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What to do for Hematuria (Blood in the Urine) ? | Eating, diet, and nutrition have not been shown to play a role in causing or preventing hematuria. |
What to do for Hematuria (Blood in the Urine) ? | Hematuria is blood in the urine. Most people with microscopic hematuria do not have symptoms. People with gross hematuria have urine that is pink, red, or colacolored due to the presence of red blood cells (RBCs). Hematuria can be caused by menstruation, vigorous exercise, sexual activity, viral illness, trauma, or infection, such as a urinary tract infection (UTI). More serious causes of hematuria include cancer of the kidney or bladder inflammation of the kidney, urethra, bladder, or prostate polycystic kidney disease blood clots blood clotting disorders, such as hemophilia sickle cell disease When blood is visible in the urine or a dipstick test of the urine indicates the presence of RBCs, the urine is examined with a microscope to make an initial diagnosis of hematuria. The next step is to diagnose the cause of the hematuria. If a thorough medical history suggests a cause that does not require treatment, the urine should be tested again after 48 hours for the presence of RBCs. If two of three urine samples show too many RBCs when viewed with a microscope, more serious causes should be explored. One or more of the following tests may be ordered: urinalysis, blood test, biopsy, cytoscopy, and kidney imaging tests. Hematuria is treated by treating its underlying cause. |
What is (are) Urinary Tract Infections in Children ? | A UTI is an infection in the urinary tract. Infections are caused by microbesorganisms too small to be seen without a microscopeincluding fungi, viruses, and bacteria. Bacteria are the most common cause of UTIs. Normally, bacteria that enter the urinary tract are rapidly removed by the body before they cause symptoms. However, sometimes bacteria overcome the bodys natural defenses and cause infection. An infection in the urethra is called urethritis. A bladder infection is called cystitis. Bacteria may travel up the ureters to multiply and infect the kidneys. A kidney infection is called pyelonephritis. |
What is (are) Urinary Tract Infections in Children ? | The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of beanshaped organs, each about the size of a fist and located below the ribs, one on each side of the spine, toward the middle of the back. Every minute, a persons kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine an adult produces each day. Children produce less urine each day; the amount produced depends on their age. The urine travels from the kidneys down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder. Routinely, urine drains in only one directionfrom the kidneys to the bladder. The bladder fills with urine until it is full enough to signal the need to urinate. In children, the bladder can hold about 2 ounces of urine plus 1 ounce for each year of age. For example, an 8yearolds bladder can hold about 10 ounces of urine. When the bladder empties, a muscle called the sphincter relaxes and urine flows out of the body through a tube called the urethra at the bottom of the bladder. The opening of the urethra is at the end of the penis in boys and in front of the vagina in girls. |
What causes Urinary Tract Infections in Children ? | Most UTIs are caused by bacteria that live in the bowel. The bacterium Escherichia coli (E. coli) causes the vast majority of UTIs. The urinary tract has several systems to prevent infection. The points where the ureters attach to the bladder act like oneway valves to prevent urine from backing up, or refluxing, toward the kidneys, and urination washes microbes out of the body. Immune defenses also prevent infection. But despite these safeguards, infections still occur. Certain bacteria have a strong ability to attach themselves to the lining of the urinary tract. Children who often delay urination are more likely to develop UTIs. Regular urination helps keep the urinary tract sterile by flushing away bacteria. Holding in urine allows bacteria to grow. Producing too little urine because of inadequate fluid intake can also increase the risk of developing a UTI. Chronic constipationa condition in which a child has fewer than two bowel movements a weekcan add to the risk of developing a UTI. When the bowel is full of hard stool, it presses against the bladder and bladder neck, blocking the flow of urine and allowing bacteria to grow. Some children develop UTIs because they are prone to such infections, just as other children are prone to getting coughs, colds, or ear infections. |
How many people are affected by Urinary Tract Infections in Children ? | Urinary tract infections affect about 3 percent of children in the United States every year. UTIs account for more than 1 million visits to pediatricians offices every year.1 |
Who is at risk for Urinary Tract Infections in Children? ? | Throughout childhood, the risk of having a UTI is 2 percent for boys and 8 percent for girls. Having an anomaly of the urinary tract, such as urine reflux from the bladder back into the ureters, increases the risk of a UTI. Boys who are younger than 6 months old who are not circumcised are at greater risk for a UTI than circumcised boys the same age.1 |
What are the symptoms of Urinary Tract Infections in Children ? | Symptoms of a UTI range from slight burning with urination or unusualsmelling urine to severe pain and high fever. A child with a UTI may also have no symptoms. A UTI causes irritation of the lining of the bladder, urethra, ureters, and kidneys, just as the inside of the nose or the throat becomes irritated with a cold. In infants or children who are only a few years old, the signs of a UTI may not be clear because children that young cannot express exactly how they feel. Children may have a high fever, be irritable, or not eat. On the other hand, children may have only a lowgrade fever; experience nausea, vomiting, and diarrhea; or just not seem healthy. Children who have a high fever and appear sick for more than a day without signs of a runny nose or other obvious cause for discomfort should be checked for a UTI. Older children with UTIs may complain of pain in the middle and lower abdomen. They may urinate often. Crying or complaining that it hurts to urinate and producing only a few drops of urine at a time are other signs of a UTI. Children may leak urine into clothing or bedsheets. The urine may look cloudy or bloody. If a kidney is infected, children may complain of pain in the back or side below the ribs. Parents should talk with their health care provider if they suspect their child has a UTI. |
How to diagnose Urinary Tract Infections in Children ? | Only a health care provider can determine whether a child has a UTI. A urine sample will be collected and examined. The way urine is collected depends on the childs age: If the child is not yet toilet trained, the health care provider may place a plastic collection bag over the childs genital area. The bag will be sealed to the skin with an adhesive strip. If this method is used, the bag should be removed right after the child has urinated, and the urine sample should be processed immediately. Because bacteria from the skin can contaminate this sample, the methods listed below are more accurate. A health care provider may need to pass a small tube called a catheter into the urethra of an infant. Urine will drain directly from the bladder into a clean container. Sometimes the best way to collect a urine sample from an infant is by placing a needle directly into the bladder through the skin of the lower abdomen. Getting urine through a catheter or needle will ensure that the urine collected does not contain bacteria from the skin. An older child may be asked to urinate into a container. The sample needs to come as directly into the container as possible to avoid picking up bacteria from the skin or rectal area. Some of the urine will be examined with a microscope. If an infection is present, bacteria and sometimes pus will be found in the urine. A urine culture should also be performed on some of the urine. The culture is performed by placing part of the urine sample in a tube or dish with a substance that encourages any bacteria present to grow. Once the bacteria have multiplied, which usually takes 1 to 3 days, they can be identified. The reliability of the culture depends on how the urine is collected and how long the urine stands before the culture is started. If the urine sample is collected at home, it should be refrigerated as soon as it is collected. The container should be carried to the health care provider or lab in a plastic bag filled with ice. The health care provider may also order a sensitivity test, which tests the bacteria for sensitivity to different antibiotics to see which medication is best for treating the infection. |
What are the treatments for Urinary Tract Infections in Children ? | Most UTIs are caused by bacteria, which are treated with bacteriafighting medications called antibiotics or antimicrobials. While a urine sample is sent to a laboratory, the health care provider may begin treatment with an antibiotic that treats the bacteria most likely to be causing the infection. Once culture results are known, the health care provider may decide to switch the childs antibiotic. The choice of medication and length of treatment depend on the childs history and the type of bacteria causing the infection. When a child is sick or unable to drink fluids, the antibiotic may need to be put directly into the bloodstream through a vein in the arm or hand or be given as an injection. Otherwise, the medicationliquid or pillsmay be given by mouth. The medication is given for at least 3 to 5 days and possibly for as long as several weeks. The daily treatment schedule recommended depends on the specific medication prescribed: The schedule may call for a single dose each day or up to four doses each day. In some cases, a child will need to take the medication until further tests are finished. After a few doses of the antibiotic, a child may appear much better, but often several days may pass before all symptoms are gone. In any case, the medication should be taken for as long as the health care provider recommends. Medications should not be stopped because the symptoms have gone away. Infections may return, and bacteria can resist future treatment if the medication is stopped too soon. If needed, the health care provider may recommend an appropriate overthecounter medication to relieve the pain of a UTI. A heating pad on the back or abdomen may also help. |
How to diagnose Urinary Tract Infections in Children ? | Once the infection has cleared, more tests may be recommended to check for abnormalities in the urinary tract. Repeated infections in an abnormal urinary tract may cause kidney damage. The kinds of tests ordered will depend on the child and the type of urinary infection. Because no single test can tell everything about the urinary tract that might be important, more than one of the tests listed below may be needed. Kidney and bladder ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging; anesthesia is not needed. The images can show certain abnormalities in the kidneys and bladder. However, this test cannot reveal all important urinary abnormalities or measure how well the kidneys work. Voiding cystourethrogram. This test is an xray image of the bladder and urethra taken while the bladder is full and during urination, also called voiding. The childs bladder and urethra are filled with a special dye, called contrast medium, to make the structures clearly visible on the xray images. The xray machine captures images of the contrast medium while the bladder is full and when the child urinates. The procedure is performed in a health care providers office, outpatient center, or hospital by an xray technician supervised by a radiologist, who then interprets the images. Anesthesia is not needed, but sedation may be used for some children. This test can show abnormalities of the inside of the urethra and bladder. The test can also determine whether the flow of urine is normal when the bladder empties. Computerized tomography (CT) scan. CT scans use a combination of x rays and computer technology to create threedimensional (3D) images. A CT scan may include the injection of contrast medium. CT scans require the child to lie on a table that slides into a tunnelshaped device where the x rays are taken. The procedure is performed in an outpatient center or hospital by an xray technician, and the images are interpreted by a radiologist; anesthesia is not needed. CT scans can provide clearer, more detailed images to help the health care provider understand the problem. Magnetic resonance imaging (MRI). MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. An MRI may include the injection of contrast medium. With most MRI machines, the child lies on a table that slides into a tunnelshaped device that may be open ended or closed at one end; some newer machines are designed to allow the child to lie in a more open space. The procedure is performed in an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed, though light sedation may be used for children with a fear of confined spaces. Like CT scans, MRIs can provide clearer, more detailed images. Radionuclide scan. A radionuclide scan is an imaging technique that relies on the detection of small amounts of radiation after injection of radioactive chemicals. Because the dose of the radioactive chemicals is small, the risk of causing damage to cells is low. Special cameras and computers are used to create images of the radioactive chemicals as they pass through the kidneys. Radionuclide scans are performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologist; anesthesia is not needed. Radioactive chemicals injected into the blood can provide information about kidney function. Radioactive chemicals can also be put into the fluids used to fill the bladder and urethra for x ray, MRI, and CT imaging. Radionuclide scans expose a child to about the same amount or less of radiation as a conventional x ray. Urodynamics. Urodynamic testing is any procedure that looks at how well the bladder, sphincters, and urethra are storing and releasing urine. Most of these tests are performed in the office of a urologista doctor who specializes in urinary problemsby a urologist, physician assistant, or nurse practitioner. Some procedures may require light sedation to keep the child calm. Most urodynamic tests focus on the bladders ability to hold urine and empty steadily and completely. Urodynamic tests can also show whether the bladder is having abnormal contractions that cause leakage. A health care provider may order these tests if there is evidence that the child has some kind of nerve damage or dysfunctional voidingunhealthy urination habits such as holding in urine when the bladder is full. |
What are the treatments for Urinary Tract Infections in Children ? | Some abnormalities in the urinary tract correct themselves as the child grows, but some may require surgical correction. While milder forms of VUR may resolve on their own, one common procedure to correct VUR is the reimplantation of the ureters. During this procedure, the surgeon repositions the connection between the ureters and the bladder so that urine will not reflux into the ureters and kidneys. This procedure may be performed through an incision that gives the surgeon a direct view of the bladder and ureters or laparoscopically. Laparoscopy is a procedure that uses a scope inserted through a small incision. In recent years, health care providers have treated some cases of VUR by injecting substances into the bladder wall, just below the opening where the ureter joins the bladder. This injection creates a kind of narrowing or valve that keeps urine from refluxing into the ureters. The injection is delivered to the inside of the bladder through a catheter passed through the urethra, so there is no surgical incision. Evidence of clinically significant obstruction may indicate the need for surgery. |
How to prevent Urinary Tract Infections in Children ? | If a child has a normal urinary tract, parents can help the child avoid UTIs by encouraging regular trips to the bathroom. The parents should make sure the child gets enough to drink if infrequent urination is a problem. The child should be taught proper cleaning techniques after using the bathroom to keep bacteria from entering the urinary tract. Loosefitting clothes and cotton underwear allow air to dry the area. Parents should consult a health care provider about the best ways to treat constipation. |
What to do for Urinary Tract Infections in Children ? | Children with a UTI should drink as much as they wish and not be forced to drink large amounts of fluid. The health care provider needs to know if a child is not interested in drinking or is unable to drink. |
What to do for Urinary Tract Infections in Children ? | Urinary tract infections (UTIs) usually occur when the body fails to remove bacteria rapidly from the urinary tract. UTIs affect about 3 percent of children in the United States every year. Most UTIs are not serious, but chronic kidney infections can cause permanent damage. A UTI in a young child may be a sign of an abnormality in the urinary tract that could lead to repeated problems. Symptoms of a UTI range from slight burning with urination or unusualsmelling urine to severe pain and high fever. A child with a UTI may also have no symptoms. Parents should talk with their health care provider if they suspect their child has a UTI. |
What is (are) Urinary Incontinence in Men ? | Urinary incontinence is the loss of bladder control, resulting in the accidental leakage of urine from the body. For example, a man may feel a strong, sudden need, or urgency, to urinate just before losing a large amount of urine, called urgency incontinence. UI can be slightly bothersome or totally debilitating. For some men, the chance of embarrassment keeps them from enjoying many activities, including exercising, and causes emotional distress. When people are inactive, they increase their chances of developing other health problems, such as obesity and diabetes. |
