Individualized pelvic physical therapy for the treatment of post-prostatectomy stress urinary incontinence and pelvic pain

AbstractBackgroundThe rehabilitation of post-prostatectomy urinary incontinence has traditionally focused on pelvic floor strengthening exercise. The goal of this study was to determine whether an individualized pelvic physical therapy (PT) program aimed at normalizing both underactive and overactive pelvic floor dysfunction (PFD) can result in improvement in post-prostatectomy stress urinary incontinence (SUI) and pelvic pain.MethodsA retrospective chart review of 136 patients with post-prostatectomy SUI and treated with pelvic PT. Patients were identified as having either underactive, overactive, or mixed-type PFD and treated accordingly with a tailored program to normalize pelvic floor function. Outcomes including decrease in SUI as measured in pad usage per day and pain rated on the numeric pain rating scale.ResultsTwenty five patients were found to have underactive PFD and were treated with strengthening. Thirteen patients had overactive PFD and were treated with relaxation training. Ninety eight patients had mixed-type PFD and were treated with a combination of relaxation training followed by strengthening. Patients demonstrated statistically significant decrease in pad usage per day (p 
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research

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We report a patient with relapsing-remitting multiple sclerosis, who developed rheumatoid arthritis after exposure to natalizumab. While some multiple sclerosis therapies are known to unmask autoimmune conditions, natalizumab is rarely implicated as a cause of alternative autoimmunity. This case illustrates an unusual clinical scenario which may support recent scientific work suggesting that when natalizumab blocks T helper 1 cells from entering the central nervous system, T helper 17 cells may continue to migrate into immune-privileged spaces and cause pathologic inflammation.Brief Background: Multiple sclerosis (MS) pati...
Source: Multiple Sclerosis and Related Disorders - Category: Neurology Source Type: research
;rez López Sánchez There is a high prevalence of comorbidities among patients with chronic obstructive pulmonary disease (COPD). Comorbidities are likely common in patients with any COPD degree and are associated with increased mortality. The aim of this study was to determine the prevalence of thirty-one different COPD comorbidities and to evaluate the association between physical activity (PA) levels in people with COPD residing in Spain. Cross-sectional data from the Spanish National Health Survey 2017 were analysed. A total of 601 adults (52.2% females) with COPD aged 15 to 69 participated in this ...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
Authors: Yan J, Ma L Abstract BACKGROUND The aim of this study was to investigate the clinical effect of tunnel-like fistulectomy plus draining seton combined with incision of internal opening of anal fistula (TFSIA) in the treatment of high transsphincteric anal fistula. MATERIAL AND METHODS There were 80 patients with high transsphincteric anal fistula randomly divided into TFSIA group and control group, 40 cases in each group. The control group was treated with cutting seton, and the seton was tightened weekly after discharge from the hospital until the seton dropped off. In the TFSIA group, the anal fistula was...
Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
After prostate surgery, individualized pelvic physical therapy to relax or strengthen the pelvic muscles may be more effective for reducing stress urinary incontinence (SUI) and pelvic pain than muscle strengthening alone, researchers suggest.Reuters Health Information
Source: Medscape Medical News Headlines - Category: Consumer Health News Tags: Urology News Source Type: news
AbstractPurpose of ReviewOveractive bladder (OAB) and interstitial cystitis/bladder pain syndrome (IC/BPS) are defined as syndromes consisting of “urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence” and “an unpleasant sensation perceived to be related to the urinary bladder, associated with lower urinary tract symptoms,” respectively. Distinguishing between the two diagnoses ca n be challenging and although OAB and IC/BPS are traditionally considered separate conditions, more evidence is emerging to suggest a continuum between the symptoms. T...
Source: Current Bladder Dysfunction Reports - Category: Urology & Nephrology Source Type: research
ConclusionThe Self Retaining Support (SRS) implant provides 97% subjective and 94.3% objective cure. Two patients (2.8%) had the implant’s frame removed surgically. The SRS is a safe and effective treatment for pelvic organ prolapse.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Bioness, a Valencia, California firm, won European regulatory approval for its StimRouter neuromodulation system to treat fecal incontinence. Previously cleared in the EU as a tool for managing chronic pain and overactive bladder, the new indicati...
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AbstractPurposeTo compare the results of laser hemorrhoidoplasty (LHP), excisional hemorrhoidectomy (EH), and sutured mucopexy (MP).MethodsA randomized, parallel-group, double-blinded, single-center prospective study.PatientsSymptomatic 2nd- or 3rd-degree hemorrhoids patients.InterventionsComputer randomization sequence, patient blinding, operating surgeon blinding, and surgeon-evaluator blinding. LHP was performed using a 1470  nm diode laser. Up to 250 J of energy delivered per 1 hemorrhoid. The procedure was performed circumferentially. MP ligations were placed in the area of visible hemorrhoidal tissue. Stand...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionsPOP surgery is associated with low rates of complication and recurrence. Complications occurred most commonly following combined surgeries for both prolapse and incontinence and in hospitals with low surgical volumes. Concomitant hysterectomy appears to be protective for the need for additional prolapse surgery, and the vaginal route leads to a lower frequency of secondary surgery for urinary incontinence.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
We present a follow-up study of the long-term function in patients who had surgery for laxative-resistant slow transit constipation.MethodsA postal survey was sent to assess bowel frequency, abdominal pain, St Mark ’s continence score, satisfaction with procedure, likelihood to choose the procedure again, and long-term rates of small bowel obstruction and ileostomy. Longitudinal data from a subgroup studied 23 years previously are reported.ResultsForty-two patients (male = 2) were available for follow-up out of an initial cohort of 102. Mean time since surgery was 15.9 years (range 1.7–2...
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
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