{"id":17687,"date":"2020-04-15T16:17:30","date_gmt":"2020-04-15T16:17:30","guid":{"rendered":"https:\/\/urosassociats.com\/tratamientos\/functional-urology-and-chronic-pelvic-pain\/"},"modified":"2026-04-10T06:40:08","modified_gmt":"2026-04-10T06:40:08","slug":"functional-urology-and-chronic-pelvic-pain","status":"publish","type":"project","link":"https:\/\/urosassociats.com\/en\/treatments\/functional-urology-and-chronic-pelvic-pain\/","title":{"rendered":"Functional Urology and Chronic Pelvic Pain"},"content":{"rendered":"<div id=\"cmsmasters_row_8ki7o68jh4\" class=\"cmsmasters_row cmsmasters_color_scheme_default cmsmasters_row_top_default cmsmasters_row_bot_default cmsmasters_row_boxed\">\n<div class=\"cmsmasters_row_outer_parent\">\n<div class=\"cmsmasters_row_outer\">\n<div class=\"cmsmasters_row_inner\">\n<div class=\"cmsmasters_row_margin\">\n<div id=\"cmsmasters_column_xlabzu7bx\" class=\"cmsmasters_column one_first\">\n<div class=\"cmsmasters_column_inner\"><div class=\"cmsmasters_tabs tabs_mode_tour tabs_pos_left\">\n<ul class=\"cmsmasters_tabs_list\">\n<li id=\"cmsmasters_tabs_list_item_2ovmejdv28\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-27\">\n<span>PATHOLOGY \/ SYMPTOMS:<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_bn6pu02lfl\" class=\"cmsmasters_tabs_list_item current_tab\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Chronic pelvic pain<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_bdxdq2d8wg\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Neurogenic bladder<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_ihw34x9ue\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Overactive bladder<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_eu2g39p4dm\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Urinary incontinence<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_ryhz607vbd\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-arrow-right\">\n<span>Pelvic organ prolapse<\/span>\n<\/a>\n<\/li><li id=\"cmsmasters_tabs_list_item_31x2xj5bp\" class=\"cmsmasters_tabs_list_item\">\n<a href=\"#\" class=\"cmsmasters-icon-custom-8\">\n<span>TREATMENTS:<\/span>\n<\/a>\n<\/li><\/ul>\n<div class=\"cmsmasters_tabs_wrap\">\n<div id=\"cmsmasters_tab_2ovmejdv28\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<ul style=\"user-select: auto;\">\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">CHRONIC PELVIC PAIN.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">NEUROGENIC BLADDER \/ HYPOCONTRACTILE DETRUSOR.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">OVERACTIVE BLADDER.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">URINARY INCONTINENCE.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">PELVIC ORGAN PROLAPSE.<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_bn6pu02lfl\" class=\"cmsmasters_tab active_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Chronic pelvic pain<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Chronic pelvic pain is pain that occurs in the area below the navel and between the hips and lasts six months or longer. It can have several causes, and be a symptom of another disease or be a condition in itself.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">If chronic pelvic pain seems to be caused by another medical problem, treating that problem may be enough to relieve the pain.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">However, many times it is not possible to identify a single cause of this pain. If this is the case, the goal of treatment is to reduce pain and other symptoms and improve quality of life.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptoms<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Chronic pelvic pain is usually described as follows:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Intense, constant pain<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Pain that comes and goes (intermittent)<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Stabbing pains or cramps<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Pressure or heaviness in a deep area of the pelvis<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Pain during sex<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Pain with bowel movement or urination<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Pain when sitting for prolonged periods of time<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The discomfort may intensify after standing for long periods and ease when you lie down. The pain can be mild and annoying or it can be so severe that you miss work, can&#8217;t sleep, or can&#8217;t exercise.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aetiology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Chronic pelvic pain is a complex condition that can have multiple causes, constituting a symptom of several medical conditions. For example, it is possible for a woman to have endometriosis and interstitial cystitis, both pathologies can cause chronic pelvic pain.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Some of the causes of chronic pelvic pain can be:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Endometriosis.<\/b><span style=\"font-weight: 400; user-select: auto;\"> This is a condition in which tissue from the lining of the uterus grows outside the uterus. These tissue deposits respond to the menstrual cycle, as does the uterine lining, i.e., thickening, rupturing, and bleeding, as hormone levels rise and fall. Because this takes place outside the uterus, blood and tissue cannot leave the body through the vagina. Instead, they remain in the abdomen, where they can lead to painful cysts and fibrous bands of scar tissue.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Musculoskeletal problems.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Disorders that affect bones, joints, and connective tissues (musculoskeletal system), such as fibromyalgia, pelvic floor muscle tension, inflammation of the pubic joint (pubic symphysis), or hernias, and can lead to recurrent pelvic pain.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Chronic pelvic inflammatory disease.<\/b><span style=\"font-weight: 400; user-select: auto;\"> This can happen if a long-term infection, usually sexually transmitted, causes scarring that affects the pelvic organs.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Ovarian remains.<\/b><span style=\"font-weight: 400; user-select: auto;\"> After surgical removal of the uterus, ovaries, and fallopian tubes, small vestiges of the ovary may accidentally remain, which could then lead to painful cysts.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Fibroids.<\/b><span style=\"font-weight: 400; user-select: auto;\"> These noncancerous uterine growths can cause pressure or a feeling of heaviness in the lower abdomen. In rare cases, they cause sharp pain.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Irritable bowel syndrome.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Symptoms associated with irritable bowel syndrome, such as inflammation, constipation, or diarrhea, may be the source of pelvic pain and pressure.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Painful bladder syndrome (interstitial cystitis).<\/b><span style=\"font-weight: 400; user-select: auto;\"> This condition is associated with recurrent bladder pain and a frequent need to urinate. You may experience pelvic pain as your bladder fills, which may temporarily give way when you urinate.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Some doctors believe that dilated varicose veins (varicose veins) around the uterus and ovaries can cause pelvic pain. However, other doctors doubt that pelvic congestion syndrome is the cause of pelvic pain because most women with dilated veins in the pelvis do not have associated pain.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Psychological factors.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Depression, chronic stress, or a history of sexual or physical abuse can increase the risk of chronic pelvic pain. Emotional distress makes pain worse, and living with chronic pain contributes to emotional suffering. These two factors often create a vicious circle.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Figuring out what&#8217;s causing chronic pelvic pain often involves a process of elimination because there are so many disorders that can cause pelvic pain.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">In addition to a detailed interview about your pain, your personal medical history and family history, your doctor may ask you to keep a diary of pain and other symptoms.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Tests or exams your doctor may order include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Pelvic exam.<\/b><span style=\"font-weight: 400; user-select: auto;\"> It may reveal signs of infection, abnormal growths, or tight pelvic floor muscles. The doctor checks for areas of tenderness. Let your doctor know if you feel any discomfort during this test, especially if the pain is similar to what you&#8217;ve been feeling.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Laboratory analysis.<\/b><span style=\"font-weight: 400; user-select: auto;\"> During the pelvic exam, your doctor may order lab tests to check for infections. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Echography.