DOCSLIB.ORG

Vulvovaginal Atrophy Vaginal Tightening (Descensus Vaginae)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Vulvovaginal Atrophy Vaginal Tightening (Descensus Vaginae) THE EFFECTIVE, CUTTING-EDGE, HORMONE-FREE LASER TREATMENT FOR VULVOVAGINAL DISEASES VULVOVAGINAL ATROPHY VAGINAL TIGHTENING (DESCENSUS VAGINAE) GENITOURINARY SYNDROME OF MENOPAUSE MILD STRESS URINARY INCONTINENCE The best alternative to hormonal therapy and surgery . Most of the urogenital diseases connected with the menopause follow a reduction in the production of estrogen by the ovaries. This involves the gradual thinning of genital epithelial tissues, vaginal and vulvar mucosa, which reduce in thickness and moistness becoming more fragile, irritable and sensitive to trauma. Hormonal therapy has been for a long time the gold standard for postmenopausal symptoms. Urological symptoms such as Stress Urinary Incontinence deriving from childbirth and natural ageing process and affecting the pelvic floor structure have been historically treated by mean of surgery restoring the vaginal anatomy. Juliet represents a minimally invasive, effective and hormone-free treatment option for all women who do not wish invasive and/or hormone based options. MCL31 IV 100 0117 EN 2 Advantages in application and technology Application Technology . Fast, painless, discreet and easy to use . Er:YAG wavelength for best results and less side effects . No anesthesia necessary . Ablative and sub-ablative mode (thermal mode) . No surgery, minimal downtime . More than 2,000 Er:YAG lasers worldwide . No risk for infection or bleeding . Over 15 years experience in Erbium technology MCL31 IV 100 0117 EN 3 Device specifications Laser: MCL31 Dermablate (Er:YAG), Class 4 Wavelength: 2,940nm Fluence: Max. 250 J/cm² Pulse duration: 100 – 1,000 µs Frequency : 1 – 20 Hz Modes: Gyn C, Gyn W, Ablation, Therm, MicroSpot Handpieces Gyn: Steri-Spot, V-Spot 90°*, V-Spot 360°* Additional handpieces: MicroSpot*, VarioTEAM* Dimensions: 36 x 60 x 93 cm (W x D x H) Weight: Ca. 75 kg * optional MCL31 IV 100 0117 EN 4 Why an Erbium:YAG Laser 100000 10000 1000 Deoxyhemoglobin ] -1 100 Water Protein 10 Melanin 1 Oxyhemoglobin 0.1 Absorption[cm Coefficient 0.01 Scattering 0.001 0.0001 100 200 300 400 500 1000 2000 3000 4000 5000 10000 Wavelength [nm] MCL31 IV 100 0117 EN 5 Why an Erbium:YAG Laser Tissue Ablation (Vaporisation) Heating Er:YAG Necrosis CO2 Er:YAG Laser CO2 Laser 2,940nm: water absorption peak Lower water absorption Ablation layer by layer Deep, uncontrolled ablation Controlled thermic effect, Uncontrolled thermal effect, no thermal damage necrosis areas Cold ablation possible No cold ablation possible MCL31 IV 100 0117 EN 6 Intravaginal handpieces V-Spot* With 90° reflecting gold-coated With 90° or 360°reflecting gold-coated mirror, for SINGLE USE mirror, for MULTIPLE USE Handpiece Optic for Handpieces Optic for Steri-Spot V-Spot * optional MCL31 IV 100 0117 EN 7 Additional handpieces MicroSpot* VarioTEAM* Fractional handpiece Ablative handpiece with 13x13 mm spot and variable cover rate with variable spot size 1-6 mm for the treatment of the vulva, it allows for a for different ablative treatments complete therapy of vulvovaginal disorders in the vulvar area * optional MCL31 IV 100 0117 EN 8 Micro-Spot Technology . Squared spot of 9 x 9mm, consisting of 169 MicroSpots . MicroSpot optic with stable and precise micro lens array technology . Selective treatment of only “fractions” of the tissue in the form of a grid . Triggers skin renewal and collagen formation with rapid wound healing supported by the untreated skin . Very low risk of side effects Laser beam entrance Pattern on the Micro lens array Fractional laser beam treated area MCL31 IV 100 0117 EN 9 Variable pulse length . The adjustable pulse length allows for both cold ablative and thermal treatment . This maximizes the results reducing the amount of sessions to two EPITHELIUM LAMINA PROPRIA MAZ* MAZ* MAZ* GYN C GYN W Pulse length 300 µs 1,000 µs Effect on the tissue Cold ablation Sub-ablative thermal treatment MCL31 IV 100 0117 EN 10 * MAZ = Microscopic ablation zone by Dr. Bettina A. Buhren & Dr. Peter A. Gerber, Hautklinik Düsseldorf Indications 1. Vulvovaginal Atrophy . Women undergoing