stress incontinence…

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female urinary tract, male urinary tract, anterior vaginal wall repair, stress incontinence, stress incontinence, incontinence, stress, stress incontinence, involuntary loss of urine that occurs, physical activity, coughing, sneezing, laughing, exercise, stress incontinence, bladder storage problem, the strength, the urethral sphincter is diminished, sphincter is not able, prevent urine flow, is increased pressure, abdomen, stress incontinence, a result of weakened pelvic muscles that support the bladder, urethra, malfunction, the urethral sphincter, prior trauma, urethral area, neurological injury, medications, weaken the urethra, sphincter weakness, occur in men following prostate surgery, in women after pelvic surgery, stress incontinence, seen in women, had multiple pregnancies, vaginal childbirths, pelvic prolapse, protrusion, the bladder, urethra, rectal wall, vaginal space, cystocele, cystourethrocele, rectocele, studies have documented, 50% of all women have occasional urinary incontinence, 10% have frequent incontinence, nearly 20% of women over age 75 experience daily urinary incontinence, stress urinary incontinence, most common type of urinary incontinence in women, risk factors, stress incontinence include female sex, advancing age, childbirth, smoking, obesity, conditions that cause chronic coughing, chronic bronchitis, asthma, increase the risk of stress incontinence, ability, hold urine, maintain continence is dependent on normal function, the lower urinary tract, kidneys, nervous system, additionally, person must possess the physical, psychological ability to recognize, urge to urinate, process of urination involves two phases, filling, storage phase, emptying phase, filling, storage phase, bladder begins to fill, urine, kidneys, bladder stretches to accommodate the increasing amounts of urine, first sensation, the need to urinate occurs, approximately 200 ml of urine is stored, healthy nervous system, respond to this stretching sensation by alerting you, urinate, allowing the bladder to continue to fill, average person, hold approximately 350 to 550 ml of urine, ability to fill, store urine properly, a functional sphincter muscle, controlling output of urine, bladder, a stable bladder wall muscle, detrusor muscle, emptying phase, the ability, the detrusor muscle to appropriately contract to force urine out, the bladder, additionally, body must also be able to simultaneously relax the sphincter, the urine to pass out, loss of urine, symptom that occurs, coughing, sneezing, standing, exercising, physical activity, a physical examination, an abdominal, rectal exam, a genital exam in men, a pelvic exam in women, women, a pelvic examination, detect cystocele, urethrocele, protrusion, the bladder, urethra, vaginal space, patients asked, keep a urinary diary, recording how urinate, night, how often urinary leaking occurs, post-void residual, pvr, to measure amount, urine left after urination, urinalysis, urine culture to rule out urinary tract infection, urinary stress test, patient is asked, stand, a full bladder, cough, pad test, after placement of a pre-weighed sanitary pad, patient is asked, exercise, following exercise, pad is re-weighed, urine loss, a pelvic, abdominal ultrasound, x-rays, contrast dye, the kidneys, bladder, cystoscopy, inspection, the inside, the bladder, urodynamic studies, tests to measure pressure, urine flow, an emg, electromyogram, performed to study muscle activity, in the urethra, pelvic floor, tests, the measurement, the change, in the angle, the urethra, at rest, straining, q-tip test, an angle change of greater than 30 degrees often indicates significant weakness, the muscles, tissues that support the bladder, choice of a specific treatment, depend on the severity, extent that the symptoms interfere, lifestyle, four major categories of treatment, stress incontinence, behavioral changes, pelvic floor muscle training, surgery, behavioral changes, changing fluid intake, voiding pattern, improve stress incontinence symptoms, physician, decrease fluid intake, drink an, excessive amount, fluids, should not decrease fluid intake, drink normal amounts of fluids, urinating more frequently, help some patients decrease the amount, urine that they leak, constipation, worsen urinary incontinence, dietary, medical treatments to help keep regular bowel habits, weight loss has been shown to decrease stress incontinence in patients who, overweight, severe stress incontinence, modify activity level to avoid movements that cause greater leakage of urine, want to modify activities that involve jumping, running, activity that causes, an increase in abdominal pressure, pelvic floor muscle therapy, pelvic muscle training exercises, kegel exercises, prove to be beneficial in controlling the leakage of urine that occurs, stress incontinence, principle behind kegel exercises, strengthen the muscles, the pelvic floor, thereby improving the urethral sphincter function, success of kegel exercises depends on proper technique, adherence to a regular exercise program, women, use vaginal cones to strengthen the, elvic floor muscles, a vaginal cone, weighted device that is inserted, vagina, woman should then try to contract the pelvic floor muscles in an effort, hold the device in place, contraction, up to 15 minutes, performed twice daily, 4 to 6 weeks, 70% of women have had some improvement in symptoms, unable to correctly perform pelvic muscle exercises, biofeedback, electrical stimulation, help identify the correct muscle group to work, biofeedback, method of positive reinforcement, electrodes, placed on abdomen, along the anal area, therapists place a sensor, in the vagina in women, anus in men to monitor contraction, the pelvic floor muscles, a monitor, which muscles, contracting, at rest, therapist, identify the correct muscles, performing kegel exercises, the people who used biofeedback, 75% have reported improvement of symptoms, 15% were cured, electrical stimulation therapy uses low-voltage electric current to stimulate, contract the correct group of muscles, current is delivered using an anal, vaginal probe, electrical stimulation therapy performed, in the clinic, at home, treatment sessions, last 20 minutes, performed every 1 to 4 days, a new technique using a specially designed chair, an electromagnetic field causes, pelvic floor muscles to contract the patient sits, in the chair, new devices, currently tested, vagina, correct bladder, urethral support, to help occlude the urethra, ask health care provider, devices, medications, medications, treat stress incontinence, aimed at increasing the contraction, the urethral sphincter muscle, medications tends