Spinal Cord Injuries

How is the bladder affected?

The Ranges of Spinal Cord Injury

“The spinal cord is a central bundle of nerves extending from the brain and branching peripherally, and is responsible for transmitting signals between the brain and the rest of the body.  The spinal cord is located within the spinal column.  Any trauma to the spinal column or the vertebrae has potential to affect the spinal cord could and result in temporary or permanent neurologic impairments”.1,7

Traumatic spinal cord injury usually begins with a traumatic injury to the spine that may result in fractures or dislocated vertebrae.3,8

According to the Centers for Disease Control, the spinal column consists of 8 cervical vertebrae (neck), 12 thoracic vertebrae (upper and middle back), 5 lumbar vertebrae (lower back), 5 sacral vertebrae (sacrum), and 2 mostly fused coccygeal vertebrae (coccyx). 1,7

Spinal cord injuries can typically be classified as tetraplegia or paraplegia.  Tetraplegia (also known as quadriplegic) typically results from to an injury between the C1 and T1.  This type of injury is typically associated with a loss of feeling or movement in the upper body such as head, neck shoulder, arms, hands and/or fingers.  Paraplegia may result from an injury between levels T2 and S5.  This type of injury can affect the lower part of the body to include the stomach, hips, legs and feet/toes. 9

The National Spinal Cord Injury (2014) Database states that the most frequent neurological category at discharge from the hospital since 2010 is incomplete tetraplegia (45%) followed by incomplete paraplegia (21%) complete paraplegia (20%) complete tetraplegia (14%).2

An incomplete injury means that the ability of the spinal cord to convey messages to or from the brain is not completely lost.  People with incomplete injuries retain some sensory function and may have voluntary motor activity below the injury site.  A complete injury prevents nerve communications from the brain and spinal cord to parts of the body below the injury site.  There is a total lack of sensory and motor function in the sacral segments S4-5. 3, 9

Common Causes of Spinal Cord Trauma

The National Spinal Cord Injury Statistical Center (2014) reports that motor vehicle crashes account for 38% of reported SCI cases.  The next most common cause of SCI is falls (30%), followed by acts of violence (14%)-primarily gunshot wounds.2

The proportion of injuries that are due to sports has decreased over time while the proportion of injuries due to falls has increased.  Violence caused 14% of spinal cord injuries prior to 1980, and peaked between 1990 and 1999 at 24.8% before declining to only 14% since 2010.2

More than 80% of all spinal cord injuries happen to males, who are primarily young adults.2


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.  


Spinal Cord Injury and Physical Function

Depending on the level where a spinal cord injury occurs effects physical functions, starting from the point where the injury is in the spinal column.

Loss of neurologic function typically occurs below the level of the injury.  So the higher the spinal injury is to the spinal column, the greater the loss of function typically experienced.

  • Cervical spinal nerves (C1 to C8) emerge from the spinal cord in the neck and control signals to the back of the head, the neck and shoulders, the arms and hands, and the diaphragm.3
  • Thoracic spinal nerves (T1 to T12) emerge from the spinal cord in the upper mid-back and control signals to the chest muscles, some muscles of the back, and many organ systems, including parts of the abdomen.3
  • Lumbar spinal nerves (L1 to L5) emerge from the spinal cord in the low back and control signals to the lower parts of the abdomen and the back, the buttocks, some parts of the external genital organs, and parts of the leg.3
  • Sacral spinal nerves (S1 to S5) emerge from the spinal cord in the low back and control signals to the thighs and lower parts of the legs, the feet, most of the external genital organs, and the area around the anus. 3,10

Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.  


Neurogenic Bladder

People who have Spinal Cord Injury (SCI) often need to perform intermittent catheterization or take other medical steps to help manage their bladder.

This could include behavior techniques, physiotherapy, transurethral and suprapubic catheters as well as appliances such a condom catheters and penile clamps.  This is because the spinal trauma that they experienced may have caused damage to the nerves that control their bladder function.11, 12

According to the National Institute of Neurological Disorders and Stroke, most spinal cord injuries affect bladder functions because the nerves that control the involved organs originate in the segments near the lower end of the spinal cord.  Although the kidneys continue to produce urine, bladder control may be lost and the risk of bladder and urinary tract infections increases.3

If you have been diagnosed with neurogenic bladder, it is important for you to follow your doctor’s orders on your care regimen. 

 


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.  


Intermittent Catherization

Depending on your level of injury and hand dexterity, the method you apply for using intermittent catheters may vary.

Using a clean technique is a key element in hygiene for catheter use regardless of the type of intermittent catheter prescribed.

Remember it is important for you to follow your doctor’s orders on your care regimen to be sure that you are self-cathing according to the prescribed number of times per day.11

Discretion is also a key part of a daily continence care regimen, as most intermittent catheter users don’t want anyone to know about their catheter use.


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.  

Resources and references for the article above

The United Spinal and the National Spinal Cord Injury Association [NSCIA] offer a variety of peer support programs through their national network of chapters and community groups.

Additional organizations like the Christopher and Dana Reeve Foundation also deliver public and professional education, information, and support on a national and local level.

The NSCIA (National Spinal Cord Injury Association) has also complied a wide variety of educational materials designed for active living with spinal cord injury, including health resources related to bladder management.  Following are links to other resources.


References:

  1. Centers for Disease Control Spinal Cord Injury Fact Sheet http://www.cdc.gov/TraumaticBrainInjury/index.html
  2. National Spinal Cord Injury Statistical Center Spinal Cord Injury Facts and Figures at a Glance: https://www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.pdf , https://www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202014.pdf
  3. NIH: National Institute of Neurological Disorders and Stroke – http://www.ninds.nih.gov/disorders/spina_bifida/spina_bifida.htm
  4. Cleveland Clinic, Diseases and Conditions – Neurogenic Bladder, http://my.clevelandclinic.org/disorders/neurogenic_bladder/hic-neurogenic-bladder.aspx
  5. Sauerwein D. Urinary tract infections in patients with Neurogenic bladder dysfunction, Int J Antimicrob Agents. 2002 Jun; 19(6):592-7.
  6. ASIA International Standards for Neurological Classification of Spinal Cord Injury
  7. Clinical Neuroanatomy, 27th Edition, McGraw-Hill Education, 2014, Chapter 5-The Spinal Cord, Chapter 6. The Vertebral Column and Other Structures
  8. Principles and Practice of Hospital Medicine, McGraw-Hill Education, 2012, Chapter 63 – Common Neurosurgical Conditions
  9. Current Diagnosis and Treatment in Orthopedics, 5th Edition, McGraw-Hill Education, 2014
  10. Harrisons™ Principles of Internal Medicine, 18th Edition, McGraw-Hill Education, 2012, Chapter 377, Diseases of Spinal Cord
  11. Smith and Tanagho’s General Urology, 18th Edition. McGraw-Hill Education, 2013
  12. Textbook of Neurogenic Bladder, J.Corus MD and E.Schick MD, Martin Dunite Ltd., United Kingdom, 2004, Chapter 43 –Conservative Treatment

Information is as of 12/2014. Please check references for updated information.


