Urinary Incontinence Naturopathic Treatment

Reclaim Bladder Control

Urinary Incontinence affects people world wide, and can cause people to avoid social contact and not want to deal with others. This ebook by Alice Benton gives you the best way to avoid the embarrassment and discomfort that is associated with urinary incontinence. Why would you want to deal with annoyance of being unable to control your own bladder when you could find a far better way to help heal yourself? This ebook gives you natural methods of taking back control of your bladder, without having to worry about the dangers associated with surgery or medications that can cause harm to your kidneys. You can learn the best natural way to heal yourself from urinary incontinence and give yourself the life that you deserve; start living the way that you deserve to live, without all of the problems that come with urinary incontinence. Take your life back now!

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All of the information that the author discovered has been compiled into a downloadable pdf so that purchasers of Reclaim Bladder Control can begin putting the methods it teaches to use as soon as possible.

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The Overactive Bladder

Oab Electrical Stimulation

Until the most recent definition of the International Continence Society (ICS), the term of bladder overactivity referred to urodynamic status. The bladder was considered as overactive when objectively shown to contract, spontaneously or on stimulation, during the filling phase of a cystometro-gram while the patient is attempting to inhibit micturition 2 . Furthermore, in the first standardization report, the threshold of 15cmH20 was necessary to conclude that an uninhibited bladder was related to detrusor overactivity 11 . The definition currently endorsed by the ICS is that of a symptom syndrome suggestive of lower urinary tract dysfunction characterized by urgency, with or without urge incontinence, usually with increased daytime frequency and nocturia, in the absence of local or metabolic factors explaining these symptoms 2 . This overactive bladder syndrome can also be described as urge syndrome or urgency-frequency syndrome. Diagnosis of Overactive Bladder Clinical Parameters...

Darifenacin Urinary Incontinence [1518

Darifenacin demonstrates greater effect on tissues in which the predominant receptor type is M3 rather than Ml or M2. In vitro darifenacin inhibits carbachol-induced contractions with greater potency in isolated guinea-pig bladder (M3) than in guinea-pig atria (M2) or dog saphenous vein (Ml). In animal models, it shows greater selectivity for inhibition of detrusor contraction over salivation or tachycardia. The synthesis of darifenacin involves the coupling of 5-(2-bromoethyl)-2, 3-dihydrobenzofuran with as a key step. The latter intermediate is prepared from 3-(R)-hydroxypyrrolidine in a five-step sequence involving N-tosylation, Mitsunobu reaction to introduce a tosy-loxy group in the 3-position with stereochemical inversion, anionic alkylation with diphenylacetonitrile, cleavage of the N-tosyl protecting group with HBr, and conversion of the cyano group to a carboxamide. Darifenacin is supplied as a controlled release formulation, and the recommended dosage is 7.5 mg once, daily....

Postoperative Urinary Continence

The rate of urinary incontinence varies greatly in the literature depending on the severity of the original ARM and on the definitions used to describe continence. Overall incontinence rates in the literature vary from 10 up to 25 3,4,37 . Rintala reviewed continence in adult high and intermediate ARM patients with mean age of 35 years and reported urinary incontinence in 33 , which greatly affected their quality of life 12 . The rate of incontinence in girls born with a cloacal anomaly can approach 60-70 37,50 .

The Mitrofanoff Procedure

The Mitrofanoff procedure is also known as continent appendicovesicostomy according to the Mitrofanoff principle. The two indications for continent vesicos-tomy in ARM are the same as those for incontinent intestinal conduits management of urinary incontinence and preservation of renal function. ARM patients usually have neurogenic bladders secondary to sacrospinal anomalies. In a small group of patients that have urethral injury secondary to their ARM reconstruction, the Mitrofanoff procedure may be helpful in the long-lasting management of urethral stricture. This is the third indication for the Mitrofanoff procedure, and has been reported in the management of urethral problems 43 . The Mitrofanoff procedure as the pioneer of CCC has helped to define the primary principles of these channels. Since the appen

Urological Complications

And is caused in most cases by a urological anomaly, vesicoureteral reflux being the most common 15 . Urinary infections may be caused by a rectourinary fistula remnant that is too long 16 . Damage to the pelvic innervation and urethra during the dissection of rectal blind pouch may cause urinary incontinence or urethral stricture 17 . The incidence of urological injuries associated with surgery are strongly related to the experience of the surgeon 18 . A detailed imaging of the rectourinary communication by contrast studies may decrease the possibility of injury. Many of the functional urinary abnormalities previously attributed to surgical intervention are congenital 13,19 .