menopause often experience a number of symptoms including vaginal dryness, itching, painful intercourse, poor lubrication, decreased libido and poor vaginal muscle elasticity and tone . This condition is also described as Vaginal Atrophy and it follows a reduction in the production of estrogen by the ovaries and is found in 10-40% of post-menopausal women. It involves the gradual thinning of genital epithelial tissues, vaginal and vulvar mucosa, which reduces in thickness and becomes more fragile, irritable and sensitive to trauma . Women with untreated vaginal atrophy often suffer from vaginal paresthesia, a feeling of dryness, itching, burning and even pain during sexual intercourse and can be a contributing factor in urinary incontinence and for many women leads to an overall lack of quality of life Premenopausal vaginal tissue Postmenopausal vaginal tissue MCL31 IV 100 0117 EN 11 Indications 2. Vaginal Tightening (First-degree Descensus Vaginae) . Descensus of the vagina occurs when, due to factors like vaginal births, weakness of the connective tissue, heavy physical work, ageing processes and hormone deficiencies, the pelvic floor tissue slackens, leading to a bulging of the vaginal walls . The mild descensus of the vagina is often experienced as an excessively wide vagina and most women refer to it complaining a loss of vaginal tightness . This is directly related to reduction in friction during intercourse and thus to a decrease or loss of sexual gratification. Normal vagina Enlarged vagina MCL31 IV 100 0117 EN 12 Indications 3. Genitourinary Syndrome of Menopause (GSM) . The term Genitourinary Syndrome of Menopause* refers to a complex of symptoms, which are essentially caused by the post-menopausal hormone deficiency described in case of vaginal atrophy . GSM is chronic, if not treated it advances and can interfere with the quality of life . It is estimated that one in two women in menopause is affected by this complex of life-quality-impairing disorders such as vaginal dryness, burning, paresthesia, restricted capacity for sexual pleasure due to decreased lubrication or even pain during intercourse, as well as urinary urgency, dysuria and repeated bladder infections. Genital symptoms: vaginal dryness, burning, irritation . Sexual symptoms: poor lubrication, dyspareunia . Uro-gynecological symptoms: urgency, urge incontinence, dysuria *Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the Study of Women's Sexual Health and the North American Menopause Society. Portman et al., Menopause. 2014 Oct;21(10):1063-8. MCL31 IV 100 0117 EN 13 Indications 4. Mild Stress Urinary Incontinence . The term Stress Urinary Incontinence (SUI) refers to the involuntary loss of urine during coughing, sneezing or physical exertion. The underlying cause of this condition is often the decreased stability of the connective tissue and a loss of support of the urethra . It is a quite widespread disease prevalent in women after their first birth (24% to 29%) and in women undergoing menopause because of the reduction in estrogen production. Similarly, frequent exercise in high-impact activities can cause athletic incontinence to develop . Women with Stress Urinary Incontinence have an altered connective tissue metabolism, which causes decreased collagen production and which may result in insufficient support of the urogenital tract. Normal pelvic floor muscle Weak pelvic floor muscle MCL31 IV 100 0117 EN 14 Mechanism of action . Juliet is a minimally invasive treatment, the goal of which is to restore the original metabolism of connective tissue by stimulating new collagen production . As a result of laser irradiation the intermolecular crosslinks of the triple helix of collagen shorten, which leads to the immediate tightening of collagen fibrils by two-thirds of their length . This leads to an improvement in the condition of the vaginal skin and in the tone of the pelvic muscle, strengthening the vaginal tissue that contributes to support of the interior tissue and wall . The inner mucosa regains elasticity and lubrication, showing improved thickness and softness MCL31 IV 100 0117 EN 15 Mechanism of action The wall of the vagina is composed of the following layers: . Epithelium: internal lining of