Evaluation and treatment of the incontinent female patient
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| Format: | Buch |
| Sprache: | English |
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Philadelphia [u.a.]
Saunders
1995
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| Schriftenreihe: | The urologic clinics of North America
22,3 |
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| 245 | 1 | 0 | |a Evaluation and treatment of the incontinent female patient |c Carl G. Klutke ... guest ed. |
| 246 | 1 | 3 | |a Surgical craft: application of organ transplant techniques to urologic surgery |
| 246 | 1 | 3 | |a Application of organ transplant techniques to urologic surgery |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 1995 | |
| 300 | |a X S., S. 481 - 697 |b zahlr. Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
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| 490 | 1 | |a The urologic clinics of North America |v 22,3 | |
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| 700 | 1 | 2 | |a Marsh, Christopher Lee |0 (DE-588)1067436006 |4 aut |t Application of organ transplant techniques to urologic surgery |
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| 249 | |a Surgical craft: application of organ transplant techniques to urologic surgery |v <<[Christopher Lee Marsh]>> | ||
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Datensatz im Suchindex
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| adam_text | I EVALUATION AND TREATMENT OF THE INCONTINENT FEMALE PATIENT
CONTENTS
Preface xiii
Carl Klutke and Shlomo Raz
Epidemiology and Psychosocial Aspects of Incontinence 481
Ananias C. Diokno
Urinary incontinence (UI) is a very prevalent condition that affects women
of all ages, domicile, and health status. UI is associated with several
medical conditions, and its consequences can be devastating to the life of
not only the patient, but family members as well. This article discusses
the prevalence of UI, voiding frequency in the elderly, medical correlates
of UI, urodynamic parameters among continent and incontinent elderly,
patient strategies to control urine loss, psychosocial correlates of UI, and
incidence and remission rates.
Functional Female Pelvic Anatomy 487
Carl G. Klutke and Cary Lynn Siegel
This article reviews important aspects of female pelvic anatomy with
particular emphasis on the structures important for pelvic organ support
and urinary control. The pelvis and supporting structures, the pelvic floor,
and the relationships of the pelvic organs are described and illustrated by
MR imaging.
Pathology and Pathophysiology of Detrusor in Incontinence 499
Ahmad Elbadawi
Incontinence is a common urologic problem, especially in the elderly.
Ultrastructural study of the detrusor is crucial for the understanding of
its normal and abnormal functional behavior. Prospective, correlative,
ultrastructural studies in the elderly revealed distinctive patterns of the
overactive (unstable) detrusor, whether occurring alone or together with
impaired detrusor contractility or bladder outlet obstruction. These pat¬
terns provide better insight into pathophysiology of the unstable bladder,
and a great potential in diagnosis of detrusor dysfunction in general.
UROLOGIC CLINICS OF NORTH AMERICA VOLUME 22 • NUMBER 3 • AUGUST 1995 vii
Preliminary Assessment of the Incontinent Woman 513
Lauri J. Romanzi, Dianne M. Heritz, and Jerry G. Blaivas
Assessment of urinary incontinence begins with a thorough history and
physical examination. This article reviews the collection of subjective,
semi objective, and objective data that allows for comprehensive evalua¬
tion of the incontinent female patient. These results will help direct further
evaluation and develop an efficient and effective treatment plan.
Urinary Incontinence in Girls: Evaluation, Treatment, and Its Place
in the Standard Model of Voiding Dysfunctions in Children 521
David A. Bloom, Gary Faerber, and M. David Bomalaski
Urinary incontinence is the principle voiding dysfunction of childhood.
This can be viewed as one among many dysfunctions in our standard
model of voiding dysfunction. A careful elimination history is essential to
manage any voiding dysfunction.
Radiography, Sonography, and Magnetic Resonance Imaging for
Stress Incontinence: Contributions, Uses, and Limitations 539
Jacek L. Mostwin, Andrew Yang, Roger Sanders, and Rene Genadry
Imaging has accompanied and advanced our thinking about stress inconti¬
nence since bead chain cystography was first introduced in 1953. Conven¬
tional radiographic studies with or without urodynamic measurement are
well understood and considered a standard. Newer techniques include
sonographic studies of real time movement of the urethra about the pubis
and dramatic dynamic MR images of simultaneous movement of all pelvic
compartments. All studies are amenable to quantitative method and offer
the clinical practitioner or investigator a wide choice of tools that enhance
anatomical knowledge and improve management of complex cases.
