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Bladder cancer typically begins in the lining of your bladder,the balloon-shaped organ in your pelvic area that stores urine. Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Chemotherapy and radiation therapy : - Treatment with the anti-cancer drugs cyclophosphamide (Cytoxan) and ifosfamide (Ifex) increases your risk of bladder cancer. Chronic bladder inflammation : - Chronic or repeated urinary infections or inflammations (cystitis), such as may happen with long-term use of a urinary catheter.
Personal or family history : - Having bladder cancer once makes it more likely you'll get it again.
Exposure to arsenic : - Drinking water containing high levels of arsenic increases risk of with bladder cancer.
Bladder birth defect : - Rare birth defects of the bladder may lead to an unusual form of bladder cancer called adenocarcinoma. To diagnose bladder cancer, the doctor will take a medical history, do a physical examination and request a urine test.
An x-ray procedure, called an Intravenous pyelogram (IVP), is used to detect any abnormalities or growths in the bladder.
A Cystoscopy is a procedure using a thin, lighted tube called a cystoscope that is inserted into the bladder through the urethra. There are four main types of treatment for bladder cancer: surgery, radiation therapy, chemotherapy and biological therapy. Transurethral resection (TUR) is an operation that uses a cystoscope inserted into the bladder through the urethra. Urinary diversion is an operation to make way for urine to pass out of the body so that it does not go through the bladder. Radiation therapy (also called radiotherapy) may be needed when the cancer cannot be removed with TUR because it involves a larger area of the bladder. When cancer involves the pelvis or has spread to other parts of the body, the doctor may suggest chemotherapy. Depending on the specific drugs, most patients take chemotherapy as an outpatient at the hospital, the doctor's office or at home. Often a form of intravesical chemotherapy, biological therapy uses materials made by the body or made in a laboratory to boost, direct or restore the body's natural defenses against the cancer. When several tumors are present in the bladder or when there is a risk that the cancer will recur, TUR may be followed by treatment with drugs. Successful heart surgery at We Care India partner hospital allows Robert Clarke to live a normal life despite a rare genetic disorder We Care india helped Robert find best super specialised surgeon for his rare conditions. We created for a renowned manufacturer of diabetes diagnostic devices, some 3D animation of their latest blood glucose meters. Boehringer-Ingelheim needed a gauze for its fair booth on the Eurotier-fair illustrating an Ileitis infection.This disease is triggered in the bowel of a pig through the Lawsonia intracellulari bacteria but can be treated with a vaccine. Animations about the physiological processes caused by Morbus Crohn, the mode-of-action of a immuntherapy drug against cancer, device for measuring the biologic age via blood pulse curves.
Offers a comprehensive resource for diagnosis, prognosis, and treatment of breast cancer, and includes information on mammograms, chemotherapy, where to get care, and how to support someone with breast cancer.
Personal stories show men how to make the right decisions for themselves, with medical insights from a leading Johns Hopkins authority on prostate cancer If you or someone you know has been diagnosed with prostate cancer, you want to know the facts about treatment options as well as what to expect through the process of treatment and recovery. Positive Options for Colorectal Cancer" offers readers everything they need to know about understanding and dealing with colorectal cancer.
Breast CancerAccording to the National Cancer Institute (NCI), it is estimated that approximately 192,000 women are diagnosed with breast cancer each year in the United States. Ovarian CancerOvarian cancer treatment is the second most common form of gynecological cancer with an estimated 21,800 new cases expected to be diagnosed in 2010.
It is estimated that there is 11,000 new cases of cervical cancer diagnosed in women the year of 2010.
The vulva consists of the opening of the vagina, the clitoris and the outer and inner lips.
