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Pelvic Relaxation

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121. Displacement after simulated pelvic ring injuries: a cadaveric model of recoil. (PubMed)

patterns and varying severity of displacement lead to different amounts of passive recoil.In 15 cadaveric pelvic specimens, unilateral anteroposterior compression (n = 7) or lateral compression (n = 8) injury patterns were experimentally created. A motion-tracking system was used to record rotational deformity of each hemipelvis before, during, and after fracture creation. The absolute and relative magnitudes of pelvic displacement and recoil after force relaxation were determined.In the simulated AO (...) Displacement after simulated pelvic ring injuries: a cadaveric model of recoil. Determining pelvic ring stability after a fracture is vital to treatment decisions. Commonly used information includes the displacement seen on initial radiographs. Static imaging studies may misrepresent the maximal amount of traumatic displacement at injury. We hypothesized that postinjury radiographs do not reveal maximal displacement of pelvic ring fractures. We also sought to determine whether different injury

2010 Journal of Trauma

122. The role of uroflowmetry biofeedback and biofeedback training of the pelvic floor muscles in the treatment of recurrent urinary tract infections in women with dysfunctional voiding: a randomized controlled prospective study. (PubMed)

The role of uroflowmetry biofeedback and biofeedback training of the pelvic floor muscles in the treatment of recurrent urinary tract infections in women with dysfunctional voiding: a randomized controlled prospective study. To evaluate the efficacy of a training program with uroflowmetry biofeedback and pelvic floor relaxation biofeedback on urodynamic and voiding parameters in women with dysfunctional voiding.Eighty-six women with recurrent urinary tract infections (UTIs) and dysfunctional (...) voiding were randomly assigned to receive a treatment schedule as follows: uroflowmetry biofeedback (group 1), biofeedback training of the pelvic floor muscles (group 2), uroflowmetry biofeedback combined to biofeedback training of the pelvic floor muscles (group 3), no treatment (group 4). Patients were regularly evaluated by American Urological Association Symptom Index and urodynamics during the study period. All the patients were followed up for 1 year with monthly urine cultures. A further

2010 Urology Controlled trial quality: uncertain

123. Recommendations for good practice in Ultrasound: Oocyte retrieval

instead of general anaesthesia; • decreased risk of intestinal trauma; • it can be easily learned, especially by operators trained in US; • decreased costs for patients; • and quick post-interventional recovery. However, in some patients, transabdominal ultrasound facilitated access when the ovaries were transposed or enlarged above the pelvic brim. Transabdominal-guided oocyte retrieval continues to be used at some centres for rare patients who have ovaries inaccessible by vaginal ultrasound (...) fertilisation IVM In vitro maturation LH Luteinizing hormone OHSS Ovarian hyperstimulation syndrome OPU Oocyte pick-up PACS Picture archiving and communication system PCOS Polycystic ovary syndrome PCSA Patient controlled sedation/analgesia PID Pelvic inflammatory disease RCOG Royal College of Obstetricians and Gynaecologists TVOR Transvaginal oocyte retrieval TV-US Transvaginal ultrasound US Ultrasound VA Verbal anaesthesia WG Working group WHO World Health Organisation Submitted for publication in HROpen

2019 European Society of Human Reproduction and Embryology

124. Non-clinical interventions for reducing unnecessary caesarean section. (PubMed)

for couples may reduce caesarean section (RR 0.59, 95% CI 0.37 to 0.94) and may increase spontaneous vaginal birth (RR 2.13, 95% CI 1.09 to 4.16). We judged this one study with 60 participants to have low-certainty evidence for the outcomes above.Nurse-led applied relaxation training programmes (RR 0.22, 95% CI 0.11 to 0.43; 104 participants, low-certainty evidence) and psychosocial couple-based prevention programmes (RR 0.53, 95% CI 0.32 to 0.90; 147 participants, low-certainty evidence) may reduce (...) the certainty of evidence to be low.We studied the following interventions, and they either made little or no difference to caesarean section rates or had uncertain effects.Moderate-certainty evidence suggests little or no difference in caesarean section rates between usual care and: antenatal education programmes for physiologic childbirth; antenatal education on natural childbirth preparation with training in breathing and relaxation techniques; computer-based decision aids; individualised prenatal

