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The book surveys the prevalence, the pathophysiology, the diagnosis, the current therapy, both conservative and operative, and the long-term outcome of treatment of urinary and fecal incontinence. It is targeted at general and colorectal surgeons, urologists, gynecologists and gastroenterologists who treat incontinent patients, and also gives general practitioners and geriatric physicians an overview of the diagnostic methods and treatment options that can be offered to incontinent patients.
Completely updated to reflect current practice, the 3rd edition of this comprehensive resource provides a multi-disciplinary, in-depth review of the physiology of continence, the pathologic mechanisms producing incontinence, and current treatment options for the various types of incontinence. Assessment, behavioral therapies, and multidisciplinary care are emphasized as key elements in the treatment and management of incontinence. In addition to the life-span content discussed throughout the book, an entire chapter is devoted to bowel and bladder management in children. Authored and contributed by leaders in the Wound, Ostomy and Continence Nurses Society (WOCN). Provides an in-depth review of the physiology of continence, the pathologic mechanisms producing incontinence, and current treatment options to facilitate optimal assessment and care. Features detailed assessment guidelines to help clinicians accurately identify causative and contributing factors, and implement of a comprehensive management plan. Discusses urinary incontinence and fecal incontinence in separate sections to address the special considerations for each in an organized, focused, easy-to-use format. Features individual, complete chapters for each of the following types of incontinence: stress, functional, reflex (neurogenic bladder), and overactive bladder (urge incontinence). Devotes separate chapters to Pathology & Management of Postprostatectomy Incontinence and Bowel and Bladder Management in Children to ensure comprehensive coverage of these topics. Offers life-span content to help clinicians provide appropriate care for patients in every stage of life. Includes self-assessment questions with answers and rationales for review and self-testing. Integrates multidisciplinary care throughout to highlight its importance in successful treatment. Features a new chapter on Pathology & Management of Postprostatectomy Incontinence that provides detailed information on this increasingly important aspect of incontinence. Includes content on the impact of spinal cord injury on bladder and bowel function.
Treatment and Care of the Geriatric Veterinary Patient offers veterinarians a complete guide to treating and managing geriatric canine and feline patients. Offers practical guidance on managing all aspects of veterinary care in geriatric pets Takes a holistic approach to managing the geriatric patient, from common diseases and quality of life to hospice, euthanasia, client communications, and business management Focuses on dogs and cats, with a chapter covering common exotic animals Provides clinically oriented advice for ensuring quality of life for older pets Includes access to a companion website with videos, client education handouts, and images
Pediatric incontinence: evaluation and clinical management offers urologists practical, 'how-to' clinical guidance to what is a very common problem affecting up to 15% of children aged 6 years old. Introductory chapters cover the neurophysiology, psychological and genetic aspects, as well as the urodynamics of incontinence, before it moves on to its core focus, namely the evaluation and management of the problem. All types of management methods will be covered, including behavioural, psychological, medical and surgical, thus providing the reader with a solution to every patient's specific problem. The outstanding editor team led by Professor Israel Franco, one of the world’s leading gurus of pediatric urology, have recruited a truly stellar team of contributors each of whom have provided first-rate, high-quality contributions on their specific areas of expertise. Clear management algorithms for each form of treatment support the text, topics of controversy are covered openly, and the latest guidelines from the ICCS, AUA and EAU are included throughout. Perfect to refer to prior to seeing patients on the wards and in the clinics, this is the ideal guide to the topic and an essential purchase for all urologists, pediatric urologists and paediatricians managing children suffering from incontinence.
Multidisciplinary Care of Urinary Incontinence - a Handbook for Health Professionals effectively uses a multidisciplinary approach to assist health professionals in their care of patients with urinary incontinence. It is recognized that the best outcomes are achieved by a multidisciplinary team approach especially with regard to complex cases and care of the elderly. This book is written by expert authors from around the world with a wealth of experience in conducting clinics on pelvic floor, aged care voiding dysfunction and neuro-rehabilitation. The text is illustrated throughout and contains case-studies with input and practical tips from the different health disciplines at each point. Each chapter concludes with a list of seminal publications and web-based resources to assist the reader in the clinical environment. Multidisciplinary Care of Urinary Incontinence - a Handbook for Health Professionals is of benefit to medical and allied health disciplines including family physicians, nurses, urologists, gynecologists, physiotherapists, geriatricians, neurologists and rehabilitation specialists.
The prevalence of fecal incontinence is approximately 5% in the general population. In all patients, the treatment of fecal incontinence is primarily conservative and surgery is offered as second line treatment. Electrical stimulation of the sacral nerves (SNS) with an implanted electrode is a minimally invasive and effective treatment of idiopathic FI and the indications for SNS are widening. However, SNS requires surgery while percutaneous electrical stimulation of peripheral nerves could be a non-invasive alternative. Stimulation for Faecal Incontinence comprises five studies. Study I examines the clinical effectiveness of transcutaneous stimulation. Study II and III examined the acute effect of rectal stimulation in idiopathic incontinent patients and patients with spinal cord injury. In study IV the validity of a new research tool for assessment of gastrointestinal motility during stimulation is evaluated. In study V, small intestinal motility is investigated in patients implanted with a sacral nerve stimulator for faecal incontinence. Based on the present book it can be concluded that: DGN stimulation reduces faecal incontinence in patients with idiopathic faecal incontinence but the mode of action remains unknown. DGN does not affect rectal wall properties in patients with idiopathic faecal incontinence. DGN increases rectal tone in patients with supraconal spinal cord injury, but the validity and clinical importance of the finding need further study. MTS-1 is useful for determination of gastric emptying and small intestinal transit time. Preliminary results indicate that SNS does not affect small intestinal motility, but data need further analysis and have to be confirmed in a larger study.
