Chronic prostatitis antibiotics 2014,alfuzosin shrink prostate fast,rectal exam violated - Downloads 2016

20.09.2014
Print Email Prostatitis refers to the swelling of the prostate, a walnut-sized gland located just under the bladder of men. There are two main types of chronic prostatitis: bacterial infection and chronic pelvic pain syndrome (CPPS), the cause of which is still not fully understood. Chronic bacterial prostatitis is pretty much what is sounds like: chronic prostatitis caused by a bacterial infection. Stress Urinary Incontinence (SUI) is a separate kind of urinary incontinence distinctly different from OAB.
The difference is significant in that OAB responds to medication, and SUI requires surgery to resuspend the bladder. Overflow incontinence is associated with leakage from the bladder that is overfilled and incompletely emptied.
X-rays may be ordered if the urinalysis is abnormal and the urine contains blood or shows signs of infection. Constipation should be prevented with an increased intake of fiber or with stool softeners. Neuromodulation with implantable sacral nerve root stimulators may help people not responding to medications and behavioral modifications. In women having prolapse of the bladder, surgical repair to support the bladder may relieve urgency. The kidneys are 2 paired organs in the area on the back above the waist protected by the two lower ribs. Certain life styles, occupational exposure, and diseases may increase the chance that you may develop renal cancer.
Smoking not only increases the risk of kidney cancer or adenocarcinoma but also of developing transitional cell carcinoma.
Over the counter medications such as NSAIDS (Ibuprofen, Naproxen) has been found to increase one’s risk. Asbestos and cadmium exposure in the work place, as well as Coke, used in the iron and steel industry may increase your risk.
Von Hippel-Lindau disease and tuberous sclerosis are inherited disorders that show an increased risk for developing cancer. Many kidney cancers are now found as an asymptomatic mass on CT scans done for other causes. In people with poor kidney function that cannot have a CT with contrast, a renal ultrasound may confirm this is a solid mass.
IVP or intravenous pyelogram and arteriography are rarely used today in diagnosing renal masses.
Blood chemistry and CBC are obtained to evaluate for abnormal levels of liver enzymes, increased calcium in the blood, increased alkaline phosphatase from bone, and a CBC to look for anemia. A biopsy is occasionally used when the X-ray diagnosis is not completely clear, but a biopsy is not routinely done.
Chromophobe RCC –These cells appear to be larger than those of clear cell carcinoma but are still clear. Collecting Duct –These cancers are only about 1% of renal cell cancers but are considered aggressive tumors. Unclassified RCC –While rare, these do not fit any of the above subtypes or are composed of multiple subtypes.
The primary treatment of renal cell carcinoma has always been surgical removal of the kidney. The need for whole kidney removal was driven by the late stage in which most patients presented to the doctor. Now that these tumors are smaller, there has been a shift to partial nephrectomy where just a portion of the kidney is removed.
Cryotherapy is the freezing of these cancers using insertion of cryo-needles that are cooled with liquid helium.
More recently, targeted therapy with Sutent (sunitinib), Nexavar (sorafenib), Votrient (pazopanib), Afinitor (everolimus), and Torisel (temsirolimus) have most recently been utilized to slow the in-growth of blood vessels into the tumor starving it of its blood supply.
Follow-up blood work and CT scans with chest X-rays to monitor for spread of the cancer after removal are routinely done for 3-5 years depending on the pathologic stage and the results of the CT scans themselves. Interstitial Cystitis (IC) is also referred to as Painful Bladder Syndrome (PBS) or Chronic Pelvic Pain. IC is usually initially treated as a form of recurrent UTIs in women or prostatitis in men. In men, IC acts as a mimic for prostatitis and is associated with painful ejaculation and occasionally as an isolated, unilateral, or bilateral testicular pain. Associated illnesses include migraine headaches, irritable bowel or IBS, and autoimmune diseases. For some time, insurance denied the existence of IC and required that a bladder biopsy with hydrodistention take place before they would approve the medications to treat IC. Hydrodistention is the stretching of the bladder under anesthesia to measure the capacity of fluid that the bladder would hold. Acidic foods such as carbonated drinks, orange juice, lemonade, grapefruit juice, tomato juice, tomatoes, or tomato sauce may also cause IC symptoms flare-up. Caffeine containing foods such as coffee, tea, sodas, and chocolate may act as stimulants that may cause bladder irritability. Learning to deal with stress can lessen IC symptoms in both frequency and severity. Stress is often associated with bad situations, but “happy” stress affects IC as well.