There are approximately 43,000 new cases of pancreatic cancer are anticipated to be diagnosed this year. A whipple procedure is used if the cancer is located on the widest part of the pancreas, also called the head. A distal pancreatectomy is performed when the tumor is located on the body and tail portions of the pancreas. 3) The final type of surgery that can be performed to treat pancreatic cancer is a total pancreatectomy, where the entire pancreas is removed as well as part of the stomach and small intestine, the spleen, the gallbladder and surrounding lymph nodes. Colorectal cancer is the cancer of the large intestine, divided into two sections: the colon, is the first four to five feet of the large intestine, and the rectum, consists of the last several inches. Options for small intestine cancer treatment are important as approximately 6,900 new cases of small intestine cancer will be diagnosed this year, making it a relatively rare form of cancer. The large intestine is divided into two sections: The rectum, which consists of the last several inches of the large intestine, and the colon, which is the first four to five feet.
A small pear-shaped organ that is responsible for storing bile, a fluid made in the liver that helps the body digest the fat from food that moves through the small intestine during the digestive process.
It is estimated that around 22,000 new cases of brain or spinal cord cancer will be diagnosed this year. Approximately 36,500 new cases of oral cavity and oropharynx cancers are expected to be diagnosed this year in the United States, with more of these cancers diagnosed in men than women. Lymphoma is a broad category of lymphatic cancers with two major subtypes: Hodgkin's lymphoma and Non-Hodgkin's lymphoma.
Esophageal cancer is estimated that there will be approximately 16,000 new cases of esophageal cancer, a cancer that affects the muscular tube that connects the throat to the stomach, diagnosed this year. Cancer of the nasopharynx, the area of the head where air inhaled from the nose travels to the throat and lungs, is referred to as nasopharyngeal cancer.
These types of cancers include those of the oral cavity (lips, tongue, gums, inside lining of the mouth), the salivary glands (the area of the mouth that produces saliva that aids in swallowing), nasal cavity (including the sinuses), pharynx (a small tube that starts behind the nose and leads to the esophagus and trachea) and the larynx (referred to as the voice box).
Definition Neurogenic bladder is a dysfunction that results from interference with the normal nerve pathways associated with urination. Effective Treatments For Overactive Bladder Medication For Overactive Bladder One of the common things done by most people with this condition is to opt for medicinal drugs.
Pelvic Floor Exercise For someone who is looking for an alternative to medicinal drugs or something better to combine it with, pelvic floor exercise is the way to go. During this exercise, you are actually tightening the muscles and then letting them relax in a start and stop manner. Bladder Training One of the commonly heard of treatments for overactive bladder comes in the form of bladder training. Surgery For people who are facing immense difficulty with their overactive bladder situation and no other treatment form is helping them, then the last resort comes in the form of a surgery. Sacral Nerve Stimulation By means of this treatment, an individual is treated by regulating those nerve impulses that connect to the bladder. Noodles are a favorite among many but it is associated with a lot of oil and fat content too!
Tangerine essential oil is derived from citrus fruits and gets extracted through cold compression method. Some bladder cancer remains confined to the lining, while others cases may invade other areas.
Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). He or she may order an x-ray test and perform a cystoscopy (described below) and if needed, a biopsy for bladder cancer. For the IVP x-ray, a special dye containing iodine is given to the patient through a needle inserted in the vein.
If the doctor sees any abnormal areas or growths, he or she will remove some of that tissue (biopsy) for further examination under a microscope.
The type and staging of the cancer, age, and overall health, determine which treatment method(s) will be used. The doctor then uses a tool with a small wire loop on the end to remove the cancer or to burn the tumor away with high-energy electricity. Sometimes, it may be necessary to stay in the hospital for a period of time to monitor the effects of the treatment. The doctor may put a solution containing the bacteria bacillus Calmette-Guerin (BCG), a form of biological therapy, directly into the bladder via a catheter (intravesical biological therapy). It presents detailed information in a clear and concise manner from a well-known advocate and author who is a personal survivor of Stage III colorectal cancer for more than 20 years.
Depending on where the cancer is located and it’s size it is doctors may decide to perform one of two types of surgeries on the breast. It can be given externally, or internally, where the radiation is placed in a small tube and inserted into the breast through a tiny incision. If it is positive,  the cancer cell relies on the hormones estrogen and progesterone to grow.
Chemotherapy is not selective to killing just the cancer cells, but also depletes other fast-growing cells in the body, which causes several debilitating side effects including liver, renal, and hematological toxicity. In 2010 alone, an estimated 220,000 new cases of lung cancer will be diagnosed and 157,000 men and women will die from the disease. 2) A segmentectomy or wedge resection is a surgery where the tumor along with a small amount of the lung that surrounded the tumor is removed.
