What Is A Rectocele
A rectocele is a bulging of the front wall of the rectum into the back of the vagina. The bulge occurs as a result of thinning and weakening of the band of tissue that separates the vagina from the rectum. This thinning has a number of causes, including:
- Advanced age.
- Multiple vaginal childbirths or trauma during childbirth .
- Repeated surgeries in the area of the pelvic floor or rectum.
- Chronic straining during bowel movements due to long-term constipation.
Normal anatomy of rectum
Rectum with rectocele
How Oab Can Affect Your Life Your Browser Does Not Support Html5 Audio Playback You May Download The Audio File Directly Here
Without treatment, OAB symptoms are uncomfortable. It can be hard to get through the day without many visits to the bathroom. OAB can impact relationships. You may not want to do things you enjoy because you worry about finding a bathroom in time. It can disrupt your sleep and sex life. It can leave you tired and short-tempered, or leaks can lead to a rash or infections. The whole experience can make anyone feel hopeless and very unhappy.
The good news is that OAB can be controlled. There are treatments available to help.
I stopped running, I stopped taking walks. Basically, I stopped doing things that didn’t allow me immediate access to a bathroom. I was so embarrassed that I didn’t talk to anyone about it for a long time. That was a mistake.
Your browser does not support HTML5 audio playback. You may download the audio file directly here Who gets OAB?
- Both men and women can get OAB.
- Older women who have gone through menopause and men who have had prostate problems are more likely to get OAB.
- Growing older is a factor, but not all people get OAB as they age. It’s not a normal part of aging.
- People with diseases that affect the brain or spinal cord such as stroke and multiple sclerosis are more likely to get OAB.
Once your doctor understands the problem, he or she can tell you about treatment options. There’s no single treatment that’s right for everyone.You may try one treatment, or a few at the same time.
What Are The Symptoms Of Urinary Retention
The signs can vary. Some people with the chronic form have a hard time starting the flow of urine. Some have a weak flow once they start. Others may feel the need to go but cant start. Others have to go a lot, while others still feel the need to go right after going. You may leak urine when you arent going because the bladder is full.
With the acute form, youre all of a sudden not able to go at all, or only able to go very small amounts. This occurs even though you have a full bladder. See a healthcare provider right away if this happens to you.
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Approach To The Patient With Urinary Retention
Possible Etiology of Urinary Retention Based on History and Physical Examination Findings
*Most patients will present with one or more lower urinary tract symptoms. Symptoms include frequency, urgency, nocturia, straining to void, weak urinary stream, hesitancy, sensation of incomplete bladder emptying, and stopping and starting of urinary stream.
Patients with 150 to 200 mL of retained urine may have a percussible or palpable bladder
Information from references 5, 6, 28, and 29.
Possible Etiology of Urinary Retention Based on History and Physical Examination Findings
*Most patients will present with one or more lower urinary tract symptoms. Symptoms include frequency, urgency, nocturia, straining to void, weak urinary stream, hesitancy, sensation of incomplete bladder emptying, and stopping and starting of urinary stream.
Patients with 150 to 200 mL of retained urine may have a percussible or palpable bladder
Diagnostic Testing in Patients with Urinary Retention
note:Imaging studies and diagnostic procedures are guided by the clinical context and suspected diagnoses.
CT = computed tomography MRI = magnetic resonance imaging.
Information from references 5, 6, and 28 through 30.
Diagnostic Testing in Patients with Urinary Retention
note:Imaging studies and diagnostic procedures are guided by the clinical context and suspected diagnoses.
CT = computed tomography MRI = magnetic resonance imaging.
Information from references 5, 6, and 28 through 30.
Obstruction In People With A Penis
Possible causes of obstruction in people with a penis
- Cystocele. Cystocele occurs when the bladder lowers and pushes against your vagina.
- Rectocele. This is when the rectum expands and pushes against your vagina.
- Uterineprolapse. Uterine prolapse occurs when the uterus lowers and pushes against the bladder.
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Causes Of Urination Problems
Incomplete bladder voiding often goes unnoticed until it reaches its end stage, known as overflow incontinence. Overflow incontinence can be caused by nerve damage or by a blockage in the urinary tract, such as a kidney stone, or a urinary tract tumor that constricts the urethra.
Some common causes of voiding difficulty include:
- Urinary retention, partial or complete, which has three main causes.
Urinary Retention: 5 Reasons You May Have Trouble Peeing
Did you know that we spend roughly 2,208 hours on the toilet in our lifetime? Thats a lot of time on the potty! And, if youre having trouble going No. 1, it could be costing you even more time than you like. Time spent anywhere else but a bathroom stall.