When dietary and behavioral modification does not help enough, medications may be prescribed.
Elmiron (Pentosan Polysulfate Sodium) is an oral medicine found to be excreted in the urine that coats the bladder as a replacement for the missing or thin layer of glycosaminoglycans.
Elavil (Amitriptyline) is a tricyclic antidepressant that suppresses pain by way of the serotonin pathway. Atarax (Hydroxyzine) is a very old, first generation, antihistamine that is used both for its antihistamine and sedating properties. Overactive bladder medicines may be used but are less effective in treating IC than in true overactive or spastic neurogenic bladders. Many names have come and gone for the medical combination of methylene blue for anesthesia, Hyoscyamine an anti spasmodic, a salicylate for pain, and methenamine as a urinary antiseptic. Postmenopausal women present similarly but frequently get better on vaginal estrogen cream as a topical therapy. Bladder cancer typically refers only to Transitional Cell Carcinoma (or TCC) of the bladder. Since transitional cell is the most common cell type and presents about 70,000 new cases a year with 14,000 deaths in 2010, this article will only deal with Transitional Cell Carcinoma. The empty bladder is a hollow, potential space organ similar to an empty balloon in the pelvis. Tobacco exposure is the most common cause of bladder cancer accounting for over 50% of all cases in the USA. Prior radiation exposure to the pelvis in the treatment of prostate, colon, and GYN cancers has been reported to increase the later risk of developing bladder cancer.
Chemotherapy exposure to cyclophosphamide has been shown to increase the risk of bladder cancer. Age over 80 years is apparently an independent risk factor, even in the absence of any chemical or tobacco exposure.
Bladder stones, chronic urinary catheters, and a Middle Eastern parasite, schistosomiasis, are all risks for squamous cell bladder carcinoma.
You may have heard that you should drink 2 liters of water a day, but water contained in the foods you eat counts as part of that fluid intake. Wearing appropriate barriers, when handling these chemicals, significantly reduces the risk of developing cancer.
Stopping all use of tobacco for 5-10 years reduces the risk of smokers to that of a non-smoker. Thus far, large studies have not found any conclusive evidence that any dietary supplement decreases your risk of bladder cancer.
Healthy eating habits with foods low in fat and red meat but high in fruits and vegetables as well as weight loss have been shown to lower the risk of all cancers. Once hematuria (or blood in the urine) is documented, a thorough history looks at occupational and tobacco exposure risk factors.
Rectal exam in men and pelvic exam in women evaluate for thickening of the pelvic tissues or fixation to the surrounding tissues that might suggest a more advanced tumor stage.
Initial staging or clinical staging of bladder cancer is done through physical findings and x-ray findings.
Grade 1, or a low-grade tumor, has fairly normal looking cells still trying to form normal layers. Mitomycin C may be placed in the bladder at the time of tumor resection in an attempt to reduce tumor recurrence. Stage 1 tumors or T0, Ta, and Tis are localized to the top layer of the bladder lining and are removed by surgery and may require nothing more than close follow-up. Stage 2 or T1 tumors begin to invade the lamina propria or connective tissue layer below the urothelium but are not deep enough to penetrate into the bladder muscle.