Spina Bifida

Causes and how urination is affected

What is Spina Bifida ?

Spina Bifida is the most common type of developmental defect that causes disabilities and is a health condition that is present at birth. Spina Bifida is a Latin term that literally means “split or open spine”.

Possible Causes of Spina Bifida

Children born with Spina Bifida have a serious birth abnormality in which there is an incomplete fusion of the vertebral arches in the lumbar region, meaning the skin covering the spinal cord does not close completely.  Many different variations of the condition are reported. 3,7,8

While there are many genetic and environmental influences that may contribute to the cause of Spina Bifida, they are not all completely known or identified.  Literature suggests that the following factors may play a role in the development of Spina Bifida:4,7,8

  • Ethnic group
  • Genes
  • Health conditions and medicines taken during pregnancy

Folic Acid

In 1992, the US Public Health Service recommended that all women of child-bearing age should consume 400mcg of folic acid daily to reduce the risk of having a pregnancy affected by neural tube defects like Spina Bifida.  Folic acid is a B vitamin that every cell in a person's body needs for normal growth and development.  The US Public Health Service also recommends that women who have Spina Bifida, have a child or pregnancy impacted by Spina Bifida, take 4000mcg (4.0 mg) of folic acid for one to three months before pregnancy.4,7,10

As a result of the determination, the U.S. Food and Drug Administration mandated adding folic acid to all enriched cereal grain products by January 1998.1,7  

Spina Bifida occurs worldwide, but there has been a downward trend in occurrence rates in the US since the US Food and Drug Administration mandate took effect. 7

According to the Centers for Disease Control, each year more than 1,500 babies are born in the United States with Spina Bifida.  In the US, Hispanic women have the highest rate of having a child affected by Spina Bifida compared with Non-Hispanic White and Non-Hispanic Black women.1,7,9, 10


Please note that the information provided by Liberator Medical in this article is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


How Spina Bifida May Affect Your Child

Spina Bifida can affect the way a child’s brain, spine, spinal cord form.4

The brain, spine, spinal cord and meninges form in the womb and function after birth. Meninges are the tissues that cover and protect the brain and the spinal cord.4,7

According to the literature, the most common types of Spina Bifida are:

  1. Myelomeningocele (also called open Spina Bifida). This is the most severe and the most common form of Spina Bifida. In this condition, part of the spinal cord pushes out with the meninges through the gap in the spine to form a sac on the baby’s back.  The spinal cord and nearby nerves are damaged.  This condition can cause paralysis (when one or more parts of your body cannot feel or move). An increase in infection rates and allergies as well as other diseases frequently occurring in conjunction with Spina Bifida have been reported.  Babies with this condition may need surgery before birth or within the first few days of life.  During surgery, a surgeon tucks the spinal cord and nerves back into the spine and cover them with muscle and skin.  This can help prevent new nerve damage and infection.  But the surgery can’t undo any damage that’s already happened.  Even with surgery, babies with this condition may have different forms and sometimes lasting disabilities, like problems walking and going to the bathroom. 3,4,7,8,9,10
  2. Spina Bifida Occulta (also called Hidden Spina Bifida).  This is the mildest form and usually doesn’t cause health problems.  In this condition, the gap in the spine is small.  The spinal cord and nerves stay in place and usually aren’t damaged.  A dimple or tuft of hair may appear on the overlying skin. 2,3,4,5,7,8,9,10
  3. Closed neural tube defect.  In this condition, the fat, bone or meninges around the spinal cord don’t form correctly.  This sometimes damages the nerves in the spinal cord.  This condition often causes no symptoms, but some babies may have problems controlling their bladder and bowels (going to the bathroom).4,10
  4. Meningocele.  This is the rarest form. In this condition, the meninges push out through the gap in the spine.  This creates a sac filled with fluid (called a meningocele) on the baby’s back.  There’s usually little or no nerve damage, but some babies may have problems controlling their bladder and bowels.  Surgery can be done to remove the meningocele. 4,7,9

The good news is that the CDC also reports “many adolescents and young adults with Spina Bifida report a high level of satisfaction with their health-related quality of life, are entering and succeeding at college life, and are participating in sports and other recreational activities.1 


Please note that the information provided by Liberator Medical in this article or on this website is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Neurogenic Bladder

Children with Spina Bifida often need to perform intermittent catheterization or take other medical steps to help empty their bladder.7,8

Using Intermittent Catheters - Children with Spina Bifida

Children with spina bifida often can’t control when they need to go to the bathroom because the nerves that control their bowel and bladder are damaged.  If a child has problems emptying their bladder completely, they can develop problems with urinary tract and kidney infections.4,8

Healthcare providers and parents agree that when it comes to continence care management, it is best for children and their caregivers’ for the child to become as independent and educated on intermittent catheter use as early as possible.7,8

Using a clean intermittent Catheterization (CIC) technique is a key part of hygiene for catheter use in children.  Additionally, many children born with spina bifida also have a latex [natural rubber] allergy, so it is important that children with SB who self-cath must use a type of intermittent catheter that is latex-free.4,7,8

With help, it is possible for children with SB to learn how self-catherize on their own.  Discretion is a key part of a daily continence care regimen, as most intermittent catheter users don’t want anyone to know about their catheter use.  However, privacy is especially important to children when it comes to their bathroom routines.5


Please note that the information provided by Liberator Medical in this article or on this website is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Resources and references for the article above

In the US, the Spina Bifida Association offers a variety of family-centered programs through their nationwide network of chapters and support groups.

Finding Additional Spina Bifida Support Resources

In the US, the Spina Bifida Association offers a variety of family-centered programs through their nationwide network of chapters and support groups. Spina Bifida Association chapters deliver public and professional education, information, and support on a community level.

Find One Near You

The Spina Bifida Association [www.spinabifidaassociation.org] also offers a wide variety of educational materials designed for both parents and children, and many of their health resources can assist with bowel and bladder programs. 