Monoclonal antibodies are specially designed to bind to specific proteins that are found on the surface of colon cancer cells in order to destroy them. During the surgery, nearby lymph nodes also will be removed and tested to determine whether or not the ovarian cancer has spread to other parts of the body.
However, at times radiation therapy is used to relieve pain associated with ovarian cancer but side effects are severe such as diarrheas, bowel adhesions, anemia and bowel perforation. Radiation therapy also can be used following surgery to destroy any cancer cells left remaining in the surrounding area.
In the uterus of a woman, there are two layers of tissue: the endometrium, is the inner lining the myometrium, is the outer layer of muscle.
A radical hysterectomy, which includes the removal of the uterus, cervix, tissues surrounding the cervix and the upper part of the vagina and lymph nodes, also may be performed if the endometrial cancer has spread to the cervix.
It also may be recommended as a first-line treatment for women who can not undergo surgery for one reason or another. The most commonly used therapies include carboplatin, cisplatin, doxorubicin and paclitaxel. The main types of hormone treatments used are called progestins, which use the female hormone progestin to slow the growth of the cancerous cells.
Typically, most cancers of the vulva are found on the outer lips and are rarely found in the other areas of the vulva. Sometimes radiation therapy is given along with chemotherapy before surgery to try to reduce the size of tumors diagnosed at a more advanced stage. However, when it is used, it typically is given in combination with radiation therapy to try to shrink the size of the tumor before surgery. This is used mainly to treat early-stage vaginal cancer and is not typically a treatment for more advanced cancers. If the vaginal cancer is located at the top part of the vagina, the cervix also may be removed, this is called a trachelectomy.


A gland found near the stomach secretes insulin and other hormones, the pancreas helps the body use and store energy that is created from food.
During this procedure, the surgeon removes this portion of the pancreas as well as part of the small intestine and stomach. The colon is responsible for removing water and nutrients from digested food and turning it into stool, which is then passed to the rectum and eventually leaves the body through the anus.
Additionally, radiation can be used to help to alleviate pain and other symptoms associated with colorectal cancer. Agents such as 5-fluorouracil, capecitabine, irinotecan, leucovorin and oxaliplatin are five most commonly used agents to treat colorectal cancer, and can be used alone or in combination with one another. Avastin, Erbitux and Vectibix are three monoclonal antibodies that can be used in combination with chemotherapy or after chemotherapy has stopped working for colorectal cancer treatment. It is estimated that every year approximately 38,000 new cases of bladder cancer are diagnosed in men and 15,000 in women, making bladder cancer the fourth most common cancer in men and the eighth most common in women. 1) transurethral resection (TUR), is used to treat early-stage or superficial bladder cancer. For superficial bladder cancer, the chemotherapy may be inserted directly into the bladder through a catheter. This type of therapy is usually given after TUR surgery for superficial bladder cancer in order to try to prevent the cancer from coming back. The small intestine, located between the stomach and large intestine, is of the body’s digestive process responsible for breaking down food to absorb necessary nutrients. If only a section of the small intestine that contains the tumor is removed, the surgeon joins the ends back together. It can be given before surgery to shrink the tumor or after surgery to try to kill any remaining cancer cells. The liver, which is the largest organ in the abdomen, is a very extremely important organ because it aids in the digestion of food and removes harmful substances from the blood. A substance is injected into an artery that is then carried to the tumor to block the blood flow necessary for the tumor to grow. It also is used to help alleviate pain when the liver cancer has spread to the surrounding bones. Because chemotherapy is not selective in only killing cancer cells, severe and debilitating side effects can occur in some people.
Given as a pill, Nexavar is the first targeted therapy approved for the treatment of liver cancer.
The colon is responsible for removing water and nutrients from digested food and turning it into stool.