epithelial tissue made up of squamous epithelial cells . Lamina propria: connective tissue that supports the mucosa and connects it with the muscularis . Muscularis: muscle tissue . Adventitia: connective tissue interlaced with elastic fibers, attaches the vagina to surrounding organs Objective of the laser treatment is to reach the Lamina propria, elastic and rich in collagen that can be stimulated. MCL31 IV 100 0117 EN 16 Mechanism of action . This action continues its beneficial effect even after the treatment is finished: for this reason, many women report further improvements during the first months post-treatment Phase I Phase II Phase III 48 – 72 h 1 Month After 1 month . Early thermal effect . Proliferation . Remodeling . Edema, collagen and elastin . Formation of new collagen . New vascularization, shrinking fibers Improved lubrication MCL31 IV 100 0117 EN 17 Mechanism of action . There are indications in the scientific literature that vaginal laser therapy can lead to an improvement in symptoms of atrophy. Histological studies by Prof. R. Milani of Monza, Italy have already shown how the vaginal epithelium regenerates following laser therapy and further clinical observations
Load more

Recommended publications
  • Screening for Urinary Incontinence
    SCREENING FOR URINARY INCONTINENCE RECOMMENDATION TO THE HEALTH RESOURCES AND SERVICES ADMINISTRATION DECEMBER 2017 © 2017 ACOG Foundation. All rights reserved. This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UHOMC29940, Bright Futures for Women’s Health: Standard Practice Guidelines for Well Women Care. This information or content and conclusions are those of the author and should not be construed as the official position nor policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government. Screening for Urinary Incontinence: Recommendation to Health Resources and Services Administration was developed by the Multidisciplinary Steering Committee of the Women’s Preventive Services Initiative. These recommendations should not be viewed as a rigid body of rules. The recommendations are general and intended to be adapted to many different situations, taking into account the needs and resources particular to the locality, the institution, or the type of practice. Variations and innovations that improve the quality of patient care are encouraged rather than restricted. The purpose of these guidelines will be well served if they provide a firm basis on which local norms may be built. Evidence Summaries and systematic reviews are used with permission from Oregon Health & Science University. Copyright 2017 by the ACOG Foundation, 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
    [Show full text]
  • Guidelines on Urinary Incontinence M.G
    Guidelines on Urinary Incontinence M.G. Lucas (Chair), D. Bedretdinova (Guidelines Associate), L.C. Berghmans, J.L.H.R. Bosch, F.C. Burkhard, F. Cruz, A.K. Nambiar, C.G. Nilsson, A. Tubaro, R.S. Pickard © European Association of Urology 2015 TABLE OF CONTENTS PAGE 1. INTRODUCTION 6 1.1 Aim 6 1.1.1 Use in different healthcare settings and by healthcare professionals 6 1.2 Publication history 6 1.3 Panel composition 7 2. METHODS 7 2.1 PICO questions 7 2.2 Search strategies 7 2.3 Terminology 8 3. DIAGNOSTIC EVALUATION 9 3.1 History and physical examination 9 3.2 Patient questionnaires 9 3.2.1 Questions 9 3.2.2 Evidence 9 3.3 Voiding diaries 12 3.3.1 Questions 12 3.3.2 Evidence 12 3.4 Urinalysis and urinary tract infection 12 3.4.1 Questions 12 3.4.2 Evidence 13 3.5 Post-voiding residual volume 13 3.5.1 Question 13 3.5.2 Evidence 13 3.6 Urodynamics 13 3.6.1 Question 14 3.6.2 Evidence 14 3.6.2.1 Variability 14 3.6.2.2 Diagnostic accuracy 14 3.6.2.3 Does urodynamics influence the outcome of conservative therapy 14 3.6.2.4. Does urodynamics influence the outcome of surgery for stress urinary incontinence? 14 3.6.2.5 Does urodynamics help to predict complications of surgery? 14 3.6.2.6 Does urodynamics influence the outcome of surgery for detrusor- overactivity? 15 3.6.2.7 Does urodynamics influence the outcome of treatment for post- prostatectomy urinary incontinence in men? 15 3.7 Pad testing 15 3.7.1 Question 16 3.7.2 Evidence 16 3.8 Imaging 16 3.8.1 Questions 16 3.8.2 Evidence 16 4.