<\/b><span style=\"font-weight: 400; user-select: auto;\"> This procedure is especially useful for detecting masses or cysts in the ovaries, uterus, or fallopian tubes.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Other imaging tests.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Your doctor may recommend abdominal X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI) scans to help detect abnormal structures or growths.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Laparoscopy.<\/b><span style=\"font-weight: 400; user-select: auto;\"> During this surgical procedure, the doctor makes a small incision in your abdomen and inserts a thin tube connected to a small camera (laparoscope). The laparoscope allows the doctor to look at the pelvic organs and check for abnormal tissues or signs of infection. This procedure is especially useful for detecting endometriosis and chronic pelvic inflammatory disease.<\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Finding the underlying cause of chronic pelvic pain can be a lengthy process and, in some cases, a clear explanation may never be found.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">However, with patience and open communication, you and your doctor can develop a treatment plan that will help you live a full life with minimal discomfort.<\/span><\/h3>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The goal of treatment is to reduce symptoms and improve quality of life.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">If your doctor can determine a specific cause, treatment will focus on that cause. However, if it is not possible to identify a cause, treatment will focus on controlling pain and other symptoms. In many cases, the optimal approach involves a combination of treatments.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Drugs<\/b><\/span><\/h3>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Analgesics.<\/b><span style=\"font-weight: 400; user-select: auto;\"> It is a symptomatic treatment that helps improve the clinic although they do not treat the cause of chronic pain.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Hormonal treatments.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Some women find that days when they have pelvic pain may coincide with a particular phase of their menstrual cycle and the hormonal changes that control ovulation and menstruation. When this is the case, birth control pills or other hormonal medications can help relieve pelvic pain.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Antibiotics.<\/b><span style=\"font-weight: 400; user-select: auto;\"> If the source of the pain is an infection, your doctor may prescribe antibiotics.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Antidepressants.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Some types of antidepressants may be helpful in relieving chronic pain. Tricyclic antidepressants, such as amitriptyline and others, appear to have analgesic and antidepressant effects. They can help improve chronic pelvic pain even in patients who do not have depression.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Other therapies<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your doctor may recommend specific therapies or procedures as part of treatment for chronic pelvic pain. These may include the following:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Physiotherapy.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Stretching exercises, massage, and other relaxation techniques can improve chronic pelvic pain. A physical therapist can help you with these therapies and develop strategies for coping with pain. Sometimes specific pain points are treated with a medical instrument called transcutaneous electrical nerve stimulation. Transcutaneous electrical nerve stimulation sends electrical impulses to nearby nerve pathways. It may also be helpful to use a psychological technique called biofeedback, which helps you identify areas of tight muscles so you can learn to relax those areas.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Neurostimulation (stimulation of the spinal cord).<\/b><span style=\"font-weight: 400; user-select: auto;\"> This treatment involves implanting a device that blocks nerve pathways so that the pain signal cannot reach the brain. It may be helpful, depending on the cause of the pelvic pain.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Trigger point injections.<\/b><span style=\"font-weight: 400; user-select: auto;\"> If your doctor finds specific points where you feel pain, you may benefit from injections of numbing medication into those painful spots (trigger points). The medication, usually a long-acting local anesthetic, can block pain and relieve discomfort.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Psychotherapy.<\/b><span style=\"font-weight: 400; user-select: auto;\"> If pain may be intertwined with depression, or any type of psychological disorder, you may find it helpful to talk to a psychologist or psychiatrist. There are different types of psychotherapy, such as cognitive behavioral therapy and biofeedback. Regardless of the underlying cause of the pain, psychotherapy can help you develop strategies for dealing with pain.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Surgery<\/b><\/span><\/h3>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Laparoscopic surgery.<\/b><span style=\"font-weight: 400; user-select: auto;\"> If you have endometriosis, your doctor may remove adhesions or endometrial tissue through laparoscopic surgery. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Hysterectomy.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In rare and complicated cases, your doctor may recommend removing your uterus (hysterectomy), fallopian tubes (salpingectomy), or ovaries (oophorectomy). Undergoing this intervention has significant health consequences. Your doctor will discuss the risks and benefits in detail before recommending this option.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Transurethral bladder resection.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In some pathologies, such as interstitial cystitis, it is sometimes useful to resect endoscopically the lesions that are in the inner lining of the bladder and that are associated with chronic pain. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Intravesical injections.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In some cases, the injection of various substances into the mucosa and bladder muscles, such as Botox and some anti-inflammatories, is very decisive. This procedure is performed endoscopically, under anesthesia. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Anesthetic block of the nerves of the pelvis.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In cases where it is identified that the pain comes specifically from the trigger points where sensitive nerves of the pelvis pass, the doctor may indicate the anesthetic block of these points, which would reduce the painful sensations of that area. Sometimes it is necessary to carry out this procedure in the operating room.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Pain Rehabilitation Program<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">You may need to try a combination of treatment approaches before you find the best option for you. If applicable, you may need to consider entering a pain rehabilitation program. In Uros Associats we have the support of the Pelvic Floor Rehabilitation section of the Teknon Clinic. They are medical specialists and nurses highly trained in stretching, biofeedback and relaxation-stimulation therapies. <\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Lifestyle<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Chronic pain can significantly affect your daily life. When you feel pain, you have trouble sleeping, exercising, or performing physical tasks.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Chronic pain can also cause anxiety and stress, both of which in turn can make pain worse.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Relaxation techniques can help relieve tension, reduce pain, calm emotions, and induce sleep. You can learn many techniques on your own, such as meditation and deep breathing.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Multidisciplinary approach<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Depending on the suspected cause of pain, your doctor may refer you to a digestive system specialist (gastroenterologist), gynecology specialist, or musculoskeletal pain specialist (physiatrist or physical therapist).<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">How to prepare for your appointment<\/b><\/span><\/h3>\n<ul style=\"user-select: auto;\">\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Make a list of all the signs and symptoms you&#8217;re experiencing.<\/b><span style=\"font-weight: 400; user-select: auto;\"> He mentions those that seemed unrelated to the reason for the consultation.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Write down key medical information.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Include major stressors or recent changes in your life.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Make a list of all the medications you take and the dosages you take.