References:

  1. Centers for Disease Control and Prevention. (2010). Data and statistics. Available online at: http://www.cdc.gov/ncbddd/spinabifida/data.html
  2. GRAY’S Anatomy Review- First Edition. Gray's Anatomy Review (Kindle Locations 15-21). Elsevier Health Sciences. Kindle Edition.
  3. NIH: National Institute of Neurological Disorders and Stroke – website
    http://www.ninds.nih.gov/disorders/spina_bifida/spina_bifida.htm
  4. March of Dimes. (2009). Birth defects: Spina Bifida. Available online at: http://www.marchofdimes.com/baby/birthdefects_spinabifida.html
  5. Spina Bifida Association. (2008). Spina Bifida. Available online at: http://tinyurl.com/3qegx2y
  6. Spina Bifida Association –National Resource Center. Folic Acid. Available on-line http://www.spinabifidaassociation.org/atf/cf/%7B85F88192-26E1-421E-9E30-4C0EA744A7F0%7D/Folic%20Acid.pdf
  7. Ozek M, Cinalli G, Maixner W, The Spina Bifida Management and Outcomes, Springer Milan Berlin Heidelberg New York, 2008
  8. Rekate H MD, Comprehensive Management of Spina Bifida, CRC Press, Boca Raton, Ann Arbor, Boston, 2006
  9. Clinical Neuroanatomy 27th Edition, McGraw-Hill Education, 2013
  10. Agopian AJ, etal. Spinal Bifida Subtypes and Sub Phenotypes by Maternal Race, Ethnicity in the National Birth Defects Prevention Study, Am J Med Genet Part A 158A:109-115, 2011

 Information is as of 12/2014. Please check references for updated information.


Multiple Sclerosis

Nervous system, MS and bladder problems

Understanding Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic autoimmune disease of the central nervous system. It causes destruction of myelin (a protein that forms a protective coating around nerve cells) in the central nervous system.

When myelin is destroyed, signals traveling through the nerve cells are interrupted or delayed, resulting in various symptoms occurring at different locations throughout the body.5,7,8

According to the National Multiple Sclerosis Society, progressive MS manifests itself differently in each person.  Whether your MS is progressive or not, it’s important to realize that “progressive” does not necessarily have to equate with severe disability.8

Primary symptoms directly caused by MS include tremor, numbness, weakness, loss of vision, pain, mobility problems, poor balance, bladder and bowel dysfunction, sexual dysfunction and mood and cognitive changes.  Any of these symptoms may increase or advance in progressive MS.4,8


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


Prevalence and Causes of Multiple Sclerosis

Studies show that MS is the result of a number of factors rather than a single factor. Most likely, genetics plays a role in determining a person's susceptibility to MS.

The disease is not entirely genetically controlled, although first-degree relatives of individuals with MS have an increased risk of developing the disease.  Exposure to environmental factors, such as a virus, UV radiation and season of birth, levels of dietary vitamin D, Epstein-Barr virus(EBV) infection, smoking and other factors may also help play a role.  The specific factors have not yet been identified.8

The average age of diagnosis is usually between 20 and 50, although it also can occur in older individuals.  MS is twice as common in women compared to men.8

2013 survey data suggested that MS affects more than 400,000 people in the US and an estimated 2.3 million people worldwide.  Worldwide, MS occurs with much greater frequency in higher latitudes (above 40° latitude) away from the equator, than in lower latitudes, closer to the equator.8

MS is more common among Caucasians (particularly those of northern European ancestry) than other races.  In certain populations, an antigen marker has been linked to MS.  It is called human leucocyte antigen DRB1 (HLA-DRB1) and is found more frequently in people with MS than in those who do not have the disease.5, 8


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Neurogenic Bladder

Neurogenic bladder is when a person lacks bladder control due to a brain, spinal cord or nerve problem.

This includes people with MS, Parkinson’s disease and people who have had stroke or spinal cord injury.  More than 70% of people with MS have bladder problems primarily due to a disruption in the signal from the spinal cord to the bladder that tells it to ‘void’.1,8

With neurogenic bladder, problems starting to urinate or emptying all of the urine out of your bladder may be common.  Your bladder may become too full, and you may leak urine from an overfull bladder.  Medication sometimes helps when your bladder is not working correctly.  Some people with MS need to use an intermittent urinary catheter to manage bladder voiding.  Other options include using an indwelling catheter and in some instances a suprapubic catheter.  Your doctor will work with you on identifying this issue and will prescribe the appropriate treatment for you.2, 8

You should seek treatment whenever changes in your bladder habits keep you from going and doing what you want to do.  While you may not be able to stop your bladder issues from continuing due to MS, you should be able to manage it comfortably without the embarrassment of leakage.3, 8

The Importance of Following Doctor’s Orders

If you have been diagnosed with neurogenic bladder, it is important for you to follow your doctor’s orders on your care regimen. If your doctor prescribed and has trained you on self catheterization, be sure that you are self-cathing according to the prescribed number of times per day. People who do not follow their prescribed care regimen for continence care may be at a higher risk of developing more serious conditions like urinary tract infections, urinary retention, and dysfunctional bladder. 8,9

Urinary tract infections (UTIs) are common in people with MS, so you will need to learn to recognize the symptoms of a UTI that include: burning when you urinate, fever, low back pain on one side and a more frequent need to urinate. 2,8


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Using Intermittent Catheters

Depending on your level of progressive MS and your requirements for catheterization, the method you apply for using intermittent catheters may vary.

Clean Intermittent Catheterization [CIC] is where you insert a catheter (a straw like tube) into yourself several times a day to empty your bladder.1,9

Using a clean technique is a key part of hygiene for catheter use regardless of the type of intermittent catheter you are prescribed.  This includes washing your hands and genitalia before cathing.  Making sure the catheter tip does not touch you or other surfaces prior to insertion.  Your health care professional will train you on proper techniques and educate you on the risks and benefits of this procedure.9


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Resources and references for the article above

The National Multiple Sclerosis Society (NMMS)  offers a wide variety of educational materials designed for active living with MS.

National Multiple Sclerosis Society (NMMS) offers a wide variety of educational materials designed for active living with MS, and many of their health resources can also assist with bowel and bladder questions.