2) a local excision, which is a procedure that removes the tumor and surrounding areas if the rectal cancer is only on the inside surface of the rectum and has not yet spread to the rectum wall. Monoclonal antibodies are designed to bind to specific proteins that are found on the surface of rectal cancer cells in order to kill and destroy them. Since the liver also can release bile, the gallbladder is not an essential organ and many people have it removed due to the development of gallstones. First, it may be used after surgery to try to kill any gallbladder cancer cells left behind. A chemotherapy drug called 5-fluorouracil is often given at the same time as radiation to try to make both gallbladder cancer treatment options more effective. This drug, given intravenously, works by preventing the growth of blood vessels needed for a tumor to grow.
The three most common type of cancer diagnosed in children includes brain, central nervous system and leukemia.
It can be given externally, meaning the radiation stems from a large machine, or internally, where the radiation is placed directly into the body in the area of the tumor. Since chemotherapy is not selective in killing just the cancer cells, it can cause several debilitating side effects including hair loss and nausea. It also can be used prior to surgery to try to shrink the tumor or used after to try to kill any remaining cancer cells in the surrounding area. It belongs to a class of drugs known as targeted therapies because it is designed to bind to epidermal growth factor receptor (EGFR) cells that are found on the surface of oral cancer cells. If the cancer is located in the upper part of the stomach a total gastrectomy is usually performed.
Radiation therapy is also often given in combination with chemotherapy to help prevent the recurrence of stomach cancer. Studies are also ongoing to determine if giving chemotherapy prior to surgery, in order to shrink the tumor, also can help prevent the stomach cancer from recurring. Nowadays surgical procedures have made it possible for many patients to avoid amputation if the cancer is removed from the leg or arm. It is often used to treat chondrosarcomas since chemotherapy cannot be used to treat these types of bone cancers.
This type of cancer typically starts in the inner lining of the esophagus and grows outward toward the muscle layer. Typically, lymph nodes surrounding the esophagus and part of the stomach also are removed. It may be used before or after surgery, as well as in combination with chemotherapy following surgery.
It usually is only appropriate for a small number of people affected by naropharynx cancer. Approximately 39,000 new cases of head and neck cancer will be diagnosed in the United States this year and are more common in men and women over the age of 50. Depending on the size of the tumor, part of the tongue, jaw, pharynx and palate also may be removed, which may affect the ability to talk, swallow or chew.
It also can be used prior to surgery to try to shrink the tumor or used after to try to kill any remaining cancer cells in the surrounding area.
It belongs to a class of drugs known as targeted therapies because it is designed to bind to epidermal growth factor receptor (EGFR) cells that are found on the surface of cancer cells.
The extent would be such that it would have a direct implication on your personal and social life. This is indeed one of the most reached out to treatments for overactive bladder. If you are comfortable with medicines then you do have some very effective drugs in the market, however, in order to get your hands on them, you need to consult a doctor.
As long as you are working on your arms and abs, you are indirectly strengthening the muscles that will help control the urination. Definitely the doctor needs to approve of this treatment method. While undergoing surgery, the doctor removes the bladder and creates an artificial construction or a replacement for an opening in the body that is attached to a bag. This procedure has earned some rave reviews. Under this procedure, a thin wire is placed near the sacral nerves and eventually passing right next to the tailbone. The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation. A urine sample is taken and then examined under a microscope for cancerous cells (for bladder cancer).
Segmental cystectomy is an operation to take out part of the bladder where the cancer is located. Internal radiation therapy, with radioactive material placed in the bladder, may be combined with external radiation, which comes from a machine located outside the body.
Chemotherapy may be given in different ways - by mouth or injection into a muscle or a vein, or by catheter into the bladder (intravesical chemotherapy). Chapters present information on prevention techniques, warning signs, and screening tests including the latest on virtual colonoscopy and how to find and talk honestly with the right doctor. The first, a lumpectomy or partial mastectomy will only remove the area of the breast that is affected by the cancer. Some women who are diagnosed with stage-I ovarian cancer and still want to preserve child bearing function after may opt to have only one ovary or fallopian tube removed in hopes of still being able to become pregnant.
Cervical cancer can be easily detected through regular Pap smears that women typically are given during an annual gynecological exam.
