Medicine Chief, Division of Geriatric Medicine University of Pittsburgh/UPMC UI: The Problem Prevalence in elderly 33% Morbidity
More informationOffice Management of Benign Prostatic Enlargement
Focus on CME at McGill University Office Management of Benign Prostatic Enlargement Symptomatic benign prostate enlargement is a common medical problem encountered in our aging society. Watchful waiting,
More informationMr. 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 informationAssociation of BPH with OAB: The Plumbing or the Pump?
Association of BPH with OAB: The Plumbing or the Pump? Ryan P. Terlecki, MD FACS Associate Professor of Urology Director, Men s Health Clinic Director, GURS Fellowship in Reconstructive Urology, Prosthetic
More informationNON-Neurogenic Chronic Urinary Retention AUA White Paper
NON-Neurogenic Chronic Urinary Retention AUA White Paper Great Lakes SUNA Inside Urology March 16, 2018 Michelle J. Lajiness FNP-BC Nurse Practitioner DMC Urology Incidence Really unknown Lack consensus
More informationManagement 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 informationTools 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 informationBladder 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 informationManagement 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 informationDiane 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 informationThe 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 informationProstate Health PHARMACIST VIEW
Prostate Health PHARMACIST VIEW Prostate Definition Prostate is a gland made of fibromuscular tissue. It is about 4 cm and surrounds the neck of the bladder and the urethra. It produces seminal fluid.
More informationNEUROGENIC 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 informationSome people experience occasional, minor leaks of urine. Others wet their clothes frequently.
Urinary Incontinence Urinary incontinence the loss of bladder control is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having
More informationEvaluation and Treatment of Incontinence
Evaluation and Treatment of Incontinence Classification of Incontinence Failure to empty: Overflow incontinence Failure to store Stress Incontinence Urge Incontinence Physiology of voiding CNS Brain sends
More informationAppendix 2 Drug Information
Appendix 2 Drug Information Chemical Name: baclofen (bak-loe-fen) Brand Name: Lioresal (U.S. and Canada) Description: Baclofen acts on the central nervous system to relieve spasms, cramping, and tightness
More informationTREATMENT 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 informationIncontinence. 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 informationCauses of Transient Incontinence. Geriatrics: Urinary Incontinence, Dementia, and Delirium. Classification of Established Incontinence
Causes of Transient Geriatrics: Urinary, Dementia, and Delirium Carla Zeilmann, PharmD, BCPS St. Louis College of Pharmacy Therapeutics 3 Fall 2003 D delirium I infection A atrophic urethritis and vaginitis
More informationDr. Melissa Kagarise, PA C
Dr. Melissa Kagarise, PA C This program has been supported by an educational grant from Pfizer Pharmaceuticals PharmCon is accredited by the Accreditation Council for Pharmacy Education as a provider of
More informationManagement of male LUTS in general practice
17 Management of male LUTS in general practice MARK J. SPEAKMAN AND FAITH MCMEEKIN The initial management of lower urinary tract symptoms in men is usually carried out in primary care. The authors explain
More informationPROSTATIC EMBOLIZATION FOR BENIGN HYPERPLASIA
St. Louis Hospital PROSTATIC EMBOLIZATION FOR BENIGN HYPERPLASIA INITIAL CLINICAL RESULTS Faculty of Medical Sciences New University of Lisbon JOÃO PISCO LUÍS CAMPOS PINHEIRO TIAGO BILHIM HUGO RIO TINTO
More informationPhysiology & 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 informationUrinary Incontinence. Lee A. Jennings, MD, MSHS. Assistant Professor Reynolds Department of Geriatrics University of Oklahoma Health Sciences Center
Urinary Incontinence Lee A. Jennings, MD, MSHS Assistant Professor Reynolds Department of Geriatrics University of Oklahoma Health Sciences Center Slides adapted from Alison Moore, MD, MPH University of
More informationUrine a Mess: Micturition Disorders Joe Bartges, DVM, PhD, DACVIM, DACVN Cornell University Veterinary Specialists Stamford, CT
Urine a Mess: Micturition Disorders Joe Bartges, DVM, PhD, DACVIM, DACVN Cornell University Veterinary Specialists Stamford, CT 1. Micturition refers to the process of storing and periodically voiding
More informationTable 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 informationINCONTINENCE What can Wee do about it?