Associations:

References:

  1. Neurogenic Bladder: When Nerve Damage Causes Bladder Problems – Urology Care Foundation: (2014) http://www.urologyhealth.org/_media/_pdf/BH_NeurogenicBladder_FactSheet_2014.pdf
  2. Multiple Sclerosis: National Institutes of Health (9/2012): http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000129.htm
  3. National Association for Continence – Seeking Treatment (2014):  http://www.nafc.org/tools/
  4. Managing Progressive MS – National Multiple Sclerosis Society(10/2013): http://www.nationalmssociety.org/NationalMSSociety/media/MSNationalFiles/Brochures/Brochure-Managing-Progressive-MS.pdf
  5. Cleveland Clinic, Diseases and Conditions – Neurogenic Bladder (11/2012), http://my.clevelandclinic.org/disorders/neurogenic_bladder/hic-neurogenic-bladder.aspx
  6. Sauerwein D. Urinary tract infections in patients with Neurogenic bladder dysfunction, Int J Antimicrob Agents. 2002 Jun; 19(6):592-7.
  7. J Kesselring, G. Combi, A Thompson, Multiple Sclerosis , Recovery of Function and Neurorehabitation, Cambridge University Press 2010
  8. O Malik, A Donnelly, M Barnett; Fast Facts: Multiple Sclerosis, Health Press, Oxford UK, 2014
  9. D Newman, M Williams,; Review Intermittent Catherization and Current Best Practices, Urologic Nursing, Jan-Feb 2011, Volume 31, Number 1

 Information is as of 12/2014. Please check references for updated information.


Prostate Cancer/BPH

What are the causes and effects of prostate problems?

Learn about Benign Prostate Hyperplasia

Benign prostate hyperplasia, or BPH, is the term for the enlarging of the prostate. It’s common for the prostate to do this with age. BPH is not cancerous, but it can cause the prostate to press down on the urethra. This pressure can cause problems with urination. One may lose bladder control and feel the need to urinate very often.1, 10, 11

First let's find out what the prostate gland is and what is does.

The prostate gland is a small gland that is only present in men and produces fluids that are part of semen.  It is about the size of a large walnut and sits just below your bladder.  It surrounds the urethra, like a collar.  Your urethra is a tube that carries urine outside of your body.  In some men, the prostate can enlarge and when this happens, it can cause the urethra to compress and this can cause symptoms such as not being able to urinate or feeling you have emptied your bladder completely, which it may not.  Conditions that can cause your prostate to enlarge include benign prostate hyperplasia (BPH), prostate cancer, bacteria and non-bacteria prostatitis.1,2,3,5,12

Possible Causes

Doctors aren't sure exactly what causes the prostate to enlarge.  It may be due to changes in the balance of sex hormones as men grow older.7

Family history and ethnic background from may also be a risk factor.  For instance there is a higher incidence of BPH in Americans and Australians and less in Chinese, Indian and Japanese.2,3,5,10

How May this Impact You?

Most men with BPH have no complications.  But when there are problems, they usually come because of urine flow being blocked.  This condition is called “urinary retention".  This means being unable to empty the bladder completely.  

There are two kinds of urinary retention.  The first is called acute urinary retention (AUR for short).  This means you cannot urinate at all, even though you have a full bladder.  This happens suddenly and lasts only a short time.  It can be very painful, and it can cause recurrent UTIs, acute kidney failure and chronic kidney disease.  If you have AUR, you should contact your doc tor as soon as possible.1,2,4,10,11

The second kind of urinary retention is called chronic urinary retention (CUR).  Chronic means it is a long-lasting medical condition.  People with chronic urinary retention can urinate but cannot completely empty all of the urine from their bladders.  They may not know they have the condition until it causes another problem.  One of these problems could be the accidental loss of urine which is called urinary incontinence. Another of them is a urinary tract infection (UTI), which is an illness caused by harmful bacteria growing in the urinary tract.1,10

Some symptoms of BPH:1,2,10,11

  • Weak urine stream
  • Difficulty starting urination - hesitation
  • Stopping and starting while urinating
  • Dribbling at the end of urination
  • Frequent or urgent need to urinate
  • Increased frequency of urination at night
  • Not being able to completely empty the bladder
  • Formation of stones in the bladder
  • Reduced kidney function
  • UTI (urinary tract infection)

What are my Treatment Options?

The first thing your doctor may do is ask you some questions and may run a series of tests.  This may include blood tests, a digital rectal exam (DRE), an ultrasound to see how your bladder is emptying and/or a urine flow test.1,3,10,11

When your symptoms are mild, your doctor may recommend “watchful waiting“.  This means he will want to see you once a year or more often to keep an eye on your symptoms.  If he sees that BPH may be a health risk for you, or if it is a big inconvenience, he may decide you need additional treatment.  There are many treatments that can make BPH less of a problem.  These include drugs, minimally invasive procedures done in the office and surgery.1,2,3,11

Where can I find more information?

You can learn more about BPH and other prostate issues by contacting your doctor and by visiting any of the following websites.

National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/Pages/default.aspx

Urology Care Foundation http://www.urologyhealth.org/


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Learn about Prostate Cancer

Cancer of the prostate is caused by cells in the prostate dividing without control. It may cause no symptoms in its early stages. But as it advances, it can cause urinary problems. Prostate cancer is the second leading cause of death in men, but if caught early, the 5-year survival rate is very good.

Cancer of the prostate is caused by cells in the prostate dividing without control.  It may cause no symptoms in its early stages. But as it advances, it can cause urinary problems.  Prostate cancer is the second leading cause of death in men, but if caught early, the 5-year survival rate is very good.3,6,7,11

What are the Causes?1,2,7

Doctors are unsure of the exact causes of prostate cancer.  They do know that if someone in the family has had the disease, it is more likely to be diagnosed.  Ethnicity can play a role.  African Americans are twice as likely to be diagnosed with prostate cancer than other populations.  And the older you get, the higher your risk.  Lifestyle choices such as diet, smoking and exercise may also have an impact.

Research continues to better understand what causes the disease.  But most doctors agree, if you do things that are heart healthy, you may also keep your prostate healthy.  Eating right, exercising, watching your weight and not smoking can improve your health and help you avoid this disease.1,7,8

How may prostate cancer impact me?1,7,11

In its early stages, prostate cancer often causes no symptoms.  When symptoms do occur, they may include any of the following:

  • Dull pain in your pelvis or lower back
  • Frequent urination
  • Problems with urination such as being unable to urinate, pain, burning, or weakened urine flow
  • Blood in your urine or semen
  • Painful ejaculation
  • General pain in the lower back, hips or upper thighs
  • Loss of appetite and/or weight
  • Persistent bone pain

How does my doctor screen for prostate cancer?

In the US, prostate cancer is the second leading cause of cancer death.  It is estimated that approximately 230,000 new cases of prostate cancer will be diagnosed in 2014 and there will be 29,000 people who will lose their life.  For some types of cancer, finding and treating the disease early may provide a better chance of survival and recovery.  But there are risks to screening, so it’s important to talk about risks and benefits with your physician.7,8,11

What are my treatment options?