2018 Cochrane

125. Chronic pain syndromes

, and chronic headache syndromes. One in 3 patients over the age of 65 years is affected by chronic pain, often due to arthritis, osteoporosis with fractures and/or lumbar spinal stenosis. These conditions are treatable and should not be considered part of the normal ageing process. Untreated chronic pain in geriatric patients can result in depression, poor quality of life, and loss of independence. Some treatments, such as stretching exercises, relaxation techniques, antidepressants, and antiepileptic (...) . Chronic pain occurs due to persistent activation of neural pain pathways and muscle spasm. Chronic pain is discussed here as a syndrome and includes non-malignant conditions without localised or regional causes (such as abdominal pain or pelvic pain). [Figure caption and citation for the preceding image starts]: Acute pain occurs with trauma or illness, decreasing during healing and resolving within 3 months. Chronic pain persists after healing is completed, due to continued activation of neural pain

2018 BMJ Best Practice

126. Optimisation of RIZIV – INAMI lump sums for incontinence

of conflict of interest to the main topic of this report’ Membership of a stakeholder group on which the results of this report could have an impact: Veerle Decalf (Urobel), Anja Declercq (fellow of InterRAI, research about BelRAI), Ronny Pieters (Urobel) Fees or other compensation for writing a publication or participating in its development: Els Bakker (courses pelvic re-education) Participation in scientific or experimental research as an initiator, principal investigator or researcher: Veerle Decalf (...) -profit organisations), Ronny Pieters (College Ghent symposium fee Coloplast, College Odisee) Presidency or accountable function within an institution, association, department or other entity on which the results of this report could have an impact: Els Bakker (president BAPRA – Belgian Abdominal Pelvic Reeducation Association), Anja Declercq (board member BelRAI), Ronny Pieters (Urobel) Layout: Ine Verhulst, Joyce Grijseels Disclaimer: • The external experts were consulted about a (preliminary

2019 Belgian Health Care Knowledge Centre

127. Canadian Urological Association guideline for the diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction

or spinal cord tumour, cauda equina syndrome, transverse myelitis, multisystem atrophy, pelvic nerve injury, and diabetes. It is well-described that neurological disorders can lead to urological complications, including: urinary incontinence, urinary tract infections (UTIs), urolithiasis, sepsis, ureteric obstruction, vesicoureteric reflux (VUR), and renal failure. 2 Due to the potential morbidity and even mortality, initial investigation, ongoing management, and surveillance is warranted (...) , renal function) Review of relevant systems Bowel function Sexual function Coexisting non-NLUTD dysfunction (prostatic enlargement, stress incontinence) Gross hematuria Gynecological/pregnancy history Genitourinary/pelvic pain Motor abilities (hand function, ability to transfer) Cognitive function Support systems/caregivers CIC: clean intermittent catheterization; MS: multiple sclerosis; NLUTD: neurogenic lower urinary tract dysfunction; SCI: spinal cord injury; UTI: urinary tract infection.CUAJ

2019 Canadian Urological Association

128. Menopause

, usually for carcinogenic illness (pelvic radiation or chemotherapy). 1. The menopauseMENOPAUSE 6 One of the questions most commonly asked by women in their late forties is: “Is it the change? Can I have a blood test?” In practice, it is rarely useful to perform blood tests as hormone levels fluctuate widely over a very short time span, making the results confusing and unreliable. Blood tests (for FSH) are usually only indicated when a premature menopause is suspected in a younger woman, or to rule out (...) and caffeine and avoiding or modifying a known trigger may help; wearing natural fabrics that can ‘breathe’ and using lightweight cotton bedding may also help • exercise can help general wellbeing and mood as well as improving stamina and fitness • relaxation or stress reduction techniques will improve coping strategies • cognitive behavioral therapies, including counseling may help to deal with life events that are causing anxiety • vaginal symptoms may be relieved by regular use of vaginal moisturisers