Prevalence INCONTINENCE What can Wee do about it? High risk groups Myths Aetiology Assessment-History Assessment-Drugs Assessment- Examination & Tests INCONTINENCE What can wee do about it? Treatment-First
More informationDefinitions 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 informationOveractive 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 informationBenign Prostatic Hyperplasia. Shahideh Amini Pharm.D clinical pharmacy resident Tehran university of medical science Department of pharmacotherapy
Benign Prostatic Hyperplasia Shahideh Amini Pharm.D clinical pharmacy resident Tehran university of medical science Department of pharmacotherapy Definition BPH is a common disorder that increases in frequency
More informationIJBCP International Journal of Basic & Clinical Pharmacology
Print ISSN: 2319-2003 Online ISSN: 2279-0780 IJBCP International Journal of Basic & Clinical Pharmacology DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160772 Research Article Efficacy and safety of
More informationUrodynamics 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 informationOverview. Urology Dine and Learn: Erectile Dysfunction & Benign Prostatic Hyperplasia. Iain McAuley September 15, 2014
Urology Dine and Learn: Erectile Dysfunction & Benign Prostatic Hyperplasia Iain McAuley September 15, 2014 Overview Review of the most recent guidelines for ED and BPH ED Guidelines CUA 2006 AUA 2011
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Centre for Clinical Practice Surveillance Programme
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Centre for Clinical Practice Surveillance Programme Clinical guideline CG97: The management of lower urinary tract symptoms in men Publication date May
More informationR. Matthew Smith M.D. Mercy Urology
R. Matthew Smith M.D. Mercy Urology None Disclosures Goals Update growth of Mercy Urology Clinic Quick Review of Hematuria and PSA Present common urologic complaints seen by the primary care physician
More informationThe 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 informationAdult 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 informationVOIDING DYSFUNCTION IN ELDERLY MALE CURRENT STATUS
VOIDING DYSFUNCTION IN ELDERLY MALE CURRENT STATUS DR. FRANCIS LEE Voiding dysfunction Storage Emptying Common voiding dysfunction in elderly male Emptying BPH Storage Incontinence Overactive bladder Post-prostatectomy
More informationBPH / LUTS. Prevalence. Prevalence of BPH. It is abnormal NOT to have benign growth of the prostate with increasing age. Prevalence.
BPH / LUTS Dr Jonny Coxon MA MD MRCS MRCGP DRCOG FECSM Beaconsfield Medical Practice, Brighton & Brighton & Sussex Universities NHS Trust As man draws near the common goal Can anything be sadder Than he
More informationClinical guideline Published: 23 May 2010 nice.org.uk/guidance/cg97
Lower urinary tract symptoms in men: management Clinical guideline Published: 23 May 2010 nice.org.uk/guidance/cg97 NICE 2017. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationSummary. 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 informationAs man draws near the common goal Can anything be sadder Than he who, master of his soul Is servant to his bladder LUTS 2. Prevalence of BPH LUTS 5
BPH / LUTS Dr Jonny Coxon MA MD MRCS MRCGP DRCOG Beaconsfield Medical Practice, Brighton As man draws near the common goal Can anything be sadder Than he who, master of his soul Is servant to his bladder
More informationPatient Information. Lower Urinary Tract Symptoms (LUTS) and Diagnosis of BPE
Patient Information English 32 Lower Urinary Tract Symptoms (LUTS) and Diagnosis of BPE Symptoms The underlined terms are listed in the glossary. Benign prostatic enlargement (BPE) can affect the way you
More informationUrology Teaching. Affects ~15% of females and 5% of males, with prevalence increasing with age. Cost to NHS of billion annually.