What is (are) Urinary Incontinence in Men ? | The urinary tract is the bodys drainage system for removing urine, which is composed of wastes and extra fluid. In order for normal urination to occur, all parts in the urinary tract need to work together in the correct order. Kidneys. The kidneys are two beanshaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. The kidneys work around the clock; a person does not control what they do. Ureters. Ureters are the thin tubes of muscleone on each side of the bladderthat carry urine from each of the kidneys to the bladder. Bladder. The bladder, located in the pelvis between the pelvic bones, is a hollow, muscular, balloonshaped organ that expands as it fills with urine. Although a person does not control kidney function, a person does control when the bladder empties. Bladder emptying is known as urination. The bladder stores urine until the person finds an appropriate time and place to urinate. A normal bladder acts like a reservoir and can hold 1.5 to 2 cups of urine. How often a person needs to urinate depends on how quickly the kidneys produce the urine that fills the bladder. The muscles of the bladder wall remain relaxed while the bladder fills with urine. As the bladder fills to capacity, signals sent to the brain tell a person to find a toilet soon. During urination, the bladder empties through the urethra, located at the bottom of the bladder. Three sets of muscles work together like a dam, keeping urine in the bladder between trips to the bathroom. The first set is the muscles of the urethra itself. The area where the urethra joins the bladder is the bladder neck. The bladder neck, composed of the second set of muscles known as the internal sphincter, helps urine stay in the bladder. The third set of muscles is the pelvic floor muscles, also referred to as the external sphincter, which surround and support the urethra. To urinate, the brain signals the muscular bladder wall to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincters to relax. As the sphincters relax, urine exits the bladder through the urethra. |
What is (are) Urinary Incontinence in Men ? | The prostate is a walnutshaped gland that is part of the male reproductive system. The prostate has two or more lobes, or sections, enclosed by an outer layer of tissue. Located in front of the rectum and just below the bladder, the prostate surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen. |
What causes Urinary Incontinence in Men ? | Urinary incontinence in men results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. The bladder muscle may contract too much or not enough because of a problem with the muscle itself or the nerves controlling the bladder muscle. Damage to the sphincter muscles themselves or the nerves controlling these muscles can result in poor sphincter function. These problems can range from simple to complex. A man may have factors that increase his chances of developing UI, including birth defectsproblems with development of the urinary tract a history of prostate cancersurgery or radiation treatment for prostate cancer can lead to temporary or permanent UI in men UI is not a disease. Instead, it can be a symptom of certain conditions or the result of particular events during a mans life. Conditions or events that may increase a mans chance of developing UI include benign prostatic hyperplasia (BPH)a condition in which the prostate is enlarged yet not cancerous. In men with BPH, the enlarged prostate presses against and pinches the urethra. The bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty, leaving some urine in the bladder. The narrowing of the urethra and incomplete emptying of the bladder can lead to UI. chronic coughinglonglasting coughing increases pressure on the bladder and pelvic floor muscles. neurological problemsmen with diseases or conditions that affect the brain and spine may have trouble controlling urination. physical inactivitydecreased activity can increase a mans weight and contribute to muscle weakness. obesityextra weight can put pressure on the bladder, causing a need to urinate before the bladder is full. older agebladder muscles can weaken over time, leading to a decrease in the bladders capacity to store urine. More information is provided in the NIDDK health topics, Nerve Disease and Bladder Control and Prostate Enlargement: Benign Prostatic Hyperplasia. |
What is (are) Urinary Incontinence in Men ? | The types of UI in men include urgency incontinence stress incontinence functional incontinence overflow incontinence transient incontinence Urgency Incontinence Urgency incontinence happens when a man urinates involuntarily after he has a strong desire, or urgency, to urinate. Involuntary bladder contractions are a common cause of urgency incontinence. Abnormal nerve signals might cause these bladder contractions. Triggers for men with urgency incontinence include drinking a small amount of water, touching water, hearing running water, or being in a cold environmenteven if for just a short whilesuch as reaching into the freezer at the grocery store. Anxiety or certain liquids, medications, or medical conditions can make urgency incontinence worse. The following conditions can damage the spinal cord, brain, bladder nerves, or sphincter nerves, or can cause involuntary bladder contractions leading to urgency incontinence: Alzheimers diseasea disorder that affects the parts of the brain that control thought, memory, and language injury to the brain or spinal cord that interrupts nerve signals to and from the bladder multiple sclerosisa disease that damages the material that surrounds and protects nerve cells, which slows down or blocks messages between the brain and the body Parkinsons diseasea disease in which the cells that make a chemical that controls muscle movement are damaged or destroyed strokea condition in which a blocked or ruptured artery in the brain or neck cuts off blood flow to part of the brain and leads to weakness, paralysis, or problems with speech, vision, or brain function Urgency incontinence is a key sign of overactive bladder. Overactive bladder occurs when abnormal nerves send signals to the bladder at the wrong time, causing its muscles to squeeze without enough warning time to get to the toilet. More information is provided in the NIDDK health topic, Nerve Disease and Bladder Control. Stress Incontinence Stress incontinence results from movements that put pressure on the bladder and cause urine leakage, such as coughing, sneezing, laughing, or physical activity. In men, stress incontinence may also occur after prostate surgery after neurologic injury to the brain or spinal cord after trauma, such as injury to the urinary tract during older age Functional Incontinence Functional incontinence occurs when physical disability, external obstacles, or problems in thinking or communicating keep a person from reaching a place to urinate in time. For example, a man with Alzheimers disease may not plan ahead for a timely trip to a toilet. A man in a wheelchair may have difficulty getting to a toilet in time. Arthritispain and swelling of the jointscan make it hard for a man to walk to the restroom quickly or open his pants in time. Overflow Incontinence When the bladder doesnt empty properly, urine spills over, causing overflow incontinence. Weak bladder muscles or a blocked urethra can cause this type of incontinence. Nerve damage from diabetes or other diseases can lead to weak bladder muscles; tumors and urinary stones can block the urethra. Men with overflow incontinence may have to urinate often, yet they release only small amounts of urine or constantly dribble urine. Transient Incontinence Transient incontinence is UI that lasts a short time. Transient incontinence is usually a side effect of certain medications, drugs, or temporary conditions, such as a urinary tract infection (UTI), which can irritate the bladder and cause strong urges to urinate caffeine or alcohol consumption, which can cause rapid filling of the bladder chronic coughing, which can put pressure on the bladder constipationhard stool in the rectum can put pressure on the bladder blood pressure medications that can cause increased urine production shortterm mental impairment that reduces a mans ability to care for himself shortterm restricted mobility |
How many people are affected by Urinary Incontinence in Men ? | Urinary incontinence occurs in 11 to 34 percent of older men. Two to 11 percent of older men report daily UI.1 Although more women than men develop UI, the chances of a man developing UI increase with age because he is more likely to develop prostate problems as he ages. Men are also less likely to speak with a health care professional about UI, so UI in men is probably far more common than statistics show. Having a discussion with a health care professional about UI is the first step to fixing this treatable problem. |
How to diagnose Urinary Incontinence in Men ? | Men should tell a health care professional, such as a family practice physician, a nurse, an internist, or a urologista doctor who specializes in urinary problemsthey have UI, even if they feel embarrassed. To diagnose UI, the health care professional will take a medical history conduct a physical exam order diagnostic tests Medical History Taking a medical history can help a health care professional diagnose UI. He or she will ask the patient or caretaker to provide a medical history, a review of symptoms, a description of eating habits, and a list of prescription and overthecounter medications the patient is taking. The health care professional will ask about current and past medical conditions. The health care professional also will ask about the mans pattern of urination and urine leakage. To prepare for the visit with the health care professional, a man may want to keep a bladder diary for several days beforehand. Information that a man should record in a bladder diary includes the amount and type of liquid he drinks how many times he urinates each day and how much urine is released how often he has accidental leaks whether he felt a strong urge to go before leaking what he was doing when the leak occurred, for example, coughing or lifting how long the symptoms have been occurring Use the Daily Bladder Diary to prepare for the appointment. The health care professional also may ask about other lower urinary tract symptoms that may indicate a prostate problem, such as problems starting a urine stream problems emptying the bladder completely spraying urine dribbling urine weak stream recurrent UTIs painful urination Physical Exam A physical exam may help diagnose UI. The health care professional will perform a physical exam to look for signs of medical conditions that may cause UI. The health care professional may order further neurologic testing if necessary. Digital rectal exam. The health care professional also may perform a digital rectal exam. A digital rectal exam is a physical exam of the prostate and rectum. To perform the exam, the health care professional has the man bend over a table or lie on his side while holding his knees close to his chest. The health care professional slides a gloved, lubricated finger into the patients rectum and feels the part of the prostate that lies in front of the rectum. The digital rectal exam is used to check for stool or masses in the rectum and to assess whether the prostate is enlarged or tender, or has other abnormalities. The health care professional may perform a prostate massage during a digital rectal exam to collect a sample of prostate fluid that he or she can test for signs of infection. The health care professional may diagnose the type of UI based on the medical history and physical exam, or he or she may use the findings to determine if a man needs further diagnostic testing. Diagnostic Tests The health care professional may order one or more of the following diagnostic tests based on the results of the medical history and physical exam: Urinalysis. Urinalysis involves testing a urine sample. The patient collects a urine sample in a special container at home, at a health care professionals office, or at a commercial facility. A health care professional tests the sample during an office visit or sends it to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color to indicate signs of infection in urine. Urine culture. A health care professional performs a urine culture by placing part of a urine sample in a tube or dish with a substance that encourages any bacteria present to grow. A man collects the urine sample in a special container in a health care professionals office or a commercial facility. The office or facility tests the sample onsite or sends it to a lab for culture. A health care professional can identify bacteria that multiply, usually in 1 to 3 days. A health care professional performs a urine culture to determine the best treatment when urinalysis indicates the man has a UTI. More information is provided in the NIDDK health topic, Urinary Tract Infections in Adults. Blood test. A blood test involves drawing blood at a health care professionals office or a commercial facility and sending the sample to a lab for analysis. The blood test can show kidney function problems or a chemical imbalance in the body. The lab also will test the blood to assess the level of prostatespecific antigen, a protein produced by prostate cells that may be higher in men with prostate cancer. Urodynamic testing. Urodynamic testing includes a variety of procedures that look at how well the bladder and urethra store and release urine. A health care professional performs urodynamic tests during an office visit or in an outpatient center or a hospital. Some urodynamic tests do not require anesthesia; others may require local anesthesia. Most urodynamic tests focus on the bladders ability to hold urine and empty steadily and completely; they may include the following: uroflowmetry, which measures how rapidly the bladder releases urine postvoid residual measurement, which evaluates how much urine remains in the bladder after urination reduced urine flow or residual urine in the bladder, which often suggests urine blockage due to BPH More information is provided in the NIDDK health topic, Urodynamic Testing. |
What are the treatments for Urinary Incontinence in Men ? | Treatment depends on the type of UI. Urgency Incontinence As a first line of therapy for urgency incontinence, a health care professional may recommend the following techniques to treat a mans problem: behavioral and lifestyle changes bladder training pelvic floor exercises urgency suppression If those treatments are not successful, the following additional measures may help urgency incontinence: medications electrical nerve stimulation bulking agents surgery A health care professional may recommend other treatments for men with urgency incontinence caused by BPH. More information is provided in the NIDDK health topic, Prostate Enlargement: Benign Prostatic Hyperplasia. Behavioral and lifestyle changes. Men with urgency incontinence may be able to reduce leaks by making behavioral and lifestyle changes: Eating, diet, and nutrition. Men with urgency incontinence can change the amount and type of liquid they drink. A man can try limiting bladder irritantsincluding caffeinated drinks such as tea or coffee and carbonated beveragesto decrease leaks. Men also should limit alcoholic drinks, which can increase urine production. A health care professional can help a man determine how much he should drink based on his health, how active he is, and where he lives. To decrease nighttime trips to the restroom, men may want to stop drinking liquids several hours before bed. Engaging in physical activity. Although a man may be reluctant to engage in physical activity when he has urgency incontinence, regular exercise is important for good overall health and for preventing and treating UI. Losing weight. Men who are overweight should talk with a health care professional about strategies for losing weight, which can help improve UI. Preventing constipation. Gastrointestinal (GI) problems, especially constipation, can make urinary tract health worse and can lead to UI. The opposite is also true: Urinary problems, such as UI, can make GI problems worse. More information about how to prevent constipation through diet and physical activity is provided in the NIDDK health topic, Constipation. To Help Prevent Bladder Problems, Stop Smoking People who smoke should stop. Quitting smoking at any age promotes bladder health and overall health. Smoking increases a persons chance of developing stress incontinence, as it increases coughing. Some people say smoking worsens their bladder irritation. Smoking causes most cases of bladder cancer. People who smoke for many years have a higher risk of bladder cancer than nonsmokers or those who smoke for a short time.2 People who smoke should ask for help so they do not have to try quitting alone. Call 1800QUITNOW (18007848669) for more information. Bladder training. Bladder training is changing urination habits to decrease incidents of UI. The health care professional may suggest a man use the restroom at regular timed intervals, called timed voiding, based on the mans bladder diary. A man can gradually lengthen the time between trips to the restroom to help stretch the bladder so it can hold more urine. Pelvic floor muscle exercises. Pelvic floor muscle, or Kegel, exercises involve strengthening pelvic floor muscles. Strong pelvic floor muscles hold in urine more effectively than weak muscles. A man does not need special equipment for Kegel exercises. The exercises involve tightening and relaxing the muscles that control urine flow. Pelvic floor exercises should not be performed during urination. A health care professional can help a man learn proper technique. More information is provided in the NIDDK health topic, Kegel Exercise Tips. Men also may learn how to perform Kegel exercises properly by using biofeedback. Biofeedback uses special sensors to measure bodily functions, such as muscle contractions that control urination. A video monitor displays the measurements as graphs, and sounds indicate when the man is using the correct muscles. The health care professional uses the information to help the man change abnormal function of the pelvic floor muscles. At home, the man practices to improve muscle function. The man can perform the exercises while lying down, sitting at a desk, or standing up. Success with pelvic floor exercises depends on the cause of UI, its severity, and the mans ability to perform the exercises. Urgency suppression. By using certain techniques, a man can suppress the urge to urinate, called urgency suppression. Urgency suppression is a way for a man to train his bladder to maintain control so he does not have to panic about finding a restroom. Some men use distraction techniques to take their mind off the urge to urinate. Other men find taking long, relaxing breaths and being still can help. Doing pelvic floor exercises also can help suppress the urge to urinate. Medications. Health care professionals may prescribe medications that relax the bladder, decrease bladder spasms, or treat prostate enlargement to treat urgency incontinence in men. Antimuscarinics. Antimuscarinics can help relax bladder muscles and prevent bladder spasms. These medications include oxybutynin (Oxytrol), tolterodine (Detrol), darifenacin (Enablex), trospium (Sanctura), fesoterodine (Toviaz), and solifenacin (VESIcare). They are available in pill, liquid, and patch form. Tricyclic antidepressants. Tricyclic antidepressants such as imipramine (Tofranil) can calm nerve signals, decreasing spasms in bladder muscles. Alphablockers. Terazosin (Hytrin), doxazosin (Cardura), tamsulosin (Flomax), alfuzosin (Uroxatral), and silodosin (Rapaflo) are used to treat problems caused by prostate enlargement and bladder outlet obstruction. These medications relax the smooth muscle of the prostate and bladder neck, which lets urine flow normally and prevents abnormal bladder contractions that can lead to urgency incontinence. 