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Indicate prescription and over-the-counter medications, vitamins or other supplements you&#8217;re taking.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">It&#8217;s a good idea to bring a family member or friend.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Sometimes it can be difficult to remember all the information provided during a visit. Someone who accompanies you may remember some fact that you forgot or did not notice.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; text-align: justify; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Prepare questions.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Preparing a list of questions can help you not forget any.<\/span><\/span><\/li>\n<\/ul>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_bdxdq2d8wg\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Neurogenic or underactive bladder<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Neurogenic <\/span><b style=\"user-select: auto;\">bladder<\/b><span style=\"font-weight: 400; user-select: auto;\"> Bladder control is a lack of bladder control due to a nervous system disturbance, such as a stroke, spinal cord injury, or tumor. Chronic diseases such as diabetes can also cause it. <\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Types of neurogenic bladder<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">There are some variants of the VN:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Flaccid:<\/b><span style=\"font-weight: 400; user-select: auto;\"> A flaccid bladder does not contract so it fills to overflowing. The urine is then released by overflow (continuous drip) through the urethra.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Spastic:<\/b><span style=\"font-weight: 400; user-select: auto;\"> The patient has involuntary bladder contractions and perceives the need to urinate, even when there is little or no urine in the bladder. Normally, contractions occur in an uncoordinated manner with the muscle that closes the opening of the bladder (urinary sphincter).<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Mixed:<\/b><span style=\"font-weight: 400; user-select: auto;\"> some patients have elements of both flaccid and spastic bladder.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptoms<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">The main symptom of NV is <\/span><b style=\"user-select: auto;\">urinary incontinence<\/b><span style=\"font-weight: 400; user-select: auto;\">. The patient continuously releases small amounts of urine. <\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Some patients with <\/span><b style=\"user-select: auto;\">spastic neurogenic bladder<\/b><span style=\"font-weight: 400; user-select: auto;\"> They also have to urinate frequently, often urgently, and need to get up during the night to urinate. In addition, the spastic variant may be caused by central nerve injury, and is associated with weakness, muscle spasms, and\/or loss of sensation in the legs.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Patients with OAB are at risk for <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/trastornos-renales-y-del-tracto-urinario\/infecciones-urinarias-iu\/introducci%C3%B3n-a-las-infecciones-urinarias-iu\"><br style=\"user-select: auto;\" \/><b style=\"user-select: auto;\">urinary tract infections<\/b><br style=\"user-select: auto;\" \/><\/a><span style=\"font-weight: 400; user-select: auto;\"> and <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/trastornos-renales-y-del-tracto-urinario\/c%C3%A1lculos-en-las-v%C3%ADas-urinarias\/c%C3%A1lculos-en-las-v%C3%ADas-urinarias\"><br style=\"user-select: auto;\" \/><b style=\"user-select: auto;\">stones<\/b><br style=\"user-select: auto;\" \/><br style=\"user-select: auto;\" \/><\/a><span style=\"font-weight: 400; user-select: auto;\">. They are also at risk of developing a <\/span><b style=\"user-select: auto;\">Hydronephrosis<\/b><span style=\"font-weight: 400; user-select: auto;\"> when urine retained in the bladder builds up to the kidneys.<\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aetiology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Any disorder that damages or interferes with the nerves that control the bladder or sphincter can lead to a neurogenic bladder. Common causes are <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/enfermedades-cerebrales,-medulares-y-nerviosas\/accidente-cerebrovascular-acv\/introducci%C3%B3n-a-los-accidentes-cerebrovasculares\"><span style=\"font-weight: 400; user-select: auto;\">stroke<\/span><\/a><span style=\"font-weight: 400; user-select: auto;\">, <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/traumatismos-y-envenenamientos\/lesiones-medulares\/lesiones-de-la-m%C3%A9dula-espinal-y-de-las-v%C3%A9rtebras\"><span style=\"font-weight: 400; user-select: auto;\">spinal cord injuries or trauma<\/span><\/a><span style=\"font-weight: 400; user-select: auto;\">, <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/enfermedades-cerebrales,-medulares-y-nerviosas\/trastornos-de-los-nervios-perif%C3%A9ricos\/esclerosis-lateral-amiotr%C3%B3fica-y-otras-enfermedades-de-las-neuronas-motoras\"><span style=\"font-weight: 400; user-select: auto;\">amyotrophic lateral sclerosis<\/span><\/a><span style=\"font-weight: 400; user-select: auto;\"> (ELA), <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/enfermedades-cerebrales,-medulares-y-nerviosas\/trastornos-del-movimiento\/enfermedad-de-parkinson\"><span style=\"font-weight: 400; user-select: auto;\">Parkinson&#8217;s disease<\/span><\/a><span style=\"font-weight: 400; user-select: auto;\">, <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/enfermedades-cerebrales,-medulares-y-nerviosas\/esclerosis-m%C3%BAltiple-y-trastornos-afines\/esclerosis-m%C3%BAltiple\"><span style=\"font-weight: 400; user-select: auto;\">multiple sclerosis<\/span><\/a><span style=\"font-weight: 400; user-select: auto;\">, <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/trastornos-hormonales-y-metab%C3%B3licos\/diabetes-mellitus-y-otros-trastornos-del-metabolismo-de-la-glucosa-sangu%C3%ADnea\/complicaciones-de-la-diabetes-mellitus#v25184863_es\"><span style=\"font-weight: 400; user-select: auto;\">diabetic neuropathy<\/span><\/a><span style=\"font-weight: 400; user-select: auto;\"> and nerve injury during pelvic surgery.<\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">To diagnose neurogenic bladder, we proceed:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Measure the amount of urine left in the bladder after urination.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Perform an ultrasound of the urinary tract.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Sometimes more detailed studies, such as cystography, cystoscopy, urodynamic study, tomography, magnetic resonance imaging of the spinal cord and electrophysiological studies.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your doctor may suspect neurogenic bladder in people with nerve injuries who have incontinence. It usually measures the amount of urine left in the bladder when the patient has just urinated (residual volume after urination) by inserting a probe into the bladder or performing an ultrasound. He also studies the rest of the urinary tract with ultrasound to detect other abnormalities. Kidney function is assessed by blood tests. <\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The specific treatment of neurogenic bladder will be determined by your doctor based on the following:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your age, general health, and medical history.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The severity of symptoms.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The cause of nerve damage.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The type of emptying dysfunction.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your tolerance to certain medications, procedures, or therapies.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your expectations for the trajectory of the disease.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your opinion or preference.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Early <\/span><b style=\"user-select: auto;\">treatment<\/b><span style=\"font-weight: 400; user-select: auto;\"> It can help prevent permanent dysfunction and kidney damage. Catheterization or certain techniques used to stimulate urination can help prevent urine from staying too long in the bladder. For example, some patients with spastic bladder may trigger urination by pressing on the lower abdomen or scratching their thighs. When urine stays in the bladder too long, the patient is at risk for developing <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/www.msdmanuals.com\/es-es\/hogar\/trastornos-renales-y-del-tracto-urinario\/infecciones-urinarias-iu\/introducci%C3%B3n-a-las-infecciones-urinarias-iu\"><span style=\"font-weight: 400; user-select: auto;\">urinary tract infections<\/span><\/a><span style=\"font-weight: 400; user-select: auto;\">. The insertion of a catheter into the bladder periodically (<\/span><b style=\"user-select: auto;\">Intermittent catheterization<\/b><span style=\"font-weight: 400; user-select: auto;\">) is generally safer than leaving a catheter continuously.