Endometrial cancer is a cancer that starts in the endometrium, or inner lining of the uterus. The breast cancer drug, tamoxifen, also is used to stop the role that estrogen plays in encouraging the growth of cancer cells. For more advanced vaginal cancers that have spread to both the uterus and cervix, a hysterectomy is typically performed.
Cancer that starts in either the colon or rectum can be referred to as colorectal cancer or as colon or rectal cancer separately. The bladder is a hollow organ that stores urine, the liquid waste that is produced by the kidneys. In this procedure, the surgeon uses a special tool that is placed through the urethra to burn away the bladder cancer with an electrical current.
For more aggressive types, chemotherapy typically is given intravenously (through a vein).
The name of the small intestine is a bit deceiving -- it actually is the largest part of the digestive system, reaching 15 to 20 feet in length. If the cancer has spread to other nearby organs, portions of these organs also may be removed.
Alcohol-related cirrhosis and liver disease associated with obesity and diabetes are the main causes of liver cancer. It is used in people who are unable to undergo surgery or a liver transplant and works by stopping the cancer cells from dividing and blocking the growth of blood vessels needed for the tumor to grow.
Cancer that starts in either the colon or rectum can be referred to as colorectal cancer, or they also can be referred to as colon or rectal cancer separately, depending on where the cancer originates.
3) a resection, which is a surgery that takes occurs when the cancer has spread to the rectum wall.
Additionally, radiation can be used to help to alleviate pain and other symptoms associated with rectal cancer that has spread to other parts of the body.
Avastin, Erbitux and Vectibix are three monoclonal antibodies that can be used in combination with chemotherapy or after chemotherapy has stopped working to treat rectal cancer.
It is estimated that about 9,700 new cases of gallbladder cancer will be detected this year.
Secondly, it may be given instead of surgery in patients who cannot tolerate surgery to remove the cancer. Other chemotherapy agents such as capecitabine, cisplatin, doxorubicin, gemcitabine or mitomycin also are commonly used to treat gallbladder cancer. In fact, leukemias make up about one-third of all childhood cancers, with the most common subtype affecting children being acute lymphoblastic leukemia. In this procedure, the entire stomach is removed and then the esophagus is connected directly to the small intestine. However, reconstructive surgery following the cancer removal may be necessary inn order to have full function of the particular limb affected. Once the esophagus is removed, a surgeon may reattach the top portion directly to the stomach or replace the area that was removed with a portion of the small or large intestine in helping eating and digesting as normal as possible.
Several types of cancer, including carcinomas, lymphomas, adenocarcinomas and adenoid cystic carcinomas can form in the nasopharynx. In these cases, reconstructive surgery may be necessary to help rebuild the areas that were removed.


As much as you can manage with such a condition when you are alone or at home, but it gets very difficult when you are out with family, friends or for that matter in any social set up. They would recommend you anticholinergics that will help to block the nerve signals reaching to the bladder muscle. This way, you will help yourself get into a schedule and with the excessive duration between the visits to the bathroom, you can find yourself in a better position than before. The doctor connects the wire to electrical impulses that help in reducing the overactive bladder symptoms and make things a lot easier for you. It offers tips on treatment options including surgery, chemotherapy, radiation in addition to advice for life after colorectal cancer and how to find support and resources for the colorectal cancer patient. The most common form is called non-small cell lung cancer, which accounts for about 85 percent of all cases. Most cases of cervical cancer result from the human papillomavirus (HPV) infection, which is transmitted through sexual intercourse. It is the most common cancer of the female reproductive system, an estimated 43,000 new cases each year. The vagina is the area from the lower part of the cervix that extends to the vulva, which are the external female genitals.
It is estimated that there will be 141,000 new cases of colorectal cancer (102,000 colon and 39,000 rectal) diagnosed this year. 2) a radical cystectomy, occurs when the surgeon removes the entire bladder, the surrounding lymph nodes, a portion of the urethra and any nearby organs that may also contain cancer cells. The most common type of cancer is adenocarcinoma, which is a cancer that releases fluids such as mucus. Liver cancer treatment depends largely on the size of the tumor, how well the liver still works if it is affected by cirrhosis and whether or not the cancer has spread to other parts of the body. 4) a pelvic extenteration, which occurs when the rectal cancer has spread to other nearby organs that also need to be removed. Unfortunately, most gallbladder cancers are not discovered until they have become more advanced and spread beyond the gallbladder itself. If the cancer that was removed is in the early-stage of development, no further surgery may be necessary.