Stage 3 or T2 tumors invade into the muscle and are at risk for local or even wide spread systemic metastasis. Stage 4 tumors have invaded through the bladder and into the fat surrounding the bladder or have spread to the pelvic lymph nodes or beyond. Neo bladder is the construction of a new bladder-like pouch that is connected to the urethra and allows for some semblance of normal voiding. Orthotopic neobladders are new bladder pouches not sewn to the urethra but brought out of the skin through a catheterizable stoma. The introduction of chemotherapy or immunotherapy into the bladder in an attempt to decrease the rate of recurrence and progression to a higher stage of tumor is considered intravesical therapy. Mitomycin, Adriamycin, and Doxorubicin are true chemo therapeutic agents used in the bladder.
Until the introduction of IV chemotherapy, once the tumor had spread, the average life expectancy was about 18 months.
Cystectomy and IV chemotherapy patients may be followed with CT scans, MRI (magnetic resonance imaging), and bone scans.
Multiple foods, medications, medical conditions, as well as dehydration, can change the color of your urine. The color of urine is affected by dehydration, foods such as asparagus, and by medications such as AZO, Pyridium or Phenazopyridine, and methylene blue for urinary pain. For a full list of foods, medications, and medical conditions that may change the color of your urine, scroll to the bottom of this page.
Microscopic hematuria is usually found by a chemical dipstick and further evaluated in the laboratory by a microscopic examination of the urine confirming the presence of visible red blood cells (RBCs). Dipstick positive hematuria or hemoglobinuria is found on chemical testing, but there is no corresponding increase in number of RBCs found on microscopic examination.
Unless this is associated with malignant hypertension and more than a trace of protein in the urine, there is usually no cause for alarm. Urine tests for cancer such as a visual Pap smear of the urine or urinary cytology may be ordered.
Long-term follow-up for up to 3 years is recommended if the initial evaluation is negative.
The second time in a young woman’s life that the number of UTIs increases is with the onset of her menstrual cycle. Evaluation for repeated UTIs is advised in women having more than 4 per year, one that will not clear, or with pyelonephritis. Ultrasound or bladder scan measurement of this residual urine is non-invasive and does not require a catheter be inserted into the urethra.
Pelvic exam looks for cystocele formation, descent of the bladder into the vagina after childbirth. Since intercourse is a common time for bacteria to enter the urinary tract, it is advised that women wash before intercourse. Some studies show that there is an increase in bacterial adherence to the vaginal mucosa with changes in the hormones at different times in the menstrual cycle. Diabetics have a decrease in their ability to fight infection and develop more frequent UTIs. Water based lubricants work better than petroleum or silicone based lubricants for prevention of UTIs.
Diaphragm usage has been noted to increase the risk of UTIs more than other forms of birth control. Microscopic urinalysis consists of placing 10-15cc of urine in a centrifuge for 10 minutes. The treatment of the UTI depends on whether it is classified as complicated or uncomplicated.
A complicated UTI is associated with fever >101°F, infection behind an obstructing kidney stone, or an infected catheter.
Pyridium or Phenazopyridine is an AZO dye, that when excreted in the urine, acts as a topical anesthetic. Antispasmodics or anticholinergic medications used for overactive bladder are also effective in treating the bladder spasms so often associated with a UTI. Drinking plenty of fluids will increase urine production and may flush out the bacteria, but rarely will your body be able to clear the infection.
Ibuprofen and other NSAID medications are anti-inflammatory medications and may help relieve the pain of urination.
Reports that pineapple juice relieves UTI symptoms are based on its purported anti-inflammatory effects on the bladder.
Infertility is a complex medical problem and can occur due to both male and female factors.
In addition, over the last 4-5 decades, there has been a slow, worldwide decrease in the number of sperm with normal morphology emitted per ejaculation. Chronic bacterial prostatitis is swelling and irritation (inflammation) of the prostate gland that develops slowly and continues for a long period of time. What causes Chronic Prostatitis and why isn’t the condition easily noticed from the beginning? Which factors are conducive to chronic inflammation of the prostate and why isn’t antibiotic therapy effective as expected? It results in unavoidable lesions affecting the function or physiology of the urethra and the rest of the organs of the urogenital system. These lesions have quite a few adverse effects on proper urination, on the ability to reproduce and on sexual potency.