5alpha reductase inhibitors. Finasteride (Proscar) and dutasteride (Avodart) block the production of the male hormone dihydrotestosterone, which accumulates in the prostate and may cause prostate growth. These medications may help to relieve urgency incontinence problems by shrinking an enlarged prostate. Beta3 agonists. Mirabegron (Myrbetriq) is a beta3 agonist a person takes by mouth to help prevent symptoms of urgency incontinence. Mirabegron suppresses involuntary bladder contractions. Botox. A health care professional may use onabotulinumtoxinA (Botox), also called botulinum toxin type A, to treat UI in men with neurological conditions such as spinal cord injury or multiple sclerosis. Injecting Botox into the bladder relaxes the bladder, increasing storage capacity and decreasing UI. A health care professional performs the procedure during an office visit. A man receives local anesthesia. The health care professional uses a cystoscope to guide the needle for injecting the Botox. Botox is effective for up to 10 months.3 Electrical nerve stimulation. If behavioral and lifestyle changes and medications do not improve symptoms, a urologist may suggest electrical nerve stimulation as an option to prevent UI, urinary frequencyurination more often than normaland other symptoms. Electrical nerve stimulation involves altering bladder reflexes using pulses of electricity. The two most common types of electrical nerve stimulation are percutaneous tibial nerve stimulation and sacral nerve stimulation.4 Percutaneous tibial nerve stimulation uses electrical stimulation of the tibial nerve, which is located in the ankle, on a weekly basis. The patient receives local anesthesia for the procedure. In an outpatient center, a urologist inserts a batteryoperated stimulator beneath the skin near the tibial nerve. Electrical stimulation of the tibial nerve prevents bladder activity by interfering with the pathway between the bladder and the spinal cord or brain. Although researchers consider percutaneous tibial nerve stimulation safe, they continue to study the exact ways that it prevents symptoms and how long the treatment can last. Sacral nerve stimulation involves implanting a batteryoperated stimulator beneath the skin in the lower back near the sacral nerve. The procedure takes place in an outpatient center using local anesthesia. Based on the patients feedback, the health care professional can adjust the amount of stimulation so it works best for that individual. The electrical pulses enter the body for minutes to hours, two or more times a day, either through wires placed on the lower back or just above the pubic areabetween the navel and the pubic hair. Sacral nerve stimulation may increase blood flow to the bladder, strengthen pelvic muscles that help control the bladder, and trigger the release of natural substances that block pain. The patient can turn the stimulator on or off at any time. A patient may consider getting an implanted device that delivers regular impulses to the bladder. A urologist places a wire next to the tailbone and attaches it to a permanent stimulator under the skin. Bulking agents. A urologist injects bulking agents, such as collagen and carbon spheres, near the urinary sphincter to treat incontinence. The bulking agent makes the tissues thicker and helps close the bladder opening. Before the procedure, the health care professional may perform a skin test to make sure the man doesnt have an allergic reaction to the bulking agent. A urologist performs the procedure during an office visit. The man receives local anesthesia. The urologist uses a cystoscopea tubelike instrument used to look inside the urethra and bladderto guide the needle for injection of the bulking agent. Over time, the body may slowly eliminate certain bulking agents, so a man may need to have injections again. Surgery. As a last resort, surgery to treat urgency incontinence in men includes the artificial urinary sphincter (AUS) and the male sling. A health care professional performs the surgery in a hospital with regional or general anesthesia. Most men can leave the hospital the same day, although some may need to stay overnight. AUS. An AUS is an implanted device that keeps the urethra closed until the man is ready to urinate. The device has three parts: a cuff that fits around the urethra, a small balloon reservoir placed in the abdomen, and a pump placed in the scrotumthe sac that holds the testicles. The cuff contains a liquid that makes it fit tightly around the urethra to prevent urine from leaking. When it is time to urinate, the man squeezes the pump with his fingers to deflate the cuff. The liquid moves to the balloon reservoir and lets urine flow through the urethra. When the bladder is empty, the cuff automatically refills in the next 2 to 5 minutes to keep the urethra tightly closed. Male sling. A health care professional performs a sling procedure, also called urethral compression procedure, to add support to the urethra, which can sometimes better control urination. Through an incision in the tissue between the scrotum and the rectum, also called the perineum, the health care professional uses a piece of human tissue or mesh to compress the urethra against the pubic bone. The surgeon secures the ends of the tissue or mesh around the pelvic bones. The lifting and compression of the urethra sometimes provides better control over urination. Stress Incontinence Men who have stress incontinence can use the same techniques for treating urgency incontinence. Functional Incontinence Men with functional incontinence may wear protective undergarments if they worry about reaching a restroom in time. These products include adult diapers or pads and are available from drugstores, grocery stores, and medical supply stores. Men who have functional incontinence should talk to a health care professional about its cause and how to prevent or treat functional incontinence. Overflow Incontinence A health care professional treats overflow incontinence caused by a blockage in the urinary tract with surgery to remove the obstruction. Men with overflow incontinence that is not caused by a blockage may need to use a catheter to empty the bladder. A catheter is a thin, flexible tube that is inserted through the urethra into the bladder to drain urine. A health care professional can teach a man how to use a catheter. A man may need to use a catheter once in a while, a few times a day, or all the time. Catheters that are used continuously drain urine from the bladder into a bag that is attached to the mans thigh with a strap. Men using a continuous catheter should watch for symptoms of an infection. Transient Incontinence A health care professional treats transient incontinence by addressing the underlying cause. For example, if a medication is causing increased urine production leading to UI, a health care professional may try lowering the dose or prescribing a different medication. A health care professional may prescribe bacteriafighting medications called antibiotics to treat UTIs. |
How to prevent Urinary Incontinence in Men ? | People who smoke should stop. Quitting smoking at any age promotes bladder health and overall health. Smoking increases a persons chance of developing stress incontinence, as it increases coughing. Some people say smoking worsens their bladder irritation. Smoking causes most cases of bladder cancer. People who smoke for many years have a higher risk of bladder cancer than nonsmokers or those who smoke for a short time.2 People who smoke should ask for help so they do not have to try quitting alone. Call 1800QUITNOW (18007848669) for more information. |
What to do for Urinary Incontinence in Men ? | Urinary incontinence (UI) is the loss of bladder control, resulting in the accidental leakage of urine from the body. The urinary tract is the bodys drainage system for removing urine, which is composed of wastes and extra fluid. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine. To urinate, the brain signals the muscular bladder wall to tighten, squeezing urine out of the bladder. At the same time, the brain signals the sphincters to relax. As the sphincters relax, urine exits the bladder through the urethra. UI results when the brain does not properly signal the bladder, the sphincters do not squeeze strongly enough, or both. Urgency incontinence happens when a man urinates involuntarily after he has a strong desire, or urgency, to urinate. Stress incontinence results from movements that put pressure on the bladder and cause urine leakage, such as coughing, sneezing, laughing, or physical activity. Functional incontinence occurs when physical disability, external obstacles, or problems in thinking or communicating keep a person from reaching a place to urinate in time. When the bladder doesnt empty properly, urine spills over, causing overflow incontinence. Weak bladder muscles or a blocked urethra can cause this type of incontinence. Transient incontinence is UI that lasts a short time. Transient incontinence is usually a side effect of certain medications, drugs, or temporary conditions. UI occurs in 11 to 34 percent of older men. Men should tell a health care professional, such as a family practice physician, a nurse, an internist, or a urologist, they have UI, even if they feel embarrassed. Treatment depends on the type of UI. Some types of treatment include behavioral and lifestyle changes, bladder training, pelvic floor exercises, and urgency suppression. People who smoke should stop. Quitting smoking at any age promotes bladder health and overall health. |
What causes Nerve Disease and Bladder Control ? | Nerves that work poorly can lead to three different kinds of bladder control problems. Overactive bladder. Damaged nerves may send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. The symptoms of overactive bladder include urinary frequencydefined as urination eight or more times a day or two or more times at night urinary urgencythe sudden, strong need to urinate immediately urge incontinenceleakage of urine that follows a sudden, strong urge to urinate Poor control of sphincter muscles. Sphincter muscles surround the urethra and keep it closed to hold urine in the bladder. If the nerves to the sphincter muscles are damaged, the muscles may become loose and allow leakage or stay tight when you are trying to release urine. Urine retention. For some people, nerve damage means their bladder muscles do not get the message that it is time to release urine or are too weak to completely empty the bladder. If the bladder becomes too full, urine may back up and the increasing pressure may damage the kidneys. Or urine that stays too long may lead to an infection in the kidneys or bladder. Urine retention may also lead to overflow incontinence. |
What causes Nerve Disease and Bladder Control ? | Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are vaginal childbirth infections of the brain or spinal cord diabetes stroke accidents that injure the brain or spinal cord multiple sclerosis heavy metal poisoning In addition, some children are born with nerve problems that can keep the bladder from releasing urine, leading to urinary infections or kidney damage. |
What are the treatments for Nerve Disease and Bladder Control ? | The treatment for a bladder control problem depends on the cause of the nerve damage and the type of voiding dysfunction that results. In the case of overactive bladder, your doctor may suggest a number of strategies, including bladder training, electrical stimulation, drug therapy, and, in severe cases where all other treatments have failed, surgery. Bladder training. Your doctor may ask you to keep a bladder diarya record of your fluid intake, trips to the bathroom, and episodes of urine leakage. This record may indicate a pattern and suggest ways to avoid accidents by making a point of using the bathroom at certain times of the daya practice called timed voiding. As you gain control, you can extend the time between trips to the bathroom. Bladder training also includes Kegel exercises to strengthen the muscles that hold in urine. Electrical stimulation. Mild electrical pulses can be used to stimulate the nerves that control the bladder and sphincter muscles. Depending on which nerves the doctor plans to treat, these pulses can be given through the vagina or anus, or by using patches on the skin. Another method is a minor surgical procedure to place the electric wire near the tailbone. This procedure involves two steps. First, the wire is placed under the skin and connected to a temporary stimulator, which you carry with you for several days. If your condition improves during this trial period, then the wire is placed next to the tailbone and attached to a permanent stimulator under your skin. The Food and Drug Administration (FDA) has approved this device, marketed as the InterStim system, to treat urge incontinence, urgencyfrequency syndrome, and urinary retention in patients for whom other treatments have not worked. Drug therapy. Different drugs can affect the nerves and muscles of the urinary tract in different ways. Drugs that relax bladder muscles and prevent bladder spasms include oxybutynin chloride (Ditropan), tolterodine (Detrol), hyoscyamine (Levsin), and propantheline bromide (ProBanthine), which belong to the class of drugs called anticholinergics. Their most common side effect is dry mouth, although large doses may cause blurred vision, constipation, a faster heartbeat, and flushing. A new patch delivery system for oxybutynin (Oxytrol) may decrease side effects. Ditropan XL and Detrol LA are timedrelease formulations that deliver a low level of the drug continuously in the body. These drugs have the advantage of onceaday administration. In 2004, the FDA approved trospium chloride (Sanctura), darifenacin (Enablex), and solifenacin succinate (VESIcare) for the treatment of overactive bladder. Drugs for depression that also relax bladder muscles include imipramine hydrochloride (Tofranil), a tricyclic antidepressant. Side effects may include fatigue, dry mouth, dizziness, blurred vision, nausea, and insomnia. Additional drugs are being evaluated for the treatment of overactive bladder and may soon receive FDA approval. Surgery. In extreme cases, when incontinence is severe and other treatments have failed, surgery may be considered. The bladder may be made larger through an operation known as augmentation cystoplasty, in which a part of the diseased bladder is replaced with a section taken from the patient's bowel. This operation may improve the ability to store urine but may make the bladder more difficult to empty, making regular catheterization necessary. Additional risks of surgery include the bladder breaking open and leaking urine into the body, bladder stones, mucus in the bladder, and infection. |
What are the treatments for Nerve Disease and Bladder Control ? | The job of the sphincter muscles is to hold urine in the bladder by squeezing the urethra shut. If the urethral sphincter fails to stay closed, urine may leak out of the bladder. When nerve signals are coordinated properly, the sphincter muscles relax to allow urine to pass through the urethra as the bladder contracts to push out urine. If the signals are not coordinated, the bladder and the sphincter may contract at the same time, so urine cannot pass easily. Drug therapy for an uncoordinated bladder and urethra. Scientists have not yet found a drug that works selectively on the urethral sphincter muscles, but drugs used to reduce muscle spasms or tremors are sometimes used to help the sphincter relax. Baclofen (Lioresal) is prescribed for muscle spasms or cramping in patients with multiple sclerosis and spinal injuries. Diazepam (Valium) can be taken as a muscle relaxant or to reduce anxiety. Drugs called alphaadrenergic blockers can also be used to relax the sphincter. Examples of these drugs are alfuzosin (UroXatral), tamsulosin (Flomax), terazosin (Hytrin), and doxazosin (Cardura). The main side effects are low blood pressure, dizziness, fainting, and nasal congestion. All of these drugs have been used to relax the urethral sphincter in people whose sphincter does not relax well on its own. Botox injection. Botulinum toxin type A (Botox) is best known as a cosmetic treatment for facial wrinkles. Doctors have also found that botulinum toxin is useful in blocking spasms like eye ticks or relaxing muscles in patients with multiple sclerosis. Urologists have found that injecting botulinum toxin into the tissue surrounding the sphincter can help it to relax. Although the FDA has approved botulinum toxin only for facial cosmetic purposes, researchers are studying the safety and effectiveness of botulinum toxin injection into the sphincter for possible FDA approval in the future. |