A partial or subtotal gastroectomy is performed when the tumor is located in the lower part of the stomach.
2) Chrondrosarcoma, which forms in cartilage pads that align with joints at either end of bone, and usually are found in the shoulder, upper leg and pelvis. Most people with such a condition dread the time when such a condition might trigger out of nowhere, because there is no standard time or pattern for its occurrence. The good news is that you no longer have to bear with such a condition. In women, this operation includes removing the uterus, fallopian tubes, ovaries and part of the vagina. During each of these two types, the surgeon will likely remove some lymph nodes under the arms in order to check to see if the cancer has spread from the breast.
The remaining cases are classified as small cell lung cancer, which tend to grow more quickly. Now, cervical cancer can be prevented through the use of two new vaccines approved to prevent HPV infections that cause cervical cancer. Endometrial cancer is considered an older woman’s cancer because it rarely is seen in women under the age of 40, the mean age of uterine cancer is 62 years old. Additionally, a cancer that affects both the cervix and the vagina is considered cervical cancer, while a cancer that involves both the vulva and the vagina is considered vulvar cancer. For women, these nearby organs include the ovaries, fallopian tubes, uterus and part of the vagina.
Other types include sarcomas, carcinoid tumors, gastrointestinal stromal tumors and lymphomas. In this surgery, the lower part of the stomach is removed and the remaining part is reattached to the small intestine. The bladder is then emptied when the contraction of the bladder wall muscles forces urine out through the urethra.
In this procedure, the gallbladder, portion of the liver, surrounding lymph nodes, the common bile duct and the pancreas may also be removed. The bladder, internal sphincters, and external sphincters may all be affected by nerve disorders that create abnormalities in bladder function. Burnett speaks openly and honestly about prostate cancer options, treatments, and aftereffects and shares stories of both well-known and ordinary prostate cancer survivors who offer their personal reflections on going through treatment and getting well.
There are two categories of neurogenic bladder dysfunction: overactive (spastic or hyper-reflexive) and underactive (flaccid or hypotonic).
The freedom lies entirely with you, allowing you to choose whatever treatment method you like, and whichever one comforts you the most. Includes personal stories from notable prostate cancer survivors such as Arnold Palmer, Ken Griffey Sr, Pat Robertson, and othersTakes an authoritative look at prostate cancer treatments, current and promising scientific breakthroughs, and life-altering side effectsAuthor Arthur Burnett, a leading prostate cancer expert, is the Patrick C.
An overactive neurogenic bladder is characterized by uncontrolled, frequent expulsion of urine from the bladder.
Walsh Professor of Urology, Cellular and Molecular Medicine at the Johns Hopkins's James Buchanan Brady Urological Institute and is renowned for his research studies that led to the formulation of ViagraOffers solutions to common side effects such as sexual problems and incontinence Combining the essential medical facts about prostate cancer with personal, intimate stories told by courageous men who have survived it, this book is an invaluable guide for men diagnosed with prostate cancer and those who care about them. Due to a loss of the sensation of bladder filling, the bladder does not contract forcefully, and small amounts of urine dribble from the urethra as the bladder pressure reaches a breakthrough point. An overactive bladder is caused by interruptions in the nerve pathways to the bladder occurring above the sacrum (five fused spinal vertebrae located just above the tailbone or coccyx). This nerve damage results in a loss of sensation and motor control and is often seen in stroke, Parkinson's disease, and most forms of spinal-cord injuries. An underactive bladder is the result of interrupted bladder stimulation at the level of the sacral nerves. This may result from certain types of surgery on the spinal cord, sacral spinal tumors, or congenital defects. It also may be a complication of various diseases, such as syphilis, diabetes mellitus, or polio.