    [Show full text]
  • Female Voiding Dysfunction and Urinary Incontinence
    Female Voiding Dysfunction and Urinary Incontinence Amanda Vo, MD, Stephanie J. Kielb, MD* KEYWORDS Overactive bladder (OAB) Urge urinary incontinence (UUI) Stress urinary incontinence (SUI) Vesicovaginal fistula (VVF) Ureterovaginal fistula (UVF) KEY POINTS Urinary continence relies on coordination of the autonomic and somatic nervous systems, in addition to normal lower urinary tract support and sphincter function. Overactive bladder may be treated in a stepwise fashion with behavioral therapies, phar- macologic management, and procedural options. Stress urinary incontinence is most effectively treated with minimally invasive surgical techniques that reinforce urethral support. Urogenital fistulas, although more common in developing countries than in the United States, are extremely distressful to patients and repair often requires larger reconstructive surgery. NORMAL URINARY CONTINENCE AND VOIDING The lower urinary tract (LUT) has 2 main functions, low-pressure storage of urine, then consciously controlled, coordinated emptying. This involves coordination of the auto- nomic and somatic nervous systems. Coordination occurs at the pontine micturition center and the cerebral cortex provides inhibition. Disease states affecting the cortex such as stroke or Parkinson’s disease can, therefore, cause of loss of inhibition, with urinary urgency, frequency, and at times urge incontinence. Neurologic disease below the pontine micturition center can cause a variety of LUT complications, including co- ordination issues which may put upper tract (renal) function at risk; the details of such conditions are complex and are not discussed further in this review. Disclosures: The authors have no disclosures to report. Department of Urology, Northwestern University Feinberg School of Medicine, 303 East Chi- cago Avenue, Tarry 16-703, Chicago, IL 60611, USA * Corresponding author.
    [Show full text]
  • Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 Published: November 27, 2017
    Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0 Published: November 27, 2017 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Common Terminology Criteria for Adverse Events (CTCAE) v5.0 Publish Date: November 27, 2017 Introduction Grades Grade 5 The NCI Common Terminology Criteria for Grade refers to the severity of the AE. The CTCAE Grade 5 (Death) is not appropriate for some AEs Adverse Events is a descriptive terminology which displays Grades 1 through 5 with unique clinical and therefore is not an option. can be utilized for Adverse Event (AE) reporting. A descriptions of severity for each AE based on this grading (severity) scale is provided for each AE general guideline: Definitions term. A brief Definition is provided to clarify the Grade 1 Mild; asymptomatic or mild meaning of each AE term. A single dash (-) symptoms; clinical or diagnostic indicates a Definition is not available. SOC observations only; intervention System Organ Class (SOC), the highest level of the not indicated. 1 MedDRA hierarchy, is identified by anatomical or Grade 2 Moderate; minimal, local or Navigational Notes physiological system, etiology, or purpose (e.g., noninvasive intervention A Navigational Note is used to assist the reporter SOC Investigations for laboratory test results). indicated; limiting age- in choosing a correct AE. It may list other AEs that CTCAE terms are grouped by MedDRA Primary appropriate instrumental ADL*. should be considered in addition to or in place of SOCs. Within each SOC, AEs are listed and Grade 3 Severe or medically significant but not the AE in question. A single dash (-) indicates a accompanied by descriptions of severity (Grade).