Microbes have been shown to be the cause of the inflammation at least in its initial stage. However, at a later stage they invade a large number of bulbourethral and peripheral tubules.
By the time symptoms appear, the microbial settlement has already reached an advanced stage.
Having invaded the prostate ducts, the microbes cause a chronic immunological phenomenon which sustains the inflammation.
Figure.2 Oedema of the periurethral zone, obstruction with suppurative secretions from prostate ducts.
The prostate is a gland shaped like an inverse widened cone with its base in direct contact with the urinary bladder and its apex facing down. As a result of the above, there is transurethral urine reflux into the prostate ducts causing calcification, further aggravation of the condition and chronicity of the inflammation. In most cases the antimicrobial treatment cannot solve the problem and at best it merely alleviates the symptoms or masks them temporarily. Functional or structural stenosis of the urethra:problems when urinating (discussed in more detail later) whose degree of severity cannot be realised by the patients themselves.
Problems related to sperm fertility: due to the toxic impact of the inflammation there are problems with the production and quality of sperm. Erectile dysfunction:the spread of the inflammation to the area of erectile nerves causes problems to the mechanism of induction and maintenance of erection. Enlargement of the prostate: due to the on-going inflammation there is hyperplasia and hypertrophy of the cells of the prostate. Increased risk of carcinogenesis: the combination of on-going inflammation with the concurrent immunosuppression (which usually occurs past the age of 60-65) increases the risks of malignancy.
A small or considerable increase in the urinary frequency: that is, whereas the normal rate of urinating is 3-4 times a day and 0 at night, this frequency progressively increases and usually goes unnoticed. A decrease in the force of urination: that is, the radius of urination slowly decreases and the patient often presses his tummy to give his urination a boost. A feeling of heaviness or numbness in the lower abdominal area above the genitals: centrally and or in the sides.
Episodes of vertigo or migraines with remissions and flare-ups which are unaccounted for after standard investigations. Balanoposthitis: Inflammation of the glans and prepuce of the penis usually of fungal aetiology which persists or relapses easily after treatment.


Blood in the stool: hemorroids often occur and get aggravated by chronic inflammation of the prostate.
The urologist has to be very experienced with special training in chronic prostatitis since specialised knowledge is required to conduct both the digital rectal examination (DRE) and the transrectal ultrasound test which are the standard tests for the diagnosis of the condition as well as for the evaluation of the severity of the inflammation.
Diagrammatic representation of transverse and longitudinal views during transrectal ultrasound examination.
Investigations also include microbiology tests of sperm and prostate secretions (after prostate massage) although these tests do not provide reliable data on which the diagnosis or the causative factor of the inflammation could be based.
Further investigations include urinometry (quality check of urination) and in cases of complications (i.e. Uncomplicated chronic prostatitis is initially managed with antimicrobial therapy for at least a month. In very few cases (less than 5-6%) despite treatment some microbial foci still persist as shown in cultures of prostate secretions (after prostate massage) and symptoms do not completely disappear.
The ingredients of such a mixture are carefully selected on the basis of an antibiogram and detailed cultures of prostate fluid – sperm.
This alternative treatment involves endoprostate injections with a combination of antimicrobial and anti-inflammatory substances once a month for an average of 3 to 6 months. Endoprostate injections are carried out with the use of transrectal ultrasonography whereby a guide is adapted to the ultrasound probe so that the needle can inject the medications where the main lesions of the prostate parenchyma are. This treatment is based on the fact that the efficacy of antimicrobial substances is increased hundreds of times when they are injected in the affected areas of the prostate. Typically, after the first endoprostate injection 40-50% of patients experience significant improvement as far as bothersome symptoms are concerned such as pain, urinary frequency, burning when urinating, etc.
This therapeutic treatment is a satisfactory alternative although it does not lead to a total cure.
