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Pelvic Relaxation

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141. Preterm labour and birth

blocker that relaxes smooth muscle 56 • Nifedipine is the tocolytic of choice 57,58 Contraindications* • If there are contraindications to Nifedipine, liaise with an Obstetrician to determine alternate tocolysis • Contraindications include 56 : o Maternal hypotension or cardiac disease o Previous adverse reaction to calcium channel blockers Dose* • Nifedipine 20 mg oral stat 56 • If contractions persist after 30 minutes repeat Nifedipine 20 mg oral 56 • If contractions persist after a further 30 (...) period • Low dull backache • The feeling that your baby is pushing down, called pelvic pressure • Belly cramps with or without diarrhoea • Change in the colour of your vaginal discharge • General feeling that something is not right • Bleeding from your vagina Call your health care provider immediately if: • Your baby stops moving • Your waters break • You have regular contractions • You have any bleeding from your vagina • You have a low dull backache. The pain may be felt in your lower back or move

2020 Queensland Health

142. Microhematuria: AUA/SUFU Guideline

was conducted in conjunction with the MH Panel. Panel Formation. The Panel was created in 2018 by the American Urological Association Education and Research, Inc. (AUAER). This guideline was developed in collaboration with the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU). The Practice Guidelines Committee (PGC) of the AUA selected the Panel Chairs who in turn appointed the additional panel members with specific expertise in this area in conjunction with SUFU (...) activity of hemoglobin using benzidine, but does not correlate perfectly with microscopic evaluation. For example, myoglobinuria, dehydration, exercise, menstrual blood, or povidone-iodine (betadine) can produce false- Copyright © 2020 American Urological Association Education and Research, Inc.® Microhematuria 11 Risk Factors Included in AUA Microhematuria Risk Stratification System Additional Urothelial Cancer Risk Factors* 6,14,47-51 Age Irritative lower urinary tract symptoms Male sex Prior pelvic

2020 Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction

143. Microhematuria: AUA/SUFU Guideline

Pelvic Medicine & Urogenital Reconstruction (SUFU). The Practice Guidelines Committee (PGC) of the AUA selected the Panel Chairs who in turn appointed the additional panel members with specific expertise in this area in conjunction with SUFU. Additionally, the Panel included representation from the American College of Obstetricians and Gynecologists (ACOG) as well as a patient advocate. Funding of the Panel was provided by the AUA; panel members received no remuneration for their work. Searches (...) symptoms Male sex Prior pelvic radiation therapy Smoking use Prior cyclophosphamide/ifosfamide chemotherapy Degree of microhematuria Family history of urothelial cancer or Lynch Syndrome Persistence of microhematuria Occupational exposures to benzene chemicals or aromatic amines (e.g., rubber, petrochemicals, dyes) History of gross hematuria Chronic indwelling foreign body in the urinary tract *The Panel recognizes that this list is not exhaustive. Clinicians should also understand

2020 American Urological Association

144. Disorders of Ejaculation: An AUA/SMSNA Guideline

and other causes of chronic pelvic pain. Post Orgasmic Illness Syndrome (POIS) 32-34 is provisional diagnosis which has been applied to cases of somatic symptoms that occur in close association with sexual climax. POIS is distinguished from painful ejaculation by the presence of symptoms outside the pelvis, such as malaise, confusion, myalgias, fatigue, or other somatic concerns. The etiology of POIS is unclear but may be an autoimmune, cytokine-mediated, or allergic reaction to seminal components has (...) by arousal, climax, and resolution. Under normal circumstances, sexual climax in men consists of two distinct physiological events. The first of these is orgasm, a sensation of intense pleasure, relaxation, or intimacy that accompanies peak sexual arousal. The second is ejaculation, antegrade expulsion of semen from the urethra. These events are typically simultaneous and the terms are often used interchangeably in the biomedical literature. However, these are distinct physiological processes 4, 5

2020 American Urological Association

145. Axonics sacral neuromodulation system for treating refractory overactive bladder

incontinence and pelvic organ prolapse and lower urinary tract symptoms. Axonics SNM system is small and does not need to be removed for most types of MRI scans, so it may be useful for people with a low body mass index (BMI) or when an MRI is likely. 1.3 Cost modelling estimates that, over 15 years, Axonics SNM system is cost saving compared with the non-rechargeable system by about £6,025 per person. Cost savings are estimated to begin 6 years after implant. This is because the device needs (...) to be replaced less frequently than the non-rechargeable system, assuming Axonics has a life span of at least 15 years. For more details, see the NICE resource impact statement. Why the committee made these recommendations Why the committee made these recommendations Axonics SNM system uses electrical impulses to stimulate the sacral nerves in the pelvic floor or groin area, to help bladder control. The system is implanted surgically and has a small stimulator that uses a rechargeable battery. Axonics SNM

