> Care of urinary incontinence and anal

Introduction

Today, there are rehabilitation treatments, pharmacological, surgical effective at addressing each of the issues described

First should be avoided “the silence” , where già present any of these inconveniences.

Often those who live in them plunges into a spiral of issues that go to undermine the sexual sphere, the relationship with the other, and the profession.

And this condition is usually experienced in private, as if it were a topic tabù, in the shade of the embarrassment and shyness. It is so hard to talk to your doctor up to deny even the existence.

thereò you add some fake common places, shared sometimes, unfortunately, even in the context of health care, such as the one that it is “minor ailments or passengers” or “little or nothing you can do…” Diagnostic Services Uroginecologica Outpatient

Pelvic Examination Functional

Includes a detailed observation of all areas of the pelvic floor (the muscles, and the bands that “claim” the urogenital apparatus of female). Is performed in the supine position, sitting, standing, and in a state of rest and under stress. Thereò it allows to identify any damaged structures, and is essential for deciding the surgical approach in the reconstruction più suitable. Also is evaluated the coordination of the muscles of the pelvic floor for a possible physiotherapy. (see: pelvic Examination in healthy women, adult, &is useful? Guidelines)

urodynamics Multichannel

this Is a test series (uroflussometria, cystometry, profilometry urethral static and dynamic study of pressure/flow with or without electromyography) are used to identify and to document objectively the type and causes of urinary disorders such as urinary incontinence, frequent urination, difficultyà of bladder emptying.

You are running on an ambulance specially equipped with a nurse specialist and a doctor that takes care of uroginecologia.

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Involves the placement of sterile a thin catheter in the bladder and a small “balloon”, connected to a catheter in the vagina or in the rectum, after which" infuses sterile saline into the bladder.

During the examination the patient is in the sitting position or supine position and is invited to perform efforts such as coughing. No needle is positioned.

The majority of patients do not experience any particular inconvenience, if not those arising from the initial natural ansietà for a complex equipment, and from the embarrassment of leakage of urine.

The complete assessment takes approximately 30-40 minutes.

Uretrocistoscopia

Consists in a visual exploration of the cavità of the bladder (distended with sterile liquid) using a tool with a diameter of a few millimeters (cystoscope) is introduced into the bladder through the urethra.

used to identify pathologies and abnormalities of the bladder and urethra.

Treatment Services Uroginecologico

re-education, and Fisioriabilitazione (Kinesitherapy, Biofeedback, Functional Electrical Stimulation) If implemented correctly, both as a therapeutic act that quote, it has the purpose of:

    the

  • ensure or improve urinary continence and anal;
  • the

  • to preserve the static of the pelvic floor and, therefore, prevent the onset or the worsening of the prolapse of the urogenital tract;
  • the

  • maintain a satisfying sex life;
  • the

  • to treat pains and perineal area are not easy to approach

The rehabilitation of the pelvic floor, in its various aspects, which include the re-education bladder training, exercises, and electrostimulation of the pelvic floor muscles, should be of concern to all women who present with risk factors during pregnancy and childbirth. The service is managed by midwives specialist medical supervision.

Pharmacological Treatment, The drugs used in uroginecologia are very different. Often, the therapeutic choices are based on a diagnosis which is not complete and/or not correct.

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The knowledge of the principles and pharmacological, of their indications, and modeà of administration, their side effects, as well asé of the pathology uroginecologica to be treated and of the related modeà assessment represent an essential precondition for positive results.

in Addition, many drugs used in current therapy may affect the lower urinary tract. At the Surgery of Uroginecologia you run the prescription drugs for the home treatment, but it also makes the administration of drugs directly in the bladder.

Surgical Treatment

The choice between the non-surgical treatment and surgical treatment depends on the type and severityà of the problem uroginecologico, età and the general health of the patient, the degree of deterioration of the qualityà of life.

The surgical strategies and feasible are the variables for the technology, access and invasività depending on the type and the seriousnessà of the pathology to be addressed. The majority of procedures are carried out by means of an access vaginal, and then without having to open the abdomen, as burdened by a lower rate of postoperative complications. They may include:

  • the removal of the uterus (hysterectomy) and ovaries (oophorectomy);
  • the

  • repair of the prolapse of the bladder using tissue fascial of the patient (cistopessi) or prosthesis material, the heterologous (TCR: repair with mesh without tension);
  • the

  • repair of prolapse of the rectum or bowel to it above;
  • the suspension of the vaginal vault prolassata after the removal of the uterus;
  • the

  • excision of caruncole urethral symptomatic;
  • the

  • for the correction of stress urinary incontinence with techniques that are called minimally invasive: plants in the urethra, through the injection of different materials (silicone, hyaluronic acid…), in local anesthesia; placement under the urethra of a banderella of the material the prosthetic tension free (TVT, SPARC, and TVT-O) in regional anaesthesia;
  • the

  • cystoscopy and bladder distension under general anesthesia in the diagnosis and treatment of interstitial cystitis
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NB: all of the interventions may, if the conditions exist permittenti, be performed in regional anaesthesia (perdurale or spinal) or general.

the Staff of the Services whenever one chooses of the Division of Uroginecologia of the Unità Operative Obstetrics and Gynaecology, university Hospital G. B. Grassi di Ostia.

Dr. Cosimo OLIVE oil

Dr.ssa Lidia DE SANTIS

Ost. Loredana CORTESE

Ost. Teresa TODARO

Inf. Laura IACOPPINI

Inf. Antoinette VALLARELLA

Information for Patients and for the Doctors Appointments for diagnostic tests

(visit uroginecologica, urodynamics, cystoscopy…):

    the

  • Visit uroginecologica: Tel. the 06.56368168 (C. U. P.) from 08:30 to 10:00 from Mon. – Fri.
  • the

  • Tests Urodinamiche /Cystoscopy: Tel. the 06.56482066 (Amb. Uroginecologia) from 08:00 to 09:00 on Mon., Thurs., Fri. between the hours of 8:30 to 19:00 the Sea.

NB: it is necessary to perform in advance HbsAg, Hcv, and a urine culture with counting colonies and susceptibility testing (the latter preferably 15 days before the exam)

Appointments for re-education and Fisioriabilitazione of the Pelvic Floor:

Tel. the 06.56482308 (Amb.) from 14:00 to 19:30 del Mar. Thurs. from 08:00 to 13:30 Sat.

Inclusion in the waiting lists for surgery:

Tel. 06.56482065

From 09:00 to 12:00 from Mon. – Fri.

Fax: 06.56482174

Other Web resources

    the

  • www.aiug.it (the Italian Association of Urology gynecology and Pelvic Floor)
  • the

  • www.aici-onlus.com (Italian Association Interstitial Cystitis)
  • the

  • www.augs.org American Urogynecologic Society
  • the

  • www.iuga.org (International Urogynecological Association)
  • the

  • www.continent.org (International Continence Society)