Urodynamic Evaluation of Stress Incontinence 551
Edward J. McGuire
Stress incontinence is a symptom that often coexists with other symptoms.
Urodynamic evaluation should be directed at the identification and quanti¬
fication of leakage resulting from abdominal pressure as an expulsive
force. Bladder storage function can be assessed with available urodynamic
instruments, but poor detrusor reflex control cannot be accurately assessed
at the present time. The quantification of the type and degree of urethral
weakness is important in the selection of an appropriate operative proce¬
dure.
Pharmacology of Incontinence 557
Alan J. Wein
Any type of filling or storage failure and urethral incontinence results
from the following abnormalities: accomodation of increasing volumes of
urine at a low intravesical pressure and with appropriate sensation, a
bladder outlet that is closed at rest and remains so during increases in
intra abdominal pressure, and absence of involuntary bladder contraction.
This article discusses the pharmacologic therapy that is effective in the
management of many types of voiding dysfunction.
Neurogenic Vesical Dysfunction 579
David A. Rivas and Michael B. Chancellor
Women with neurogenic vesical dysfunction are prone to the development
of urologic complications. These patients require diagnostic evaluation
Viii CONTENTS
including the use of urodynamic study, imaging, and often endoscopy.
These studies ultimately determine whether medical management or surgi¬
cal intervention will minimize the long term risk of urologic complications.
Proper definitive treatment of this patient group effectively enhances qual¬
ity of life and patient satisfaction.
Detrusor Instability 593
David R. Couillard and George D. Webster
Detrusor instability is a common cause of urgency and urge incontinence
in neurologically normal patients. It is defined as an involuntary phasic
detrusor contraction of any pressure associated with symptoms of urge or
leakage while the patient is attempting to inhibit micturition. The etiology
is unknown but it has been associated with congenital causes, aging, stress
incontinence, and bladder outlet obstruction. Diagnosis relies on a urologic
history and physical examination, a voiding diary, and a urodynamic
evaluation. Treatment is primarily pharmacologic and behavioral, with
surgical options being reserved for selected patients.
Nonsurgical Therapy for Stress Incontinence 613
Alain P. Bourcier and Jean C. Juras
This article discusses the therapies that have been developed for the
treatment of stress incontinence due to female pelvic floor dysfunction. A
combination of pelvic muscle exercises, biofeedback, behavioral modifica¬
tion, and electrical stimulation are all treatment options that do not involve
surgery. When physiotherapy proves successful, and surgery is avoided,
it is necessary for the patient to be put on a maintenance program to
avoid relapse. The authors also discuss the link between urinary stress
incontinence and women involved in sports.
Hormonal Influence on the Urinary Tract 629
John J. Klutke and Arieh Bergman
This article describes the hormonal changes in the female and the effect of
these changes on the urinary tract. Current concepts in hormone replace¬
ment therapy as it relates to incontinent, estrogen deficient women are
discussed, along with the relationship between collagen and estrogen.
Finally, the authors assess the published research on the effect of estrogen
on incontinence.
Vaginal Reconstructive Surgery for Female Incontinence and
Anterior Vaginal Wall Prolapse 641
Lynn Stothers, Ashok Chopra, and Shlomo Raz
The surgical procedure of choice to correct stress urinary incontinence
using a vaginal approach depends not only on the anatomic origin of the
incontinence (hypermobility or intrinsic sphincter dysfunction) but also on
the degree of coexistent anterior vaginal wall prolapse. The grade of
coexistent cystocele and the finding of a central or lateral defect are
important observations that help the surgeon plan the optimum surgical
approach. Grade 4 cystocele with central and lateral defects represents the
most severe form of anterior vaginal wall prolapse. In this case, the
surgical goals are to correct both central and lateral defects, as well as
hypermobility related to the mid urethra and bladder neck.