2020 National Institute for Health and Clinical Excellence - Medical technologies

146. 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

2020 Queensland Health

147. Perineal care

Guideline: Perineal care Refer to online version, destroy printed copies after use Page 5 of 39 Abbreviations AOR Adjusted odds ratio APM Antenatal perineal massage CT Computed tomography CI Confidence intervals CS Caesarean section EAS External anal sphincter FGM Female genital mutilation GP General Practitioner HHS Hospital and Health Service IAP Intra-abdominal pressure IAS Internal anal sphincter IPM Intrapartum perineal massage IV Intravenous NSAID Non-steroidal anti-inflammatory drugs PFMT Pelvic (...) floor muscle training OASIS Obstetric anal sphincter injury or injuries OR Odds ratio OT Operating theatre PR Per rectum RCT Randomised controlled trial RR Relative risk USS Ultrasound scan Definition of terms Accoucheur Clinician directly assisting with birth of baby. Anal manometry A test which measures the pressures of the anal sphincter muscles. Crowning When the widest part of the fetal head (biparietal diameter) has passed through the pelvic outlet. Deinfibulation A surgical procedure to cut

2020 Queensland Health

148. The Management of adult patients with severe chronic small intestinal dysmotility

of the urethral sphincter to relax (Fowler’s on August 24, 2020 by guest. Protected by copyright. http://gut.bmj.com/ Gut: first published as 10.1136/gutjnl-2020-321631 on 21 August 2020. Downloaded from 6 Nightingale JMD, et al. Gut 2020;0:1–19. doi:10.1136/gutjnl-2020-321631 Guidelines Figure 2 Main factors contributing to severe chronic intestinal dysmotility and its traditional classification. syndrome) and hypoglycaemia. 37 Mast cell activation disorder 39 is being increasingly reported (most commonly (...) be exam- ined for amyloidosis. Genetic testing is now readily available for the hereditary type of amyloidosis, which may present more commonly in men and with peripheral neuropathy and cardiac as well as gut involvement. Chronic irradiation damage This usually occurs after pelvic irradiation for gynaecological cancers or genitourinary cancers. The sigmoid and terminal ileal areas are often most involved. However, the whole small bowel can be involved giving rise to a pseudo- obstruction picture

2020 British Society of Gastroenterology

149. 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

150. 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

151. 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

152. 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

153. 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

154. 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

156. Peramivir (Alpivab) - Influenza, Human

study: renal tubular and pelvic mineralization, tubular dilatation, epithelial renal hyperplasia) and juvenile rats (drug-related minor renal cortical tubular changes), species that do not generate acyl glucuronide. The applicant has discussed this topic further, with a requirement for Assessment report EMA/CHMP/148367/2018 Page 23/108 updating sections 4.8 and 5.3 focus on the potential for renal toxicity and the possible clinical relevance. As renal necrosis has been seen in rabbits, reports

2018 European Medicines Agency - EPARs

157. Antenatal and Postnatal Analgesia Full Text available with Trip Pro

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

2018 Royal College of Obstetricians and Gynaecologists

158. Management of symptomatic hypermobility in children and young people

can be useful such as having a stool to rest their feet on in front of the toilet to help optimize the position of the pelvis and enable effective bowel opening ? Onward referral for medical management of significant bowel symptoms may be required ? Onward referral for medical management of significant urological symptoms may be required 4 Cardiovascular autonomic dysfunction – patients with symptomatic hypermobility may describe symptoms of autonomic dysfunction, which affects heart rate, blood (...) , into which the young person and family/carers put their own collection of activities and interventions which can be used to reduce the pain experience, can be a useful adjunct. These can include items to encourage distraction, positive coping statements, relaxation scripts or apps, sleep hygiene, mindfulness, aromatherapy oils, exercises, comforting objects. These may be real or a virtual box that has been created by the young person and family/carers (https://www.swft.nhs.uk/application/files/7714/6012

2019 British Society for Rheumatology

159. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: an AUA/SUFU Guideline

about OAB, the benefits versus risks/burdens of the available treatment alternatives and the fact that acceptable symptom control may require trials of multiple therapeutic options before it is achieved. Clinical Principle Treatment: First-Line Treatments: Behavioral Therapies 6. Clinicians should offer behavioral therapies (e.g., bladder training, bladder control strategies, pelvic floor muscle training, fluid management) as first line Approved by the AUA Board of Directors April 2019 Authors (...) ’ disclosure of potential conflicts of interest and author/staff contributions appear at the end of the article. © 2019 by the American Urological Association American Urological Association (AUA)/ Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) Guideline DIAGNOSIS AND TREATMENT OF OVERACTIVE BLADDER (Non-Neurogenic) IN ADULTS: AUA/SUFU GUIDELINE E. Ann Gormley, Deborah J. Lightner, Kathryn L. Burgio, Toby C. Chai, J. Quentin Clemens, Daniel J. Culkin, Anurag Kumar Das

2019 American Urological Association

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