Gene therapy applications in the lower urinary tract

The lower urinary tract is ideally suited for minimally invasive therapy. All of the lower urinary tract can be reached either percutaneously or through endoscopy. Using MDSCs to deliver growth factor genes, an ex viv approach, could treat such disabling and prevalent conditions as urinary incontinence, interstitial cystitis (IC), and erectile dysfunction (ED) and limit the risk of systemic side effects. Figure 2 depicts MDSC-based tissue engineering in the lower urinary tract. This section focuses on gene therapy strategies that use both viral and nonviral approaches in the lower urinary tract. 5.1. Urinary Incontinence Urinary incontinence is a serious and prevalent condition worldwide. The pharmaceutical industry has recently realized the significance of this disability and the potential market size that urinary incontinence represents. In the United States alone, an estimated 17 million men and women suffer from bladder control problems (36). The Agency for Health Care Policy and...

My clinician has advised that I use hip protectors What are they and why should I use them

Hip protectors are available in different styles and sizes. Hip pads that fit into washable underwear cushion the blow of a fall, but these pads are not washable. Another style has pads sewn into the underwear in the space over the hips and is fully washable. A third style of protector fits over regular underwear but under your clothes. A belt-type hip guard can be worn outside clothing. Figure 12 shows two different types of hip protectors. There is also a style designed specifically for men. If you also have urinary incontinence, some styles allow for the use of pads.

Preoperative Evaluation

The patient history should include preoperative constipation and incontinence symptoms, bowel frequency, obstetric history, and other associated pelvic floor disorders, such as co-existing urinary incontinence or genital prolapse. Patients with rectal prolapse are at an increased risk for other concomitant pelvic floor abnormalities.

Clofarabine Anticancer [1014

Darifenacin is a novel muscarinic M3 selective antagonist for the once-daily oral treatment of urinary incontinence and overactive bladder. The majority of over-active bladder symptoms are thought to result from the overactivity of the detrusor muscle, which is primarily mediated by acetylcholine-induced stimulation of mus-carinic M3 receptors in the bladder. Consequently, antimuscarinic agents have become the mainstay of overactive bladder treatment. Darifenacin has a higher level of M3 selectivity than the previously marketed antimuscarinic agents. It has K values of 16 nM for M1, 50 nM for M2, and 1.6 nM for M3 receptors. It is slightly more M3 selective than solifenacin (M1 K 25 nM, M2 K 126 nM, M3 K 10 nM), which was launched in 2004. Darifenacin is significantly more selective than other muscarinics such as tolterodine, oxybutynin, and trospium, which are all essentially equipotent against M1, M2, and M3 receptors. In addition,

Therapeutic Alternatives and Developping Treatments in Refractory Urge Incontinence and Idiopathic Bladder Overactivity

Conservative therapies such as pelvic floor exercises, bladder retraining, electrical stimulation of the pelvic floor and pharmacotherapy involving anticholinergics, antispasmodics and tricyclic antidepressants are primary discussed. The use of pelvic floor muscle training with or without biofeedback for overactive bladder is suggested to inhibit detrusor muscle contraction by voluntary contraction of the pelvic floor at the same time, and to prevent sudden falls in urethral pressure by change in pelvic floor muscle morphology, position and neuromuscular function 17 . Some promising results have been reported, and these treatments are widely used, but there is still a need for high quality randomized trials on the effect of pelvic floor exercises on the inhibition of detrusor contraction. Detrusor over-activity current pharmacological treatment involve use of muscarinic receptor antagonists, but their therapeutic activity is limited by side effects resulting in the non continuance of...