    [Show full text]
  • The Effectiveness of Pelvic Floor Muscle
    UNIVERSITAT DE LLEIDA “The effectiveness of Pelvic Floor Muscle Training through Immersive Virtual Reality for the treatment of Stress Urinary Incontinence based on the impact on the quality of life in adult women elite athletes” - A randomized controlled trial - Done by: Clàudia Arumí Trujillo FACULTAT D’INFERMERIA I FISIOTERÀPIA Grau en Fisioteràpia Tutor: Francesc Valenzuela Pascual Final degree assignment 2017/18 25th May 2018 INDEX TABLE INDEX ....................................................................................................................... 4 FIGURE INDEX ..................................................................................................................... 5 ACRONYM INDEX ................................................................................................................ 6 RESUMEN ............................................................................................................................ 7 ABSTRACT ........................................................................................................................... 8 INTRODUCTION ................................................................................................................... 9 1 THEORICAL FRAMEWORK .........................................................................................10 1.1 ANATOMY AND PHISIOLOGY ..............................................................................10 1.1.1 URINARY WOMEN SYSTEM .........................................................................10
    [Show full text]
  • National Model EMS Clinical Guidelines (NASEMSO)
    National Model EMS Clinical Guidelines January 2019 VERSION 2.2 These guidelines will be maintained by NASEMSO to facilitate the creation of state and local EMS system clinical guidelines, protocols or operating procedures. System medical directors and other leaders are invited to harvest content as will be useful. These guidelines are either evidence-based or consensus- based and have been formatted for use by field EMS professionals. NASEMSO Medical Directors Council www.nasemso.org Contents INTRODUCTION .................................................................................................................................... 5 PURPOSE AND NOTES .......................................................................................................................... 6 TARGET AUDIENCE ....................................................................................................................................... 7 NEW IN THE 2017 EDITION ........................................................................................................................... 7 ACKNOWLEDGEMENTS .................................................................................................................................. 7 UNIVERSAL CARE ................................................................................................................................. 8 UNIVERSAL CARE GUIDELINE .......................................................................................................................... 8 FUNCTIONAL NEEDS ..................................................................................................................................
    [Show full text]
  • 100 Case Studies in Pathophysiology
    Bruyere_FM_i-xiv.qxd 5/6/08 12:44 PM Page iv This page intentionally left blank. Bruyere_FM_i-xiv.qxd 5/6/08 12:44 PM Page i 100 CASE STUDIES IN PATHOPHYSIOLOGY Harold J. Bruyere, Jr., Ph.D. PROFESSOR EMERITUS UNIVERSITY OF WYOMING LARAMIE, WYOMING Bruyere_FM_i-xiv.qxd 5/6/08 12:44 PM Page ii Acquisitions Editor: David Troy Managing Editor: Meredith L. Brittain Marketing Manager: Allison M. Noplock Associate Production Manager: Kevin P. Johnson Designer: Teresa Mallon Compositor: International Typesetting and Composition Copyright © 2009 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street 530 Walnut Street Baltimore, MD 21201 Philadelphia, PA 19106 Printed in the United States of America All rights reserved. This book is protected by copyright. No part of this book may be reproduced or trans- mitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins at 530 Walnut Street, Philadelphia, PA 19106, via email at [email protected], or via website at lww.com (products and services). 9 8 7 6 5 4 3 2 1 Library of Congress Cataloging-in-Publication Data Bruyere, Harold Joseph, 1947- 100 case studies in pathophysiology / Harold J.