Fecal incontinence is a common and embarrassing condition with a devastating impact on patients’ lives. Since it may result from a variety of pathophysiological situations, an accurate diagnostic work-up is crucial. A range of therapies is available, but choosing the correct option is pivotal to successful management. This book reviews the latest advances in the epidemiologic, socio-economic, psychological, diagnostic, and therapeutic aspects of fecal incontinence, helping to establish effective treatment guidelines.
The number of Americans 65 years of age or older is projected to more than double to over 98 million by 2060, making them 24% of the overall population. Women constitute more than 50% of this group. Most clinicians who provide primary care for older women receive minimal training about their unique health issues and needs during residency however, and few resources exist to guide them regarding these issues in practice. This book provides user-friendly, evidence-based guidance to manage common challenges in healthcare for women during menopause and beyond, filling a huge and growing unmet need for primary care clinicians. Edited by a multidisciplinary team with content expert authors from family medicine, oncology, urogynecology, obstetrics and gynecology, psychology, and more, this text provides clinically relevant information about important conditions impacting the health of older women, including suggested guidelines for management and helpful resources for patient counselling and care. The first half of the book covers general topics such as menopause, bone health, depression and grief, cancer survivorship, and obesity. The second half focuses on issues below the belt that are difficult to talk about, such as incontinence, vulvar pathology, and sexual health after menopause. While there is copious literature about the menopausal transition, few resources for clinicians exist about caring for women beyond the 6th decade. Challenges in Older Women’s Health: A primer for clinicians provides focused, evidence-based information about high-yield topics for a too often neglected group of patients.
Dedicated to ostomies and continent diversions, this comprehensive reference book features information on the history of enterostomal therapy, anatomy and physiology of diseases that necessitate intestinal or urinary diversions, pouching system management principles, ostomy related complications, care of the cancer patient as well as the patient with chronic disease, and current trends and issues affecting the person with an ostomy. Current topics covered include intestinal diversions requiring temporary diversions, medical and surgical treatments for inflammatory bowel disease, colo-rectal cancers advances and ischemic intestinal disease. Fecal and Urinary Diversions: Management Principles is a valuable resource to students, nurses, physicians, surgeons, and individuals who care for a person with an ostomy without the benefit of a Certified Ostomy (ET) Nurse. - Covers lifespan considerations to address the special needs of patients of all ages. - Includes an 8-page color insert with 25 full-color photos illustrating ostomy-related complications to help nurses improve their assessment skills. - Offers a unique framework for pouch selection to help nurses choose the most effective and cost-conscious options. - Covers coping and quality-of-life issues to guide nurses in handling these important patient and professional considerations. - Features practical, step-by-step guidelines for pouching, irrigation, and other techniques. - Provides review questions and answers to help evaluate learning and prepare for certification or recertification.
As the Baby Boomers age, concerns over healthcare systems' abilities to accommodate geriatric patients grow increasingly challenging. This is especially true with the population deemed to be “the oldest of the old,” specifically those over the age of 85. Unlike any other time in history, this demographic is the fastest growing segment of most developed countries. In the United States the oldest old is projected to double from 4.3 million to 9.6 million by 2030. The increased life expectancy of the population since the early 1900s has been built on the improvement of living conditions, diet, public health and advancement in medical care. With this we have seen a steady decline in the age-specific prevalence of vascular and heart diseases, stroke and even dementia. Older persons are healthier today than their counterparts decades ago. More importantly than in any other age group, the care of the oldest old must be individualized; management decisions should be made taking into consideration the older persons’ expressed wishes, quality of life, function and mental capacity. The inevitable consequence is that there will be an increase in the prevalence of older persons with chronic diseases, multiple co-existing pathologies and neuro-degenerative diseases. The oldest of the aging population are often excluded from drug trials and their treatments are largely based on findings extrapolated from that of the younger old. Furthermore, among the oldest old, physiologically they are more diverse than other segments of the population. Their demographic characteristics are unparalleled and different compared to that of the younger old. Several studies have drawn attention to the differing attitudes among health professionals towards elderly people and many show prejudice because they are old. As a result, the use of age as a criteria in determining the appropriateness of treatment is of very limited validity, yet there are limited resources that guide physicians through these challenges. This book creates a greater awareness of these challenges and offers practical guidelines for working within the infrastructures vital to this demographic. This book is designed for geriatricians, primary care physicians, junior medical officers, specialty geriatrics nurses, and gerontologists. It is divided into 3 sections: General Considerations, Chronic diseases and Geriatric Syndromes. Each chapter provides a summary of important and essential information under the heading of Key Points. Case studies are included in some of the chapters to highlight the principles of management.