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">The patient has <\/span><b style=\"user-select: auto;\">to drink enough fluids<\/b><span style=\"font-weight: 400; user-select: auto;\"> and <\/span><b style=\"user-select: auto;\">limit calcium in the diet<\/b><span style=\"font-weight: 400; user-select: auto;\"> to prevent stone formation. Your doctor also checks your kidney function regularly.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Antibiotics <\/span><b style=\"user-select: auto;\"><\/b><span style=\"font-weight: 400; user-select: auto;\"> They are sometimes used prophylactically to prevent recurrent infections. In addition, there are <\/span><b style=\"user-select: auto;\">Non-antibiotic medications<\/b> that can <span style=\"font-weight: 400; user-select: auto;\"> help reduce the frequency of infections, and that the patient can take uninterruptedly. <\/span> <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Sometimes, drugs used to treat urge incontinence can be helpful. Used <\/span><b style=\"user-select: auto;\">anticholinergics<\/b><span style=\"font-weight: 400; user-select: auto;\"> and <\/span><b style=\"user-select: auto;\">stimulants of certain nerve receptors in the bladder<\/b><span style=\"font-weight: 400; user-select: auto;\">, which relax it and therefore improve incontinence. On rare occasions <\/span><b style=\"user-select: auto;\">Surgery<\/b> to <span style=\"font-weight: 400; user-select: auto;\"> create another pathway for urine to leave the body.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">In Uros Associats we have all the diagnostic resources to address patients with neurogenic bladder. After a thorough evaluation, our urologists will propose the best possible therapeutic options, and will schedule a close follow-up to avoid complications in the short, medium and long term. Likewise, we help ourselves with a <\/span><b style=\"user-select: auto;\">Multidisciplinary team<\/b><span style=\"font-weight: 400; user-select: auto;\">, with neurologists, neurophysiologists and pelvic floor physiotherapists. Our action protocols are based on international guidelines, and guarantee optimal results.<\/span><\/span><\/p>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_ihw34x9ue\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Overactive bladder<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Overactive bladder causes an urgent and sudden need to urinate. That need can be difficult to control, and overactive bladder can lead to involuntary loss of urine (urge incontinence).<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Overactive bladder and urinary incontinence have a profound effect on the quality of life of affected individuals, with social, psychological, occupational, domestic, physical and sexual repercussions.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptoms<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">If you have overactive bladder, you may:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">You feel an urgent, sudden urge to urinate that is hard to control.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Have urge incontinence: The involuntary loss of urine immediately after the urgent need to urinate.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinate frequently, usually eight or more times in a 24-hour period.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Wake up two or more times during the night to urinate.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Although you may arrive at the bathroom on time when you feel the need to urinate, having to urinate unexpectedly frequently or at night can be life-altering.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aetiology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Overactive bladder occurs when the bladder muscles begin to contract involuntarily, even though the volume of urine stored in the bladder is low. This involuntary contraction generates the urgent need to urinate. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">There are a number of conditions that can contribute to the signs and symptoms of overactive bladder, including:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Neurological disorders<\/b>, <span style=\"font-weight: 400; user-select: auto;\">such as stroke, multiple sclerosis, spina bifida, Parkinson&#8217;s disease.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diabetes<\/b><span style=\"font-weight: 400; user-select: auto;\">.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Medicines<\/b><span style=\"font-weight: 400; user-select: auto;\"> that cause a rapid increase in urine output or that must be taken with plenty of fluids.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Acute urinary tract infections<\/b><span style=\"font-weight: 400; user-select: auto;\"> that can cause symptoms similar to those of overactive bladder.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Abnormalities in the bladder<\/b><span style=\"font-weight: 400; user-select: auto;\">, such as <\/span><b style=\"user-select: auto;\">tumors<\/b><span style=\"font-weight: 400; user-select: auto;\"> or <\/span><b style=\"user-select: auto;\">stones<\/b><span style=\"font-weight: 400; user-select: auto;\">.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Factors that obstruct bladder outflow: <\/span><b style=\"user-select: auto;\">enlarged prostate (benign prostatic hyperplasia),<\/b> <b style=\"user-select: auto;\">constipation<\/b>, <span style=\"font-weight: 400; user-select: auto;\">or <\/span><b style=\"user-select: auto;\">previous surgeries<\/b><span style=\"font-weight: 400; user-select: auto;\"> to treat other types of incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Excessive consumption of <\/span><b style=\"user-select: auto;\">caffeine<\/b><span style=\"font-weight: 400; user-select: auto;\"> or <\/span><b style=\"user-select: auto;\">alcohol<\/b><span style=\"font-weight: 400; user-select: auto;\">.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Impaired cognitive function due to aging<\/b><span style=\"font-weight: 400; user-select: auto;\">, which can prevent the bladder from correctly interpreting signals sent by the brain.<\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The specific cause of overactive bladder may be unknown.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Risk factors<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Risk factors for overactive bladder include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aging.<\/b><span style=\"font-weight: 400; user-select: auto;\"> With aging, the risk of certain diseases, such as an enlarged prostate and diabetes, which can contribute to other problems related to bladder function, increases.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Cognitive impairment.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Alzheimer&#8217;s disease and neurological deterioration that occurs after some strokes can lead to overactive bladder. Incontinence that occurs from these types of situations can be controlled with fluid drinking schedules, urination schedules and reminders, absorbent clothing, and bowel movement programs.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Smoking, alcoholism and some illicit drugs<\/b><span style=\"font-weight: 400; user-select: auto;\">. All of these substances are considered bladder irritants, and they cause the nerves in the bladder to work abnormally.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Consumption of coffee, tea, very sugary and carbonated drinks<\/b><span style=\"font-weight: 400; user-select: auto;\">. They are also bladder irritants and diuretics.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Complications<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Overactive bladder can significantly affect daily activities, such as work and social relationships. This disease can cause:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">emotional distress or depression<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">anxiety<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">sleep disturbances<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">sexuality problems<\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The first step is an adequate diagnostic evaluation through interrogation, specific questionnaires, physical examination, voiding diary and, if necessary, complementary studies. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">The <\/span><b style=\"user-select: auto;\">urodynamic study<\/b><span style=\"font-weight: 400; user-select: auto;\"> It is the complementary test par excellence to diagnose overactive bladder. It is a minimally invasive study that requires prior preparation. It is usually indicated in cases of difficult control with medications or with mixed symptoms.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Before starting a specific treatment, any cause that could cause the symptoms should be ruled out, such as urinary infections, lithiasis, among others.