What are the treatments for Nerve Disease and Bladder Control ? | Urine retention may occur either because the bladder wall muscles cannot contract or because the sphincter muscles cannot relax. Catheter. A catheter is a thin tube that can be inserted through the urethra into the bladder to allow urine to flow into a collection bag. If you are able to place the catheter yourself, you can learn to carry out the procedure at regular intervals, a practice called clean intermittent catheterization. Some patients cannot place their own catheters because nerve damage affects their hand coordination as well as their voiding function. These patients need to have a caregiver place the catheter for them at regular intervals. If regular catheter placement is not feasible, the patients may need to have an indwelling catheter that can be changed less often. Indwelling catheters have several risks, including infection, bladder stones, and bladder tumors. However, if the bladder cannot be emptied any other way, then the catheter is the only way to stop the buildup of urine in the bladder that can damage the kidneys. Urethral stent. Stents are small tubelike devices inserted into the urethra and allowed to expand, like a spring, widening the opening for urine to flow out. Stents can help prevent urine backup when the bladder wall and sphincter contract at the same time because of improper nerve signals. However, stents can cause problems if they move or lead to infection. Surgery. Men may consider a surgery that removes the external sphinctera sphincterotomyor a piece of ita sphincter resectionto prevent urinary retention. The surgeon will pass a thin instrument through the urethra to deliver electrical or laser energy that burns away sphincter tissue. Possible complications include bleeding that requires a transfusion and, rarely, problems with erections. This procedure causes loss of urine control and requires the patient to collect urine by wearing an external catheter that fits over the penis like a condom. No external collection device is available for women. Urinary diversion. If other treatments fail and urine regularly backs up and damages the kidneys, the doctor may recommend a urinary diversion, a procedure that may require an outside collection bag attached to a stoma, a surgically created opening where urine passes out of the body. Another form of urinary diversion replaces the bladder with a continent urinary reservoir, an internal pouch made from sections of the bowel or other tissue. This method allows the person to store urine inside the body until a catheter is used to empty it through a stoma. |
What is (are) Pregnancy and Thyroid Disease ? | Thyroid disease is a disorder that affects the thyroid gland. Sometimes the body produces too much or too little thyroid hormone. Thyroid hormones regulate metabolismthe way the body uses energyand affect nearly every organ in the body. Too much thyroid hormone is called hyperthyroidism and can cause many of the bodys functions to speed up. Too little thyroid hormone is called hypothyroidism and can cause many of the bodys functions to slow down. Thyroid hormone plays a critical role during pregnancy both in the development of a healthy baby and in maintaining the health of the mother. Women with thyroid problems can have a healthy pregnancy and protect their fetuses health by learning about pregnancys effect on the thyroid, keeping current on their thyroid function testing, and taking the required medications. |
What is (are) Pregnancy and Thyroid Disease ? | The thyroid is a 2inchlong, butterflyshaped gland weighing less than 1 ounce. Located in the front of the neck below the larynx, or voice box, it has two lobes, one on either side of the windpipe. The thyroid is one of the glands that make up the endocrine system. The glands of the endocrine system produce, store, and release hormones into the bloodstream. The hormones then travel through the body and direct the activity of the bodys cells. The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). T3 is the active hormone and is made from T4. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. Thyroid hormone production is regulated by thyroidstimulating hormone (TSH), which is made by the pituitary gland in the brain. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary responds by decreasing TSH production. |
What to do for Pregnancy and Thyroid Disease ? | During pregnancy, the body requires higher amounts of some nutrients to support the health of the mother and growing baby. Experts recommend pregnant women maintain a balanced diet and take a prenatal multivitamin and mineral supplement containing iodine to receive most nutrients necessary for thyroid health. More information about diet and nutrition during pregnancy is provided by the National Agricultural Library available at www.choosemyplate.gov/nutritionalneedsduringpregnancy. Dietary Supplements Because the thyroid uses iodine to make thyroid hormone, iodine is an important mineral for a mother during pregnancy. During pregnancy, the baby gets iodine from the mothers diet. Women need more iodine when they are pregnantabout 250 micrograms a day. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Choosing iodized saltsalt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met. However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hyperthyroidism and hypothyroidism. More information about iodine is provided by the National Library of Medicine in the fact sheet, Iodine in diet. To help ensure coordinated and safe care, people should discuss their use of dietary supplements with their health care provider. Tips for talking with health care providers are available at the National Center for Complementary and Integrative Health's Time to Talk campaign. |
What to do for Pregnancy and Thyroid Disease ? | Thyroid disease is a disorder that results when the thyroid gland produces more or less thyroid hormone than the body needs. Pregnancy causes normal changes in thyroid function but can also lead to thyroid disease. Uncontrolled hyperthyroidism during pregnancy can lead to serious health problems in the mother and the unborn baby. During pregnancy, mild hyperthyroidism does not require treatment. More severe hyperthyroidism is treated with antithyroid medications, which act by interfering with thyroid hormone production. Uncontrolled hypothyroidism during pregnancy can lead to serious health problems in the mother and can affect the unborn babys growth and brain development. Hypothyroidism during pregnancy is treated with synthetic thyroid hormone, thyroxine (T4). Postpartum thyroiditisinflammation of the thyroid glandcauses a brief period of hyperthyroidism, often followed by hypothyroidism that usually goes away within a year. Sometimes the hypothyroidism is permanent. |
What is (are) Human Growth Hormone and Creutzfeldt-Jakob Disease Resource List ? | MAGIC (Major Aspects of Growth in Children) Foundation is a national, nonprofit organization that provides support and education about growth disorders in children and growth hormone deficiency in adults. Staff will help connect people who have similar interests or concerns. The Human Growth Foundation (HGF) is a nonprofit organization concerned with childrens growth disorders and adult growth hormone deficiency. The HGF offers a brochure about adult growth hormone deficiency. The foundation also sponsors adult and pediatric Internet discussion forums to support the exchange of information about growth hormone deficiency and growth hormone replacement therapy. To subscribe, follow the instructions at www.hgfound.org. The CreutzfeldtJakob Disease (CJD) Foundation, Inc. was created in 1993 by two families who lost relatives to CJD and the neurologist who treated the patients. This nonprofit corporation seeks to promote awareness of CJD through research and education and to reach out to people who have lost loved ones to this illness. |
What is (are) Human Growth Hormone and Creutzfeldt-Jakob Disease Resource List ? | Health Alert: Adrenal Crisis Causes Death in Some People Who Were Treated with Human Growth Hormone National Hormone and Pituitary Program (NHPP): Information for People Treated with Pituitary Human Growth Hormone (Summary) National Hormone and Pituitary Program (NHPP): Information for People Treated with Pituitary Human Growth Hormone (Comprehensive Report) CreutzfeldtJakob Disease. Fact sheet of the National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH) NIH and Italian Scientists Develop Nasal Test for Human Prion Disease What is a prion?from Scientific American: Ask the Experts |
What is (are) Cystocele ? | A cystocele, also called a prolapsed or dropped bladder, is the bulging or dropping of the bladder into the vagina. The bladder, located in the pelvis between the pelvic bones, is a hollow, muscular, balloonshaped organ that expands as it fills with urine. During urination, also called voiding, the bladder empties through the urethra, located at the bottom of the bladder. The urethra is the tube that carries urine outside of the body. The vagina is the tube in a womans body that runs beside the urethra and connects the womb, or uterus, to the outside of the body. |
What causes Cystocele ? | A cystocele occurs when the muscles and supportive tissues between a womans bladder and vagina weaken and stretch, letting the bladder sag from its normal position and bulge into the vagina or through the vaginal opening. In a cystocele, the bladder tissue remains covered by the vaginal skin. A cystocele may result from damage to the muscles and tissues that hold the pelvic organs up inside the pelvis. A womans pelvic organs include the vagina, cervix, uterus, bladder, urethra, and small intestine. Damage to or weakening of the pelvic muscles and supportive tissues may occur after vaginal childbirth and with conditions that repeatedly strain or increase pressure in the pelvic area, such as repetitive straining for bowel movements constipation chronic or violent coughing heavy lifting being overweight or obese A womans chances of developing a cystocele increase with age, possibly because of weakening muscles and supportive tissues from aging. Whether menopause increases a womans chances of developing a cystocele is unclear. |
What are the symptoms of Cystocele ? | The symptoms of a cystocele may include a vaginal bulge the feeling that something is falling out of the vagina the sensation of pelvic heaviness or fullness difficulty starting a urine stream a feeling of incomplete urination frequent or urgent urination Women who have a cystocele may also leak some urine as a result of movements that put pressure on the bladder, called stress urinary incontinence. These movements can include coughing, sneezing, laughing, or physical activity, such as walking. Urinary retentionthe inability to empty the bladder completelymay occur with more severe cystoceles if the cystocele creates a kink in the womans urethra and blocks urine flow. Women with mild cystoceles often do not have any symptoms. |
How to diagnose Cystocele ? | Diagnosing a cystocele requires medical tests and a physical exam of the vagina. Medical tests take place in a health care providers office, an outpatient center, or a hospital. The health care provider will ask about symptoms and medical history. A health care provider uses a grading system to determine the severity of a womans cystocele. A cystocele receives one of three grades depending on how far a womans bladder has dropped into her vagina: grade 1mild, when the bladder drops only a short way into the vagina grade 2moderate, when the bladder drops far enough to reach the opening of the vagina grade 3most advanced, when the bladder bulges out through the opening of the vagina If a woman has difficulty emptying her bladder, a health care provider may measure the amount of urine left in the womans bladder after she urinates. The remaining urine is called the postvoid residual. A health care provider can measure postvoid residual with a bladder ultrasound. A bladder ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off the bladder to create an image and show the amount of remaining urine. A specially trained technician performs the procedure, and a radiologista doctor who specializes in medical imaginginterprets the images. A woman does not need anesthesia. A health care provider can also use a cathetera thin, flexible tubeto measure a womans postvoid residual. The health care provider inserts the catheter through the womans urethra into her bladder to remove and measure the amount of remaining urine after the woman has urinated. A postvoid residual of 100 mL or more is a sign that the woman is not completely emptying her bladder. A woman receives local anesthesia. A health care provider may use a voiding cystourethrograman xray exam of the bladderto diagnose a cystocele as well. A woman gets a voiding cystourethrogram while urinating. The xray images show the shape of the womans bladder and let the health care provider see any problems that might block normal urine flow. An xray technician performs a voiding cystourethrogram, and a radiologist interprets the images. A woman does not need anesthesia; however, some women may receive sedation. A health care provider may order additional tests to rule out problems in other parts of a womans urinary tract. |
What are the treatments for Cystocele ? | Cystocele treatment depends on the severity of the cystocele and whether a woman has symptoms. If a womans cystocele does not bother her, a health care provider may recommend only that she avoid heavy lifting or straining, which could worsen her cystocele. If a woman has symptoms that bother her and wants treatment, the health care provider may recommend pelvic muscle exercises, a vaginal pessary, or surgery. Pelvic floor, or Kegel, exercises involve strengthening pelvic floor muscles. Strong pelvic floor muscles more effectively hold pelvic organs in place. A woman does not need special equipment for Kegel exercises. The exercises involve tightening and relaxing the muscles that support pelvic organs. A health care provider can help a woman learn proper technique. More information about pelvic muscle exercises is provided in the NIDDK health topic, Kegel Exercise Tips. A vaginal pessary is a small, silicone medical device placed in the vagina that supports the vaginal wall and holds the bladder in place. Pessaries come in a number of shapes and sizes. A health care provider has many options to choose from to find the most comfortable pessary for a woman. A heath care provider may recommend surgery to repair the vaginal wall support and reposition the womans bladder to its normal position. The most common cystocele repair is an anterior vaginal repairor anterior colporrhaphy. The surgeon makes an incision in the wall of the womans vagina and repairs the defect by folding over and sewing together extra supportive tissue between the vagina and bladder. The repair tightens the layers of tissue that separate the organs, creating more support for the bladder. A surgeon who specializes in the urinary tract or female reproductive system performs an anterior vaginal repair in a hospital. The woman receives either regional or general anesthesia. The woman may stay overnight in the hospital, and full recovery may take up to 4 to 6 weeks. |
What to do for Cystocele ? | Researchers have not found that eating, diet, and nutrition play a role in causing or preventing a cystocele. |
What to do for Cystocele ? | A cystocele, also called a prolapsed or dropped bladder, is the bulging or dropping of the bladder into the vagina. A cystocele occurs when the muscles and supportive tissues between a womans bladder and vagina weaken and stretch, letting the bladder sag from its normal position and bulge into the vagina or through the vaginal opening. Diagnosing a cystocele requires medical tests and a physical exam of the vagina. Cystocele treatment depends on the severity of the cystocele and whether a woman has symptoms. |
What is (are) Polycystic Kidney Disease ? | Polycystic kidney disease is a genetic disorder that causes numerous cysts to grow in the kidneys. A kidney cyst is an abnormal sac filled with fluid. PKD cysts can greatly enlarge the kidneys while replacing much of their normal structure, resulting in chronic kidney disease (CKD), which causes reduced kidney function over time. CKD may lead to kidney failure, described as endstage kidney disease or ESRD when treated with a kidney transplant or bloodfiltering treatments called dialysis. The two main types of PKD are autosomal dominant PKD and autosomal recessive PKD. PKD cysts are different from the usually harmless simple cysts that often form in the kidneys later in life. PKD cysts are more numerous and cause complications, such as high blood pressure, cysts in the liver, and problems with blood vessels in the brain and heart. |
What causes Polycystic Kidney Disease ? | A gene mutation, or defect, causes polycystic kidney disease. Genes provide instructions for making proteins in the body. A gene mutation is a permanent change in the deoxyribonucleic acid (DNA) sequence that makes up a gene. In most cases of PKD, a person inherits the gene mutation, meaning a parent passes it on in his or her genes. In the remaining cases, the gene mutation develops spontaneously. In spontaneous cases, neither parent carries a copy of the mutated gene. Researchers have found three different gene mutations associated with PKD. Two of the genes are associated with autosomal dominant PKD. The third gene is associated with autosomal recessive PKD. Gene mutations that cause PKD affect proteins that play a role in kidney development. Genetic Disorders Each cell contains thousands of genes that provide the instructions for making proteins for growth and repair of the body. If a gene has a mutation, the protein made by that gene may not function properly, which sometimes creates a genetic disorder. Not all gene mutations cause a disorder. People inherit two copies of most genes; one copy from each parent. A genetic disorder occurs when one or both parents pass a mutated gene to a child at conception. A genetic disorder can also occur through a spontaneous gene mutation, meaning neither parent carries a copy of the mutated gene. Once a spontaneous gene mutation has occurred, a person can pass it to his or her children. Read more about genes and genetic conditions in the U.S. National Library of Medicines (NLMs) Genetics Home Reference. |