This measurement is done by draining the bladder with a small rubber tube (catheter) after the person has urinated.
Cystometry may be used to estimate the capacity of the bladder and the pressure changes within it. These measurements can help determine changes in bladder compliance in order to assess the effectiveness of treatment.
Doctors may use a cystoscope to look inside the bladder and tubes that lead to it from the kidneys (ureters).
Cystoscopy may be used to assess the loss of muscle fibers and elastic tissues and, in some cases, for removing small pieces of tissue for biopsy. In intermittent catheterization, a small rubber catheter is inserted at regular intervals (four to six times per day) to approximate normal bladder function. This avoids the complications that may occur when a catheter remains in the bladder's outside opening (urethra) continuously (an indwelling catheter).
Intermittent catheterization should be performed using strict sterile technique (asepsis) by skilled personnel, and hourly fluid intake and output must be recorded. Indwelling catheters avoid distension by emptying the bladder continuously into a bedside drainage collector. Individuals with indwelling catheters are encouraged to maintain a high fluid intake in order to prevent bacteria from accumulating and growing in the urine. Increased fluid intake also decreases the concentration of calcium in the urine, minimizing urine crystallization and the subsequent formation of stones. Moving around as much as possible and a low calcium diet also help to reduce stone formation. The unwanted contractions of an overactive bladder with only small volumes of urine may be suppressed by drugs that relax the bladder (anticholinergics) such as propantheline (Pro-Banthine) and oxybutynin (Ditropan). Contraction of an underactive bladder with normal bladder volumes may be stimulated with parasympathomimetics (drugs that mimic the action resulting from stimulation of the parasympathetic nerves) such as bethanechol (Urecholine). Long-term management for the individual with an overactive bladder is aimed at establishing an effective spontaneous reflex voiding. The amount of fluid taken in is controlled in measured amounts during the waking hours, with sips only toward bedtime to avoid bladder distension. At regular intervals during the day (every four to six hours when fluid intake is two to three liters per 24 hours), the patient attempts to void using pressure over the bladder (Crede maneuver).
The patient may also stimulate reflex voiding by abdominal tapping or stretching of the anal sphincter.
The Valsalva maneuver, involving efforts similar to those used when straining to pass stool, produces an increase in intra-abdominal pressure that is sometimes adequate to completely empty the bladder. The amount of urine remaining in the bladder (residual volume) is estimated by a comparison of fluid intake and output. The patient also may be catheterized immediately following the voiding attempt to determine residual urine. Catheterization intervals are lengthened as the residual urine volume decreases and catheterization may be discontinued when urine residuals are at an acceptable level to prevent urinary tract infection. For an underactive bladder, the patient may be placed on a similar bladder routine with fluid intake and output adjusted to prevent bladder distension. If an adequate voiding reflex cannot be induced, the patient may be maintained on clean intermittent catheterization. Some individuals who are unable to control urine output (urinary incontinence) due to deficient sphincter tone may benefit from perineal exercises.
Although this is a somewhat dated technique, male patients with extensive sphincter damage may be helped by the use of a Cunningham clamp.
The clamp is applied in a horizontal fashion behind the glans of the penis and must be removed approximately every four hours for bladder emptying to prevent bacteria from growing in the urine and causing an infection.
Alternation of the Cunningham clamp with use of a condom collection device will reduce the skin irritation sometimes caused by the clamp.
Urinary diversion away from the bladder may involve creation of a urostomy or a continent diversion. The surgical implantation of an inflatable sphincter is another option for certain patients. An indwelling urinary catheter is sometimes used when all other methods of incontinence management have failed.
The long-term use of an indwelling catheter almost inevitably leads to some urinary tract infections, and contributes to the formation of urinary stones (calculi). Doctors may prescribe antibiotics preventively to reduce recurrent urinary tract infection. Initial symptoms include sweating (particularly on the forehead) and headache, with progression to slow heart rate (bradycardia) and high blood pressure (hypertension).
Patients should notify their physician promptly if symptoms do not subside after the bladder (or rectum) is emptied, or if the bladder (or rectum) is full and cannot be emptied.



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