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Treatment of overactive bladder is multiple. Patients are asked to <\/span><b style=\"user-select: auto;\">Modify their fluid intake schedules<\/b>, <span style=\"font-weight: 400; user-select: auto;\">make <\/span><b style=\"user-select: auto;\">adjustments to their diet<\/b>, <span style=\"font-weight: 400; user-select: auto;\">and <\/span><b style=\"user-select: auto;\">abandon certain habits that contribute to the severity of the pathology<\/b><span style=\"font-weight: 400; user-select: auto;\"> (smoking, drinking alcohol, illicit drugs). <\/span> <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">If modifying these habits is not enough, oral or topical medications (in the form of patches) are used. These drugs act on receptors in the bladder. They are not without side effects, most often mild and well tolerated. Despite this, many patients stop the drug treatment after a few months.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Some <\/span><b style=\"user-select: auto;\">antidepressants<\/b>, <span style=\"font-weight: 400; user-select: auto;\">such as imipramine, are also helpful in managing symptoms. <\/span> <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">When drug therapy is not effective due to the severity of symptoms or is not tolerated by the patient, <\/span><b style=\"user-select: auto;\">intravesical botulinum toxin injection<\/b> is indicated.<span style=\"font-weight: 400; user-select: auto;\">. This procedure is performed in the operating room, under regional anesthesia, and produces relief of symptoms for a long time (sometimes up to 1 year). It is a very used treatment with good results.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">In other cases, the use of <\/span><b style=\"user-select: auto;\">neuromodulation is proposed<\/b>.<span style=\"font-weight: 400; user-select: auto;\">. Several sessions of electrostimulation of nerve roots that have connection with the bladder are performed, to readapt its contractile function to low bladder volumes. This procedure is performed in the consultation of our Pelvic Floor Unit, and manages to control the symptoms very resistant to other therapies in a good percentage of cases. Neuromodulation can also be carried out by implanting a small device that is placed under the skin of the patient&#8217;s back or buttock, with anesthesia and sedation. This device avoids the need for repetitive electrostimulation sessions in consultation, and has a low complication rate.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">In Uros Associats we have specialists in Pelvic Floor and bladder emptying and filling disorders. Our diagnostic-therapeutic approach ensures that the patient controls their symptoms and that their quality of life increases significantly. <\/span><\/p>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_eu2g39p4dm\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urinary incontinence<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary incontinence \u2014 loss of bladder control \u2014 is a common problem. The intensity ranges from occasionally leaking urine when you cough or sneeze to having a need to urinate so sudden and loud that you don&#8217;t get to the bathroom in time.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">While it occurs more frequently as people age, urinary incontinence is not an inevitable consequence of aging. In most people, simple lifestyle changes or medical treatment can relieve discomfort or stop urinary incontinence.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Types of urinary incontinence<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Types of urinary incontinence include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Stress incontinence.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Urine leaks out when you put pressure on your bladder by coughing, sneezing, laughing, exercising, or lifting something heavy.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urge incontinence.<\/b><span style=\"font-weight: 400; user-select: auto;\"> You have a sudden, intense urge to urinate, followed by an involuntary loss of urine. You may need to urinate frequently, even throughout the night. Urge incontinence may be due to a minor condition, such as an infection, or a more serious illness, such as a neurological disorder or diabetes.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Overflow incontinence.<\/b><span style=\"font-weight: 400; user-select: auto;\"> You have frequent or constant dribbling of urine because your bladder doesn&#8217;t empty completely.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Functional incontinence.<\/b><span style=\"font-weight: 400; user-select: auto;\"> A physical or mental deterioration prevents you from getting to the bathroom in time. For example, if you have severe arthritis, you may not be able to unbutton your pants fast enough.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Mixed incontinence.<\/b><span style=\"font-weight: 400; user-select: auto;\"> You have more than one type of urinary incontinence.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptoms<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary incontinence is not a disease, but a symptom. It can be caused by certain daily habits, underlying illnesses or physical problems. A thorough evaluation by your doctor can help determine what causes incontinence.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Transient urinary incontinence<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Certain foods, drinks, and medications can act as diuretics (stimulate the bladder and increase the volume of urine). Some of them are:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Alcohol<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Caffeine<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Soft drinks and sparkling mineral water<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Artificial sweeteners<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Chocolate<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Chewing gum<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Foods high in spices, sugar, or acid, especially citrus fruits<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Blood pressure and heart medications, sedatives, and muscle relaxants<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Large doses of vitamin C<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary incontinence can also be caused by an easily treatable disease, for example:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urinary tract infection.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Infections can irritate the bladder, cause a strong urge to urinate, and sometimes incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Constipation.<\/b><span style=\"font-weight: 400; user-select: auto;\"> The rectum is located near the bladder and shares many nerves. Hard, tight stools in the rectum cause these nerves to stay overactive and increase urinary frequency.<\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Persistent urinary incontinence<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary incontinence can also be a persistent disorder caused by underlying physical problems or disorders, including:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Pregnancy.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Hormonal changes and fetal weight gain can lead to stress incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Parturition.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Vaginal delivery can weaken the muscles needed to control the bladder and also damage your nerves and bra tissue, leading to the pelvic floor descending (prolapsed). Prolapse can push down the bladder, uterus, rectum, or small intestine from their usual position, causing them to appear in the vagina. These bumps can be associated with incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Age-related changes.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Aging bladder muscle can decrease the ability to store urine. In addition, involuntary bladder contractions become more frequent over the years.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Menopause.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In menopause, women produce less estrogen, a hormone that helps keep the membrane lining the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Hysterectomy.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In women, the bladder and uterus are supported by many muscles and ligaments they share. Any surgery involving a woman&#8217;s reproductive system, such as removal of the uterus, can damage the pelvic floor support muscles and lead to incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Enlarged prostate.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Especially in older men, incontinence often comes from enlargement of the prostate gland, a condition known as benign prostatic hyperplasia.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Prostate cancer.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In men, stress incontinence or urge incontinence may be associated with untreated prostate cancer. But more often, incontinence is a side effect of prostate cancer treatments, such as surgery and radiation therapy.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Obstruction.<\/b><span style=\"font-weight: 400; user-select: auto;\"> A tumor anywhere in the urinary tract can block the normal flow of urine and cause overflow incontinence. Urinary stones can sometimes cause urine leakage.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Neurological disorders.