Urology Teaching Continence Types Urge o Urine loss accompanied by urgency resulting from abnormal bladder contractions Stress o Urine loss resulting from sudden increased intra-abdominal pressure Mixed
More informationLower Urinary Tract Symptoms BPH vs OAB FLOW vs VOLUME. Matt T. Rosenberg, MD Family Practice Mid Michigan Health Centers Jackson, Michigan
Lower Urinary Tract Symptoms BPH vs OAB FLOW vs VOLUME Matt T. Rosenberg, MD Family Practice Mid Michigan Health Centers Jackson, Michigan 1 Definition of OAB Syndrome or symptom complex defined as urgency,
More informationBenign Prostatic Hyperplasia. Management of Benign Prostatic Hyperplasia. Goals of Therapy
Benign Prostatic Hyperplasia Management of Benign Prostatic Hyperplasia Goals of Therapy Improve or abolish lower urinary tract symptoms (LUTS) Prevent or delay clinical progression of benign prostatic
More informationIncontinence: The silent scourge of the young and old. The International Continence Society has. In this article:
Focus on CME at the University of Toronto Incontinence: The silent scourge of the young and old By Sender Herschorn, BSc, MDCM, FRCSC In this article: 1. What is the workup for urinary incontinence? 2.
More informationOveractive 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 informationEVALUATION OF THE EFFICACY OF TADALAFIL IN IMPROVING LOWER URINARY TRACT SYMPTOMS IN PATIENTS WITH SYMPTOMATIC BENIGN PROSTATIC ENLARGEMENT
Basrah Journal Of Surgery EVALUATION OF THE EFFICACY OF TADALAFIL IN IMPROVING LOWER URINARY TRACT SYMPTOMS IN PATIENTS WITH SYMPTOMATIC BENIGN PROSTATIC ENLARGEMENT MB, ChB, FIBMS, Assistant Professor
More informationURINARY 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 informationDOWNLOAD OR READ : TREATMENT OF BENIGN PROSTATIC HYPERPLASIA PDF EBOOK EPUB MOBI
DOWNLOAD OR READ : TREATMENT OF BENIGN PROSTATIC HYPERPLASIA PDF EBOOK EPUB MOBI Page 1 Page 2 treatment of benign prostatic hyperplasia treatment of benign prostatic pdf treatment of benign prostatic
More informationURODYNAMICS 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 informationMODULE 9: URINARY INCONTINENCE
MODULE 9: URINARY INCONTINENCE KEYWORDS: PROSTATIC HYPERTROPHY, PROSTATIC HYPERPLASIA, PSA, VOIDING DYSFUNCTION, LOWER URINARY TRACT SYMPTOMS (LUTS). Learning Objectives At the end of this clerkship, the
More informationIntegrated Treatment of the Adult Geriatric Male Patient
Michigan Osteopathic Association David D. Wartinger, D.O., J.D. Michigan State University College of Osteopathic Medicine May 13, 2016 1400-1830 Integrated Treatment of the Adult Geriatric Male Patient
More informationWorkshop : Managing Urinary Stones and BPH
Workshop : Managing Urinary Stones and BPH How common are they? lifetime risk 15% men, 6% women Dr John Tuckey Urologist Auckland 105 new stones /100,000 peak age incidence 30-50 males 2.3:1 How common
More information10/9/2015. Dana A. Brown, Pharm.D., BCPS Assistant Dean for Academics, Associate Professor of Pharmacy Practice Palm Beach Atlantic University
Dana A. Brown, Pharm.D., BCPS Assistant Dean for Academics, Associate Professor of Pharmacy Practice Palm Beach Atlantic University 1. Explain the pathophysiology of benign prostatic hyperplasia (BPH),
More informationBen 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 informationMale 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