Health Index
Pads and garments, disposable or reusable, worn to absorb leaked urine. Absorbent products include shields, undergarment pads, combination pad-pant systems, diaper like garments, and bed pads.
ABP is caused by bacteria traveling up the urethra and the backward flow of infected urine into the prostatic ducts. This may be brought on by the use of a urinary catheter during a medical procedure, or it may be caused by an enlargement of the patient's prostate, a congenital defect in his urinary tract or a recent bladder infection. Engaging in anal intercourse also can cause ABP, although the disease is not sexually transmitted (cannot be passed from partner to partner).
| Adrenal Cancer |
Although there are two parts to the adrenal gland, the vast majority of malignancies of the adrenal gland occur in the cortex. Carcinomas of the adrenal gland are considered either functional or nonfunctional; that is, they either produce steroids (which may lead to clinical symptoms) or they don't. This disease is very rare, affecting 2 per 1 million people.
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Cloning Genes For Adrenal Tumors: A Journey From Rare Human Diseases To Important Genes And Signaling Pathways Constantine A. Stratakis, M.D., D.Sc., National Institute Of Child Health And Human Development videocast.nih.gov 57:02 REAL 256K |
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Adrenal Disorders Of Childhood G. Cutler, M.D., J. Yanovski, M.D., Ph.D. And C. Stratakis, M.D. videocast.nih.gov 59:56 REAL 256K |
Alpha-adrenergic agonists are drugs, which stimulate sites in the nervous system that respond to the chemical norepinephrine. Therefore, patients suffering from forms of incontinence requiring increased muscle tone and urethral resistance -- for example, stress incontinence -- may benefit from the use of alpha-adrenergic agonists.
Benign prostatic hyperplasia -- non cancerous enlargement of the prostate -- can encroach upon the urinary tract, leading to overflow or urge incontinence. Alpha-1 adrenergic receptor blocking agents --known as alpha-1 blockers or alpha blockers -- are used to treat BPH, because they reduce the tone of striated and smooth muscle, thereby decreasing urethral resistance and relieving symptoms of obstruction. Alpha-blockers should not be used in people who are hypersensitive (have an exaggerated reaction) to such medication or who experience postural hypotension (extremely low blood pressure when standing up or standing still).
In addition to standard methods such as biofeedback, drug therapy and surgery, a number of treatment devices are available to help patients achieve bladder control. Interstim is a new therapy which may be effective in treating urge incontinence in some patients. It consists of a device, about the size of a pacemaker, that is implanted into the sacral nerves of the lower spine, where it delivers electrical impulses that help regulate bladder function. In this way, Interstim reduces the likelihood and severity of accidental urination or leakage. The surgery required for implantation is minimal, and the device can be adjusted to meet the bladder control needs of each patient. Prosthetic occluding devices can be used to block the flow of urine by squeezing the urethra shut. For men, such mechanical devices include penile clamps (for example, the Cunningham clamp) and compression rings. The penile clamp is a V-shaped casing with a foam cushion that fits over and under the penis. When closed, the penile clamp should stop the flow of urine without causing discomfort. Compression devices are adjustable rings that surround the penis and, when inflated with air, pinch off the urine flow. Occluding devices usually are reserved for temporary use by individuals with stress incontinence. These devices must be removed at regular 2- to 3-hour intervals to empty the bladder. Therefore, they should be used only by mentally competent individuals who are able to adjust them by hand and who are able to remember the bladder-emptying schedule. Improper use of penile clamps and compression devices can result in penile and urethral erosion, penile edema (swelling), pain and obstruction. Vaginal pessaries -- ring, cube or doughnut-shaped devices made of rubber or silicone -- are inserted into the vagina to support the bladder neck in female patients with stress incontinence. Vaginal pessaries are available in different sizes, and they are generally put in place by a gynecologist. The major side effects of pessary use are wearing away of the vaginal skin and vaginal infection. Therefore, people who use pessaries need frequent examinations to ensure vaginal health. Erosion problems usually can be managed by removal of the pessary until the skin heals, and vaginal infections are treatable by douching and/or antibiotic therapy. Pessaries may be an alternative form of treatment for frail elderly women who cannot undergo other forms of incontinence therapy. Introl is a pessary-like vaginal prosthesis that also works to support the bladder neck. A woman can insert and remove the device, which should not be worn continuously for more than 24hours without proper cleaning. The manufacturer recommends removing the prosthesis at night before going to bed. A number of additional treatment devices recently have become available for women. The first device--the Reliance urinary control insert--also is known as a urethral plug. The Reliance insert is a single-use, balloon-tipped tube that is about one-fifth the size of a tampon. The insert can be placed in the urethra by means of a special applicator. When in place, the small balloon (which extends into the bladder) can be inflated with air to prevent leakage. If the wearer wishes to urinate, she just pulls a string to deflate the balloon and then removes the insert. Unfortunately, fairly high infection rates are seen with this device, because it is placed directly into the urethra. The manufacturer reports that urinary tract infections are most common during the first month of use and decrease as women become more familiar with its proper use. Amitriptyline (Elavil) and doxepin (Sinequan) act as antidepressants when given in large doses. In smaller doses, they can help IC symptoms by blocking pain, calming bladder spasms, and decreasing inflammation. Some cases of IC may be caused by too much histamine in the bladder. Antihistamine drugs such as hydroxyzine (Vistaril and Atarax) and cimetidine (Tagamet) relieve symptoms in some IC patients. If taken at bedtime, hydroxyzine may also help patients sleep.