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Multiple sclerosis, Parkinson&#8217;s disease, stroke, brain tumor, or spinal cord injury can interfere with nerve signals involved in bladder control and cause urinary incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Surgical or non-surgical treatments of pelvic diseases.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Prostate surgery, for both benign and malignant diseases, can be complicated by incontinence. Radiotherapy in men and women for the treatment of pelvic cancer (prostate, cervix, uterus) is also associated. <\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Risk factors<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Factors that increase the risk of urinary incontinence include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Sex.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Women are more likely to suffer from stress incontinence. Pregnancy, childbirth, menopause and normal female anatomy account for this difference. However, men with prostate problems are at high risk for urge and overflow incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Age.<\/b><span style=\"font-weight: 400; user-select: auto;\"> As we age, the muscles of the bladder and urethra lose strength. The changes that occur with age reduce the amount the bladder can hold and increase the chance of releasing urine involuntarily.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Being overweight.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Excess weight increases pressure on your bladder and surrounding muscles, weakening them and allowing you to lose urine when you cough or sneeze.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Smoke.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Tobacco use can increase the risk of urinary incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Family history.<\/b><span style=\"font-weight: 400; user-select: auto;\"> If a close family member has urinary incontinence, especially urge incontinence, you&#8217;re at increased risk for the condition.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Other diseases.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Neurological diseases or diabetes can increase the risk of incontinence.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Complications<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Complications of chronic urinary incontinence include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Skin disorders.<\/b><span style=\"font-weight: 400; user-select: auto;\"> When the skin remains constantly moist it can promote the appearance of rashes, skin infections and sores.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urinary tract infections.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Incontinence increases the risk of recurrent UTIs.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Impact on private life.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Incontinence can affect social, work, and personal relationships.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Prevention<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary incontinence cannot always be prevented. However, to reduce the risk, it may be helpful to:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Maintaining a healthy weight<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Practice pelvic floor exercises<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Avoiding foods that irritate the bladder, such as caffeine, alcohol, and acidic foods<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Eating more fiber, which can prevent constipation, a cause of urinary incontinence<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Not smoking or seeking help to quit smoking<\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">For the diagnosis of incontinence we use simple, but very practical resources. The <\/span><b style=\"user-select: auto;\">Medical history<\/b><span style=\"font-weight: 400; user-select: auto;\"> and <\/span><b style=\"user-select: auto;\">physical examination<\/b><span style=\"font-weight: 400; user-select: auto;\"> are essential. <\/span> <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">We usually request:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urine test and culture.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Analysis of a urine sample is used to look for signs of infection, traces of blood, or other abnormalities.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Journal of bladder function.<\/b><span style=\"font-weight: 400; user-select: auto;\"> For several days, write down how much you drink, when you urinate, how much urine you produce, whether you experienced a urge to urinate, and how many episodes of incontinence you had.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Post-urination measurement.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Your doctor asks you to urinate into a container that measures urine output. He or she then monitors the amount of residual urine in your bladder using a catheter or ultrasound. A large amount of residual urine may mean you have a blockage in your urinary tract or a problem with your bladder nerves or muscles.<\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">In addition, to evaluate the anatomical state of the urinary system, it may be indicated:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Echography<\/b><\/span><\/li>\n<li style=\"user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Pelvic floor MRI<\/b><\/span><\/li>\n<li style=\"user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urodynamic study<\/b><\/span><\/li>\n<li style=\"user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Cystoscopy<\/b><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Treatment of urinary incontinence depends on the type of incontinence, severity, and underlying cause. <\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your doctor is likely to suggest less invasive treatments at first and continue other options only if these techniques fail.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Behavioral techniques<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your doctor may recommend:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Bladder training,<\/b><span style=\"font-weight: 400; user-select: auto;\"> to delay urination after you feel the need to urinate. You can start by trying to contain it for 10 minutes whenever you feel the urge to urinate. The goal is to extend the time between trips to the bathroom until you urinate only every 2.5 to 3.5 hours.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Urinating twice,<\/b><span style=\"font-weight: 400; user-select: auto;\"> to help you learn how to empty your bladder as much as possible to avoid overflow incontinence. In this case, &#8220;urinating twice&#8221; means urinating, and then waiting a few minutes and trying again.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Scheduled times<\/b> to go to the bathroom, to <span style=\"font-weight: 400; user-select: auto;\"> urinate every two to four hours instead of waiting until you have the need to go.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Fluid and diet control,<\/b><span style=\"font-weight: 400; user-select: auto;\"> to regain bladder control. You may need to limit or avoid alcohol, caffeine and acidic foods. Reducing fluid intake, losing weight, or increasing physical activity can also alleviate the problem.<\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Pelvic floor exercises<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Your doctor may recommend that you do these exercises frequently to strengthen the muscles that help control urination. These exercises, also known as &#8220;<\/span><b style=\"user-select: auto;\">Kegel exercises<\/b><span style=\"font-weight: 400; user-select: auto;\">&#8221; are especially effective in treating stress incontinence, but can also be helpful in treating urge (urgent) incontinence.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">When performing the exercises to strengthen the pelvic floor, imagine that you are trying to stop the flow of urine. After:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Tighten (contract) the muscles you would use to stop urination and hold contraction for five seconds; Then, relax them for five seconds. (If you find it too difficult, start by holding the contraction for two seconds and relax them for three seconds.)<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Continue the exercise until you hold contractions for 10 seconds at a time.<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Aim for at least three sets of 10 reps per day.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">To help you identify and contract the right muscles, your doctor might suggest that you work with a physical therapist or try biofeedback techniques.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Neurostimulation<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Electrodes are temporarily inserted <\/span><b style=\"user-select: auto;\"><\/b><span style=\"font-weight: 400; user-select: auto;\"> in the rectum or vagina to stimulate and strengthen the pelvic floor muscles. The <\/span>Mild <b style=\"user-select: auto;\">electrical stimulation<\/b><span style=\"font-weight: 400; user-select: auto;\"> can be effective for stress incontinence and urge incontinence, but you may need multiple treatments over several months.