Along with other painful symptoms, prostatitis is frequently known to cause pain or difficulty during urination.
Either type will cause lower pelvic pain  and possibly pain or difficulty urinating in the patient. It may be the result of a germ that is as of yet unidentified, a problem with the nerves running through the prostate, or even an autoimmune disorder, in which the immune system attacks the prostate instead of an invading infection. This occurs when a cough or sneeze pushes down on the bladder, and that pressure starts an uncontrollable bladder contraction or bladder spasm. To confuse things even more, bladder suspension surgeries that are tightened too much can convert SUI to OAB. The most common neurologic conditions that cause OAB are stroke, Parkinson’s disease, and a spinal cord injury.
This procedure fills the bladder with water and measures the bladder’s filling pressure and its response to filling, such as unstable bladder contractions. Older drugs such as oral generic Oxybutynin have more of these side effects and have been associated with decline in cognitive function in the elderly.
The kidney’s purpose is to filter the blood and remove metabolic waste products from the blood.
These masses can become quit large and still remain confined to the kidney without spreading or metastasizing. These tumors are very vascular, and the larger ones have bleeding after a biopsy that rarely leads to an emergency kidney removal.
With CT scanners now in every hospital and emergency room, these tumors are often now found at an earlier stage while looking for other intra-abdominal problems. If the tumor is small, < 5cm, and is on the upper or lower portion of the kidney, only that portion of the kidney containing the tumor may be removed.
Instead of freezing the tumor, it is heated, and essentially the tumor is cooked, killing that portion of the kidney containing the tumor. Much like a heart catheterization, a catheter is introduced through the groin into the renal arterial branch feeding the tumor, and the blood flow is blocked. All three of these things refer to the same thing, so for simplicity we will refer to it simply as IC, the acronym for Interstitial Cystitis. It is not currently known how they are related to IC, but some studies have found that 33% of IC patients also have IBS and migraines.
A solution of medications is instilled into the bladder to see if this combination of bicarbonate, Lidocaine, and heparin temporarily relieves the pain. DMSO or dimethyl sulfoxide (Rimso-50) was used as a topical treatment instilled into the bladder as an anti-inflammatory or antihistamine treatment. Recoating the bladder is similar to a mother’s use of Desitin Ointment in the treatment of a baby’s diaper rash. Remember, mast cells in the bladder lining are full of histamine and are associated with IC on bladder biopsy. This class of medications includes VESIcare (Solifenacin), Enablex (Darifenacin), Toviaz (Fesoterodine), Sanctura (Trospium), Detrol (Tolterodine), and Ditropan (Oxybutynin). While IC or interstitial cystitis may take months to control, estrogen deficiency is usually better in 2-3 weeks or less with estrogen replacement therapy. When this is new in onset and coupled with blood in the urine, tests for cancer are ordered.
Even the handling of the finished product without gloves over long periods of time may cause cancer. So, the most correct way is to tell you to eat and drink enough fluid to produce two liters of urine a day. Gloves, respirators, and protective clothing requirements when handling chemicals are available in every work place in the MSDS (Material Safety Data Sheet) file required by OSHA (Occupational Safety and Health Administration). The urine is concentrated in a centrifuge, and the last drop is stained with the Pap (Papanicolaou) stain.
The pathologist then evaluates the type of cancer and depth of bladder wall invasion using the TNM (tumor nodes metastasis) staging system to find the pathologic stage. These often form finger-like projections on stalks similar but finer than on a head of a broccoli floret. This provides tissue for the pathologist to evaluate for tissue cell type, grade of the tumor, and depth of invasion or pathologic stage of the tumor. These have a higher recurrence rate and progression to higher-grade tumors and are usually treated with liquid chemotherapy introduced into the bladder by way of a catheter. It was replaced by chemotherapy after it was found to suppress bone marrow production in 13% of those patients.
It uses the introduction of a weakened strain of bovine tuberculosis to stimulate your own immune system to fight the cancer and reduce the chances of recurrence of a tumor.
