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Pelvic Relaxation

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141. 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

142. 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

143. 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

144. 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

145. 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

146. 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

148. 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

149. 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

150. 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 (

2019 British Society for Rheumatology

151. 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

153. WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights

of caesarean sections, among others). Low- to moderate-certainty evidence REC 1b: Nurse-led applied relaxation training programme (content includes group discussion of anxiety and stress-related issues in pregnancy and purpose of applied relaxation, deep breathing techniques, among other relaxation techniques). REC 1c: Psychosocial couple-based prevention programme (content includes emotional self-management, conflict management, problem solving, communication and mutual support strategies that foster (...) Executive summary TABLE 1 (continued) RECOMMENDATION (REC) a STRENGTH OF RECOMMENDATION, CERTAINTY OF EVIDENCE Interventions for leg cramps REC 5: Magnesium, calcium or non-pharmacological treatment options can be used for the relief of leg cramps in pregnancy, based on a woman’s preferences and available options. Not specified Interventions for low back and pelvic pain REC 6: Regular exercise throughout pregnancy is recommended to prevent low back and pelvic pain. There are a number of different

2019 World Health Organisation Guidelines

155. Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults

: Behavioral Therapies 6. Clinicians should offer behavioral therapies (e.g., bladder training, bladder control strategies, pelvic floor muscle training, fluid management) as first line therapy to all patients with OAB. Standard (Evidence Strength Grade B) 7. Behavioral therapies may be combined with pharmacologic management. Recommendation (Evidence Strength Grade C) Second-Line Treatments: Pharmacologic Management 8. Clinicians should offer oral anti-muscarinics or oral β 3 -adrenoceptor agonists (...) and discussed all submitted comments and revised the draft as needed. Once finalized, the guideline was submitted for approval to the PGC. Then it was submitted to the AUA Board of Directors (BOD) for final approval. Funding of the panel was provided by the AUA and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU), although panel members received no remuneration for their work. AUA's amendment process provides for the amendment of existing evidence-based guideline

2019 American Urological Association

156. Management of Infertility

and who wish to become pregnant? o KQ 3a. Does the optimal treatment strategy vary by patient characteristics such as age, ovarian reserve, race, BMI, presence of other potential causes of female infertility, or presence of male factor infertility? • KQ 4. What are the comparative safety and effectiveness of available treatment strategies for women with tubal or peritoneal factors (e.g., pelvic adhesions) who are infertile and who wish to become pregnant? o KQ 4a. Does the optimal treatment strategy

2019 Effective Health Care Program (AHRQ)

157. Society of Interventional Radiology Multisociety Consensus Position Statement on Prostatic Artery Embolization for Treatment of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia Full Text available with Trip Pro

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

2019 Society of Interventional Radiology

158. Pentosan polysulfate sodium (Elmiron) - bladder pain syndrome characterised by either glomerulations or Hunner’s lesions

be a patient disutility associated with use of bladder instillations relative to PPS although the level of this disutility is uncertain. ? The ICER versus BSC for patients who are considered inappropriate for bladder instillation is sensitive to the response rate assumed for placebo in the meta-analyses, the utility for BSC and an assumption that the efficacy of BSC wanes after one year (increases the ICER if this assumption is relaxed). However, BSC alone is not considered a major comparator to pentosan (...) , and after application of the appropriate SMC modifiers, the Committee accepted pentosan polysulfate sodium for use in NHSScotland. Other data were also assessed but remain confidential.* Additional information: guidelines and protocols The European Association of Urology (EAU) published guidelines on “Chronic Pelvic Pain” in March 2018. This recommends multimodal behavioural, physical and psychological techniques alongside oral or invasive treatments for bladder pain syndrome. It recommends: ? dietary

2019 Scottish Medicines Consortium

159. 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

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