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Drugs<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Medicines commonly used to treat incontinence include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Anticholinergics.<\/b> <\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Mirabegron.<\/b><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Alpha-blockers.<\/b> <\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Topical estrogen.<\/b> <\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Devices<\/i><\/b><\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">The urethral occluder. <\/b><span style=\"font-weight: 400; user-select: auto;\">A small, disposable tampon-like device that is inserted into the urethra before a specific activity that can trigger incontinence; for example, playing tennis. The occluder acts as a plug to prevent leakage and is removed before urinating.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Anti-incontinence tweezers. <\/b><span style=\"font-weight: 400; user-select: auto;\">They are placed in the balanopreputial groove of the penis. They occlude the urethra to prevent the exit of urine, like a sphincter. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">The pessary.<\/b><span style=\"font-weight: 400; user-select: auto;\"> A rigid ring that is inserted into the vagina and worn throughout the day. The device is often used in women who have a prolapse that causes incontinence. The pessary helps hold the bladder, which is located near the vagina, to prevent urine leakage.<\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Interventions<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Minimally invasive interventions may be indicated in certain cases:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Injections of filler material.<\/b><span style=\"font-weight: 400; user-select: auto;\"> A synthetic material is injected into the tissue surrounding the urethra. The filling material keeps the urethra closed and reduces urine leakage. This procedure is usually much less effective than more invasive treatments, such as surgery for stress incontinence, and often has to be repeated periodically.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Botulinum toxin type A (botox).<\/b><span style=\"font-weight: 400; user-select: auto;\"> Botox injections into the bladder muscle may be beneficial for people who have overactive bladder. Botox is usually prescribed only if other first-line medications have not worked.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Nerve stimulators.<\/b><span style=\"font-weight: 400; user-select: auto;\"> A pacemaker-like device is implanted under the skin that delivers painless electrical impulses to nerves involved in bladder control (sacral nerves). Stimulation of the sacral nerves may control urge incontinence if other therapies have not worked. The device can be implanted under the skin on the buttocks and connected to wires in the lower back, above the pubic area or, with the use of a special device, it can be inserted into the vagina.<\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Surgery<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">If other treatments don&#8217;t work, several surgical procedures can treat the problems that cause urinary incontinence:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Procedures with sling.<\/b><span style=\"font-weight: 400; user-select: auto;\"> To create a pelvic sling around the urethra or bladder neck, small bands of synthetic material or mesh are currently used. The sling helps keep the urethra fixed by preventing incontinence, especially when performing Valsalva (such as when you cough or sneeze). This procedure is used to treat stress incontinence.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Suspension of the bladder neck.<\/b><span style=\"font-weight: 400; user-select: auto;\"> This procedure is intended to support the urethra and bladder neck. This involves an abdominal incision; therefore, it is carried out under general or intradural anesthesia.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Prolapse surgery.<\/b><span style=\"font-weight: 400; user-select: auto;\"> In women with mixed incontinence and pelvic organ prolapse, surgery may include a combination of the sling procedure and prolapse surgery.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Artificial urinary sphincter.<\/b><span style=\"font-weight: 400; user-select: auto;\"> A small mechanism is implanted around the urethra to prevent incontinence. This mechanism is activated and deactivated at will to be able to perform urination voluntarily. <\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\"><i style=\"user-select: auto;\">Absorbent compresses and catheters<\/i><\/b><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">If medical treatments can&#8217;t completely eliminate incontinence, you can try products that help relieve the discomfort and discomfort of urine leakage:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Compresses and protective clothing.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Most products are no bulkier than regular underwear and can be worn comfortably under everyday clothing. Men with urine drip problems may use a droplet collector (a small pocket of absorbent compress that is placed over the penis and held in place in tight underwear).<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Catheter.<\/b><span style=\"font-weight: 400; user-select: auto;\"> If you have incontinence because your bladder doesn&#8217;t empty properly, your doctor might recommend that you learn how to insert a catheter into your urethra several times a day to drain your bladder. <\/span><\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">At Uros Associats we have specialists in the Pelvic Floor and in the treatment of incontinence. The approach is carried out in steps, from less invasive therapies to surgical ones, always indicating the most beneficial procedure for the patient. <\/span><\/p>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_ryhz607vbd\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<h2 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Pelvic organ prolapse<\/b><\/span><\/h2>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Uterine prolapse occurs when the muscles and ligaments of the pelvic floor stretch and weaken, so they stop providing adequate support for the uterus. Consequently, the uterus slips into or protrudes from the vagina. Uterine prolapse can affect women of any age. However, it usually affects postmenopausal women who had one or more vaginal births.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Pelvic organ prolapse is less common than urinary or faecal incontinence, but affects about 3% of women in Europe, and 1 in 11 women will need intervention to treat prolapse in their lifetime.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Mild uterine prolapse usually does not require treatment. However, when symptoms occur, such as discomfort, pelvic weight sensation, obstruction of urine leakage or incontinence, trouble having sex, repeated UTIs, etc., treatment may help.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Symptomatology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">In general, mild uterine prolapse causes no signs or symptoms. Signs and symptoms of moderate to severe uterine prolapse include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Feeling of heaviness or a pull in the pelvis<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Tissue protruding from the vagina<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Urinary problems, such as leakage (incontinence) or retention of urine<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Problems having a bowel movement<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Feeling of sitting on a small ball or as if something is falling out of your vagina<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Sexual concerns, such as a feeling of loosening the tone of vaginal tissue<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Symptoms are often less bothersome in the morning and worsen throughout the day.<\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Aetiology<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Uterine prolapse occurs as a result of weakening of the pelvic muscles and bra tissues. Causes of weakening of pelvic muscles and tissues include:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Pregnancy<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Difficult labor and delivery or trauma during childbirth<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Delivering a large baby<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Overweight or obesity<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">A lower estrogen level after menopause<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Chronic constipation or pressure when bowel movements<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Bronchitis or chronic cough<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Lifting heavy objects repeatedly<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Some types of pelvic surgery (external or internal genitalia)<\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Ageing<\/span><\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Patients with a family history <\/span> of <b style=\"user-select: auto;\">connective tissue weakness<\/b><span style=\"font-weight: 400; user-select: auto;\"> and those who come from <\/span><b style=\"user-select: auto;\">Hispanic or Caucasian ethnicity<\/b> <span style=\"font-weight: 400; user-select: auto;\">are at increased risk of developing prolapse.