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Blood In Urine (Hematuria) Treatment
Treatment Of Erectile Dysfunction
Treatment of H.I.V
Hydrocele Treatment (Surgical)
Kidney Transplant Treatment
Treatment Of Male Sexual Problems
Minimally Invasive Urology Surgery
Open Prostatectomy Surgery
Reconstructive Surgery Procedures
Reconstructive Urology Surgery
Transurethral Incision Of The Prostate (Tuip) Proc
Transurethral Resection Of The Prostate (Turp) Pro
Urinary Incontinence (Ui) Treatment
Urology Minimally Invasive Surgery
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Many people are hesitant to see a doctor for incontinence as they feel embarrassed or believe it can't be treated or that the problem will eventually go away by itself. This may be true in a few cases, but many cases can be successfully treated or managed. The treatment of incontinence will vary according to whether it is faecal or urinary incontinence and will depend on the cause, type and severity of the problem.
1. Stress incontinence
• Weight loss
• Cessation of smoking
• Pelvic floor exercises
• Vaginal weights
• Electrical stimulation
Non-medical treatment can be very effective in motivated patients with minor degrees of stress incontinence. The short-term results are often very good, but this isn't always maintained in the long term. Published studies quote cure/improvement rates of 50-80% for pelvic-floor exercises.
• Combination of the above
Medical treatment doesn't have a great role in stress incontinence. Postmenopausal atrophy affects the closure of the urethra. Oestrogens, which can be taken orally or applied locally, restores the bulk of urethral tissue leading to more effective closure. Alpha-agonist s increase the tone in the bladder neck, thereby increasing outflow resistance. Some studies indicate a beneficial effect using a combination of oestrogen and an alpha-agonist in older post-menopausal women.
• Periurethral injections of bulking agents
• Suspension operations
• Sling operations
• Artificial urinary sphincters
Periurethral injections involve the injection of bulking agents into the urethra to improve effective urethral closure. Commonly used agents include fat, collagen, Teflon paste and silicon particles. Injection therapy is suitable for women with intrinsic sphincter deficiency rather than hyper mobility, as well as for men with post-prostatectomy incontinence. The major advantage of injection therapy is that it's a minor procedure. Short-term results are good, but often not maintained long-term.
The various suspension operations restore the normal anatomy in patients with hyper mobility and improve the support of the urethra and the bladder neck. Open suspension operations like the Burch copo suspension provide the best long-term results. The various needle suspensions have fallen into disuse due to high failure rates.
Urethral slings can be used in people with intrinsic sphincter deficiency as well as those with hyper mobility. It involves the placement of a strip of tissue or artificial substance that supports the urethra and bladder neck like a hammock. It increases outflow resistance and improves urethral closure by supporting the mid urethra. The vast majority of patients can be rendered dry in this way, but the operation does carry the risk of difficulty with passing urine afterwards. Other complications include infection or erosion of the synthetic sling material which then has to be removed.
An artificial urinary sphincter (AUS) made of silicone can be used in someone with total incontinence resulting from irreparable damage to the sphincter. The AUS consists of a small cuff that is placed around the urethra (bladder tube), with a reservoir (balloon) that is placed in the lower belly next to the bladder. Both of these are connected with a small tube to a valve placed in the scrotum, which the person then uses to inflate or deflate the cuff. An AUS is very effective, but it is quite expensive, and there is a risk of infection or erosion of the synthetic material.
2. Urge incontinence
• Bladder training
• Pelvic floor exercises
Voiding by the clock and progressively increasing the time between voids can improve the symptoms of patients with urge incontinence and otherwise normal bladders. This can be combined with biofeedback and pelvic floor exercises.
Drug therapy forms the mainstay of treatment for patients with urge incontinence due to bladder instability. These anti cholinergic agents relax the bladder muscle and increase bladder capacity. Side effects include a dry mouth, constipation and blurred vision.
Injection of botulinum A toxin (Botox) into the bladder muscle (detrusor) can be used if the urge incontinence is due to a neurological disease causing overactive bladder contractions.
Tiny bladders due to radiation or tuberculosis can be enlarged surgically. A segment of intestine is patched onto the opened bladder, thereby increasing the capacity. Patients with intractable bladder instability who have failed medical treatment can also be treated in this way.
3. Overflow incontinence
Overflow incontinence due to bladder outflow obstruction is treated by surgically alleviating the obstruction. The most common example would be a man with prostatic enlargement treated by resection of the prostate gland. If the incontinence is due to failure of the bladder to contract then intermittent clean self-catheterisation is the most appropriate treatment. Permanent indwelling catheters should be avoided if at all possible.
4. Total incontinence
Total incontinence due to a vesico vaginal fistula or auretero vaginal fistula is treated by surgical repair of the defect.
Treating faecal incontinence
Once your doctor has established the underlying cause of faecal incontinence, they will decide on the most suitable treatment, which could involve a combination of medication, exercise and other methods.