    [Show full text]
  • Urinary Incontinence in Elderly Women Objectives
    5/2/2016 Urinary Incontinence In Elderly Women Lubna Sorathia, M.D. Assistant professor Division of Geriatrics Medical College of Wisconsin Objectives Recognize the age related lower urinary tract changes Appreciate unique aspects of geriatric voiding problems Distinguish among various forms of incontinence and nocturia Steps in the evaluation and a variety of management strategies Criteria for referral Urinary Incontinence = involuntary leakage of urine 1 5/2/2016 The Burden of Urinary Incontinence ● Very common among the elderly !!. 44–57% of women 40-60 years old 75% for women > 75 years old ● UI presents physical, psychological, and social burdens that can range from mildly bothersome to debilitating 6% of nursing home admissions Urinary incontinence severity by decade of life. of women are directly attributable to UI management ● Expensive !! Annual costs in US averaged $19.5 billion in 2004 Abrams P, Anderson KE, Birder L, et al. Neurourol Urodyn 2012;29(1):213‐40. PMID: 20025020. Anger JT, Saigal CS, Madison R, et al. J Urol 2006 Jul;176(1):247‐51; discussion 51. PMID: 16753411. Boyington JE, Howard DL, Carter‐Edwards L, et al. Nurs Res. 2007 Mar‐Apr;56(2):97‐107. PMID 17356440. Process of Micturation Dual control of urination: 1. Autonomic nervous system control Nerve coming from the spinal cord and go directly to the bladder When bladder gets fuller, signals are sent to the brain 2. Central nervous system Voluntary control to choose when to void Both can be altered by aging or neurological disease 5 2 5/2/2016 Genitourinary
    [Show full text]
  • Evaluation of Hematuria in Children Kevin E.C
    Urol Clin N Am 31 (2004) 559–573 Evaluation of hematuria in children Kevin E.C. Meyers, MBBCh Division of Nephrology, Department of Pediatrics, Children’s Hospital of Philadelphia, University of Pennsylvania School of Medicine, 34th Street and Civic Center Boulevard, Main Building, 2nd Floor, Philadelphia, PA 19104-4399, USA The detection of even microscopic amounts of Nine milliliters is decanted and the sediment blood in a child’s urine alarms the patient, is resuspended and an aliquot examined. The urine parents, and physician, and often prompts the is examined by microscopy by high power field performance of many laboratory studies. Hema- (hpf) that is 400Â magnification. Macroscopic turia is one of the most important signs of renal or hematuria often does not require concentration. bladder disease, but proteinuria is a more impor- Bright-red urine, visible clots, or crystals with tant diagnostic and prognostic finding, except in normal-looking red blood cells (RBCs) suggests the case of calculi or malignancies. Hematuria is bleeding from the urinary tract. Cola-colored almost never a cause of anemia. The physician urine, RBC casts, and deformed (dysmorphic) should ensure that serious conditions are not RBCs suggest glomerular bleeding [4]. An absence overlooked, avoid unnecessary and often expen- of RBCs in the urine with a positive dipstick re- sive laboratory studies, reassure the family, and action suggests hemoglobinuria or myoglobinuria. provide guidelines for additional studies if there is The sensitivity and specificity of the dipstick a change in the child’s course [1]. This article method for detecting blood in the urine vary. provides an approach to the evaluation and When tested on urine samples in which a prede- management of hematuria in a child [2,3].