<\/span><\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Complications<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">In general, uterine prolapse is associated with prolapse of other pelvic organs. You might have:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Anterior prolapse (cystocele).<\/b><span style=\"font-weight: 400; user-select: auto;\"> Weakness of the connective tissue separating the bladder and vagina can cause the bladder to protrude into the vagina. Anterior prolapse is also called a prolapsed bladder.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Posterior vaginal prolapse (rectocele).<\/b><span style=\"font-weight: 400; user-select: auto;\"> Weakness of the connective tissue separating the rectum and vagina can cause the rectum to protrude into the vagina. You may have difficulty having a bowel movement.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Uterine prolapse<\/b><span style=\"font-weight: 400; user-select: auto;\">. It occurs when the uterus protrudes from the vagina. <\/span><span style=\"font-weight: 400; user-select: auto;\">Severe uterine prolapse can displace part of the vaginal lining, causing it to protrude out of the body. Vaginal tissue that rubs against clothing can cause sores in the vagina (ulcers). Rarely, sores can become infected.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Prevention<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">To reduce the risk of uterine prolapse:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Perform Kegel exercises regularly.<\/b><span style=\"font-weight: 400; user-select: auto;\"> These exercises can strengthen your pelvic floor muscles, which is especially important after having a baby.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Treats and prevents constipation.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Drink plenty of fluids and eat fiber-rich foods.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Lift objects correctly and avoid heavy lifting.<\/b><span style=\"font-weight: 400; user-select: auto;\"> When lifting, use your legs instead of your waist or back.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Control coughing.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Seek treatment for chronic cough or bronchitis, and don&#8217;t smoke.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Prevents weight gain.<\/b><span style=\"font-weight: 400; user-select: auto;\"> Talk to your doctor to determine your ideal weight and get advice on weight-loss strategies if you need them.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Diagnosis<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">In general, uterine prolapse is diagnosed during a <\/span><b style=\"user-select: auto;\">pelvic exam.<\/b><span style=\"font-weight: 400; user-select: auto;\">. In the pelvic exam we evaluate the <\/span><b style=\"user-select: auto;\">degree of prolapse<\/b><span style=\"font-weight: 400; user-select: auto;\"> and <\/span><b style=\"user-select: auto;\">strength of pelvic floor musculature <\/b> <span style=\"font-weight: 400; user-select: auto;\">asking the patient to increase abdominal pressure and then tightening the pelvic and vaginal muscles. The degree of prolapse is classified according to international scales, from which treatment may be recommended.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">In some cases, a test that clarifies the functioning of the bladder may be requested, such as the <\/span><b style=\"user-select: auto;\">urodynamic study<\/b><span style=\"font-weight: 400; user-select: auto;\">.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"> <b style=\"user-select: auto;\">Urinalysis<\/b><span style=\"font-weight: 400; user-select: auto;\"> will rule out a concomitant urinary tract infection, which alone worsens the symptoms related to prolapse and decreases the effectiveness of conventional treatments.<\/span><\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">Pelvic <\/span><b style=\"user-select: auto;\">floor MRI<\/b><span style=\"font-weight: 400; user-select: auto;\"> is also a useful tool, as it allows you to measure how descended the uterus and bladder are relative to the pelvic frame, and how much that decrease worsens during an increase in abdominal pressure, such as when we cough or bowel movements. <\/span> <\/span><\/p>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Conservative treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Treatment depends on the severity of the uterine prolapse. Your doctor might recommend:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Self-care measures.<\/b><span style=\"font-weight: 400; user-select: auto;\"> If your uterine prolapse causes few or no symptoms, some simple self-care measures can provide relief or help prevent the prolapse from getting worse. Some of the self-care measures are performing Kegel exercises to strengthen pelvic muscles, lose weight, and treat constipation.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Pessary.<\/b><span style=\"font-weight: 400; user-select: auto;\"> A vaginal pessary is a plastic or rubber ring that is inserted into the vagina to support weakened tissues. The pessary should be removed regularly for cleaning.<\/span><\/span><\/li>\n<\/ul>\n<h3 style=\"text-align: justify; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Surgical treatment<\/b><\/span><\/h3>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Your doctor might recommend surgery to repair uterine prolapse. Minimally invasive (laparoscopic) or vaginal surgery may be an option.<\/span><\/p>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">Surgery may involve:<\/span><\/p>\n<ul style=\"text-align: justify; user-select: auto;\">\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Repair of weakened pelvic floor tissues.<\/b><span style=\"font-weight: 400; user-select: auto;\"> This surgery is usually done through the vagina, but sometimes through the abdomen. The surgeon may place a graft of his own tissue, a donor, or a synthetic material into the weakened pelvic floor structures to support the pelvic organs.<\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Removal of the uterus (hysterectomy).<\/b><span style=\"font-weight: 400; user-select: auto;\"> In certain cases, hysterectomy may be recommended for uterine prolapse. <\/span><\/span><\/li>\n<li style=\"font-weight: 400; user-select: auto;\" aria-level=\"1\"><span style=\"color: #000000; user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"><b style=\"user-select: auto;\">Surgery to close the vagina. <\/b> <span style=\"font-weight: 400; user-select: auto;\">This surgery, called <\/span><a style=\"color: #000000; user-select: auto;\" href=\"https:\/\/espanol.womenshealth.gov\/a-z-topics\/pelvic-organ-prolapse\"><span style=\"font-weight: 400; user-select: auto;\">colpocleisis<\/span> <\/a><\/span><\/span>\n<p style=\"user-select: auto;\"><span style=\"font-weight: 400; user-select: auto;\">, treats prolapse by closing the vaginal opening. It may be an option for women who don&#8217;t have sex.<\/span><\/p>\n<\/li>\n<\/ul>\n<p style=\"text-align: justify; user-select: auto;\"><span style=\"font-weight: 400; color: #000000; user-select: auto;\">The Pelvic Floor Unit of Uros Associats has an excellent team of professionals specialized in the diagnosis and treatment of pelvic organ prolapse. The thorough evaluation and selection of the most appropriate treatment depending on the degree of prolapse, is what guarantees the optimal results we offer our patients.<\/span><\/p>\n<\/div>\n<\/div><div id=\"cmsmasters_tab_31x2xj5bp\" class=\"cmsmasters_tab\">\n<div class=\"cmsmasters_tab_inner\">\n<ul style=\"user-select: auto;\">\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">INTRAVESICAL INSTILLATIONS<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">INTRAVESICAL BOTULINUM TOXIN INJECTION<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">NEUROSTIMULATION OF THE POSTERIOR TIBIAL N.<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\"> PUDENDAL NERVE BLOCK<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">PLACEMENT OF TRANSOBTURATOR MESHES<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">MESH PLACEMENT FOR PELVIC ORGAN PROLAPSE<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">LAPAROSCOPIC SACROCOLPOPEXY<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">PLACEMENT OF URETHRAL SLINGS<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">ARTIFICIAL SPHINCTER PLACEMENT<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">TOT PLACEMENT<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">REMMEX PLACEMENT<\/span><\/li>\n<li style=\"user-select: auto;\"><span style=\"color: #000000; user-select: auto;\">TVT PLACEMENT<\/span><\/li>\n<\/ul>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div 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