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Pelvic Relaxation

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161. 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

163. 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

164. 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

165. 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

167. 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

168. Gynaecological Cancers: a Handbook for Aboriginal and Torres Strait Islander Health Workers and Health Practitioners

Complementary therapies are treatments or therapies that can be used alongside conventional treatments to improve quality of life and overall wellbeing. Examples include relaxation therapy and meditation. Aboriginal and T orres Strait Islander women may wish to use bush medicine alongside conventional treatments. Some complementary therapies and bush medicine can reduce the effectiveness of conventional treatments provided by the doctors. That is why it is important that the doctors are aware of any bush (...) in the cervix • Stage II: cancer has spread to the vagina or other tissue next to the cervix • Stage III: cancer has spread to tissue on the side of the pelvis (pelvic sidewall) • Stage IV: cancer has spread to the bladder or rectum, or beyond the pelvis to the lung, liver or bones. i31 CERVICAL CANCER Treatments for cervical cancer The aims of treatment for cervical cancer are to: • remove the cancer • destroy the cancer cells and slow growth of the cancer and/or • manage the symptoms of cervical cancer

2018 Cancer Australia

169. Anterior vaginal repair for urinary incontinence in women. (PubMed)

from three of these trials that this was reflected in a need for more repeat operations for incontinence (25/107 (23%) versus 4/164 (2%); RR 8.87, 95% CI 3.28 to 23.94). These findings held, irrespective of the co-existence of prolapse (pelvic relaxation). Although fewer women had a prolapse after anterior repair (RR 0.24, 95% CI 0.12 to 0.47), later prolapse operation appeared to be equally common after vaginal (3%) or abdominal (4%) operation.In respect of the type of open abdominal retropubic

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2017 Cochrane

170. Utian Translational Science Symposium report: New Ttherapies for Leiomyomas: When Surgery May Not Be the Best Option

symptoms may produce pelvic pressure; uri- nary frequency, urgency, and incontinence; abdominal distension; constipation; back pain; or dyspareunia. 4 Repro- ductivedysfunction,althoughusuallyadiagnosisofexclusion from other factors, may include difficulty conceiving and recurrentpregnancyloss.Pregnanciesmaybecomplicatedby abnormalplacentation,small-for-gestational-ageinfants,pre- mature delivery, malpresentation, increases in caesarean delivery rates, or postpartum haemorrhage. 4,5 Risks for uterine (...) because of necrosis or torsion of a pedunculated leio- myoma, deep vein thrombosis because of physical obstruc- tion, or even polycythemia because of erythropoietin produced by the leiomyoma. 11 A mass may be observed or palpatedinthelowerabdomen,andirregularuterineenlarge- ment may be found during pelvic examination. A pelvic ultrasound will confirm the diagnosis. Magnetic resonance imaging(MRI)or3-Dultrasoundcanbeusedforpreoperative mappingandmayberequiredtodifferentiateanovarianfrom a uterine mass

2018 The North American Menopause Society

171. Erectile Dysfunction

, or urinary tract infec- tion. (Clinical Principle) 21. For young men with ED and focal pelvic/penile arterial occlusion and without documented generalized vascular disease or veno-occlusive dysfunction, penile arterial reconstruction may be considered. (Conditional Recom- mendation; Evidence Level: Grade C) 22. For men with ED, penile venous surgery is not recommended. (Moderate Recommendation; Evidence Level: Grade C) 23. For men with ED, low-intensity extracorporeal shock wave therapy (ESWT) should (...) /sexuality expert into the treatment plan. Involvement of a mental health expert with knowledge and experience to address issues of sexuality with men and their partners can benefit most patients (see Guideline Statement 6) and should be strongly considered when unresolved issues appear to be affecting the sexual relationship. 54-56 In situations in which sudden or severe ED is likely to develop (e.g., men considering definitive therapy for pelvic cancers) or in cases with complex psychosocial issues

2018 American Urological Association

172. Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review

or (for headache) biofeedback? Exercise was chosen as a common comparator for all conditions except headache as it is recommended in most guidelines for these conditions and a frequent comparator in the chronic pain literature. Interventions considered in the review include exercise (including aspects of physical therapy), mind-body practices (yoga, tai chi, qigong), psychological therapies (cognitive- behavioral therapy, biofeedback, relaxation techniques, acceptance and commitment therapy), multidisciplinary

2018 Effective Health Care Program (AHRQ)

173. Spine Surgery

Surgery 6 Definitions 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 therapy ? Manual therapy or spinal manipulation ? Alternative therapies such as acupuncture (...) segments (List separately in addition to code for primary procedure) 22846 Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition to code for primary procedure) 22847 Anterior instrumentation; 8 or more vertebral segments (List separately in addition to code for primary procedure) 22848 Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony structures) other than sacrum (List separately in addition to code for primary procedure) 22849 Reinsertion of spinal

2018 AIM Specialty Health

174. Low Back Pain, Adult Acute and Subacute

of corticosteroids • Trauma with neurological signs Note: There is not sufficient data on a history of osteoporosis as a specific risk factor. Infection An uncommon but serious cause for back pain is infection. A spinal infection such as vertebral osteomyelitis or spinal epidural abscess can present as back pain with a fever. Consideration of other non-spine origins Low back pain can be due to visceral disease. Examples include (Goldman, 2011): • Disease of pelvic organs (prostatitis, endometriosis, chronic (...) pelvic inflammatory disease) • Renal disease (nephrolithiasis, pyelonephritis, perinephric abscess) • Aortic aneurysm • Gastrointestinal disease • Pancreatitis • Cholecystitis • Penetrating ulcer • Cardiac or pericardial disease • Pulmonary or pleural disease Evaluate Function Using tools can help with proper management of low back pain. The following are some of the available tools for low back pain evaluation. Other validated tools may be used, as well. Adult Acute and Subacute Low Back Pain

2018 Institute for Clinical Systems Improvement

175. 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

2018 Queensland Health

176. CRACKCast E180 – Labor & Delivery

don’t have the luxury of whisking off the patient to the OR Let’s kick it back to our obs/gyne block and think through the causative factors; or the three P’s The passage – narrow pelvic architecture The passenger – big head, or malpresentation The power problem – uterus isn’t pushing like it should Tired mom Mother is sedated too much Chorioamnionitis Electrolyte abnormality (Ks, Cas, Mg, Phos, Na) Usually the cause is multifactorial! 6) Describe the steps in a “normal” delivery (in the ER) Let’s (...) . At this point, reduce the infusion rate to 1 to 2 mL/min. 7) List 8 factors linked to pre-term labor. Describe the management of premature labor in the ED. List 3 tocolytics. Preterm labor is defined as uterine contractions with cervical changes before 37 weeks of gestation. Early maternal signs and symptoms include an increase or change in vaginal discharge, pain resulting from uterine contractions (sometimes perceived as back pain), pelvic pressure, vaginal bleeding, and fluid leak. Box 181.2 – Factors

2018 CandiEM

177. 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

2018 European Association of Urology

179. Neuro-urology

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 with multiple sclerosis. Neurourol (...) 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 dysreflexia severity during urodynamics and cystoscopy

2018 European Association of Urology

180. 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

2018 European Association of Urology

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