How many people are affected by Polycystic Kidney Disease ? | Estimates of PKDs prevalence range from one in 400 to one in 1,000 people.1 According to the United States Renal Data System, PKD accounts for 2.2 percent of new cases of kidney failure each year in the United States. Annually, eight people per 1 million have kidney failure as a result of PKD.2 Polycystic kidney disease exists around the world and in all races. The disorder occurs equally in women and men, although men are more likely to develop kidney failure from PKD. Women with PKD and high blood pressure who have had more than three pregnancies also have an increased chance of developing kidney failure. |
What is (are) Polycystic Kidney Disease ? | Autosomal dominant PKD is the most common form of PKD and the most common inherited disorder of the kidneys.3 The term autosomal dominant means a child can get the disorder by inheriting the gene mutation from only one parent. Each child of a parent with an autosomal dominant mutation has a 50 percent chance of inheriting the mutated gene. About 10 percent of autosomal dominant PKD cases occur spontaneously.4 The following chart shows the chance of inheriting an autosomal dominant gene mutation: Health care providers identify most cases of autosomal dominant PKD between the ages of 30 and 50.4 For this reason, health care providers often call autosomal dominant PKD adult PKD. However, the onset of kidney damage and how quickly the disorder progresses varies. In some cases, cysts may form earlier in life and grow quickly, causing symptoms in childhood. The cysts grow out of nephrons, the tiny filtering units inside the kidneys. The cysts eventually separate from the nephrons and continue to enlarge. The kidneys enlarge along with the cystswhich can number in the thousandswhile roughly retaining their kidney shape. In fully developed autosomal dominant PKD, a cystfilled kidney can weigh as much as 20 to 30 pounds. |
What are the symptoms of Polycystic Kidney Disease ? | In many cases, PKD does not cause signs or symptoms until cysts are half an inch or larger. When present, the most common symptoms are pain in the back and sidesbetween the ribs and hipsand headaches. The pain can be temporary or persistent, mild or severe. Hematuriablood in the urinemay also be a sign of autosomal dominant PKD. |
What are the complications of Polycystic Kidney Disease ? | The complications of autosomal dominant PKD include the following: Pain. Cyst infection, other types of urinary tract infections (UTIs), bleeding into cysts, kidney stones, or stretching of the fibrous tissue around the kidney because of cyst growth can cause pain in the area of the kidneys. High blood pressure. High blood pressure is present in about half of the people with autosomal dominant PKD and normal kidney function between the ages of 20 and 35.4 Almost 100 percent of people with kidney failure and autosomal dominant PKD have high blood pressure.1 High blood pressuregreater than 140/90 mm Hgincreases the likelihood of heart disease and stroke, as well as adding to the damage already done to the kidneys by the cysts. Kidney failure. Kidney failure means the kidneys no longer work well enough to maintain health. A person with kidney failure may have the following symptoms: little or no urination edemaswelling, usually in the legs, feet, or ankles and less often in the hands or face drowsiness fatigue, or feeling tired generalized itching or numbness dry skin headaches weight loss appetite loss nausea vomiting sleep problems trouble concentrating darkened skin muscle cramps shortness of breath chest pain Untreated kidney failure can lead to coma and death. More than half of people with autosomal dominant PKD progress to kidney failure by age 70.1 UTIs. Kidney cysts block the flow of urine through the kidneys. Stagnant urine can set the stage for infection. Bacteria enter the urinary tract through the urethra and spread up to the kidneys. Sometimes, the kidney cysts become infected. UTIs may cause scarring in the kidneys. Kidney stones. About 20 percent of people with autosomal dominant PKD have kidney stones.1 Kidney stones can block the flow of urine and cause pain. Liver cysts. Liver cysts are the most common nonkidney complication of autosomal dominant PKD.1 Liver cysts generally cause no symptoms. Pancreatic cysts. PKD can also cause cysts in the pancreas. Pancreatic cysts rarely cause pancreatitisinflammation, or swelling, of the pancreas. Abnormal heart valves. Abnormal heart valves may occur in up to 25 percent of people with autosomal dominant PKD.1 Insufficient blood flow in the aortathe large artery that carries blood from the heartmay result from the abnormal heart valves. Diverticula. Diverticula are small pouches, or sacs, that push outward through weak spots in the colon wall. This complication is more common in people with PKD who have kidney failure.1 Brain aneurysms. An aneurysm is a bulge in the wall of a blood vessel. Aneurysms in the brain might cause headaches that are severe or feel different from other headaches. Brain aneurysms can rupture, or break open, causing bleeding inside the skull. A ruptured aneurysm in the brain is a lifethreatening condition and requires immediate medical attention. |
What is (are) Polycystic Kidney Disease ? | Autosomal recessive PKD is a rare genetic disorder that affects the liver as well as the kidneys. The signs of autosomal recessive PKD frequently appear in the earliest months of life, even in the womb, so health care providers often call it infantile PKD. In an autosomal recessive disorder, the child has to inherit the gene mutation from both parents to have an increased likelihood for the disorder. The chance of a child inheriting autosomal recessive mutations from both parents with a gene mutation is 25 percent, or one in four. If only one parent carries the mutated gene, the child will not get the disorder, although the child may inherit the gene mutation. The child is a carrier of the disorder and can pass the gene mutation to the next generation. Genetic testing can show whether a parent or child is a carrier of the mutated gene. Autosomal recessive disorders do not typically appear in every generation of an affected family. The following chart shows the chance of inheriting an autosomal recessive mutation from parents who both carry the mutated gene: Read more about how people inherit genetic conditions at the NLMs Genetics Home Reference. |
What are the symptoms of Polycystic Kidney Disease ? | An early sign of autosomal recessive PKD is an enlarged kidney, seen in a fetus or an infant using ultrasound. Kidney function is crucial for early physical development, so children with autosomal recessive PKD and decreased kidney function are usually smallerthanaverage size, a condition called growth failure. Some people with autosomal recessive PKD do not develop signs or symptoms until later in childhood or even adulthood. |
What are the complications of Polycystic Kidney Disease ? | Babies with the most severe cases of autosomal recessive PKD often die hours or days after birth because they cannot breathe well enough to sustain life. Their lungs do not develop as they should during the prenatal period. Pressure from enlarged kidneys also contributes to breathing problems. Children born with autosomal recessive PKD often develop kidney failure before reaching adulthood. Liver scarring occurs in all people with autosomal recessive PKD and is usually present at birth. However, liver problems tend to become more of a concern as people with autosomal recessive PKD grow older. Liver scarring can lead to progressive liver dysfunction and other problems. Additional complications of autosomal recessive PKD include high blood pressure and UTIs. |
How to prevent Polycystic Kidney Disease ? | Scientists have not yet found a way to prevent PKD. However, people with PKD may slow the progression of kidney damage caused by high blood pressure through lifestyle changes, diet, and blood pressure medications. People with PKD should be physically active 30 minutes a day most days of the week. See Eating, Diet, and Nutrition for diet advice on lowering blood pressure and slowing the progression of kidney disease in general. If lifestyle and diet changes do not control a persons blood pressure, a health care provider may prescribe one or more blood pressure medications, including ACE inhibitors or ARBs. |
What to do for Polycystic Kidney Disease ? | A dietitian specializes in helping people who have kidney disease choose the right foods and plan healthy meals. People with any kind of kidney disease, including PKD, should talk with a dietitian about foods that should be added to their diet and foods that might be harmful. PKD may require diet changes for blood pressure control. Kidney disease in general also calls for certain diet changes. Following a healthy eating plan can help lower blood pressure. A health care provider may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan, which focuses on fruits, vegetables, whole grains, and other foods that are heart healthy and lower in sodium, which often comes from salt. The DASH eating plan is low in fat and cholesterol features fatfree or lowfat milk and dairy products, fish, poultry, and nuts suggests less red meat, sweets, added sugars, and sugarcontaining beverages is rich in nutrients, protein, and fiber More information about the DASH eating planis available from the National Heart, Lung, and Blood Institute. As your kidneys become more damaged, you may need to eat foods that are lower in phosphorus and potassium. The health care provider will use lab tests to watch your levels. Foods high in potassium include bananas oranges potatoes tomatoes Lowerpotassium foods include apples peaches carrots green beans Foods higher in phosphorus include large portions of meat, fish and dairy foods bran cereals and oatmeal beans and nuts colas Lowerphosphorus alternatives include fresh fruits and vegetables breads pasta rice corn and rice cereals lightcolored sodas People with kidney disease and high blood pressure should also limit how much sodium they get to 2,300 mg or less each day.5 People with CKD may need to watch how much protein they eat. Everyone needs protein. However, protein breaks down into wastes the kidneys must remove. Large amounts of protein make the kidneys work harder. Highquality proteins such as meat, fish, and eggs create fewer wastes than other sources of protein. Beans, whole grains, soy products, nuts and nut butters, and dairy products can also be good sources of protein. Most people eat more protein than they need. Eating highquality protein and smaller portions of protein can help protect the kidneys. More information about nutrition for kidney disease is provided in the NIDDK health topics: Nutrition for Children with Chronic Kidney Disease Nutrition for Adults with Early Chronic Kidney Disease Nutrition for Adults with Advanced Chronic Kidney Disease The National Kidney Disease Education Program offers a series of easytoread fact sheets about nutrition for people with CKD. |
What to do for Polycystic Kidney Disease ? | Polycystic kidney disease (PKD) is a genetic disorder that causes numerous cysts to grow in the kidneys. A gene mutation, or defect, causes polycystic kidney disease. Autosomal dominant PKD is the most common form of PKD and the most common inherited disorder of the kidneys. Health care providers identify most cases of autosomal dominant PKD between the ages of 30 and 50. The most common symptoms of PKD are pain in the back and sidesbetween the ribs and hipsand headaches. The pain can be temporary or persistent, mild or severe. Hematuriablood in the urinemay also be a sign of autosomal dominant PKD. The complications of autosomal dominant PKD include the following: pain high blood pressure kidney failure urinary tract infections (UTIs) kidney stones liver cysts pancreatic cysts abnormal heart valves diverticula brain aneurysms A health care provider diagnoses autosomal dominant PKD using imaging tests and genetic testing. A radiologista doctor who specializes in medical imagingwill interpret the images produced by the following imaging tests: ultrasound computerized tomography scans magnetic resonance imaging Genetic testing can show whether a persons cells carry a gene mutation that causes autosomal dominant PKD. A health care provider may also use genetic testing results to determine whether someone with a family history of PKD is likely to develop the disorder in the future. Prenatal testing can diagnose autosomal recessive PKD in unborn children. Although a cure for autosomal dominant PKD is not currently available, treatment can ease symptoms and prolong life. Autosomal recessive PKD is a rare genetic disorder that affects the liver as well as the kidneys. The complications of autosomal recessive PKD include the following: death due to breathing problems kidney failure liver scarring high blood pressure UTIs A health care provider diagnoses autosomal recessive PKD with ultrasound imaging, even in a fetus or newborn. Treatments for autosomal recessive PKD focus on the symptoms and complications. Scientists have not yet found a way to prevent PKD. However, people with PKD may slow the progression of kidney damage caused by high blood pressure through lifestyle changes, diet, and blood pressure medications. People with any kind of kidney disease, including PKD, should talk with a dietitian about foods they should add to their diet and foods that might be harmful. |
What is (are) Solitary Kidney ? | When a person has only one kidney or one working kidney, this kidney is called a solitary kidney. The three main causes of a solitary kidney are birth defects. People with kidney agenesis are born with only one kidney. People born with kidney dysplasia have both kidneys; however, one kidney does not function. Many people with kidney agenesis or kidney dysplasia do not discover that they have a solitary kidney until they have an x ray, an ultrasound, or surgery for an unrelated condition. surgical removal of a kidney. Some people must have a kidney removed to treat cancer or another disease or injury. When a kidney is removed surgically due to disease or for donation, both the kidney and ureter are removed. kidney donation. A growing number of people are donating a kidney to be transplanted into a family member or friend whose kidneys have failed. In general, people with a solitary kidney lead full, healthy lives. However, some people are more likely to develop kidney disease. |
What is (are) Solitary Kidney ? | The kidneys are two beanshaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. |
What to do for Solitary Kidney ? | People with a solitary kidney do not need to eat a special diet. However, people with reduced kidney function may need to make changes to their diet to slow the progression of kidney disease. More information about recommended dietary changes is provided in the NIDDK health topics, Nutrition for Early Chronic Kidney Disease in Adults and Nutrition for Advanced Chronic Kidney Disease in Adults, and on the National Kidney Disease Education Program website. People should talk with their health care provider about what diet is right for them. Controlling Blood Pressure People can control their blood pressure by not smoking, eating a healthy diet, and taking certain medications. Medications that lower blood pressure can also significantly slow the progression of kidney disease. Two types of blood pressurelowering medications, angiotensinconverting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), have proven effective in slowing the progression of kidney disease. Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or ARB, a diuretica medication that helps the kidneys remove fluid from the bloodmay be prescribed. Betablockers, calcium channel blockers, and other blood pressure medications may also be needed. Preventing Injury For people with a solitary kidney, loss of the remaining working kidney results in the need for dialysis or kidney transplant. People should make sure their health care providers know they have a solitary kidney to prevent injury from medications or medical procedures. People who participate in certain sports may be more likely to injure the kidney; this risk is of particular concern with children, as they are more likely to play sports. The American Academy of Pediatrics recommends individual assessment for contact, collision, and limitedcontact sports. Protective equipment may reduce the chance of injury to the remaining kidney enough to allow participation in most sports, provided that such equipment remains in place during activity. Health care providers, parents, and patients should consider the risks of any activity and decide whether the benefits outweigh those risks. |
What to do for Solitary Kidney ? | When a person has only one kidney or one working kidney, this kidney is called a solitary kidney. The three main causes of a solitary kidney are birth defects, surgical removal of a kidney, and kidney donation. In general, people with a solitary kidney lead full, healthy lives. However, some people are more likely to develop kidney disease. People with a solitary kidney should be tested regularly for the following signs of kidney damage: albuminuria decreased glomerular filtration rate (GFR) high blood pressure People with a solitary kidney can protect their health by eating a nutritious diet, keeping their blood pressure at the appropriate level, and preventing injury to the working kidney. |
What is (are) Simple Kidney Cysts ? | Simple kidney cysts are abnormal, fluidfilled sacs that form in the kidneys. Simple kidney cysts are different from the cysts that develop when a person has polycystic kidney disease (PKD), which is a genetic disorder. Simple kidney cysts do not enlarge the kidneys, replace their normal structure, or cause reduced kidney function like cysts do in people with PKD. Simple kidney cysts are more common as people age. An estimated 25 percent of people 40 years of age and 50 percent of people 50 years of age have simple kidney cysts.1 |