Act as antidepressants when given in large doses. In smaller doses, they can help IC symptoms by blocking pain, calming bladder spasms, and decreasing inflammation.
Like 5-alpha-reductase deficiency, androgen receptor deficiency is a genetically-linked expression of abnormal androgen (male sex hormone) activity. And, like 5-alpha-reductase deficiency, androgen receptor deficiency can produce a syndrome of pseudohermaphroditism (see also 5-alpha-reductase deficiency). The clinical features of androgen receptor deficiency, also known as Reifenstein syndrome, may range from infertility alone to pseudohermaphroditism (incomplete masculinization of the external male genitalia in men with bilateral testes). Cryptorchidism may be present, along with vas deferens defects and incomplete sperm production. Patients often show high blood levels of testosterone, coupled with increased levels of luteinizing hormone (LH) and increased secretion of estradiol (natural estrogen) by the testes. The enhanced estradiol output leads to feminization (development of female sex characteristics), androgen resistance and changeable degrees of masculinization. Irreversible fertility often results from the severe deficiency or lack of sperm caused by this disorder.
A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume.
Antibiotics frequently are prescribed to eliminate infections that could impair fertility, such as infections of the urinary tract and prostate. The physician will be especially inclined to prescribe an antibiotic if leukocytes (white blood cells) are detected in the man's semen sample. Strong antibiotic medications - like double- strength trimethoprim plus sulfamethoxazole (Bactrim DS) and doxycycline hyclate (Vibramycin) - often are the drugs of choice. They usually are administered for intervals of 1 to 3 months. Nitrofuran antibiotics are avoided, since they may impair sperm maturation. STDs, such as gonorrhea or ureaplasma, commonly are treated with ceftriaxone sodium or doxycycline.
A debilitating condition of fear, which interferes with normal life functions.
This procedure usually is reserved for patients whose overall health does not permit surgery, such as those with heart or lung problems. In arterial embolization, a very small tube called a catheter is inserted through a blood vessel in the groin and passed up to the kidney. There it is used to inject a small piece of gelatin sponge into the artery that supplies blood to the cancerous kidney. This cuts off the flow of blood to the kidney and the cancerous tumor, which die. The kidney usually is surgically removed at a later date, if and when the patient's overall condition permits.
Artificial insemination (AI) is a process in which a relatively large number of healthy sperm are deposited in a woman by artificial means. The sperm are placed either at the entrance to the cervix or directly into the uterus (womb) near the fallopian tubes (intrauterine insemination or IUI). Artificial insemination is particularly useful when the male partner's sperm count is low or when sperm quality is below average (e.g., in cases of spinal cord injury, ejaculation disorder or impotence). The sperm can be prepared by washing, concentration, or other methods to ensure the best chance of conception (see also Sperm Retrieval). Artificial insemination also is commonly performed using sperm from a donor.
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Artificial Sphincter |
Sometimes complicated cases of incontinence require implantation of a device known as an artificial urinary sphincter. People who might benefit from this treatment include those who are incontinent after surgery for prostate cancer or stress incontinence, trauma victims and people with congenital (present at birth) defects in the urinary system. The artificial sphincter has three components, including a pump, balloon reservoir, and a cuff that encircles the urethra and prevents urine from leaking out. The cuff is connected to the pump, which is surgically implanted in the scrotum (in men) or labia (in women). The pump can be activated (usually by squeezing or pressing a button) to deflate the cuff and permit the bladder to empty. After a brief interval, the cuff refills itself and the urethra is again pressed closed. Because the artificial sphincter is an implant, it is subject to the risks common to implants, such as infection, erosion (breaking down of tissue) and mechanical malfunction. Yet with appropriate pre surgical evaluation, operative techniques and postoperative follow-up, many problems can be avoided and incontinent patients can experience an improved quality of life with this device.
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Anal sphincter anatomy |
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Artificial Urinry Sphincter American Medical Systems morristownurology.net 04:34 REAL 56K |
The new forms of fertility treatment incorporate many methods of sperm retrieval and preparation. Once the sperm have been processed to ensure optimal fertilizing potential, they are used in a variety of procedures that aid the process of conception. These procedures include artificial insemination (AI), in vitro fertilization (IVF), and sperm microinjection techniques.
The AUA Score or Symptom Index is a self-administered questionnaire used to establish how severe a patient's BPH symptoms may be. It asks seven questions related to common symptoms of BPH and asks the patient to rate the degree of frequency or severity for each on a scale of 1 to 5. A total AUA Score of 0 to 7 is considered mild; 8 to 19 is rated moderate, and 20 to 35, severe.
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Makes the bladder larger, most often by adding a section of the patient's small intestine, a tube-like structure that absorbs and transports nutrients from food for use by the body. With this treatment, scarred, ulcerated and inflamed sections of the patient's bladder are removed, leaving only healthy tissue and the base of the bladder. A piece of the patient's small intestine is removed, reshaped, and attached to what remains of the bladder. After the incisions heal, the patient may be able to void normally. Even in carefully selected patients-those with small, contracted bladders-the pain, frequency, and urgency may remain or return after surgery and the patient may have additional problems with infections in the new bladder and difficulty absorbing nutrients from the shortened intestine. Some patients are incontinent while others cannot void at all and must insert a catheter into the urethra to empty urine from the bladder.