The first step is to diagnose.  The key screening tools are a digital rectal exam (DRE) where your doctor will look to see if you have an enlarged prostate and a blood test called a PSA (Prostate specific Antigen).  He may order additional tests.  If these are positive, you may need a biopsy where they take some tissue from your prostate.1,3,7,11

Once diagnosed, doctors use a range of treatments to help with prostate cancer.  If you are suffering from this disease, discuss these options with your doctor and ask if there are other potential alternatives

Some prostate cancers are very slow growing, so, like with BPH, your doctor may prescribe active surveillance (watchful waiting) as the best option.7,11

Your doctor may recommend taking hormones to lower your levels of testosterone (male hormone).  By doing this, you may be able to slow the growth of cancer cells over time.  These hormones may also be used in combination with Brachytherapy (radiation therapy) to shrink the prostate and the tumor.1,11

Brachytherapy is another prostate cancer treatment. It involves implanting radioactive “seeds” around your prostate gland.  These seeds stay permanently and deliver a dose of radiation directly to the cancer cells slowly over time.1,7  Side effects may include urinary problems, bowel problems, erectile dysfunction or impotence (difficulty in getting or keeping an erection of the penis), and fatigue (or tiredness).1,7,11

External radiation is another treatment for prostate cancer.  It uses high-energy X-rays directed from outside the body at the prostate gland.  Side effects may include problems with urination and impotence, as well as injury to the bowel.1,7

With some prostate cancers, surgery may be required to remove the prostate and lymph nodes affected with the disease.  The two most common side effects of this surgery are loss of bladder control (incontinence) and the inability to maintain an erection (impotence).1,7,11

Where can I find more information?

The following organizations publish resources for men with questions about prostate cancer:


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.


References for the article above

Click to view all the references for the article above.

References:

  1. Kirby R.S. Prostate Disease and their Treatments, Health Press Oxford 2010
  2. Diseases and Conditions; Benign Prostatic Hyperplasia, Updated 12/2001 http://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/basics/symptoms/con-20030812
  3. Urology Care Foundation (American Urology Association, BPH: Minimally invasive Management BPH, Updated 4/2013 http://www.urologyhealth.org/urology/index.cfm?article=144
  4. Lepo H, Management and Preventing Acute Urinary Retention, Rev Urol. 2005; 7 (Suppl 8) S26-S33
  5. National Kidney and Urological Diseases, Updated 8/2014 http://kidney.niddk.nih.gov/kudiseases/pubs/UrinaryRetention/What is Cancer,
  6. National Cancer Institute, 3/2014 http://www.cancer.gov/cancertopics/cancerlibrary/what-is-cancer
  7. Urology Care Foundation (American Urology Association, Prostate Cancer, Updated 4/2014 http://www.urologyhealth.org/urology/index.cfm?article=146&display=1
  8. Information about Prostate Cancer and Screening, Bard Medical, http://www.bardmedical.com/media/127667/prostatecancerpatientscreenings_1009_33.pdf
  9. Prostate Cancer Treatment – Questions and Answers, Bard Medical http://www.bardmedical.com/media/127676/prostatecancertreatment_patientbrochure1pformat__1010-23.pdf
  10. Pathophysiology of Disease: Introduction to Clinical Medicine, Seventh Edition, McGraw-Hill Education, 2014, pgs 26-40
  11. S Chao MD , R Chippendale MD, Current Diagnosis and Treatment: Geriatrics, Second Edition, Chapter 40, McGraw-Hill Education, 2014
  12. Campbell-Walsh Urology, 9th Edition, Saunders-Elsevier Philadelphia PA, 2007, pgs 57-61

Urinary Incontinence

What is it and what causes urinary incontinence?

What Causes Urinary Incontinence?

Several muscles and nerves have to work right for you to have normal bladder control. 10 When the system is working normally, your body stores urine in the bladder, which is a balloon-like organ at the bottom of the pelvis.

The bladder is connected to the urethra, which is the tube that drains urine from your body.  A small ring-like muscle called the urethral sphincter stops urine from leaking by staying closed until you’re ready to go to the bathroom.1, 3,10

When your bladder is full, the receptors and nerves send signals to your brain and you will have an urge to urinate.  Then the bladder muscles squeeze to push the urine out through your urethra.  The sphincters open up and the bladder contracts.3,10

If the sphincter or other muscles around the bladder are weakened or otherwise working incorrectly, urine can leak.  There are many things that can interfere with the urinary system working correctly.  They include diseases like diabetes (a condition where blood sugar is too high), stroke, Multiple Sclerosis, and Parkinson’s disease.  Surgery, menopause and obesity can also cause incontinence.  There are many medicines that can cause you to lose bladder control or make incontinence worse: diuretics, sedatives, narcotics, antidepressants, antihistamines, calcium channel-blockers and alpha-blockers.2, 3,10,11

Urinary incontinence is more common in women than in men.  Pregnancy, childbirth and hormonal changes that come with aging can all make incontinence more likely.3  In men, the most common cause of incontinence is prostate surgery.2  For both men and women, injury to the nervous system, birth defects, and physiological problems associated with aging can cause incontinence.3,10,11

The older you are, the more likely you may experience incontinence.  It is a medical problem and your doctor can help you find a solution, often without surgery.3, 6,10,11

Incontinence can be a problem for children too.  Preschoolers by the age of 4 -6 years old should be completely trained during the day with occasional accidents.  Normal school age children should have normal daytime continence with few exceptions.  If this is not happening medical attention should be sought.  There are medical conditions that could be triggering this.  These include urinary tract infections, diabetes, kidney problems, nerve problems, constipation, obstructive sleep apnea (a condition in which breathing is interrupted during sleep, often because of inflamed or enlarged tonsils), obesity or a structural problem in the urinary tract. 7,10,11

There are three forms of urinary incontinence: 2, 3, 6,10,11

  • Stress incontinence is when an action like coughing, sneezing or lifting causes you to leak urine.  It happens because these activities put extra pressure on the muscles around your bladder. 
  • Urge incontinence (overactive bladder) is a urine leak that happens after you feel an overwhelming urge to urinate that cannot be stopped.  This is usually the result of an overactive bladder.
  • Overflow incontinence happens when the bladder is full.  You may experience constant dribbling and need to go to the bathroom often.  It is rare in women and more common if you are a man and have problems with your prostate.

Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.


How is Urinary Incontinence Diagnosed?

Your doctor will ask you questions about your medical history and give you a physical examination.

He/she may perform tests to find the cause of your urinary incontinence.1, 2, 6,10,11  You may need tests such as:

  • a cough stress test
  • urinalysis, which tests your urine sample to show the source of any problems
  • urodynamic testing, which includes several painless tests2 and helps your doctor understand how your urinary system is working.1,2

In some cases, your doctor may find causes of leakage that can be corrected.  Impacted stool, constipation, urinary tract infection and vaginal infection or irritation are some of these causes.  Medications you may be taking and restricted mobility are other causes that are not difficult to resolve.  Pads or diapers can prevent embarrassing leaks, but other treatment options may allow you to stop using them.2,10,11


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


What are Your Treatment Options?