Surgical Treatment of Intrinsic Urethral Dysfunction: Slings 657
Edward J. McGuire and Helen E. O Connell
Slings are a durable and effective treatment for intrinsic sphincter defi¬
ciency, regardless of its etiology. The history of slings throughout the 20th
CONTENTS ix
century, and the current surgical technique, is described in this article. A 1
comparison of slings with alternative treatments of intrinsic sphincter I
deficiency, such as artificial sphincters and collagen is presented. Slings
play a significant role in the treatment of stress incontinence.
Surgical Treatment of Intrinsic Urethral Dysfunction: Injectables (Fat) 665
Brett A. Trockman and Gary E. Leach
Injection of autologous fat has been used for many years to correct cos¬
metic surgical defects. More recently, autologous fat injection has been
applied to the treatment of urinary incontinence. The background and
technique of periurethral fat injection are described in this article. The
technique is safe, and preliminary results are encouraging in women with
intrinsic sphincter deficiency. Long term follow up and comparative trials
will determine the ultimate utility of periurethral fat injection for the
treatment of women with intrinsic sphincter deficiency.
Periurethral Injection of Collagen in the Treatment of Intrinsic
Sphincteric Deficiency in the Female Patient 673
]. Christian Winters and Rodney Appell
Female stress urinary incontinence may result from anatomic displacement
of a normally functioning urethra or intrinsic sphincteric deficiency (ISD).
Patients with a fixed, well supported urethra and ISD are excellent candi¬
dates for the transurethral or periurethral injection of collagen as treatment
of their incontinence. Excellent success rates are achieved within one to
three injections under local anesthesia, and the complications associated
with the procedure are minimal. Of the patients who achieve dryness,
more than 50% remain dry two years following injection. Periurethral
injection of collagen is a nonsurgical option in the management of female
stress urinary incontinence.
The Craft of Urologic Surgery
Application of Organ Transplant Techniques to Urologic Surgery 679
Christopher Lee Marsh
This article presents a detailed description of surgical techniques that have
been adapted from multi organ procurement procedures and liver and
pancreas transplantation that may be applied to urologic surgery, specifi¬
cally difficult excision of urologic tumors in the upper abdomen and
retroperitoneum. Techniques for exposure, mobilization of the liver, mobi¬
lization of the pancreas and spleen segment, isolation of the suprarenal
intra abdominal inferior vena cava, and the intra abdominal approach of
the intracardiac inferior vena cava through a pericardial window are
described. The addition of the described techniques to the urologist s
surgical armamentarium may be beneficial for providing increased access
and exposure in difficult urologic cases.
Index 693
Subscription Information Inside back cover
x CONTENTS
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| illustrated | Illustrated |
| indexdate | 2025-02-03T16:34:53Z |
| institution | BVB |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-006944981 |
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| physical | X S., S. 481 - 697 zahlr. Ill., graph. Darst. |
| publishDate | 1995 |
| publishDateSearch | 1995 |
| publishDateSort | 1995 |
| publisher | Saunders |
| record_format | marc |
| series | The urologic clinics of North America |
| series2 | The urologic clinics of North America |
| spellingShingle | Marsh, Christopher Lee Evaluation and treatment of the incontinent female patient The urologic clinics of North America Harninkontinenz (DE-588)4072326-4 gnd Frau (DE-588)4018202-2 gnd |
| subject_GND | (DE-588)4072326-4 (DE-588)4018202-2 (DE-588)4143413-4 |
| title | Evaluation and treatment of the incontinent female patient |
| title_alt | Surgical craft: application of organ transplant techniques to urologic surgery Application of organ transplant techniques to urologic surgery |
| title_auth | Evaluation and treatment of the incontinent female patient |
| title_exact_search | Evaluation and treatment of the incontinent female patient |
| title_full | Evaluation and treatment of the incontinent female patient Carl G. Klutke ... guest ed. |
| title_fullStr | Evaluation and treatment of the incontinent female patient Carl G. Klutke ... guest ed. |
| title_full_unstemmed | Evaluation and treatment of the incontinent female patient Carl G. Klutke ... guest ed. |
| title_short | Evaluation and treatment of the incontinent female patient |
| title_sort | evaluation and treatment of the incontinent female patient |
| topic | Harninkontinenz (DE-588)4072326-4 gnd Frau (DE-588)4018202-2 gnd |
| topic_facet | Harninkontinenz Frau Aufsatzsammlung |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=006944981&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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