Male Genital Anomalies

Adult Sexual Breast Vagina

The associated spinal abnormalities, especially hemi-vertebrae. The reconstructive surgery probably has little additional effect. The bladder problem is usually an upper motor neurone hyperreflexia due to lumbosacral anomalies. In a review of the literature, 29 of those with a high ARM and 6 with a low anomaly had urinary incontinence 32 . If an analogy can be drawn with the general myelodysplasia population, the impact on potency may not be great, especially if the neurological lesion is incomplete. All males with myelodysplasia with intact sacral reflexes and urinary continence are potent. With absent sacral reflexes, 64 with levels below D10 and 14 with levels above D10 are potent 33 . As most of those with ARM and neuropathy have a level well below D10, few should be impotent.

Radical vaginal hysterectomy

Ureter Injury Uterine Artery

The second role of laparoscopy is, in the cases where RVH is chosen as definitive treatment, to assist the vaginal operation. In fact, during the first years of our experience the 'coelio-Schauta' procedure was simply the addition of laparoscopic pelvic lymphadenectomy to a genuine Schauta operation. At the time the endostapler became available it became clear that laparoscopy could be used as to make RVH both more radical and simpler to perform. Hence was born the concept of Laparoscopically Assisted Radical Vaginal Hysterectomy (LARVH). The first LARVHs performed were more radical than the Schauta Amreich procedures, (i.e. the most radical variant of the classical Schauta operation). Due to its radical nature the 'LARVH prototype' was more dangerous than the initial coelio-Schauta, particularly in the field of urinary bladder dysfunction. This negative outcome led Denis Querleu and the author to set up a third variant which appears as radical as the Schauta Amreich procedure but...

Clinical Application of Sacral Neuromodulation

For treatment of incontinence, the primary outcome measure should include a voiding diary recording the number of episodes of incontinence and micturition during a specified time. Recording the mean number of pads used per 24 hours may be helpful. For some authors, the quantification of the amount of urine lost during the pad test is also recommended 14 . Patient assessment of the severity of the symptoms can be recorded by a validated urinary incontinence outcome score, such as the Urogital Distress Inventory, the Bristol Female Lower Urinary Tract Symptoms or the Incontinence Impact Questionnaire 89, 90, 141, 168 . Many scores, such as the Short-form-36 (SF-36) and Beck Depression Inventory (BDI), may

Historical Evolution of Functional Surgery in Lower Urinary Tract Dysfunction

In 1963 Caldwell 130 performed the first stimulator implantation in a pelvic sphincter to treat urinary incontinence. However, it was observed shortly afterward that transrectal stimulation and transvaginal stimulation in women gave the same results. At present, the mechanism of these stimulations is known the stimulated pudendal afferents activate the sympathetic inhibitor neurons, which in turn inhibit the central parasympathetic neurons, thereby reducing bladder hyperactivity 108 .

Autonomic Function Tests

Assessment of bladder function is mandatory in MSA and usually provides evidence of involvement of the autonomic nervous system already at an early stage of the disease. Following a careful history regarding frequency of voiding, difficulties in initiating or suppressing voiding, and the presence and degree of urinary incontinence, a standard urine analysis should exclude an infection. Postvoid residual volume needs to be determined sonographically or via catheterization to initiate intermittent self-catheterization in due course. In some patients only cystometry can discriminate between hypocontractile detrusor function and a hyperreflexic sphincter-detrusor dyssynergy.

Urinary Tract Problems

A high incidence of neurovesical dysfunction in patients with ARM has been reported by several authors 13,26,86,87 . Neurovesical dysfunction is usually congenital and often associated with lumbosacral or intraspinal abnormalities 24,87 . This is reflected by the dominance of hyperreflexic findings in cystom-etry and radiological investigations, suggesting upper motor neuron lesion. Vesicoureteral reflux in patients with ARM is commonly associated with neurovesical dysfunction, and therefore carries a high risk of recurrent urinary infection and subsequent renal damage. Urinary incontinence is related to dysplastic sacrum, urethral and bladder anomalies, and neurovesical dysfunction. Surgical damage to the bladder neck or urethra accounts for a minority of causes of urinary incontinence 24,87 . Urinary incontinence is uncommon in patients with low anomalies, which probably reflects the lower incidence of spinal anomalies and neurogenic bladder in these patients. Rintala and Lindahl 28...