This includes cystoscopy every 3 months for 1-2 years, then every 6 months for 1 year, and then yearly for 10 years for tumors localized to the bladder and treated with BCG. Hematuria has multiple causes, and all causes of blood in the urine need to be evaluated by a urologist. Doctors are more concerned about how this relates to a microscopic evaluation of the urine for evidence of infection, stones, or cancer. A well-hydrated person’s urine will be almost colorless while significantly dehydrated urine will have a very dark almost orange color. Blood changes the urine red if the bleeding is fresh, but slow bleeding may change the urine to coffee, tea, or Coke-colored brown.
Normal centrifuged and concentrated urine will have 0-3 RBCs per high-powered microscopic field (HPF).
While the most common things are benign, there are some cancers of the urinary tract that must be ruled out. This is required to look for polyps, stones, infections, prostatic bleeding, and cancer of the bladder.
This usually consists of repeated microscopic urinalyses in the office but may require repeat X-rays in some patients.
They range from urinary stone disease (stones in the kidney, ureter, and bladder) to prostatic problems to infections. We see more women than men for UTIs because about 40 % of women and only 12% of men will develop UTIs.
The initial bladder infection has gained access to the ureter and traveled up all the way into the kidneys.
Whether this is hormonal, immunosuppression in the mother, or stasis in the system, it is not clear.
Some of the other illnesses that may mimic UTIs are interstitial cystitis (IC), estrogen deficiency, and endometriosis.
Flexible cystoscopes are used in the office and are more comfortable than rigid cystoscopic evaluations. This is to prevent the bacteria around the anus from being brought forward towards the vagina. Bubble baths in small children as well as perfumes, feminine hygiene sprays, and laundry detergents have been implicated.
Washing after intercourse may lower the infection rate by removing lubricant, bacteria, and semen.
Many women have told me that only at certain points in their cycle are they susceptible to UTIs with intercourse. This in turn leads to better adherence of bacteria to the skin and vaginal lining with increased risk of a UTI. This is likely due to the ammonia irritation of the skin with increased bacterial colonization. Douching washes away any protective factor that the normal vaginal secretions provide in preventing infection.
This begins with a chemical dipstick that changes color in the presence of blood, bacteria, and white blood cells (WBCs). The liquid is poured off, and the last drop is resuspended and placed on a microscope slide. If bacteria grow, then they are tested against antibiotics to determine the sensitivity of the bacteria. While most women just urinate in a cup without proper cleaning, this is the worst possible specimen for accurate diagnosis.
An uncomplicated UTI is a simple bladder infection without fever or association with stones, catheters, or other complicating illnesses. In young, healthy, college coed’s, studies have shown that 50% will clear with one dose of antibiotics.
If associated with a kidney stone, the kidney will need to be unblocked before antibiotics can be effective.
These help with the frequency and urgency of urination until the antibiotic can kill the bacteria. One study reported that if one drank 32 ounces of cranberry juice per day, there was a 20% reduction in the number of UTIs.
The dose has been reduced only from prescription strength 100mg to 95mg in the AZO over the counter. The cause of this is unknown but is theorized to be due to the number of chemical pollutants in the environment.
An estimated 40-50% of the male population seeks help for the management of persisting symptoms which present either as pain in the pelvic area or as complications stemming from the gradual progression of the disease having mainly to do with erectile dysfunction and toxic impact on sperm.
Subsequently, there is obstruction in almost all the affected prostate ducts, periglandular induration and fibrosis with strangulation of the blood vessels and the nerves of the prostatic parenchyma.