Your options for treatment depend on three things: what type of incontinence you have, how severe it is, and what’s causing it.

You may need more than one treatment.  It is likely your doctor will recommend the least invasive treatments first (listed below).  If these lifestyle changes do not work, your doctor may move on to other options.9,10

Managing What You Drink.  One method for reducing urinary incontinence is to keep track of the fluids you drink.  Drinks like fruit juices, and caffeine containing drinks such as colas, coffee and tea can irritate the bladder so your doctor may recommend limiting those.  Your doctor may also recommend drinking six to eight glasses of water per day, which can help reduce bladder irritation.2,10

Bladder Training.  Keeping track of how often you urinate, when you have leakage and what you’ve been drinking is the first step toward training your bladder.  Your doctor may recommend you keep a journal to record the details.  If you don’t usually urinate often enough, he or she may also recommend visiting the bathroom every one to two hours when you are awake.  By regularly emptying your bladder, leaking should become less of a problem, particularly with stress incontinence and urge incontinence.2, 3,10,11

Bladder Retraining.  With this technique, you may also use a journal to record the details of when you urinate.  The goal here is to reduce frequency.  Your doctor may suggest you slowly increase the time between bathroom visits by 15 to 30 minutes per week.  You try to extend the time between visits so that you are going only every two to four hours (while awake).  This can help reduce urgency and incontinence.2, 3,10,11

Kegel Exercises.  The pelvic floor muscles support the bladder neck, rectum and vagina.  Dr. Kegel in 1948 suggested using exercises to strengthen the pelvic floor.  Like any exercise, they must be done regularly to remain effective.  With this technique, you contract or tighten the pelvic floor muscles, which are the same muscles you use to hold urine or stop urine flow.  Hold the muscles tight for two seconds and then relax for two.  If this is easy, try holding for five seconds and relaxing for five.  Repeat this cycle ten times and do this three times per day.  If you have trouble figuring out how to tighten these muscles, your doctor can help.2, 3,10,11

If none of these therapies help, your doctor may recommend other treatments as well.  These include:

Medications.  Some drugs help with incontinence by either tightening the bladder neck or allowing the bladder muscle to relax.  If you are a women who has become incontinent after menopause, hormone treatments may help.  All drugs carry risks and possible side effects, so your doctor will need to guide you to the right choice.2, 3,10,11

Medical Devices.  There are devices designed for women with incontinence that can bring you relief.  Some options include a urethral insert which is temporary and acts as a plug to prevent leakage or a pessary which is worn all day.  It helps support your bladder to prevent leakage.3, 9,10

Interventional Therapies.  Some examples include injections of bulking material to help keep the urethra closed and reduce leaking.  Botox and nerve stimulators which may help some people by activating nerves to control urge incontinence.3, 9,10

Surgery.  There are also surgical options if other treatments don’t work for you.  These include the use of slings to create more support for the urethra and bladder and/or the use of inserted devices to control the flow of urine.3, 9,10,11

Other Options.  Absorbent pads are often no more bulky than regular underwear and are very effective at capturing leaks.  If you are incontinent because your bladder does not empty properly, you may need to learn to use a catheter.  Your doctor will show you how to insert this soft tube into your urethra to drain your bladder.1, 3, 9,10

If you and your doctor have tried medical treatments but haven’t been able to stop your incontinence, there are other products you may wish to try.  Ask your doctor to discuss the risks and benefits of any of these treatments mentioned above with you and help you find the appropriate treatment for you.

Left untreated, urinary incontinence is a condition that can be upsetting and isolating.  If you’re suffering from leakage, be sure to visit your doctor.  He or she can work with you to find the treatment that will allow you to resume your normal activities.2


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional.


Resources and References

There are a number of places you can find more information.  Click here to find some help or to view all the references from the article above.

Here are a few places you can go to get additional information.

Urology Care Foundation’s pamphlet: Loss of Bladder Control/Urinary Incontinence
US Dept. of Health and Human Services - How to Do Kegel Exercises
US Dept. of Health and Human Services - Urinary Incontinence in Women
US Dept. of Health and Human Services - Urinary Incontinence in Men


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional. 

References

  1. Urology Care Foundation – Neurogenic Bladder Symptoms http://www.urologyhealth.org/urology/index.cfm?article=9#SymptomNB May 2014
  2. Urology Care Foundation – Loss of Bladder Control/Urinary Incontinence http://www.urologyhealth.org/_media/_pdf/AUA2014_BladderIncontinence_web.pdf 2014
  3. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) – Urinary Incontinence in Women http://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/index.aspx September 2013
  4. Cleveland Clinic, Diseases and Conditions – Neurogenic Bladder http://my.clevelandclinic.org/disorders/neurogenic_bladder/hic-neurogenic-bladder.aspx - Nov 2012
  5. Urology Care Foundation – Neurogenic Bladder Fact Sheet http://www.urologyhealth.org/_media/_pdf/BH_NeurogenicBladder_FactSheet_2014.pdf 2014
  6. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) – Urinary Incontinence in Men http://kidney.niddk.nih.gov/KUDiseases/pubs/uimen/index.aspx June 2012
  7. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) – Urinary Incontinence in Children http://kidney.niddk.nih.gov/KUDiseases/pubs/uichildren/index.aspx#6 June 2012
  8. Urology Care Foundation – Neurogenic Bladder http://www.urologyhealth.org/urology/index.cfm?article=9&display=1   May 2014
  9. Mayo Clinic - Urinary Incontinence, Treatment and Drugs http://www.mayoclinic.org/diseases-conditionsurinary-incontinence/basics/treatment/con-20037883 Aug. 2014
  10. Slack A, Newman D, Wein A, Fast Facts: Bladder Disorders, Health Press, Oxford UK, 2011
  11. Urinary Incontinence , Pat D O’Donnell MD, Mosby Ltd, St Louis, 1997

Information is as of 12/2014. Please check references for updated information. 


Urinary Retention

What is and what causes urinary retention

What is Urinary Retention?

Urinary retention (UR) means someone is unable to completely empty their bladder. They may only produce a "dribble" of urine. Others strain to push out the urine, or can't urinate at all.1,5,6,8,9

There are two kinds of urinary retention. The first is called acute urinary retention (AUR for short). This happens suddenly and lasts only a short time. It can be very painful, and it can be a life-threatening medical condition. If you have AUR, you should go to the emergency room as soon as possible. 2,3,4,5,7,9

The second kind of urinary retention is called chronic urinary retention (CUR). Chronic means it is a long-lasting medical condition. People with chronic urinary retention can urinate but cannot completely empty all of the urine from their bladders. They may not know they have the condition until it causes another problem. One of these problems could be the accidental loss of urine (which is called urinary incontinence). Another of them is a urinary tract infection (UTI), which is an illness caused by harmful bacteria growing in the urinary tract. 2,5,9


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


What Causes Urinary Retention?