Let’s look at some of the treatment options available for FI:
Dietary changes: If your FI is caused by diarrhoea or constipation, making changes to your diet may sometimes help to normalize and regulate bowel movements. Your doctor may ask you to keep a food diary to monitor the impact of dietary changes. For example, he or she may suggest increasing your intake of high-fibre foods and fluids, or to eliminate foods that may exacerbate the problem.
Medications: Your doctor may recommend specific medication or bulking agents such as fibre supplements to change stool consistency, depending on whether you suffer from diarrhoea or constipation. Another option is Solesta, an injectable FDA-approved gel that's injected into the anus and effectively reduces or completely treats FI in some people. This gel narrows the anal opening by increasing the growth of rectal tissue and helping it to remain tightly closed.
Bowel retraining: This routine encourages normal bowel movements and helps you achieve greater control by becoming more aware of the need to use the toilet. It may incorporate various aspects such as making a conscious effort to have a bowel movement at a specific time of day and using suppositories to stimulate bowel movements.
Biofeedback: This improves the strength and coordination of the anal muscles that help control bowel movements, and heightens the sensation related to the rectum filling with stool. It usually involves a specially trained physiotherapist teaching you simple exercises to strengthen your pelvic-floor muscles, sense when stool is ready to be released and contract the muscles if it's not appropriate to have a bowel movement at a specific time.
Kegel exercises: Also called pelvic-floor exercises, these focus on strengthening the muscles of the anus, buttocks and pelvis. When done correctly, they can be effective in improving or resolving FI. They involve a routine of repeatedly contracting muscles used when making a bowel movement. Hold these muscles as if you're trying to stop the flow of stool or passing gas for a slow count of five, and then relax. Kegel exercises should be done in a series of 30 contractions three times a day. They usually strengthen the pelvic-floor muscles within a few weeks.
Surgery: In some cases, surgery may help people with severe FI who haven't responded to other treatments or people with an underlying condition causing incontinence that need surgery to regain control. There are various surgical options and your doctor will probably refer you to a specialist.
My urine colour is very yellow every day. How can we solve them it now? And I am not cause of any dease. Please give me a write answers thank-you.
Hi I m 35 years old n healthy. For the past 3 years I m suffering from kidney (i have copper t inserted after my second child). When detected I had 3 stones, while last when I checked only 1is remaining. My stones were detected because I use to have back pain on my right side, but then the pain had reduced. But now recently again the pain had started I usually it is in the morning when I sleep for long hours. Also I have observed the there is blood passing in my vaginal discharge. Please help.
Information given above is of my baby girl of two months. She is not doing motion everyday since from 15 days and from 3 days onwards she is doing urination only 3 to 4 times daily. Is tat normal in this summer? Are there any solutions for tat?
Hello sir. Sir I want to know the food or fruits which should be taken or avoided in case of kidney stone so that one can easily get rid of kidney stone properly. please sir name d fruits to avoid and take so that a middle class person can have it.
Mujhe peshab karne me thori awarodh utpan karta h. ultrasound karwaya usme urinary blader increase aya h. Please meri help kare.
The general perception that hereditary diseases cannot be prevented is changing. Polycystic kidney disease (PKD) is one such hereditary condition. The kidneys are the body's detox machine, which remove all impurities and flush it out of the system through urine. PKD is a condition where there are multiple, fluid-filled cysts which develop in the kidneys. These can vary in size and though noncancerous, can grow to a very large extent, producing severe symptoms including extremely high blood pressures and kidney failure.
In the recent past, however, there have been various theories that put forth how a modified and healthy lifestyle can prevent PKD. A child with a parent who suffers from PKD has 50% likelihood to develop the same. That cannot be prevented; however, changes can be made which can delay the onset and reduce the severity of symptoms of PKD, most notably high blood pressure and kidney failure which may require lifelong dialysis.
Symptoms and complications: The most common symptoms include high blood pressure, kidney pain (behind the back above the buttocks), infections of the kidneys or the bladder, bloody urine, kidney failure, headache, bloated abdomen due to the fluid-filled cysts, frequent urination, and kidney stones. There could be impact on pregnancy plans, with high blood pressure complicating the pregnancy. This needs extra care in management and is not life-threatening in most cases.
Prevention: The kidneys take the brunt of all the toxins that a body is subjected to. It is therefore, very important to reduce the exposure of body, especially kidneys to toxins. One of the best ways to keep the kidneys in good health is to control blood pressure. Some of the ways to do this include:
- Following a low-sodium diet with a good amount of hydration
- Reduce fat in the diet as much as possible
- Include a lot of berries, broccoli and apples
- Be diligent in taking your blood pressure medications as directed
- Ensure that your weight is within the prescribed limits for you
- Quit smoking and drinking
- At least 30 minutes of moderate physical activity should be included in your daily regimen
Read up on symptoms of PKD and keep an eye on them. If you are having a bloated feeling or pain in the kidneys or blood in the urine, consult a doctor. If you are planning on having a baby, genetic counseling may be useful to see if there is a risk of passing on the genes to the baby. Keep a positive outlook and have a frank discussion with family and friends on your overall condition. So, as much as PKD is a hereditary disease, there are ways to manage it and improve the quality of life.