Urinary incontinence

urge incontinence

Treatment: Initially, lifestyle modifications: bladder training 

                 If bladder training is not helpful, try anti-muscarinic agents (Tolteridone, solifenacin, Darifenacin)

                  when anticholinergic agents fail, try

                                   -percutaneous tibial nerve stimulation

                                   -botulinum toxin injection

Stress incontinence

causes: urethral hypermobility, and intrinsic sphincter deficiency

   initial measures include weight reduction, dietary modification, and pelvic floor exercise, pessary

   if the above measures fail, then try the urethral sling procedure

overflow incontinence

patients with overflow incontinence have underlying neuropathy (e.g. diabetes mellitus), spinal surgery, and multiple sclerosis. on examination, you can find decreased perineal sensation due to underlying neuropathy.

patients with these conditions when taking anticholinergic agents develop incontinence.

Genitourinary syndrome of menopause

urinary symptoms occur but it is associated with other features of menopause like vulvovaginal irritation, dyspareunia, 

Comments

Post a Comment

Popular posts from this blog

 HERBAL SUPPLEMENTS 1. BLACK COHOSH: it has been promoted for the treatment of post-menopausal symptoms. it causes hypotension, adverse estrogenic effects, and hepatotoxicity. 2. LICORICE: it contains glycyrrhenetic acid, which inhibits the conversion of cortisol to cortisone. it is used for viral infections/ bronchitis, and stomach ulcer. 3. Ginkgo biloba: it has been marketed as an anti-oxidant, used for memory enhancement. it is also used in dementia, macular degeneration, and peripheral vascular disease. Adverse effects include increased bleeding, especially in people taking aspirin. 4. Ginseng: it is also used for memory enhancement. Side effects include increased bleeding. 5. saw palmetto: it is used for the treatment of Benign prostate hyperplasia. Its adverse effects include mild stomach discomfort and increased bleeding risk 6. St John wort: It has been marketed for use in mild to moderate depression and insomnia. it is also used as an anti-inflammatory and wound healing. Its
Read more
Image
1. How do medication, other physiological conditions like pregnancy, and pathological conditions like acute hepatitis and chronic liver disease affect thyroid hormone metabolism and the requirement of levothyroxine if the patient is already on thyroid supplements? There are some proteins in blood like thyroxine-binding globulin (TBG) that transport levothyroxine (T3, T4) In blood to peripheral tissue. pregnancy, acute hepatitis, oral contraceptive pills containing estrogen, and medications like tamoxifen, and raloxifene increase TBG. When TBG rises in the blood, TBG binds to free T3 and free T4 increasing the total T3, and T4 in the blood and decreasing the concentration of free T3, and free T4. Peripheral tissue senses the low level of free T3, and free T4, thus it stimulates the pituitary gland to produce more TSH. TSH in turn stimulates the thyroid gland to produce free T3 and free T4. 2. what are conditions where TBG decreases? a. chronic liver disease b. drugs like androgenic horm
Read more
  Group B streptococcal (GBS) infection in pregnancy It is also called streptococcus agalactie. If there is the colonization of this bacteria in the rectum and vagina, there is the possibility of transmission of this bacteria to newborns while delivery. so, if there is colonization, treat it we check with a rectovaginal swab at  35 to 37-week periods of gestation (POG). GBS colonization is transient or intermittent, that's why check at 35-37 weeks POG. Let us take one example to understand this: A female was admitted at 38 weeks of period of gestation because of a rupture of the membrane and labor pain. Her medical history included group B streptococcal colonization at 36-week periods of gestation in her previous pregnancy. At that time, she was treated with IV penicillin. Does this time also, require penicillin? The answer is: In this case, we do not know the colonization status of her in this pregnancy. so, we need to wait for 18 hours in this case. If she does not deliver by 18
Read more