There are a number of conditions that can keep your bladder from emptying. Each typically falls under one of these four categories:

  • Your urethra is blocked (the urethra is the thin muscle tube that carries urine from the bladder)
  • Nerve problems
  • Medications
  • Weakened bladder muscles5,6,8,9

If your urethra is blocked or narrowed, urine can’t flow out of the body. Conditions that may cause this block include: 

Benign prostatic hyperplasia (BPH). BPH affects the prostate, which is typically a walnut-sized gland that surrounds the urethra. It is a condition in which the prostate is enlarged but not cancerous. When it is enlarged, it can compress the urethra, making it difficult to pass urine. Over time, the bladder wall becomes thicker. Eventually, the bladder may weaken and lose the ability to empty completely, leaving some urine in the bladder. This is a common cause of urinary retention for men in their 50s and 60s. 2,5,6,9

Urethral stricture. This means there is a narrowing or closure of the urethra. Surgery, scar tissue from surgery, disease, recurring UTIs, or injury can cause it. Prostatitis, which is inflammation of the prostate, is a common cause of urethral stricture in men. And since men have a longer urethra than women, urethral stricture is more common in men than women. Urethral stricture and acute or chronic urinary retention may occur when the muscles surrounding the urethra do not relax. This condition happens mostly in women. 5,6,7,9

Urinary tract stones. When crystals form in the urine, they can build up and form urinary tract stones. These crystals may build up on the inner surfaces of the kidneys, ureters, or bladder. Stones in your bladder may block the opening to the urethra and cause urinary retention. 5,9

Cystocele. A cystocele is when the bladder pushes into the vagina. This happens because the muscles and supportive tissues between a woman’s bladder and her vagina weaken and stretch. This allows the bladder to sag from its normal position and bulge into the vagina. It may also press against and pinch the urethra. 5,9

Rectocele. A rectocele is when the rectum pushes into the vagina. Like cystocele, this happens when the muscles and supportive tissues between a woman’s rectum and vagina weaken and stretch. The rectum sags from its normal position and bulges into the vagina and may press against and pinch the urethra. 5,9

Constipation. A hard stool in the rectum can cause urinary retention by pressing against the bladder and urethra. A rectocele makes this more likely to happen. 5,9

Tumors and cancers. A cancerous or noncancerous tumor in the bladder or urethra can gradually grow larger. Over time it may block the bladder outlet or press against and pinch the urethra. Either of these can block urine flow. 5,9

The second category of conditions that can cause urinary retention are nerve problems.

Nerves pass signals between the brain and the bladder and the sphincters. Both the bladder and sphincters (small ring-like muscles) tighten or relax to control the flow of urine. There are a number of events or conditions that can interfere with these signals. When this happens, the brain may not get the signal that the bladder is full. Or the bladder muscles that squeeze urine out may not get the signal to push. Or the sphincters may not get the signal to relax and allow the urine to flow out. 1, 5,8,9

Nerve problems like this can happen to you no matter how young you are. For example, a baby may be born with spina bifida, which affects the spinal cord and can cause urinary retention. 1,5,6

The most common causes of nerve problems that can lead to temporary or permanent urinary retention are:

  • Vaginal childbirth
  • Brain or spinal cord infections or injuries
  • Diabetes
  • Stroke
  • Multiple sclerosis
  • Pelvic injury or trauma1,5,6,9

Urinary retention can also be caused by medications that interfere with nerve signals to the bladder and prostate. 

  • Antihistamines to treat allergies
  • Anticholinergics/antispasmodics to treat stomach cramps, muscle spasms, and urinary incontinence
  • Tricyclic antidepressants to treat anxiety and depression 5,9

Other medications that seem to increase your chances of urinary retention include:

  • Decongestants
  • Nifedipine (Procardia), a medication to treat high blood pressure and chest pain
  • Carbamazepine (Tegretol), a medication to control seizures in people with epilepsy
  • Cyclobenzaprine (Flexeril), a muscle relaxant medication
  • Diazepam (Valium), which is used to relieve anxiety, muscle spasms, and seizures
  • Nonsteroidal anti-inflammatory drugs
  • Amphetamines
  • Opioid analgesics 5,9

If you are a man with prostate enlargement, some over-the-counter cold and allergy medications can increase your symptoms of urinary retention. This is true of the ones that contain decongestants, like pseudoephedrine, and antihistamines, such as diphenhydramine. 5

Finally, weakened bladder muscles can also cause urinary retention.

As you age, many of your muscles may weaken, including the bladder and the muscles around it. They may not contract strongly enough or long enough to empty the bladder completely, resulting in urinary retention. 5,6,9


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


How Can Urinary Retention Affect You?

When urinary retention is acute, it can be very painful. It can also be life-threatening.

If you have any of these symptoms, you should see a health care provider right away:

  • Cannot urinate at all
  • Have discomfort or pain in your lower abdomen
  • Painful, urgent need to urinate
  • Bloating of the lower abdomen 5,7,8,9

With chronic urinary retention you may experience these symptoms: 

  • Urination eight or more times a day
  • Trouble beginning a urine stream
  • A weak or an interrupted urine stream 
  • An urgent need to urinate with little success when trying to urinate
  • Feeling the need to urinate after finishing urination
  • Mild and constant discomfort in the lower abdomen and urinary tract 5,8

None of these symptoms may seem severe enough to require seeing a doctor. But if you have chronic urinary retention and do not get treatment, you have a higher chance of developing more serious medical problems. 5


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


What to Expect When You See Your Doctor

Your doctor will try to diagnose your problem with a physical exam and by measuring how much urine is left in your bladder after you urinate.5,9

The physical exam includes the doctor finding out more about your symptoms and examining your lower abdomen. He or she may tap on your belly to see how full your bladder is. An ultrasound machine (which uses sound waves to create a picture) is sometimes used to measure the amount of urine remaining after you urinate. A catheter may also be used. It is a thin, flexible tube the doctor inserts through the urethra into the bladder. It drains any remaining urine. If 100 milliliters or more remains, it tells the doctor your bladder is not emptying completely.5,9

To find out what may be causing your urinary retention, your doctor may use an instrument called a cystoscope to see if anything is blocking the urinary tract like urethral stricture or bladder stones. He or she may also use a CT scan. This device uses a combination of x-ray and computer technology to create a picture of your lower abdomen. It helps your doctor determine if a urinary tract infection, urinary tract stones, tumor, cyst or injury could be causing your urinary retention.5,9

A technique called electromyography provides more information for your doctor. It measures the electrical activity of the muscle and nerves in and around the bladder and sphincters. This helps your doctor understand if the messages sent to the bladder and sphincters coordinate correctly.5,9


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


Treatments for Urinary Retention

With both acute and chronic UR, your doctor will ask you questions about your medical history, give you a physical examination, and may perform tests to...