If you cant get the flow going when you feel you need to, and your bladder is full, you may have urinary retention. Urinary retention is the inability to pass urine in your bladder, and it can be acutea sudden inability to urinateor chronica gradual or slow inability to empty the bladder.
The difference can be from the cause and sometimes the symptoms, said James Wolach, MD, a urologist at Banner Health Clinic in Colorado. Acute is usually painful and they have the sensation to void but cant, whereas many people with chronic retention dont have any feeling they are not able to empty their bladders. While chronic may not seem as serious, it can lead to serious problems, so its important that both receive attention from your doctor.
There are many different causes for urinary retention, and much of your treatment will depend on the underlying cause. Here are five reasons you may be stuck and ways to improve your flow.
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Problems With Enlarged Prostate Gland
Benign enlargement of the prostate gland is more common as men get older. It can cause troublesome symptoms, although it doesnt always.
The urethra passes through the prostate gland, so men may have problems urinating if the enlarged gland restricts the flow of urine. If the flow stops completely, a catheter is required to empty the bladder. It is rare for this form of acute urinary retention to cause kidney damage.
An enlarged prostate doesn’t always cause urinary problems. Studies indicate that the size of a man’s prostate gland has little influence on the type or severity of his urination problems. BPH is just one possible cause of urinary symptoms.
Another cause of urinary symptoms can be changes to the muscular wall of the bladder, which may cause spasms of the bladder or weaken the bladder, causing problems passing urine.
Causes Of Incomplete Bladder Emptying
Urinary retention and incomplete emptying can result from a number of causes . In some cases, the flow of urine is blocked, for example, in men with benign prostatic hyperplasia. This causes obstruction. Another form of impaired emptying is nonobstructive, that is, there is no problem with the urethra but the bladder muscle is less able to adequately contract. When the bladder cannot contract properly, some or all of the urine remains in the bladder. If left untreated, this condition can lead to urinary tract infection and damage to the kidneys.
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Where Can It Occur
It may occur on the front wall of the vagina, back wall of the vagina, the uterus or top of the vagina.
- Prolapse of the front wall of the vagina -This is the most common and involves the bladder and /or urethra bulging into the vagina
- Prolapse of the back wall of the vagina This is when the lower part of the large bowel bulges into the back wall of the vagina and/or part of the small intestine bulges into the upper part of the back wall of the vagina
- Uterine prolapse This occurs when the uterus drops or herniates into the vagina. This is the second most common form
- Vaginal vault prolapse Following a hysterectomy, the top of the vagina may collapse downwards, towards or out of the vagina
Medical And Surgical Treatment
Your doctor may prescribe drugs to relax your bladder muscle. If drugs do not help you, then the doctor may prescribe injections to relax the muscle. These injections can paralyze the bladder muscles, and prevent it from contracting quite often.
If medication and injection do not help you, then the doctor may prescribe surgery. This includes enlarging your bladder, diverting the urine to a bag outside the body, and in some cases even bladder removal.
The first step in the successful treatment of OAB is to discuss your problem with your doctor. Once your doctor clearly understands the extent of your problem and how it affects you, they can prescribe the right treatment.
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Symptoms Of Urinary Problems
Urinary symptoms commonly experienced with prostate problems include:
- the need to urinate frequently during the night
- urinating more often during the day
- urinary urgency the urge to urinate can be so strong and sudden that you may not reach the toilet in time
- the urine stream is slow to start
- urine dribbling for some time after finishing urination
- a sensation that the bladder isn’t fully emptied after urination
- lack of force to the urine flow, which makes directing the stream difficult
- the sensation of needing to go again soon after urinating.
Although these symptoms often do not need treatment, see your doctor if they are causing you difficulty, as they can be successfully treated.
What Do You Know About Hair Loss
Thirty or more years ago, when I learned to use ergonomics to go to the bathroom, it was so I wouldnt have to self-catheterize. There was always a risk of getting more infections from self-catheterizing, not because it was unclean, but because it was invasive, often scraping the urethra and causing irritation .
This method was the answer to my prayers. All I wanted was to get a good nights sleep.
My Own Personal Method
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Schedule An Appointment With Dr Shteynshlyuger:
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Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of urinary problems. He uses modern effective and proven treatment methods including Botox for OAB, Interstim neuromodulation. He is highly recommended by top primary care physicians in the New York area.
He has successfully treated hundreds of men and women of all ages with urinary problems including bladder problems, kidney problems, urethral and ureteral problems.
If you or someone you know has been experiencing urological symptoms, to take advantage of Dr. Shteynshlyugers expert advice. Please feel free to Contact Us with any questions.