to be more successful in patients, mild-to-moderate stress incontinence, alpha-adrenergic agonist drugs, phenylpropanolamine, pseudoephedrine, common components of over-the-counter cold medications, treat stress incontinence, work by increasing the strength, the urethral sphincter, improve symptoms in, 50% of patients, additionally, tricyclic antidepressant imipramine has similar properties, treat stress incontinence, estrogen therapy, improve symptoms of urinary frequency, urgency, burning in postmenopausal women, has also been shown to increase the tone, blood supply, the urethral sphincter muscles, whether estrogen treatment improves stress incontinence is controversial, estrogen taken by mouth, by a skin patch, applied, vaginal mucosa, cream form, women, a history of breast, uterine cancer should, not use estrogen therapy, the treatment of stress urinary incontinence, surgery, surgical treatment is only recommended after thorough evaluation, determination, the exact cause, the urinary incontinence, person considering surgery, aware, the potential risks, the expected benefit, the procedure, goal of these surgical procedures, cure the cause, the stress urinary incontinence either by supporting the bladder, urethra in its proper position, function properly, by tightening the urethral sphincter, similar in men, women, rationale, performing the procedure, outcomes vary by gender, collagen injection, a minor surgical procedure, collagen periurethral injection recommended, treatment of male, female stress incontinence, urethral sphincter dysfunction, procedure is performed in an outpatient setting, a local, spinal anesthesia, repeated after a few months to achieve bladder control, collagen injection helps control the urine leakage by bulking up the area around the urethra, compressing the sphincter, women who were treated, collagen injection therapy reported a higher success rate, 75% improved, cured, than men, 52% improved, cured, who were treated, the same collagen therapy, potential complications, occur after a collagen injection, infection, urine retention, temporary erectile dysfunction in men, potentially serious allergic reaction to collagen, potential candidate, collagen injection must have a skin test, prior to treatment to check, an allergic reaction, anterior vaginal repair, paravaginal repair, vaginal procedures, performed in women, the bladder is prolapsing, vagina, a cystocele, an anterior vaginal repair is performed, a vaginal incision, a paravaginal repair is performed, either a vaginal, an abdominal incision, in an anterior repair, pubocervical fascia, supportive tissue between the vagina, bladder, folded, stitched together to bring the bladder, urethra in proper position, paravaginal repair, pubocervical fascia is stitched, fascia covering the pelvic floor muscles to support the bladder, urethra, the cure rate, stress urinary incontinence from these procedures is only, 40-65%, surgeries, more effective, performed, repair a cystocele, stress urinary incontinence, another procedure, stress incontinence, retropubic suspension, needle bladder neck suspension, several surgical procedures, performed in women, a minor abdominal incision, a vaginal incision, repair the bladder, urethral dysfunction, needle procedures, special needle instruments, utilized, surgery, only a small abdominal incision, various procedures, modified pereyra, stamey procedure, differ, the structures, anchor, support the bladder, women treated, procedures have a 40-80% cure rate, the success rate tends to be lower than that achieved, retropubic suspensions, sling procedures, performed less often than, complications include urinary tract infection, inability to urinate, wound infection, fistula, new onset of urge incontinence, retropubic suspension, retropubic suspension, describe a group of surgical procedures performed to elevate the bladder, urethra, the pelvic region, an abdominal incision, burch colposuspension, marshall-marchetti-krantz, mmk, differ, the structures, anchor, support the bladder, women treated, procedures have a 75-90% cure rate, complications include urinary tract infection, inability to urinate, wound infection, fistula, new onset of urge incontinence, sling procedure, procedure is rarely performed in men, more often, treat women, stress incontinence, weakened urethral sphincter muscles, a sling is formed by taking a piece, the abdominal tissue, fascia, a piece of synthetic material, using it to compress the urethral sphincter, preventing leakage of urine, stress maneuvers, procedures, require a small abdominal incision, a vaginal incision, many modifications, the sling procedure have been developed, the transvaginal tape procedure, type of sling procedure is performed, smaller incisions, an outpatient surgery, among the people, had sling procedures, stress incontinence, an 80-90% cure rate, complications include infection, erosion, the sling, non-healing vaginal wall, fistula, abscess formation, urgency, urge incontinence, urinary retention, artificial urinary sphincter, surgical procedure to treat stress incontinence in men, most commonly occurs after prostate surgery, artificial urinary sphincters, rarely used in women, most experts advise patients to try other treatments, resorting to this treatment, men who were treated, device had an 82% cure rate, women had a 92% cure rate, complications of this surgery include wound infection, urethral erosion, requiring removal, the device, additionally, the pump mechanism, in the labia in women, scrotum, men, modify some activities, bicycle riding, to accommodate the pump, monitoring, urinary incontinence, chronic, long-term, problem, some people cured by various treatments, should continue, health care provider to evaluate the progress of symptoms, monitor, complications of treatment, behavioral changes, pelvic floor exercise therapy, medical management of stress incontinence, improves symptoms rather than cures the disorder, surgery, 75% to 95% cure rate, patients, selected, a poorer outcome is expected, previous surgical failures, genital, urinary problems, systemic conditions, prevent adequate healing, make the technical aspects, the surgery more difficult, physical complications, vaginal discharge, vulvar irritation, pain, intercourse, relatively rare, unpleasant odors, psychosocial implications of incontinence significant, the condition, affect, disrupt social activities, careers, relationships, symptoms of stress incontinence occur, bothersome, performing kegel exercises, tightening muscles, the pelvic floor, trying to stop urine stream, prevent the development of symptoms, performing kegel exercises, after pregnancy, decrease the risk of developing stress urinary incontinence after childbirth.