1/6. pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction and postmicturition dribble: three case studies.Three successful case studies of men receiving treatment for erectile dysfunction and postmicturition dribble are presented to alert nurses to the possible benefits of pelvic floor muscle exercises.- - - - - - - - - - ranking = 1keywords = floor (Clic here for more details about this article) |
2/6. Spasticity of the pelvic floor mimicking an obstructive anomaly.STUDY OBJECTIVE: hematocolpos or hydrocolpos in menstruating women raises suspicion of a partial uterine or vaginal obstruction. The study objective is to report two unusual cases of a spastic pelvic floor leading to urine collecting in the vagina and mimicking an outflow obstruction. DESIGN, SETTING, PARTICIPANTS: The study took place at a tertiary care university's reproductive health Care Clinic for women with developmental disabilities and involved two patients with spastic quadriplegic cerebral palsy and developmental disabilities who presented with irregular menses and abdominal pain and whose radiological evaluations were suspicious for an outflow obstruction. medical records, including clinic visits, radiological findings, and surgical findings, were reviewed. INTERVENTIONS: Both patients underwent ultrasound and MRI evaluation of their reproductive tracts that demonstrated fluid collections in the vagina. An examination under anesthesia was performed in one patient to rule out an obstruction. In the second patient, a pelvic examination under ultrasound observation revealed initial vaginal distension with urine, which resolved after placement of a speculum. RESULTS: In both cases, the pseudo-obstruction was felt to be a urine-distended vagina due to a spastic pelvic floor. CONCLUSION: A spastic pelvic floor in an incontinent patient with spastic quadriplegia may result in urine accumulation in the vagina, mimicking an outflow tract obstruction. If the history, pelvic examination, and radiological images are inconsistent, performing an ultrasound-guided examination may assist with diagnosis.- - - - - - - - - - ranking = 1.4keywords = floor (Clic here for more details about this article) |
3/6. Approach to urinary incontinence in women. diagnosis and management by family physicians.OBJECTIVE; To outline an approach to diagnosis and management of the types of urinary incontinence seen by family physicians. SOURCES OF INFORMATION: Recommendations for diagnosis are based on consensus guidelines. Treatment recommendations are based on level I and II evidence. Guidelines for referral are based on the authors' opinions and experience. MAIN MESSAGE: Diagnoses of stress, urge, or mixed urinary incontinence are easily established in family physicians' offices by history and gynecologic examination and sometimes a urinary stress test. There is little need for formal diagnostic testing. Management by family physicians (without need for specialist referral) includes lifestyle modification, pelvic floor muscle strengthening, bladder retraining, and pharmacotherapy with muscarinic receptor antagonists. patients with pelvic organ prolapse might require specialist referral for consideration of pessaries or surgery, but family physicians can provide follow-up care. women with more complex problems, such as severe prolapse or failed continence surgery, require referral. CONCLUSION: urinary incontinence is a common condition in women. In most cases, it can be diagnosed and managed effectively by family physicians.- - - - - - - - - - ranking = 0.2keywords = floor (Clic here for more details about this article) |
4/6. Electrical stimulation of pelvic floor musculature by percutaneous implantable electrodes: a case report.A forty-year-old man with reflex urinary incontinence due to spinal cord injury was treated with electrical stimulation of the pelvic floor musculature. In this case we employed percutaneous implantable electrodes and an external pulse regulator. After 4 weeks of stimulation incontinence was improved and urodynamically maximum cystometric capacity increased from 220 ml to 350 ml. Our method is easy and not invasive. This technique can be an alternative for the electrical stimulation for urinary incontinence.- - - - - - - - - - ranking = 1keywords = floor (Clic here for more details about this article) |
5/6. Management of urinary incontinence in women in general practice: actions taken at the first consultation.The investigators set out to find out how Norwegian general practitioners (GPs) manage women suffering from urinary incontinence by using responses to a questionnaire containing six typical case histories. questionnaires were sent to 191 GPs, of whom 139 (73%) replied. In 93% of all case histories the GPs responded that they would conduct some kind of investigation or treatment. Gynaecological examination and microscopy of the urine were the most frequent investigations stated. Drugs were prescribed in 41% of cases, mainly following appropriate indications. Instruction in pelvic floor exercises was predominant for the younger patients, while old patients were prescribed incontinence pads. Thus it seems that the therapeutic ambitions of the practitioner are reduced as the patients get older. Bladder training was only stipulated in 14% of cases. Adequate treatment is defined as relevant drugs and exercises in combination with pads, or referral. According to this definition 46% of the patients were treated adequately, 28% by the GPs themselves. Twenty five percent of the patients were referred to a gynaecologist.- - - - - - - - - - ranking = 0.2keywords = floor (Clic here for more details about this article) |
6/6. The treatment of detrusor incontinence by electrical stimulation.Cystometrograms were done on 20 patients before and during transrectal stimulation to determine if electrical stimulation increased the detrusor reflex threshold. In 4 patients the detrusor reflex threshold was increased during stimulation and urinary continence was restored. However, each patient became incontinent when transrectal stimulation was discontinued for 1 to 5 days. Thus, cyclic periods of stimulation were necessary to maintain the beneficial effects of electrical stimulation and a permanent pelvic floor stimulator was implanted since chronic transrectal stimulation was inconvenient.- - - - - - - - - - ranking = 0.2keywords = floor (Clic here for more details about this article) |