It surrounds the urethra which emerges through the aperture of the urinary bladder and into which the prostate ducts as well as the two ejaculatory ducts drain at a level of a formation called colliculus seminalis. 3 Prostatitis complications such as urethral stenosis, incomplete emptying of the bladder, enlargement of the prostate and endoprostate urine reflux. In fact, in 20-30% of cases neither the causative agent of the inflammation (that is the microbes), nor any additional evidence of inflammation (e.g. After this period of time and provided that clinical and ultrasound examinations demonstrate that the inflammation persists, the management of the condition should be radical. In these cases, infusion of a combination of 3-5 antimicrobial drugs into the prostate and sometimes into the seminal vesicles is indicated. 1 to 3 sessions (7-10 days apart) of these ultrasonography-guided transrectal infusions lead to permanent cure of this chronic condition since drug concentrations on the regenerated prostate tissue are 1000-fold when compared to therapy with drugs taken orally (per os). The antimicrobial mixture contains a combination of antibiotic and anti- inflammatory substances fully covering the microbial spectrum which causes chronic prostatitis. As it pertains to obstructive problems such as difficulty in passing water, the rate of improvement is lower. Men of any age may be affected, but it is most common in men between the ages of 30 and 50.
Acetylcholine attaches to the muscarinic (M2 and M3) receptors in the bladder to stimulate muscle contractions. This treatment relies on insertion of an electrode into the S3 sacral foramen to the 3rd sacral nerve root. Occasionally after SUI surgery, OAB symptoms will start or worsen especially if the sling is too tight or if there is postoperative urinary retention.
These factors just predict a higher chance of developing cancer in those people than in people without these risk factors.
Most renal cell carcinomas are distinctive enough on CT scans done without IV contrast then repeated with IV contrast that they do not require biopsy. This involves the removal of the entire kidney including Gerota’s fascia, the fatty tissue around the kidney.
With the introduction of laparoscopy, the kidney is now removed through a small incision in the front of the abdomen. Partial nephrectomy may only remove the diseased, nonfunctioning portion and have little reduction in total renal function.
When the recurrent “UTI” fails to respond to treatment, the patients usually end up at the urologist for men and the gynecologist for women. As the cause is unknown, there have been studies that link IC to pelvic trauma, chronic overdistension of the bladder, repeated UTIs, genetic factors, and autoimmune factors. The urologist will ask about frequency of urination, urgency by day, and nighttime urination or nocturia. If biopsies are taken, they usually show increased chronic inflammatory response in the submucosal areas of the biopsy. The stimulant affect of this causes an increase in the frequency of urination and the pain of IC.
It relaxes the bladder by affecting the anticholinergic nerve pathways much as the newer overactive bladder medications work.
While the second generation Benadryl, third generation Zyrtec, and Claritin are also antihistamines, they are much less potent.
The bladder, as well as the ureters, is lined with a tissue type called transitional cells. The muscle layer is the layer that contracts to allow the urine to flow out from the bladder at the time of urination.
This may be visible to the naked eye as gross hematuria or microscopic and can be detected by your doctor upon urinalysis. There is literature to support that tobacco in any form can initiate the formation of bladder cancer.
Dyes used in the leather industry, textile industry, paint industry, and hair dye industries have been implicated. Doing this keeps the urine diluted and decreases the time that any of the known carcinogens are in contact with the bladder lining.
So far, we have not been able to find a substitute for this direct visual inspection of the bladder. Frequently these tumors have a small stalk-like attachment to the bladder with a larger head of tumor on the end of that stalk. Bladder biopsies of the right, left, posterior bladder, bladder dome and trigone, and possibly the prostatic urethra in men are obtained to evaluate the remainder of the “normal” looking bladder for signs of pre-cancerous changes. Blood is divided into three broad categories: gross hematuria, microscopic hematuria, and dipstick positive hemoglobinuria.
Odor alone is rarely a first sign of urinary infection but most often is of little meaning if no other symptoms, such as pain, burning on urination, or frequent urination, are present. Dehydration is caused by not drinking enough fluid as well as by increased loss of fluid from sweating, diuretics, vomiting, and diarrhea. Beets, which contain betalain, rhubarb, and blackberries will often change the urine to a pink or red color. Usually this monitoring will be for a period of two to three years and all that’s needed is periodic visits to the urologist’s office for a simple, painless microscopic RBC evaluation.