Why do some patients with MS become unable to urinate when they have to urinate all day and night

Emptying the bladder is the result of three parts of the bladder functioning in sequence. To empty the urine from the bladder effectively, the bladder wall (the detrusor muscle) has to contract. When the pressure in the bladder has reached the right level, and only then, the bladder neck will normally relax and then the internal sphincter will relax. If the external sphincter is relaxed, voiding will occur. Sometimes, early in the course of MS, the bladder may not contract normally, and the sphincter does not relax, thus preventing the bladder from emptying. This is a so-called hyporeflexic bladder. However, most bladders are hyperreflexic, and the patient feels the urge to urinate frequently, sometimes with a feeling of great urgency. At times, the bladder uncontrollably empties unexpectedly or prematurely, resulting in urinary incontinence.

Should I stop exercising if I break a bone

Hip Fracture Locations

In people who are likely to have severe complications related to surgery, orthopedic surgeons use a traction (tension) system to help the hip fracture heal. But the extended immobility associated with this treatment has its own complications. Being immobile for a long time can lead to blood clots, urinary incontinence, loss of muscle conditioning, pneumonia, pressure sores (bedsores), depression, social isolation, and greater bone loss. Unfortunately, once you fracture your hip or any other bone, you are at greater risk of fracturing a bone again.

Time Course Of The Disease

MSA is a disease that commonly causes clinical symptoms beginning in the sixth decade, although occasionally symptoms commence as early as the fourth decade (Sima et al., 1993). In a series of one hundred cases of MSA reported by Wenning et al. (1994a), the median age of onset was 53 and the range was 33 to 76 years. In a metaanalysis of 433 cases, mean age of onset was 54.2 years (range 31 to 78) (Ben Shlomo et al., 1997). Latency to onset, but not duration, of symptomatic orthostatic hypotension or urinary incontinence differentiates PD from other parkinsonian syndromes, particularly MSA. Wenning et al. (1999c) found significant group differences for latency, but not duration, of symptomatic orthostatic hypotension and urinary incontinence Latencies to onset of either feature were short in patients with MSA, intermediate in patients with DLB, CBD, and PSP, and long in those with PD. Symptomatic orthostatic hypotension occurring within the first year after disease onset predicted MSA...

Cost of Sacral Neuromodulation

Urinary incontinence and urinary retention are a costly illness that affect personal resources, medical treatment and quality of life. The overall prevalence of overactive bladder is similar between men (16.0 ) and women (16.9 ), but sex specific prevalence differed substantially by severity of symptomes 150 . Anatomic differences increase the frequency of urge incontinence linked to bladder overactivity among women compared with men. In women, prevalence of urge incontinence increase with age from 2.0 to 8.9 , and in men from 0.3 to 19 . Moreover, symptome occurrence is later in age in men. United States most recent estimates of the annual direct costs of incontinence in all ages are approximately 16 billion 11 billion in community and 5 billion in nursing home (1994 dollars) 59 . These costs estimate increased by 250 over 10 years 86 , greater than can be accounted by medical inflation. Data from the National Overactive Bladder Evaluation (NOBLE) survey in the United States had...

Treatment Of Vulval Lesions Microinvasive vulval cancer

Surgical removal should achieve lateral margins of at least 1 cm and deep margins should be to the inferior fascia of the urogenital diaphragm and the fascia over the symphysis pubis. If the lesion is close to the urethra, the lower 1 cm of the urethra may be removed with a low possibility of causing urinary incontinence. If histologically the surgical margins are less than 5 mm careful consideration should be given to radiotherapy.