    [Show full text]
  • Classification of Lower Urinary Tract Symptoms (LUTS) and Urinary Incontinence (UI) David R
    cmE case prESENTaTION For more information see below. case 1: classification of Lower Urinary Tract Symptoms (LUTS) and Urinary Incontinence (UI) David R. Staskin, MD LEarNINg ObjEcTIves: Associate Professor of Urology 1. Discuss screening and identification of LUTS; Director, Female Urology and Male Voiding Dysfunction St. Elizabeth’s Medical Center 2. identify different causes of LUTS; Tufts University School of Medicine, Boston, MA 3. demonstrate an awareness of what can be Disclosure record for David R. Staskin, M.D. accomplished in the PCP office in regards Last reviewed/edited this information on January 10, 2011. to evaluation; Uroplasty: Consultant or Advisor; American Medical Systems: Consultant or Advisor; Astellas: Consultant or Advisor; Pfizer: 4. specify treatment options for OAB and BPH; and Consultant or Advisor; Glaxo: Consultant or Advisor; Allergan: Consultant or Advisor 5. examine when to refer for specialist evaluation case/patient #1a: case/patient #1b: case/patient #1c: case/patient #1D: A 62 y/o G4P4 obese A 42 y/o G2P2 female A 79 y/o community dwelling female A 67 y/o male female complains of “weekend athlete” in has recently been discharged from complains of nocturia urgency, frequency, and otherwise excellent health the hospital following THR secondary and recent onset of urgency incontinence. complains of urinary loss to a fall, during which time she had urgency incontinence. She voids 10 times/ with “effort”. She reports an indwelling foley catheter. She On further questioning day and 2 times/night, bothersome urinary leakage complained of minimal voiding he admits to an accompanied by urgency “drops to squirt” with symptoms prior to admission.
    [Show full text]
  • Male External Catheters in Adults Urinary Catheter Management
    Evidence-based Guidelines for Best Practice in Urological Health Care Male external catheters in adults Urinary catheter management Condom Catheter Urinary Sheath Penile Sheath 2016 © 2008, Golgeon Group, Inc. Group, Golgeon © 2008, European Association of Urology Nurses Evidence-based Guidelines for Best Practice in Urological Health Care Male external catheters in adults Urinary catheter management Condom Catheter Urinary Sheath Penile Sheath V. Geng H. Cobussen-Boekhorst H. Lurvink I. Pearce S. Vahr 2 Male external catheters in adults – March 2016 Preface The European Association of Urology Nurses (EAUN) was created in April 2000 to represent European urology nurses. The underlying goal of the EAUN is to foster the highest standards of urological nursing care throughout Europe. Improving current standards of urological nursing care is top of our agenda, with the aim of directly helping healthcare professionals in this field develop or update their expertise. To fulfil this essential goal, we have updated the EAUN guidelines published in 2008: The Male External Catheter. With administrative, financial and advisory support from the European Association of Urology (EAU), the EAUN also encourages research and aspires to develop European standards for education and accreditation of urology nurses. Local policies We believe that excellent healthcare goes beyond geographical boundaries. This document is intended to support good clinical practice and should only be used in conjunction with local policies and protocols, and with recognition of the individual situation of the patient. This text is made available to all individual EAUN members, both electronically and in print. The full text can be accessed and downloaded from the EAUN website (http://nurses.uroweb.
    [Show full text]
  • Urinary Incontinence in Older People, Part 3
    7 . Psychosocial impact of urinary continence It might seem self-evident that incontinence has a psychosocial impact on the individual. However, it is valuable to consider the reasons for this, because it may guide the type and quality of support which may be offered. Sociologists have suggested that modern social norms require us to achieve mastery and control over our bodies (Brittain & Shaw, 2007). Success in achieving valued social status and roles is partly dependent on one’s looks, apparent self-reliance and maturity, which helps to explain why people with disabilities find it difficult to establish themselves in valued social roles (Wolfensberger, 1998). A breakdown in the physical body is accompanied by a risk to an individual’s social roles. If a body’s boundaries are violated or broken, it can signal not only physical distress, but also a social and psychological loss. Incontinence violates the individual’s boundaries through leakage of both fluids and of odours which may not be easily concealed, and thus immediately exposes the person’s private life to the public. Extra vigilance on the part of the individual and the carer/s is required to ensure that dignity and autonomy is not compromised (Brittain & Shaw, 2007). Psychosocial impacts must be carefully assessed because urinary incontinence has a significant impact on an individual’s quality of life. Point of Interest Self-rated health is a significant and reliable measure of an individual’s actual health status . In a group of older community-dwelling people, the presence of urinary incontinence was linked with ‘poor’ self-rated health .
    [Show full text]