2018 Royal College of Nursing

129. Hysterectomy

. Leiomyomas: For symptomatic fibroids, hysterectomy providesa permanent solution to menorrhagia and the pressure symptoms related to an enlarged uterus (I-A). 2. Abnormal uterine bleeding: Endometrial lesions must be excluded and medical alternatives should be considered as a first line of therapy (III-B). 3. Endometriosis: Hysterectomy is often indicated in the presence of severe symptoms with failure of other treatments and when fertility is no longer desired (I-B). 4. Pelvic relaxation: A surgical (...) solution usually includes vaginal hysterectomy, but must include pelvic supporting procedures (II-B). 5. Pelvic pain: A multidisciplinary approach is recommended, as there is little evidence that hysterectomy will cure chronic pelvic pain. When the pain is confined to dysmenorrhea or associated with significant pelvic disease, hysterectomy may offer relief (II-C). Preinvasive Disease 1. Hysterectomy is usually indicated for endometrial hyperplasia with atypia (I-A). 2. Cervical intraepithelial

2018 Society of Obstetricians and Gynaecologists of Canada

131. AIM Clinical Appropriateness Guidelines for Interventional Pain Management

management should include a combination of strategies to reduce inflammation, alleviate pain, and improve function, including but not limited to the following: ? Prescription strength anti-inflammatory medications and analgesics ? Adjunctive medications such as nerve membrane stabilizers or muscle relaxants ? Physician-supervised therapeutic exercise program or physical therapy ? Manual therapy or spinal manipulation ? Alternative therapies such as acupuncture ? Appropriate management of underlying (...) procedure. Studies have validated the efficacy of this intervention in chronic pain of facet origin. General Requirements Conservative management should include a combination of strategies to reduce inflammation, alleviate pain, and improve function, including but not limited to the following: ? Prescription strength anti-inflammatory medications and analgesics ? Adjunctive medications such as nerve membrane stabilizers or muscle relaxants ? Physician-supervised therapeutic exercise program or physical

2019 AIM Specialty Health

133. Management of Irritable Bowel Syndrome (IBS)

to improve IBS symptoms. GRADE: Conditional recommendation, moderate-quality evidence 29: We recommend offering constipation-predominant IBS patients linaclotide to improve IBS symptoms. GRADE: Strong recommendation, high-quality evidence STATEMENTS WITH NO RECOMMENDATIONS No recommendation A: The consensus group does not make a recommendation (neither for nor against) offering IBS patients relaxation techniques to improve IBS symptoms. No recommendation B: The consensus group does not make

2019 Canadian Association of Gastroenterology

134. Approaches to Limit Intervention During Labor and Birth

, but few have been studied extensively enough to determine clear or relative effectiveness. During the first stage of labor, water immersion has been found to lower pain scores without evidence of harm (8, 34). Intradermal sterile water injections, relaxation techniques, acupuncture, and massage may result in reduction in pain in many studies, but methodologies for rating pain and applying these techniques have been varied; therefore, exact tech- niques that are most effective have not been determined (...) pushing during the second stage of labor on postpartum pelvic floor structure and function. Am J Obstet Gynecol 2005;192:1692–6. 52. Brancato RM, Church S, Stone PW. A meta-analysis of passive descent versus immediate pushing in nulliparous womenwithepiduralanalgesiainthesecondstageoflabor. J Obstet Gynecol Neonatal Nurs 2008;37:4–12. 53. Rouse DJ, Weiner SJ, Bloom SL, Varner MW, Spong CY, Ramin SM, et al. Second-stage labor duration in nullipa- rous women: relationship to maternal and perinatal out