Screening at the Population Level Trends in Incidence and Mortality

Prostate Cancer Trends

The morbidities of prostate cancer treatment are better defined than the efficacy of the treatment itself. All forms of localized prostate cancer therapy have side effects but those for radical prostatectomy and external beam radiation are best described. Both are known to cause impotence, rectal injury, urinary incontinence, and urethral stricture. Literature reviews from physicians at major medical centers give impotence rates of 25 to 40 , rectal injury rates of 1 to 3 , urinary incontinence rates of 3 to 6 , and urethral stricture rates of 8 to 18 , with radiation therapy at the lower range compared to surgery.37 higher than physician-reported morbidity rates. In a survey of Medicare patients38 undergoing radical prostatectomy from 1988 to 1992, 30 reported the chronic need for pads and urinary clamps. More than 60 reported a problem with wetting, 60 reported having no erections since surgery, and 90 reported no erections sufficient for intercourse in the month prior to answering...

Review of Key Concepts

The pons is immediately rostral to the medulla. It conducts signals up and down the brainstem and between the brainstem and cerebellum, and contains nuclei involved in sleep, hearing, equilibrium, taste, eye movements, facial expression and sensation, respiration, swallowing, bladder control, and posture. Cranial nerve V arises from the pons, and nerves VI through VIII arise between the pons and medulla.

Functional

The etiology of lower urinary tract dysfunction in ARM and cloacal anomalies is poorly understood 2-4,50,51 . However, bladder dysfunction causes significant urological morbidity in the pediatric population, resulting in renal damage from recurrent urinary tract infections and urinary incontinence, both of which can cause profound morbidity and disability 7 . Recurrent urinary tract infection may be overlooked or attributed to coexisting vesicoure-teric reflux or renal anomalies, which are prevalent in a high proportion of these children 7,27 . Consequently, detecting bladder dysfunction at an early age is essential in avoiding deterioration in renal function 5,18,24,45,46 .

Spinal Deformities

These are the most commonly associated malformations with ARM. The most common of the spinal deformities are aberrations in the numbers and symmetrical development of the pelvic vertebrae. There are usually hemivertebrae present that will tilt the pelvis to a varying degree and, if extensive, may result in severe deformity of the lower body. The absence of several pelvic vertebrae is more often associated with urinary incontinence than with bowel incontinence.

Nursing Homes

The poor quality of care provided in nursing homes has been known for decades. There has been some improvement since the Institute of Medicine (IOM) released a critical report in 1986, but a more recent report in 2000 indicated that serious problems still exist. One critical passage from the report indicates that serious problems concerning quality of care apparently continue to affect residents of this country's nursing homes, and persistently poor providers of care are still in operation. Pain, pressure sores, malnutrition, and urinary incontinence have all been shown to be serious problems in recent studies of nursing home residents.

Medical Management

Neuromodulation Sacral nerve stimulation (SNS), initially developed for urinary incontinence, represents a departure from previous models of fecal incontinence therapy. Instead of correcting or replacing defective morphology, this treatment aims to augment physiologic function by recruiting and stimulating S2, S3, or S4 nerves as they exit the sacral foramina. The three-part procedure begins with placement of a subcutaneous electrode in the sacral foramina to identify the site of maximal pelvic floor and minimal lower extremity stimulation. Next, the lead is connected to an external pulse generator for a 3-week test period. After 3 weeks, if functional improvement is adequate, we implant a permanent pulse generator (Figure 88-2).

Taurelated Disorders

In other families, a more typical picture of frontotemporal dementia with cognitive and behavioral disturbances predominates, followed by parkinsonism, and other neurological disturbances such as supranuclear gaze palsy, pyramidal tract dysfunction, and urinary incontinence to a variable degree during the later course of the disease. These phenotypes are more commonly associated with missense mutations in the constitutively spliced exons 9, 12, and 13 (58). Other mutations have been associated with dementia with epilepsy (72), progressive subcortical sclerosis (73), or familial multiple system tauopathy (74).