What is (are) Simple Kidney Cysts ? | The kidneys are two beanshaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every day, the two kidneys process about 200 quarts of blood to filter out about 1 to 2 quarts of urine, composed of waste products and extra water. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination. |
What causes Simple Kidney Cysts ? | The cause of simple kidney cysts is not fully understood. Obstruction of tubulestiny structures within the kidneys that collect urineor deficiency of blood supply to the kidneys may play a role. Diverticulasacs that form on the tubulesmay detach and become simple kidney cysts. The role of genetic factors in the development of simple kidney cysts has not been studied. |
What are the symptoms of Simple Kidney Cysts ? | Simple kidney cysts usually do not cause symptoms or harm the kidneys. In some cases, however, pain can occur between the ribs and hips when cysts enlarge and press on other organs. Sometimes cysts become infected, causing fever, pain, and tenderness. Simple kidney cysts are not thought to affect kidney function, but one study found an association between the presence of cysts and reduced kidney function in hospitalized people younger than 60 years of age.1 Some studies have found a relationship between simple kidney cysts and high blood pressure. For example, high blood pressure has improved in some people after a large cyst was drained. However, this relationship is not well understood.2 |
How to diagnose Simple Kidney Cysts ? | Most simple kidney cysts are found during imaging tests done for other reasons. When a cyst is found, the following imaging tests can be used to determine whether it is a simple kidney cyst or another, more serious condition. These imaging tests are performed at an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. Ultrasound may also be performed in a health care providers office. Anesthesia is not needed though light sedation may be used for people with a fear of confined spaces who undergo magnetic resonance imaging (MRI). Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. An abdominal ultrasound can create images of the entire urinary tract. The images can be used to distinguish harmless cysts from other problems. Computerized tomography (CT) scan. CT scans use a combination of x rays and computer technology to create threedimensional (3D) images. A CT scan may include the injection of a special dye, called contrast medium. CT scans require the person to lie on a table that slides into a tunnelshaped device where the x rays are taken. CT scans can show cysts and tumors in the kidneys. MRI. MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. An MRI may include the injection of contrast medium. With most MRI machines, the person lies on a table that slides into a tunnelshaped device that may be open ended or closed at one end; some newer machines are designed to allow the person to lie in a more open space. Like CT scans, MRIs can show cysts and tumors. |
What are the treatments for Simple Kidney Cysts ? | Treatment is not needed for simple kidney cysts that do not cause any symptoms. Simple kidney cysts may be monitored with periodic ultrasounds. Simple kidney cysts that are causing symptoms or blocking the flow of blood or urine through the kidney may need to be treated using a procedure called sclerotherapy. In sclerotherapy, the doctor punctures the cyst using a long needle inserted through the skin. Ultrasound is used to guide the needle to the cyst. The cyst is drained and then filled with a solution containing alcohol to make the kidney tissue harder. The procedure is usually performed on an outpatient basis with a local anesthetic. If the cyst is large, surgery may be needed. Most surgeries can be performed using a laparoscopea special tool with a small, lighted video camera. The procedure is usually done under general anesthesia in a hospital. The surgeon drains the cyst and then removes or burns away its outer tissue. This type of surgery allows for a smaller incision and quicker recovery. |
What to do for Simple Kidney Cysts ? | Eating, diet, and nutrition have not been shown to play a role in causing or preventing simple kidney cysts. |
What to do for Simple Kidney Cysts ? | Simple kidney cysts are abnormal, fluidfilled sacs that form in the kidneys. Simple kidney cysts usually do not cause symptoms or harm the kidneys. Most simple kidney cysts are found during imaging tests done for other reasons. Treatment is not needed for simple kidney cysts that do not cause any symptoms. Simple kidney cysts that are causing symptoms or blocking the flow of blood or urine through the kidney may need to be treated using sclerotherapy or surgery. |
What is (are) Kidney Stones in Children ? | A kidney stone is a solid piece of material that forms in a kidney when substances that are normally found in the urine become highly concentrated. A stone may stay in the kidney or travel down the urinary tract. Kidney stones vary in size. A small stone may pass out of the body causing little or no pain. A larger stone may get stuck along the urinary tract and can block the flow of urine, causing severe pain or blood that can be seen in the urine. |
What is (are) Kidney Stones in Children ? | The urinary tract is the bodys drainage system for removing wastes and extra water. The urinary tract includes two kidneys, two ureters, a bladder, and a urethra. The kidneys are a pair of beanshaped organs, each about the size of a fist and located below the ribs, one on each side of the spine, toward the middle of the back. Every minute, a persons kidneys filter about 3 ounces of blood, removing wastes and extra water. The wastes and extra water make up the 1 to 2 quarts of urine an adult produces each day. Children produce less urine each day; the amount produced depends on their age. The urine travels from the kidneys down two narrow tubes called the ureters. The urine is then stored in a balloonlike organ called the bladder. When the bladder empties, urine flows out of the body through a tube called the urethra at the bottom of the bladder. |
What causes Kidney Stones in Children ? | Kidney stones can form when substances in the urinesuch as calcium, magnesium, oxalate, and phosphorousbecome highly concentrated due to one or more causes: Defects in the urinary tract may block the flow of urine and create pools of urine. In stagnant urine, stoneforming substances tend to settle together into stones. Up to onethird of children who have stones have an anatomic abnormality in their urinary tract. Kidney stones may have a genetic cause. In other words, the tendency to form stones can run in families due to inherited factors. An unhealthy lifestyle may make children more likely to have kidney stones. For example, drinking too little water or drinking the wrong types of fluids, such as soft drinks or drinks with caffeine, may cause substances in the urine to become too concentrated. Similarly, too much sodium, or salt, in the diet may contribute to more chemicals in the urine, causing an increase in stone formation. Some doctors believe increases in obesity rates, less active lifestyles, and diets higher in salt may be causing more children to have kidney stones. Sometimes, a urinary tract infection can cause kidney stones to form. Some types of bacteria in the urinary tract break down ureaa waste product removed from the blood by the kidneysinto substances that form stones. Some children have metabolic disorders that lead to kidney stones. Metabolism is the way the body uses digested food for energy, including the process of breaking down food, using foods nutrients in the body, and removing the wastes that remain. The most common metabolic disorder that causes kidney stones in children is hypercalciuria, which causes extra calcium to collect in the urine. Other more rare metabolic conditions involve problems breaking down oxalate, a substance made in the body and found in some foods. These conditions include hyperoxaluria, too much oxalate in the urine, and oxalosis, characterized by deposits of oxalate and calcium in the bodys tissues. Another rare metabolic condition called cystinuria can cause kidney stones. Cystinuria is an excess of the amino acid cystine in the urine. Amino acids are the building blocks of proteins. |
What are the symptoms of Kidney Stones in Children ? | Children with kidney stones may have pain while urinating, see blood in the urine, or feel a sharp pain in the back or lower abdomen. The pain may last for a short or long time. Children may experience nausea and vomiting with the pain. However, children who have small stones that pass easily through the urinary tract may not have symptoms at all. |
What is (are) Kidney Stones in Children ? | Four major types of kidney stones occur in children: Calcium stones are the most common type of kidney stone and occur in two major forms: calcium oxalate and calcium phosphate. Calcium oxalate stones are more common. Calcium oxalate stone formation has various causes, which may include high calcium excretion, high oxalate excretion, or acidic urine. Calcium phosphate stones are caused by alkaline urine. Uric acid stones form when the urine is persistently acidic. A diet rich in purinessubstances found in animal proteins such as meats, fish, and shellfishmay cause uric acid. If uric acid becomes concentrated in the urine, it can settle and form a stone by itself or along with calcium. Struvite stones result from kidney infections. Eliminating infected stones from the urinary tract and staying infectionfree can prevent more struvite stones. Cystine stones result from a genetic disorder that causes cystine to leak through the kidneys and into the urine in high concentration, forming crystals that tend to accumulate into stones. |
How to diagnose Kidney Stones in Children ? | The process of diagnosing any illness begins with consideration of the symptoms. Pain or bloody urine may be the first symptom. Urine, blood, and imaging tests will help determine whether symptoms are caused by a stone. Urine tests can be used to check for infection and for substances that form stones. Blood tests can be used to check for biochemical problems that can lead to kidney stones. Various imaging techniques can be used to locate the stone: Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. An abdominal ultrasound can create images of the entire urinary tract. The procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging; anesthesia is not needed. The images can show the location of any stones. This test does not expose children to radiation, unlike some other imaging tests. Although other tests are more useful in detecting very small stones or stones in the lower portion of the ureter, ultrasound is considered by many health care providers to be the best screening test to look for stones. Computerized tomography (CT) scans use a combination of x rays and computer technology to create threedimensional (3D) images. A CT scan may include the injection of a special dye, called contrast medium. CT scans require the child to lie on a table that slides into a tunnelshaped device where the x rays are taken. The procedure is performed in an outpatient center or hospital by an xray technician, and the images are interpreted by a radiologist; anesthesia is not needed. CT scans may be required to get an accurate stone count when children are being considered for urologic surgery. Because CT scans expose children to a moderate amount of radiation, health care providers try to reduce radiation exposure in children by avoiding repeated CT scans, restricting the area scanned as much as possible, and using the lowest radiation dose that will provide the needed diagnostic information. Xray machines use radiation to create images of the childs urinary tract. The images can be taken at an outpatient center or hospital by an xray technician, and the images are interpreted by a radiologist; anesthesia is not needed. The x rays are used to locate many kinds of stones. A conventional x ray is generally less informative than an ultrasound or CT scan, but it is less expensive and can be done more quickly than other imaging procedures. |
What are the treatments for Kidney Stones in Children ? | The treatment for a kidney stone usually depends on its size and what it is made of, as well as whether it is causing symptoms of pain or obstructing the urinary tract. Small stones usually pass through the urinary tract without treatment. Still, children will often require pain control and encouragement to drink lots of fluids to help move the stone along. Pain control may consist of oral or intravenous (IV) medication, depending on the duration and severity of the pain. IV fluids may be needed if the child becomes dehydrated from vomiting or an inability to drink. A child with a larger stone, or one that blocks urine flow and causes great pain, may need to be hospitalized for more urgent treatment. Hospital treatments may include the following: |
How to prevent Kidney Stones in Children ? | To prevent kidney stones, health care providers and their patients must understand what is causing the stones to form. Especially in children with suspected metabolic abnormalities or with recurrent stones, a 24hour urine collection is obtained to measure daily urine volume and to determine if any underlying mineral abnormality is making a child more likely to form stones. Based on the analysis of the collected urine, the treatment can be individualized to address a metabolic problem. In all circumstances, children should drink plenty of fluids to keep the urine diluted and flush away substances that could form kidney stones. Urine should be almost clear. |
What to do for Kidney Stones in Children ? | Families may benefit from meeting with a dietitian to learn how dietary management can help in preventing stones. Depending on the underlying cause of the stone formation, medications may be necessary to prevent recurrent stones. Dietary changes and medications may be required for a long term or, quite often, for life. Some common changes include the following: Children who tend to make calcium oxalate stones or have hypercalciuria should eat a regular amount of dietary calcium and limit salt intake. A thiazide diuretic medication may be given to some children to reduce the amount of calcium leaking into the urine. Children who have large amounts of oxalate in the urine may need to limit foods high in oxalate, such as chocolate, peanut butter, and darkcolored soft drinks. Children who form uric acid or cystine stones may need extra potassium citrate or potassium carbonate in the form of a pill or liquid medication. Avoiding foods high in purinessuch as meat, fish, and shellfishmay also help prevent uric acid stones. |
What to do for Kidney Stones in Children ? | A kidney stone is a solid piece of material that forms in a kidney when some substances that are normally found in the urine become highly concentrated. Kidney stones occur in infants, children, and teenagers from all races and ethnicities. Kidney stones in children are diagnosed using a combination of urine, blood, and imaging tests. The treatment for a kidney stone usually depends on its size and composition as well as whether it is causing symptoms of pain or obstructing the urinary tract. Small stones usually pass through the urinary tract without treatment. Still, children will often require pain control and encouragement to drink lots of fluids to help move the stone along. Children with larger stones, or stones that block urine flow and cause great pain, may need to be hospitalized for more urgent treatment. Hospital treatments may include shock wave lithotripsy (SWL), removal of the stone with a ureteroscope, lithotripsy with a ureteroscope, or percutaneous nephrolithotomy. To prevent recurrent kidney stones, health care providers and their patients must understand what is causing the stones to form. In all circumstances, children should drink plenty of fluids to keep the urine diluted and flush away substances that could form kidney stones. Urine should be almost clear. |
What is (are) Urinary Incontinence in Children ? | Urinary incontinence is the loss of bladder control, which results in the accidental loss of urine. A child with UI may not stay dry during the day or night. Some UI is caused by a health problem such as a urinary tract infection (UTI) diabetes, a condition where blood glucose, also called blood sugar, is too high kidney problems nerve problems constipation, a condition in which a child has fewer than two bowel movements a week and stools can be hard, dry, small, and difficult to pass obstructive sleep apnea (OSA), a condition in which breathing is interrupted during sleep, often because of inflamed or enlarged tonsils a structural problem in the urinary tract Most of the time, the exact cause of UI is not known, but it is often the result of more than one factor. Although UI affects many children, it usually disappears naturally over time. UI after age 3the age when most children achieve daytime drynessmay cause great distress and embarrassment. Many children experience occasional UI, and treatment is available for most children who have a hard time controlling their bladder. Thus, caregivers of children who wet the bed or have accidents during the day should approach this problem with understanding and patience. The age at which children achieve dryness varies. Wetting in younger children is common and not considered UI, so daytime UI is not usually diagnosed until age 5 or 6, and nighttime UI is not usually diagnosed until age 7. Enuresis Urinary incontinence is also called enuresis. Types of enuresis include the following: Primary enuresis is wetting in a child who has never been consistently dry. Secondary enuresis is wetting that begins after at least 6 months of dryness. Nocturnal enuresis is wetting that usually occurs during sleep, also called nighttime UI. Diurnal enuresis is wetting when awake, also called daytime UI. |
How many people are affected by Urinary Incontinence in Children ? | By 5 years of age, more than 90 percent of children can control urination during the day. Nighttime wetting is more common than daytime wetting in children, affecting 30 percent of 4yearolds. The condition resolves itself in about 15 percent of children each year; about 10 percent of 7yearolds, 3 percent of 12yearolds, and 1 percent of 18yearolds continue to experience nighttime wetting.1 |