2019 American College of Obstetricians and Gynecologists

135. Tizanidine

Study to Assess the Pharmacokinetics, Safety and Tolerability, and Pharmacodynamics of Tizanidine at 4 Different Oral Dose Levels in Pediatric Subjects 2 2011 6. A double-blind comparative trial of new muscle relaxant, tizanidine (DS 103-282), and baclofen in the treatment of chronic spasticity in multiple sclerosis. 7016449 1981 08 20 1981 08 20 2014 11 20 0300-7995 7 6 1981 Current medical research and opinion Curr Med Res Opin A double-blind comparative trial of new muscle relaxant, tizanidine (...) (DS 103-282), and baclofen in the treatment of chronic spasticity in multiple sclerosis. 374-83 A double-blind trial with two parallel groups was carried out (...) to compare the antispastic effect and tolerability of a new muscle relaxant, tizanidine (DS 103-282), with those of baclofen in the treatment of spasticity due to multiple sclerosis. Twenty-one hospitalized patients with stable spasticity participated in the 6-week trial. Eleven received tizanidine and 10 baclofen in gradually

2018 Trip Latest and Greatest

136. Diazepam

Diazepam is a long-acting benzodiazepine used as a hypnotic, anxiolytic, anticonvulsant and muscle relaxant. Its actions are mediated (...) by enhancement of the activity of gamma-aminobutyric acid (GABA), a major inhibitory neurotransmitter in the brain. Data on the risk of congenital malformation following use of diazepam in pregnancy are highly confounded by the research techniques employed in the majority of the available studies. Evidence is therefore conflicting; with some older studies (...) of orally administered diazepam . The evaluation of the overall sedative effects of the diazepam and nitrous oxide together were better than the sedative effects of diazepam alone. Best Evidence (you may view more info by clicking 2013 20. Intra-vaginal diazepam for high-tone pelvic floor dysfunction: a randomized placebo-controlled trial. 23681047 2013 10 21 2014 06 23 2013 10 21 1433-3023 24 11 2013 Nov International urogynecology journal Int Urogynecol J Intra-vaginal diazepam for high-tone pelvic

2018 Trip Latest and Greatest

137. Constipation

. This is the third blog in our new series Evidence for Everyday Health Choices. Constipation is a miserable condition which can worsen co-morbidities like low back pain, muscle (...) can cause constipation , particularly in children – it’s best to move your bowels when you feel the first urge. Poo position You can help reduce the stress on the tissues and reduce straining by squatting to pass a bowel movement. This position encourages the pelvic floor to relax. This can be mimicked on a Western style toilet (...) in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button 2018 10. Easing the strain: put your feet up for constipation Easing the strain: put your feet up for constipation - Evidently Cochrane Search and hit Go By February 24, 2016 // In this guest blog, pelvic physiotherapist and comedian Elaine Miller tells us what we need to know to avoid constipation and when the going gets tough

2018 Trip Latest and Greatest

138. Antenatal and Postnatal Analgesia

Antenatal analgesia Many women experience pain during pregnancy including headache, lower back pain and pelvic pain. Prior to giving advice regarding analgesic options pain should be investigated as appropriate to exclude serious causes. Non‐pharmacological interventions should be considered first line; for example, adequate rest, hot and cold compresses, massage, acupuncture, physiotherapy, relaxation and exercise. Some women find aromatherapy soothing and very useful as an aid to relaxation, so it can

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2018 Royal College of Obstetricians and Gynaecologists

139. Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia

reduction of LUTS. This effect may be potentiated by a reduction of the α-1 adrenergic receptor density in the embolized prostate, causing relaxation of smooth muscle ( x 19 Sun, F., Crisostomo, V., Baez-Diaz, C., and Sanchez, F.M. Prostatic artery embolization (PAE) for symptomatic benign prostatic hyperplasia (BPH): part 2, insights into the technical rationale. Cardiovasc Intervent Radiol . 2016 ; 39 : 161–169 ) (19) . The therapeutic effect of PAE was first described in a case report in 2000 ( x 20

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2019 Society of Interventional Radiology

140. Primary postpartum haemorrhage

, colour, cerebral perfusion) o Hypovolemic shock disproportionate to the revealed blood loss o Feelings of pelvic or rectal pressure o Urinary retention · Act promptly to: o Resuscitate as required [refer to 3.3 Resuscitation] o Perform vaginal/rectal examination to determine site and extent o Consider transfer to operating theatre (OT) for clot evacuation, primary repair and/or tamponade of blood vessels · Refer to Queensland Clinical Guideline: Perineal care 38 Refer to online version, destroy

2019 Queensland Health

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