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Pelvic Relaxation

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142. 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)

143. 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)

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

145. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations—2019 update

for gynecologic surgery. The presence of malignancy, higher body mass index, age, pelvic surgery, extra-pelvic disease, histology, pre-operative corticosteroids, receipt of chemotherapy, immobility, and a hypercoagulable state have all been identified as independent risk factors for VTE and are common among women undergoing gynecologic surgery, especially for cancer. All gynecologic oncology patients who undergo major surgery lasting longer than 30 min should receive dual VTE mechanical prophylaxis (...) coverage is recommended if the bowel is entered during pelvic surgery for cancer. Dosage may need to be adjusted based on patient weight. Most antibiotics should be administered within 1 hour of incision in order to obtain the highest drug serum levels at incision. Antibiotic redosing should be monitored for compliance based on operative time and blood loss. Several surgical site infection reduction bundles include an emphasis on antibiotic dosing and timing of administration. Appropriate antimicrobial

2019 ERAS Society

147. 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

148. Treatment for Acute Pain: An Evidence Map

several classes. Pain relieving analgesics include opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen. These are often used in combination. Based on putative pain mechanisms, providers may also manage acute pain with muscle relaxants, antidepressants, alpha-2 agonists, GABA analogues, corticosteroids, NMDA receptor antagonists, local anesthetics, cannabinoids, among others. 23, 24 Topical agents such as capsaicin and lidocaine are also used. 23 Many medications for pain

2019 Effective Health Care Program (AHRQ)

150. 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

152. 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

154. Neuro-urology

bladder diary in women with urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct, 2008. 19: 955. 61. Henze, T. Managing specific symptoms in people with multiple sclerosis. Int MS J, 2005. 12: 60. 62. Liu, C.W., et al. The relationship between bladder management and health-related quality of life in patients with spinal cord injury in the UK. Spinal Cord, 2010. 48: 319. 63. Khalaf, K.M., et al. The impact of lower urinary tract symptoms on health-related quality of life among patients (...) augmentation cystoplasty: A transitional urologist’s viewpoint. J Pediatr Urol, 2017. 97. Yang, C.C., et al. Bladder management in women with neurologic disabilities. Phys Med Rehabil Clin N Am, 2001. 12: 91. 98. Podnar, S., et al. Protocol for clinical neurophysiologic examination of the pelvic floor. Neurourol Urodyn, 2001. 20: 669. 99. Harrison, S., et al. Urinary incontinence in neurological disease: assessment and management. NICE Clinical Guideline 2012. [CG148]. 100. Liu, N., et al. Autonomic

2019 European Association of Urology

155. Urological Trauma

., et al. Diagnosis and management of ureteric injury: an evidence-based analysis. BJU Int, 2004. 94: 277. 121. Chou, M.T., et al. Prophylactic ureteral catheterization in gynecologic surgery: a 12-year randomized trial in a community hospital. Int Urogynecol J Pelvic Floor Dysfunct, 2009. 20: 689. 122. Delacroix, S.E., Jr., et al. Urinary tract injures: recognition and management. Clin Colon Rectal Surg, 2010. 23: 104. 123. Visco, A.G., et al. Cost-effectiveness of universal cystoscopy to identify (...) Kidney Autotransplantation: A Minimally Invasive Way to Salvage Kidneys. Eur Urol Focus, 2018. 4: 198. 152. Zhao, L.C., et al. Robotic Ureteral Reconstruction Using Buccal Mucosa Grafts: A Multi-institutional Experience. Eur Urol, 2017. 153. Pereira, B.M., et al. Bladder injuries after external trauma: 20 years experience report in a population-based cross-sectional view. World J Urol, 2013. 31: 913. 154. Figler, B.D., et al. Multi-disciplinary update on pelvic fracture associated bladder

2019 European Association of Urology

156. Male Sexual Dysfunction

. Erectile dysfunction in the cardiovascular patient. Eur Heart J, 2013. 34: 2034. 50. Seftel, A.D., et al. Coexisting lower urinary tract symptoms and erectile dysfunction: a systematic review of epidemiological data. Int J Clin Pract, 2013. 67: 32. 51. Rosen, R., et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol, 2003. 44: 637. 52. Zhang, Y., et al. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome (...) 2 and 4 years after radical prostatectomy. J Urol, 2009. 181: 731. 79. Incrocci, L., et al. Pelvic radiotherapy and sexual function in men and women. J Sex Med, 2013. 10 Suppl 1: 53. 80. Morgia, G., et al. Association between long-term erectile dysfunction and biochemical recurrence after permanent seed I(125) implant brachytherapy for prostate cancer. A longitudinal study of a single-institution. Aging Male, 2016. 19: 15. 81. Stember, D.S., et al. The concept of erectile function preservation

2019 European Association of Urology

158. Muscle-invasive and Metastatic Bladder Cancer

, and late gadolinium-enhanced imaging. Radiology, 1994. 193: 239. 103. Kim, J.K., et al. Bladder cancer: analysis of multi-detector row helical CT enhancement pattern and accuracy in tumor detection and perivesical staging. Radiology, 2004. 231: 725. 104. Yang, W.T., et al. Comparison of dynamic helical CT and dynamic MR imaging in the evaluation of pelvic lymph nodes in cervical carcinoma. AJR Am J Roentgenol, 2000. 175: 759. 105. Kim, S.H., et al. Uterine cervical carcinoma: evaluation of pelvic lymph (...) carcinoma. Acta Radiol, 1988. 29: 251. 121. Lauenstein, T.C., et al. Whole-body MR imaging: evaluation of patients for metastases. Radiology, 2004. 233: 139. 122. Schmidt, G.P., et al. Whole-body MR imaging of bone marrow. Eur J Radiol, 2005. 55: 33. 123. Yang, Z., et al. Is whole-body fluorine-18 fluorodeoxyglucose PET/CT plus additional pelvic images (oral hydration-voiding-refilling) useful for detecting recurrent bladder cancer? Ann Nucl Med, 2012. 26: 571. 124. Maurer, T., et al. Diagnostic

2019 European Association of Urology

159. Urinary Incontinence

, S.S., et al. Responsiveness of the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire in women undergoing treatment for pelvic floor disorders. Int Urogynecol J, 2013. 24: 213. 16. Kim, J., et al. 1576 Is there a relationship between incontinence impact questionnaire 7 score after surgery for stress urinary incontinence and patient-perceived satisfaction and improvement? J Urol. 189: e647.J Urol. 189: e647. (13)03402-2/abstract 17. Tran, M.G., et al. Patient reported outcome (...) )/International Continence Society (ICS) joint terminology and classification of the complications related directly to the insertion of prostheses (meshes, implants, tapes) and grafts in female pelvic floor surgery. Neurourol Urodyn, 2011. 30: 2. 21. Brown, J.S., et al. Measurement characteristics of a voiding diary for use by men and women with overactive bladder. Urology, 2003. 61: 802. 22. Nygaard, I., et al. Reproducibility of the seven-day voiding diary in women with stress urinary incontinence. Int

2019 European Association of Urology

160. 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

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