What causes Urinary Incontinence in Children ? | The exact cause of most cases of nighttime UI is not known. Though a few cases are caused by structural problems in the urinary tract, most cases probably result from a mix of factors including slower physical development, an overproduction of urine at night, and the inability to recognize bladder filling when asleep. Nighttime UI has also been associated with attention deficit hyperactivity disorder (ADHD), OSA, and anxiety. Children also may inherit genes from one or both parents that make them more likely to have nighttime UI. Slower Physical Development Between the ages of 5 and 10, bedwetting may be the result of a small bladder capacity, long sleeping periods, and underdevelopment of the bodys alarms that signal a full or emptying bladder. This form of UI fades away as the bladder grows and the natural alarms become operational. Overproduction of Urine at Night The body produces antidiuretic hormone (ADH), a natural chemical that slows down the production of urine. More ADH is produced at night so the need to urinate lessens. If the body does not produce enough ADH at night, the production of urine may not slow down, leading to bladder overfilling. If a child does not sense the bladder filling and awaken to urinate, wetting will occur. Structural Problems A small number of UI cases are caused by physical problems in the urinary tract. Rarely, a blocked bladder or urethra may cause the bladder to overfill and leak. Nerve damage associated with the birth defect spina bifida can cause UI. In these cases, UI can appear as a constant dribbling of urine. Attention Deficit Hyperactivity Disorder Children with ADHD are three times more likely to have nighttime UI than children without ADHD.2 The connection between ADHD and bedwetting has not been explained, but some experts theorize that both conditions are related to delays in central nervous system development. Obstructive Sleep Apnea Nighttime UI may be one sign of OSA. Other symptoms of OSA include snoring, mouth breathing, frequent ear and sinus infections, sore throat, choking, and daytime drowsiness. Experts believe that when the airway in people with OSA closes, a chemical may be released in the body that increases water production and inhibits the systems that regulate fluid volume. Successful treatment of OSA often resolves the associated nighttime UI. Anxiety Anxietycausing events that occur between 2 and 4 years of agebefore total bladder control is achievedmight lead to primary enuresis. Anxiety experienced after age 4 might lead to secondary enuresis in children who have been dry for at least 6 months. Events that cause anxiety in children include physical or sexual abuse; unfamiliar social situations, such as moving or starting at a new school; and major family events such as the birth of a sibling, a death, or divorce. UI itself is an anxietycausing event. Strong bladder contractions resulting in daytime leakage can cause embarrassment and anxiety that lead to nighttime wetting. Genetics Certain genes have been found to contribute to UI. Children have a 30 percent chance of having nighttime UI if one parent was affected as a child. If both parents were affected, there is a 70 percent chance of bedwetting.1 |
What causes Urinary Incontinence in Children ? | Daytime UI can be caused by a UTI or structural problems in the urinary tract. Daytime UI that is not associated with UTI or structural problems is less common and tends to disappear much earlier than nighttime UI. Overactive bladder and infrequent or incomplete voiding, or urination, are common causes of daytime UI. Overactive Bladder Overactive bladder is a condition in which a child experiences at least two of the following conditions: urinary urgencyinability to delay urination urge urinary incontinenceurinary leakage when the bladder contracts unexpectedly urinary frequencyurination eight or more times a day or more than twice at night Infrequent or Incomplete Voiding Infrequent voiding is when children voluntarily hold urine for prolonged periods of time. For example, children may not want to use the toilets at school or may not want to interrupt enjoyable activities, so they ignore the bodys signal of a full bladder. In these cases, the bladder can overfill and leak urine. In addition, these children often develop UTIs, leading to an irritated or overactive bladder. Factors that may combine with infrequent voiding to produce daytime UI include small bladder capacity structural problems anxietycausing events pressure from constipation drinks or foods that contain caffeine Sometimes, overly demanding toilet training may make children unable to relax the sphincters enough to completely empty the bladder. Incomplete voiding may also lead to UTIs. |
What are the treatments for Urinary Incontinence in Children ? | Most UI fades away naturally as a child grows and develops and does not require treatment. When treatment is needed, options include bladder training and related strategies, moisture alarms, and medications. Growth and Development As children mature bladder capacity increases natural body alarms become activated an overactive bladder settles down production of ADH becomes normal response to the bodys signal that it is time to void improves Bladder Training and Related Strategies Bladder training consists of exercises to strengthen the bladder muscles to better control urination. Gradually lengthening the time between trips to the bathroom can also help by stretching the bladder so it can hold more urine. Additional techniques that may help control daytime UI include urinating on a scheduletimed voidingsuch as every 2 hours avoiding food or drinks with caffeine following suggestions for healthy urination, such as relaxing muscles and taking enough time to allow the bladder to empty completely Waking children up to urinate can help decrease nighttime UI. Ensuring children drink enough fluids throughout the day so they do not drink a lot of fluids close to bedtime may also help. A health care provider can give guidance about how much a child needs to drink each day, as the amount depends on a childs age, physical activity, and other factors. Moisture Alarms At night, moisture alarms can wake children when they begin to urinate. These devices use a watersensitive pad connected to an alarm that sounds when moisture is first detected. A small pad can clip to the pajamas, or a larger pad can be placed on the bed. For the alarm to be effective, children must awaken as soon as the alarm goes off, stop the urine stream, and go to the bathroom. Children using moisture alarms may need to have someone sleep in the same room to help wake them up. Medications Nighttime UI may be treated by increasing ADH levels. The hormone can be boosted by a synthetic version known as desmopressin (DDAVP), which is available in pill form, nasal spray, and nose drops. DDAVP is approved for use in children. Another medication, called imipramine (Tofranil), is also used to treat nighttime UI, though the way this medication prevents bedwetting is not known. Although both of these medications may help children achieve shortterm success, relapse is common once the medication is withdrawn. UI resulting from an overactive bladder may be treated with oxybutynin (Ditropan), a medication that helps calm the bladder muscle and control muscle spasms. |
What to do for Urinary Incontinence in Children ? | Eating, diet, and nutrition have not been shown to play a role in causing or preventing UI in children, though ensuring sufficient fluid intake throughout the day and avoiding caffeine intake may be helpful. |
What to do for Urinary Incontinence in Children ? | Urinary incontinence (UI) is the loss of bladder control, which results in the accidental loss of urine. A child with UI may not stay dry during the day or night. Although UI affects many children, it usually disappears naturally over time. By 5 years of age, more than 98 percent of children can control urination during the day. Nighttime wetting is more common than daytime wetting in children, affecting 30 percent of 4yearolds. The exact cause of most cases of nighttime UI is not known. Though a few cases are caused by structural problems in the urinary tract, most cases result from more than one factor including slower physical development, an overproduction of urine at night, and the inability to recognize bladder filling when asleep. Nighttime UI has also been associated with attention deficit hyperactivity disorder (ADHD), obstructive sleep apnea (OSA), and anxiety. Certain genes have been found to contribute to UI. Daytime UI that is not associated with urinary tract infection (UTI) or structural problems in the urinary tract may be due to an overactive bladder or infrequent or incomplete voiding problems. Most UI fades away naturally as a child grows and develops and does not require treatment. When treatment is needed, options include bladder training and related strategies, moisture alarms, and medications. |
What is (are) Perineal Injury in Males ? | Perineal injury is an injury to the perineum, the part of the body between the anus and the genitals, or sex organs. In males, the perineum is the area between the anus and the scrotum, the external pouch of skin that holds the testicles. Injuries to the perineum can happen suddenly, as in an accident, or gradually, as the result of an activity that persistently puts pressure on the perineum. Sudden damage to the perineum is called an acute injury, while gradual damage is called a chronic injury. |
What are the complications of Perineal Injury in Males ? | Injury to the blood vessels, nerves, and muscles in the perineum can lead to complications such as bladder control problems sexual problems Bladder control problems. The nerves in the perineum carry signals from the bladder to the spinal cord and brain, telling the brain when the bladder is full. Those same nerves carry signals from the brain to the bladder and pelvic floor muscles, directing those muscles to hold or release urine. Injury to those nerves can block or interfere with the signals, causing the bladder to squeeze at the wrong time or not to squeeze at all. Damage to the pelvic floor muscles can cause bladder and bowel control problems. Sexual problems. The perineal nerves also carry signals between the genitals and the brain. Injury to those nerves can interfere with the sensations of sexual contact. Signals from the brain direct the smooth muscles in the genitals to relax, causing greater blood flow into the penis. In men, damaged blood vessels can cause erectile dysfunction (ED), the inability to achieve or maintain an erection firm enough for sexual intercourse. An internal portion of the penis runs through the perineum and contains a section of the urethra. As a result, damage to the perineum may also injure the penis and urethra. |
What causes Perineal Injury in Males ? | Common causes of acute perineal injury in males include perineal surgery straddle injuries sexual abuse impalement Perineal Surgery Acute perineal injury may result from surgical procedures that require an incision in the perineum: A prostatectomy is the surgical removal of the prostate to treat prostate cancer. The prostate, a walnutshaped gland in men, surrounds the urethra at the neck of the bladder and supplies fluid that goes into semen. The surgeon chooses the location for the incision based on the patients physical characteristics, such as size and weight, and the surgeons experience and preferences. In one approach, called the radical perineal prostatectomy, the surgeon makes an incision between the scrotum and the anus. In a retropubic prostatectomy, the surgeon makes the incision in the lower abdomen, just above the penis. Both approaches can damage blood vessels and nerves affecting sexual function and bladder control. Perineal urethroplasty is surgery to repair stricture, or narrowing, of the portion of the urethra that runs through the perineum. Without this procedure, some men would not be able to pass urine. However, the procedure does require an incision in the perineum, which can damage blood vessels or nerves. Colorectal or anal cancer surgery can injure the perineum by cutting through some of the muscle around the anus to remove a tumor. One approach to anal cancer surgery involves making incisions in the abdomen and the perineum. Surgeons try to avoid procedures that damage a persons blood vessels, perineal nerves, and muscles. However, sometimes a perineal incision may achieve the best angle to remove a lifethreatening cancer. People should discuss the risks of any planned surgery with their health care provider so they can make an informed decision and understand what to expect after the operation. Straddle Injuries Straddle injuries result from falls onto objects such as metal bars, pipes, or wooden rails, where the persons legs are on either side of the object and the perineum strikes the object forcefully. These injuries include motorcycle and bike riding accidents, saddle horn injuries during horseback riding, falls on playground equipment such as monkey bars, and gymnastic accidents on an apparatus such as the parallel bars or pommel horse. In rare situations, a blunt injury to the perineum may burst a blood vessel inside the erectile tissue of the penis, causing a persistent partial erection that can last for days to years. This condition is called highflow priapism. If not treated, ED may result. Sexual Abuse Forceful and inappropriate sexual contact can result in perineal injury. When health care providers evaluate injuries in the genital area, they should consider the possibility of sexual abuse, even if the person or family members say the injury is the result of an accident such as a straddle injury. The law requires that health care providers report cases of sexual abuse that come to their attention. The person and family members should understand the health care provider may ask some uncomfortable questions about the circumstances of the injury. Impalement Impalement injuries may involve metal fence posts, rods, or weapons that pierce the perineum. Impalement is rare, although it may occur where moving equipment and pointed tools are in use, such as on farms or construction sites. Impalement can also occur as the result of a fall, such as from a tree or playground equipment, onto something sharp. Impalement injuries are most common in combat situations. If an impalement injury pierces the skin and muscles, the injured person needs immediate medical attention to minimize blood loss and repair the injury. |
What causes Perineal Injury in Males ? | Chronic perineal injury most often results from a jobor sportrelated practicesuch as bike, motorcycle, or horseback ridingor a longterm condition such as chronic constipation. Bike Riding Sitting on a narrow, saddlestyle bike seatwhich has a protruding nose in the frontplaces far more pressure on the perineum than sitting in a regular chair. In a regular chair, the flesh and bone of the buttocks partially absorb the pressure of sitting, and the pressure occurs farther toward the back than on a bike seat. The straddling position on a narrow seat pinches the perineal blood vessels and nerves, possibly causing blood vessel and nerve damage over time. Research shows wider, noseless seats reduce perineal pressure.1 Occasional bike riding for short periods of time may pose no risk. However, men who ride bikes several hours a weeksuch as competitive bicyclists, bicycle couriers, and bicycle patrol officershave a significantly higher risk of developing mild to severe ED.2 The ED may be caused by repetitive pressure on blood vessels, which constricts them and results in plaque buildup in the vessels. Other activities that involve riding saddlestyle include motorcycle and horseback riding. Researchers have studied bike riding more extensively than these other activities; however, the few studies published regarding motorcycle and horseback riding suggest motorcycle riding increases the risk of ED and urinary symptoms.3 Horseback riding appears relatively safe in terms of chronic injury,4 although the action of bouncing up and down, repeatedly striking the perineum, has the potential for causing damage. Constipation Constipation is defined as having a bowel movement fewer than three times per week. People with constipation usually have hard, dry stools that are small in size and difficult to pass. Some people with constipation need to strain to pass stools. This straining creates internal pressure that squeezes the perineum and can damage the perineal blood vessels and nerves. More information is provided in the NIDDK health topic, Constipation. |
Who is at risk for Perineal Injury in Males? ? | Men who have perineal surgery are most likely to have an acute perineal injury. Straddle injuries are most common among people who ride motorcycles, bikes, or horses and children who use playground equipment. Impalement injuries are most common in military personnel engaged in combat. Impalement injuries can also occur in construction or farm workers. Chronic perineal injuries are most common in people who ride bikes as part of a job or sport, or in people with constipation. |
What are the treatments for Perineal Injury in Males ? | Treatments for perineal injury vary with the severity and type of injury. Tears or incisions may require stitches. Traumatic or piercing injuries may require surgery to repair damaged pelvic floor muscles, blood vessels, and nerves. Treatment for these acute injuries may also include antibiotics to prevent infection. After a health care provider stabilizes an acute injury so blood loss is no longer a concern, a person may still face some longterm effects of the injury, such as bladder control and sexual function problems. A health care provider can treat highflow priapism caused by a blunt injury to the perineum with medication, blockage of the burst blood vessel under xray guidance, or surgery. In people with a chronic perineal injury, a health care provider will treat the complications of the condition. More information is provided in the NIDDK health topics: Erectile Dysfunction Urinary Incontinence in Men More information about the lower urinary tract is provided in the NIDDK health topic, The Urinary Tract and How It Works. |