With acute UR, your doctor’s first concern will be to relieve your pain by draining the urine from your bladder. He may do this by inserting a catheter into the urethra. In some cases the catheter may be inserted through your abdomen and into the bladder. In this case, he may use local or general anesthesia to prevent pain. When BPH is the cause, he may also prescribe medicine to prevent future UR episodes. 5,9

With both acute and chronic UR, your doctor will ask you questions about your medical history, give you a physical examination, and may perform tests to determine what’s causing your urinary retention. 5,9

There are a number of treatment options. This includes:

Bladder Drainage
If your UR is chronic, your doctor may prescribe clean intermittent catheterization (or CIC for short). CIC is where you insert a catheter yourself several times a day to empty your bladder. A condition known as neurogenic bladder (which is caused by nerve problems) can cause chronic UR. If you have neurogenic bladder, your doctor may recommend CIC or long-term catheter use if other treatments do not work. 5,9

Urethral Dilation
If your UR is caused by a urethral stricture, your doctor may try to open the stricture by placing wider and wider tubes in the urethra to try and widen it.5

Medications
For men who have BPH, your doctor may recommend different medications that can help to shrink your prostate such as Avodart or Proscar or others that may help to relax the bladder muscles such as Uroxatral, Cardura, Cialis, Flomax and many others. 2,5,9

Surgery
Surgery is an option for men with an enlarged prostate (BPH). There are a number of different procedures. Some can be done in your doctor’s office and others require hospitalization 2,5

For women, if UR is caused by cystocele or rectocele, you may need surgery to lift the fallen bladder or rectum into its normal position. There are a number of ways your doctor may make this repair and your doctor will recommend the best procedure for you based on your conditions.5,8

The key is if you are having any of these symptoms, contact your doctor. They will be able to determine what the primary cause of your problem is and provide the most appropriate treatment. Remember, there is always the risk of complications with any treatment. This can include urinary tract infections, bladder and or kidney damage, and urinary incontinence.

Your doctor will present you with the options that are available to treat your specific condition and explain the risks and benefits of the procedures that may best serve your needs.

Places You Can Find More Information

About Urinary Retention - National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)
The Urinary System and How it Works - the Urology Foundation
• Imaging of the Urinary Tract - National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)


Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional. 


References for the article above

Please note that this information provided by Liberator Medical is not intended to be used in place of a visit, consultation, or advice of a medical professional...

References

  1. Urology Care Foundation – Neurogenic Bladder Symptoms, Updated May 2014 http://www.urologyhealth.org/urology/index.cfm?article=9#SymptomNB
  2. Kirby R.S. Prostate Disease and their Treatments, Health Press Oxford 2010
  3. Diseases and Conditions; Benign Prostatic Hyperplasia (BPH), Updated 12/2001 http://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/basics/symptoms/con-20030812
  4. Lepo H, Managing and Preventing Acute Urinary Retention, Urol. 2005; 7 (Suppl 8) S26-S33
  5. National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) Urinary Retention Updated 8/2014 http://kidney.niddk.nih.gov/KUDiseases/pubs/UrinaryRetention/UrinaryRetention_508.pdf
  6. R Appell MD, Voiding Dysfunction – Diagnosis and Treatment, Humana Press Inc. New Jersey 2000
  7. A Wein MD, Campbell-Walsh Urology, Elsevier Saunders, Philadelphia PA, 2012
  8. A Slack, D Newman, A Wein MD, Fast Facts: Bladder Disorders, Oxford Press Ltd., Oxford UK, 2011
  9. B Selius DO, R Subedi MD, Urinary Retention in Adults: Diagnosis and Management, American Family Physician, Volume 77 Number 3, 2008

Information is as of 12/2014. Please check references for updated information.


Liberator Medical Overview

Liberator Medical Supply, Inc. has been Bringing Better Healthcare Home to You since 1999. We are a national direct-to-consumer provider of sterile intermittent catheters and urological supplies, ostomy supplies, diabetes testing supplies as well as mastectomy bras and breast prostheses.

Liberator Medical received provider accreditation from The Joint Commission, a national accreditation organization authorized by the federal government's centers for Medicare and Medicaid Services, and holds an A+ rating with the Better Business Bureau.

Liberator Medical is owned by C. R. Bard, Inc., an S&P 500 company, publicly-traded under NYSE:BCR, headquartered in Murray Hill, NJ. For more than 100 years, Bard® has been a multinational developer and manufacturer of innovative, life-enhancing medical technologies in the fields of urology, vascular, oncology and surgical specialties.

macbook

Liberator Medical's Commitment to Customer Care & Service Excellence

Products

  • Access to one of the largest, most complete “on hand” inventories in the U.S.
  • FREE* samples of innovative products from the leading manufacturers so you can be certain you’re using the best products for you and your lifestyle
  • We will never substitute the products you ordered without your consent

Free Service & Support

  • Access to Product Specialists to help you get the best products for your individual needs
  • Customer Support - 24/7 access to the most up-to-date product news and information
  • Online chat with Product Specialists - A fast and discreet way to discuss sensitive issues
  • Access to Physicians - We’ll help you locate a physician if you need to renew your prescription

Insurance & Billing

  • Access to Insurance Specialists - Now you have an ally to help you to maximize your benefits
  • 3-way calls with a Liberator Medical Insurance Specialist, you and your insurer to help you get a full understanding of your insurance coverage
  • We handle all insurance paperwork and billing for you, taking the complexity off your hands
  • We’re in-network with over 3,000 insurance plans, and we're adding additional plans every day

Free** Shipping & Delivery

  • Free** Shipping - Delivered discreetly right to your home or alternate location
  • Advanced Automated Shipping Process - Providing faster and more accurate order delivery
  • Auto-Ship for most Private Insurance Customers

** Free shipping on all Medicare, Medicaid and Private Insurance orders.

Re-Ordering

  • Free Re-Order Reminders - Never worry about running out of your medical supplies again
  • 14-Day Supply Packs - This package contains 14 days of supplies. When opening this package last, call us to help ensure you’ll get your next order on time