Conclusion

The technique of sacral neuromodulation is available in neuro-urologic situations in which there is an imbalance between the neurological systems which regulate retention and micturition. It is generally used to treat vesical overactivity with pollakiuria, which disturbs patients' quality of life. The need to urinate can even trigger urinary or fecal leakage. When the pharmacological arsenal has been tried to no avail, sacral neuromodulation remains an alternative to urologic interventions of the bladder. Neu-rogenic and idiopathic overactive bladder must be differentiated, and it is essential to considerer psychological factors affecting the patient. Urologic etiologies are a contra-indication for sacral neuromodulation. The major indication is bladder overactivity, followed by idiopathic chronic retention and chronic pelvic pains. Sacral neuromodulation is a mini-invasive technique but requires methodological rigor and a preliminary percutaneous test. When selection is performed,...

Treatment

In neurogenic bladder dysfunction including residual urine clean intermittent catheterization three to four times per day is a widely accepted approach to prevent secondary consequences from failure to micturate. It can become necessary to provide the patient with a permanent transcuta-neous suprapubic catheter if mechanical obstruction in the urethra or motor symptoms of MSA prevent uncomplicated catheterization. Pharmacological options with anti- or pro-cholinergic or -adrenergic substances are usually not successful to adequately reduce post-void residual volume in MSA, but anticholinergic agents like oxybutynin can improve symptoms of detrusor hyperreflexia or sphincter-detrusor dyssynergy in the early course of the disease (Beck et al., 1994). Recently, a-adrenergic receptor antagonists (prazosin and moxisylyte) have been shown to improve voiding with reduction of residual volumes in MSA patients (Sakakibara et al., 2000b). Urological surgery must be avoided in these patients...

Investigations

Assessment of bladder function is mandatory in MSA and usually provides evidence of involvement of the autonomic nervous system at an early stage of the disease. Following a careful history regarding frequency of voiding, difficulties in initiating or suppressing voiding, and the presence and degree of urinary incontinence, standard urinalysis should exclude infection. Post-void residual volume needs to be determined sonographically or via catheterization to initiate intermittent self-catheterization (ISC) in due course. In some patients only cystometry can discriminate between hypocon-tractile detrusor function and a hyperreflexic sphincter-detrusor dyssynergy.

Presentation

Fistulas between the urinary tract and the female genital tract are characteristically said to present with continuous urinary incontinence, with limited sensation of bladder fullness, and with infrequent voiding. Where there is extensive tissue loss, as in obstetric or radiation fistulas, this typical history is usually present, the clinical findings gross, and the diagnosis rarely in doubt. With postsurgical fistulas, however, the history may be atypical and the orifice small, elusive or occasionally completely invisible. Under these circumstances the diagnosis can be much more difficult, and a high index of clinical suspicion must be maintained.

Dysautonomia

Urinary disturbances often appear early in the course of the disease, or are a presenting symptom (impotence common in men). Urinary incontinence (70 of MSA) or retention (30 ) may be detected by medical history, leading to more refined explorations. MSA, PSP, as well as PD patients complain of urgency, frequent voiding, or dysuria. Some describe difficulties voiding but are not aware of chronic urinary retention. Incontinence is never observed in patients with PD and rarely in late stages in PSP. In all cases, additional laboratory tests such as urodynamic tests and sphincter electromyogram (EMG) may make the association between urinary symptoms and urinary tract denervation (13). Patients with PD have less severe urinary dysfunction, by contrast with these common findings in MSA. However, sphincter EMG does not distinguish MSA from PSP.

Ureteric Ectopia

Ureteric ectopia is a rare clinical entity. It is associated with complete ureteric duplication in 80 of cases. Single system ureteric ectopia usually presents with persistent urinary incontinence and hydroureterone-phrosis and is more frequently seen in patients with cloacal anomalies (A. Trainer, personal communication) 51 . It is associated with a renal abnormality such as horseshoe kidney, crossed-fused renal ecto-pia, malrotated kidney, renal dysplasia, and pelvic kidney. Surgical options to correct this condition usually include ureteric reimplantation and procedures to increase bladder outlet resistance.