If you have any questions, to schedule a consultation or if you need a second opinion, pleasecontact us or call:
We offer affordable, highest-quality urology care with or without insurance. Find out our . We offer weekday, weekend, and evening office hours.
When To See Your Doctor
Itâs time to get things checked out if:
- You have to go to the bathroom a lot more than usual, and often canât hold in your urine until you get to the toilet
- You leak when you sneeze, cough, or even stand up
- You leak at random times, even if you didnât cough or sneeze
- You feel like your bladder still has urine in it, even after you go
- Your stream of urine is weak
- You have to strain when you urinate
- It hurts to urinate
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How Is Urinary Retention Diagnosed
First, we record a history of when the problem started and how often its been happening. Well check if your bladder feels hard or if there are any signs of constipation. Well also do an ultrasound scan of the bladder and kidneys.
We might suggest a bladder function assessment. This is a combination of tests we use to examine your childs urinary system and how its working in close detail. This is usually carried out over a period of up to five hours, using a special uroflow toilet, which takes lots of measurements as your child is weeing.
Some children may benefit from having a micturating cystourethrogram , which is a scan that shows how well the childs bladder works. We use this to diagnose why your child may have urinary tract infections, and to see any abnormalities with their urinary system.
Another test that the doctor might suggest is a cystoscopy, a test that allows us to look inside and around your childs bladder using a cystoscope .
You can find out more about all these tests here.
What Tests Will I Need
Your GP will take a history which will include:
- Your urinary symptoms.
- Any past history of any medical problems.
- A review of the medicines that you are taking .
Your GP will also perform an examination of your tummy to feel for any increase in size of the bladder and any abnormality of your kidneys. An examination of the prostate gland is important for men. A vaginal examination is important for women in order to help find the cause of the urinary retention.
Your GP may be able to diagnose and treat the cause of your problems passing urine on the basis of the history and examination. Blood tests may be arranged, including a test of how well your kidneys are working.
If you have sudden urinary retention and cannot pass any urine then you will need to be seen straightaway in hospital. If you have persistent urinary retention your GP will often refer you to see a urology specialist for tests. These are undertaken to find out the cause of your urinary retention and the best ways to treat the problem.
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What Is A Post
The amount of urine that remains in your bladder after you urinate is called post-void residual . A post-void residual urine test measures the amount of urine left in your bladder.
Ideally, when you go to the bathroom, your bladder should empty completely. But sometimes, urine stays in the bladder even after you think youve emptied it. The PVR test can tell your healthcare provider if youve completely emptied your bladder. A small amount of residual urine is generally ok, but large amounts can be concerning for urinary retention.
Urination Difficulty At A Glance:
- Having trouble urinating also referred to as voiding difficulty is caused by an underlying mechanical problem with the coordination between the urethra and the bladder muscle that allows urine to freely pass.
- Urination problems include difficulty initiating urination and impaired bladder emptying, as well as urinary incontinence.
- Urine voiding problems in women can be caused by a variety of conditions, including urinary retention, prolapsed bladder, urinary tract infections, and the effects of menopause and pregnancy.
- Symptoms are painful urination, difficulty starting the urine stream, a sense of incomplete bladder voiding, and sometimes an inability to urinatean emergency situation known as acute urinary retention that requires immediate treatment.
- Treatments for voiding problems depend upon the underlying cause, but may include bladder muscle conditioning, medications, implant devices and surgery.
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What Happens During And After Surgery For A Cystocele
A moderate or severe cystocele may require reconstructive surgery to move the bladder into a normal position. There are a number of ways to perform this surgery, including an anterior repair. In an anterior repair, an incision is made in the wall of the vagina and the tissue that separates the bladder from the vagina is tightened. Another option, for more severe prolapse, is to place a synthetic material with a robotic or laparoscopic approach through the abdomen. This method may give more support to the tissue and help prevent the condition from happening again.
The patient usually goes home the day of the surgery. Complete recovery typically takes four to six weeks.
For women who never plan on having sexual intercourse again, surgeries that sew the vagina shut and shorten it so it no longer bulges are nearly 100 percent effective.
Bowel Cancer: Dr Chris Reveals Symptoms And How To Test
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Bowel cancer can progress by infecting and destroying nearby tissues. The cancer can even travel to other parts of the body . Eventually, the cancer can lead to death. To improve chances of survival rates, early diagnosis is paramount.
The next time you come back from the toilet, does it feel as though your bladder has been completely emptied?
If not, this is cause for alarm. The sensation that your bladder is still partially full after releasing yourself is one symptom of bowel cancer.
Bowel cancer can either begin in the large bowel or the back passage (in other words, the rectum, a chamber that begins at the end of the large intestine and ends at the anus.
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