How to prevent Perineal Injury in Males ? | Preventing perineal injury requires being aware of and taking steps to minimize the dangers of activities such as construction work or bike riding: People should talk with their health care provider about the benefits and risks of perineal surgery well before the operation. People who play or work around moving equipment or sharp objects should wear protective gear whenever possible. People who ride bikes, motorcycles, or horses should find seats or saddles designed to place the most pressure on the buttocks and minimize pressure on the perineum. Many health care providers advise bike riders to use noseless bike seats and to ride in an upright position rather than lean over the handle bars. The National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention, recommends noseless seats for people who ride bikes as part of their job.1 People with constipation should talk with their health care provider about whether to take a laxative or stool softener to minimize straining during a bowel movement. |
What to do for Perineal Injury in Males ? | To prevent constipation, a diet with 20 to 35 grams of fiber each day helps the body form soft, bulky stool that is easier to pass. Highfiber foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, brussels sprouts, cabbage, and carrots. For people prone to constipation, limiting foods that have little or no fiber, such as ice cream, cheese, meat, and processed foods, is also important. A health care provider can give information about how changes in eating, diet, and nutrition could help with constipation. |
What to do for Perineal Injury in Males ? | Perineal injury is an injury to the perineum, the part of the body between the anus and the genitals, or sex organs. In males, the perineum is the area between the anus and the scrotum, the external pouch of skin that holds the testicles. Injury to the blood vessels, nerves, and muscles in the perineum can lead to complications such as bladder control problems sexual problems Common causes of acute perineal injury in males include perineal surgery straddle injuries sexual abuse impalement Chronic perineal injury most often results from a job or sportrelated practicesuch as bike, motorcycle, or horseback ridingor a longterm condition such as chronic constipation. Traumatic or piercing injuries may require surgery to repair damaged pelvic floor muscles, blood vessels, and nerves. Treatment for these acute injuries may also include antibiotics to prevent infection. In people with a chronic perineal injury, a health care provider will treat the complications of the condition, such as erectile dysfunction (ED) and urinary incontinence. Preventing perineal injury requires being aware of and taking steps to minimize the dangers of activities such as construction work or bike riding. The National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention, recommends noseless seats for people who ride bikes as part of their job. |
What is (are) Graves' Disease ? | Graves disease, also known as toxic diffuse goiter, is the most common cause of hyperthyroidism in the United States. Hyperthyroidism is a disorder that occurs when the thyroid gland makes more thyroid hormone than the body needs. The Thyroid The thyroid is a 2inchlong, butterflyshaped gland in the front of the neck below the larynx, or voice box. The thyroid makes two thyroid hormones, triiodothyronine (T3 ) and thyroxine (T4 ). T3 is made from T4 and is the more active hormone, directly affecting the tissues. Thyroid hormones circulate throughout the body in the bloodstream and act on virtually every tissue and cell in the body. Thyroid hormones affect metabolism, brain development, breathing, heart and nervous system functions, body temperature, muscle strength, skin dryness, menstrual cycles, weight, and cholesterol levels. Hyperthyroidism causes many of the bodys functions to speed up. Thyroid hormone production is regulated by another hormone called thyroidstimulating hormone (TSH), which is made by the pituitary gland in the brain. When thyroid hormone levels in the blood are low, the pituitary releases more TSH. When thyroid hormone levels are high, the pituitary responds by decreasing TSH production. Autoimmune Disorder Graves disease is an autoimmune disorder. Normally, the immune system protects the body from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances. But in autoimmune diseases, the immune system attacks the bodys own cells and organs. With Graves disease, the immune system makes an antibody called thyroidstimulating immunoglobulin (TSI)sometimes called TSH receptor antibodythat attaches to thyroid cells. TSI mimics TSH and stimulates the thyroid to make too much thyroid hormone. Sometimes the TSI antibody instead blocks thyroid hormone production, leading to conflicting symptoms that may make correct diagnosis more difficult. |
What are the symptoms of Graves' Disease ? | People with Graves disease may have common symptoms of hyperthyroidism such as nervousness or irritability fatigue or muscle weakness heat intolerance trouble sleeping hand tremors rapid and irregular heartbeat frequent bowel movements or diarrhea weight loss goiter, which is an enlarged thyroid that may cause the neck to look swollen and can interfere with normal breathing and swallowing A small number of people with Graves disease also experience thickening and reddening of the skin on their shins. This usually painless problem is called pretibial myxedema or Graves dermopathy. In addition, the eyes of people with Graves disease may appear enlarged because their eyelids are retractedseem pulled back into the eye socketsand their eyes bulge out from the eye sockets. This condition is called Graves ophthalmopathy (GO). |
What is (are) Graves' Disease ? | Graves ophthalmopathy is a condition associated with Graves disease that occurs when cells from the immune system attack the muscles and other tissues around the eyes. The result is inflammation and a buildup of tissue and fat behind the eye socket, causing the eyeballs to bulge out. Rarely, inflammation is severe enough to compress the optic nerve that leads to the eye, causing vision loss. Other GO symptoms are dry, gritty, and irritated eyes puffy eyelids double vision light sensitivity pressure or pain in the eyes trouble moving the eyes About 25 to 30 percent of people with Graves disease develop mild GO, and 2 to 5 percent develop severe GO.1 This eye condition usually lasts 1 to 2 years and often improves on its own. GO can occur before, at the same time as, or after other symptoms of hyperthyroidism develop and may even occur in people whose thyroid function is normal. Smoking makes GO worse. 1Yeung SJ, Habra MA, Chiu AC. Graves disease. emedicine website. emedicine.medscape.com/article/120619overview. Updated 2010. Accessed December 10, 2011. |
How to diagnose Graves' Disease ? | Health care providers can sometimes diagnose Graves disease based only on a physical examination and a medical history. Blood tests and other diagnostic tests, such as the following, then confirm the diagnosis. TSH test. The ultrasensitive TSH test is usually the first test performed. This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available. T3 and T4 test. Another blood test used to diagnose Graves disease measures T3 and T4 levels. In making a diagnosis, health care providers look for belownormal levels of TSH, normal to elevated levels of T4, and elevated levels of T3. Because the combination of low TSH and high T3 and T4 can occur with other thyroid problems, health care providers may order other tests to finalize the diagnosis. The following two tests use small, safe doses of radioactive iodine because the thyroid uses iodine to make thyroid hormone. Radioactive iodine uptake test. This test measures the amount of iodine the thyroid collects from the bloodstream. High levels of iodine uptake can indicate Graves disease. Thyroid scan. This scan shows how and where iodine is distributed in the thyroid. With Graves disease the entire thyroid is involved, so the iodine shows up throughout the gland. Other causes of hyperthyroidism such as nodulessmall lumps in the glandshow a different pattern of iodine distribution. TSI test. Health care providers may also recommend the TSI test, although this test usually isnt necessary to diagnose Graves disease. This test, also called a TSH antibody test, measures the level of TSI in the blood. Most people with Graves disease have this antibody, but people whose hyperthyroidism is caused by other conditions do not. More information about testing for thyroid problems is provided in the NIDDK health topic, Thyroid Tests. |
What are the treatments for Graves' Disease ? | People with Graves disease have three treatment options: radioiodine therapy, medications, and thyroid surgery. Radioiodine therapy is the most common treatment for Graves disease in the United States. Graves disease is often diagnosed and treated by an endocrinologista doctor who specializes in the bodys hormone secreting glands. Radioiodine Therapy In radioiodine therapy, patients take radioactive iodine131 by mouth. Because the thyroid gland collects iodine to make thyroid hormone, it will collect the radioactive iodine from the bloodstream in the same way. Iodine131stronger than the radioactive iodine used in diagnostic testsgradually destroys the cells that make up the thyroid gland but does not affect other body tissues. Many health care providers use a large enough dose of iodine131 to shut down the thyroid completely, but some prefer smaller doses to try to bring hormone production into the normal range. More than one round of radioiodine therapy may be needed. Results take time and people undergoing this treatment may not notice improvement in symptoms for several weeks or months. People with GO should talk with a health care provider about any risks associated with radioactive iodine treatments. Several studies suggest radioiodine therapy can worsen GO in some people. Other treatments, such as prescription steroids, may prevent this complication. Although iodine131 is not known to cause birth defects or infertility, radioiodine therapy is not used in pregnant women or women who are breastfeeding. Radioactive iodine can be harmful to the fetus thyroid and can be passed from mother to child in breast milk. Experts recommend that women wait a year after treatment before becoming pregnant. Almost everyone who receives radioactive iodine treatment eventually develops hypothyroidism, which occurs when the thyroid does not make enough thyroid hormone. People with hypothyroidism must take synthetic thyroid hormone, a medication that replaces their natural thyroid hormone. Medications Beta blockers. Health care providers may prescribe a medication called a beta blocker to reduce many of the symptoms of hyperthyroidism, such as tremors, rapid heartbeat, and nervousness. But beta blockers do not stop thyroid hormone production. Antithyroid medications. Health care providers sometimes prescribe antithyroid medications as the only treatment for Graves disease. Antithyroid medications interfere with thyroid hormone production but dont usually have permanent results. Use of these medications requires frequent monitoring by a health care provider. More often, antithyroid medications are used to pretreat patients before surgery or radioiodine therapy, or they are used as supplemental treatment after radioiodine therapy. Antithyroid medications can cause side effects in some people, including allergic reactions such as rashes and itching a decrease in the number of white blood cells in the body, which can lower a persons resistance to infection liver failure, in rare cases In the United States, health care providers prescribe the antithyroid medication methimazole (Tapazole, Northyx) for most types of hyperthyroidism. Antithyroid medications and pregnancy. Because pregnant and breastfeeding women cannot receive radioiodine therapy, they are usually treated with an antithyroid medication instead. However, experts agree that women in their first trimester of pregnancy should probably not take methimazole due to the rare occurrence of damage to the fetus. Another antithyroid medication, propylthiouracil (PTU), is available for women in this stage of pregnancy or for women who are allergic to or intolerant of methimazole and have no other treatment options. Health care providers may prescribe PTU for the first trimester of pregnancy and switch to methimazole for the second and third trimesters. Some women are able to stop taking antithyroid medications in the last 4 to 8 weeks of pregnancy due to the remission of hyperthyroidism that occurs during pregnancy. However, these women should continue to be monitored for recurrence of thyroid problems following delivery. Studies have shown that mothers taking antithyroid medications may safely breastfeed. However, they should take only moderate doses, less than 1020 milligrams daily, of the antithyroid medication methimazole. Doses should be divided and taken after feedings, and the infants should be monitored for side effects.2 Women requiring higher doses of the antithyroid medication to control hyperthyroidism should not breastfeed. 2Ogunyemi DA. Autoimmune thyroid disease and pregnancy. emedicine website. emedicine.medscape.com/article/261913overview. Updated March 12, 2012. Accessed April 10, 2012. Stop your antithyroid medication and call your health care provider right away if you develop any of the following while taking antithyroid medications: fatigue weakness vague abdominal pain loss of appetite skin rash or itching easy bruising yellowing of the skin or whites of the eyes, called jaundice persistent sore throat fever Thyroid Surgery Surgery is the leastused option for treating Graves disease. Sometimes surgery may be used to treat pregnant women who cannot tolerate antithyroid medications people suspected of having thyroid cancer, though Graves disease does not cause cancer people for whom other forms of treatment are not successful Before surgery, the health care provider may prescribe antithyroid medications to temporarily bring a patients thyroid hormone levels into the normal range. This presurgical treatment prevents a condition called thyroid storma sudden, severe worsening of symptomsthat can occur when hyperthyroid patients have general anesthesia. When surgery is used, many health care providers recommend the entire thyroid be removed to eliminate the chance that hyperthyroidism will return. If the entire thyroid is removed, lifelong thyroid hormone medication is necessary. Although uncommon, certain problems can occur in thyroid surgery. The parathyroid glands can be damaged because they are located very close to the thyroid. These glands help control calcium and phosphorous levels in the body. Damage to the laryngeal nerve, also located close to the thyroid, can lead to voice changes or breathing problems. But when surgery is performed by an experienced surgeon, less than 1 percent of patients have permanent complications.1 People who need help finding a surgeon can contact one of the organizations listed under For More Information. Eye Care The eye problems associated with Graves disease may not improve following thyroid treatment, so the two problems are often treated separately. Eye drops can relieve dry, gritty, irritated eyesthe most common of the milder symptoms. If pain and swelling occur, health care providers may prescribe a steroid such as prednisone. Other medications that suppress the immune response may also provide relief. Special lenses for glasses can help with light sensitivity and double vision. People with eye symptoms may be advised to sleep with their head elevated to reduce eyelid swelling. If the eyelids do not fully close, taping them shut at night can help prevent dry eyes. In more severe cases, external radiation may be applied to the eyes to reduce inflammation. Like other types of radiation treatment, the benefits are not immediate; most people feel relief from symptoms 1 to 2 months after treatment. Surgery may be used to improve bulging of the eyes and correct the vision changes caused by pressure on the optic nerve. A procedure called orbital decompression makes the eye socket bigger and gives the eye room to sink back to a more normal position. Eyelid surgery can return retracted eyelids to their normal position. |
What are the treatments for Graves' Disease ? | Treatment for Graves disease can sometimes affect pregnancy. After treatment with surgery or radioactive iodine, TSI antibodies can still be present in the blood, even when thyroid levels are normal. If a pregnant woman has received either of these treatments prior to becoming pregnant, the antibodies she produces may travel across the placenta to the babys bloodstream and stimulate the fetal thyroid. A pregnant woman who has been treated with surgery or radioactive iodine should inform her health care provider so her baby can be monitored for thyroidrelated problems later in the pregnancy. Pregnant women may safely be treated with antithyroid medications. For more information about pregnancy and antithyroid medications, see Medications under the section titled How is Graves disease treated?More information about pregnancy and thyroid disease is provided in the NIDDK health topic, Pregnancy and Thyroid Disease. |
What to do for Graves' Disease ? | Experts recommend that people eat a balanced diet to obtain most nutrients. More information about diet and nutrition is provided by the National Agricultural Library available at www.nutrition.gov. Dietary Supplements Iodine is an essential mineral for the thyroid. However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hyperthyroidism. More information about iodine is provided by the National Library of Medicine in the fact sheet, Iodine in diet, available at www.nlm.nih.gov/medlineplus. Women need more iodine when they are pregnantabout 250 micrograms a daybecause the baby gets iodine from the mothers diet. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Choosing iodized saltsalt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met. To help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health. 3 Zimmerman MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. American Journal of Clinical Nutrition. 2009;89(2):668S672S. |