Initial evaluation consists of an x-ray, a visual inspection of the bladder, and possibly some urine tests. After introduction of Lidocaine anesthetic gel into the urethra in men or applied to the scope in women, the telescope is inserted into the bladder.


These include Nuclear Matrix Protein #22 (NMP-22) and FISH assay (fluorescence in situ hybridization). If the number of RBCs increases on serial urinalyses over time, there may be something in the urinary tract that was too small to find the first time around. All of the above are far more common than cancers of the kidney, bladder, and prostate, which most patients are worried about.
Due to the position of the female urethra in the upper edge of the vagina, sex irritates the urethra and allows bacteria to enter the urethra. The loss of estrogen has a direct effect on the health of the lining of the bladder as well as the lining of the vagina. If bacteria grow, then they are treated with different antibiotics to see which one is the most effective treatment.
The difficulty in clearing the UTI is due to the stagnant urine left in the bladder after each urination. The perineum is that area behind the vaginal opening and includes that area in front of the anus. These dipstick test results can be falsely positive if there is contamination from the urine flowing past the vagina. Under 400-power magnification, the urine undergoes a white blood cell count (WBC), a red blood cell count (RBC), and an evaluation for crystals, bacteria, and epithelial cells. Catheterization is the introduction of a small tube up the urethra into the bladder just far enough to get a urine specimen. That means if a woman has 5 UTIs per year the cranberry juice lowered that number from 5 to 4. In an additional 20% of infertile couples, there is a combination of both male and female factors contributing to problems with conception of a child. Examples of these chemicals are DDT, dioxin, polychlorinated biphenyls (PCBs), and hexachlorobenzene. They are first detected in the bulbourethral ducts of the prostate where they grow at a slow rate causing no significant discomfort. This makes treatment extremely difficult, if not impossible, since the standard antimicrobial therapy cannot reach the microbial foci. On either side of the urethra lie the bulbourethral glands whose tubes cover a short spiral distance and the peripheral ducts with tubules following a straight but much longer course. Therefore, most patients reach stage two of the disease involving many more problems and complications. As a result, they underestimate the severity of the disease in order for their patients to feel better, or they simply prescribe drugs to relieve the symptoms but fail to inform their patients about the long term consequences of a temporary solution to their problem. Otherwise, progressive aggravation of the inflammation is likely with relapse of symptoms and side effects previously mentioned (erectile dysfunction, hypofertility, etc). 20- 25) or whose prostate exceeds 60-70 grams and prostate lesions are quite advanced, a total of up to 10 sessions might be required.
When the patient has a flare-up, he may experience pain or discomfort in the pelvic region, primarily at the base of the penis, around the anus, just above the pubic bone, and even in the lower back. Non neurologic causes are bladder cancer, prostate enlargement or BPH, and interstitial cystitis. This relaxes the bladder avoiding the side effect of constipation that is so common among the anticholinergic drugs. This is a distinctly different cancer than that originating from the lining of the kidney’s collecting system. Urine is then stored in the bladder until there is an appropriate time to empty the bladder. Oncocytomas are benign solid tumors of the kidney but cannot reliably be differentiated from cancers by needle biopsy.
You just need an incision large enough to get the kidney out, usually the incision is about 4 inches in length. There may be incomplete destruction of the tumor, and occasionally, there may be damage to the adjacent, normal kidney. Women, after being determined by their gynecologist to not have endometriosis, pudendal nerve neuralgia, endometriosis, pelvic floor dysfunction, or pelvic congestion syndrome, are subsequently referred to the urologist. It may be a genetic deficiency of the glycosaminoglycan layer of protection on the bladder surface. This is a condition of increased pain over muscles and soft tissue that leads to sleep disturbance and fatigue.
The lining or mucosa frequently becomes reddened and there may be submucosal hemorrhages called glomerulations. The Lidocaine numbs the bladder and works best when the acid in the urine has been neutralized. For people that cannot take this orally, it is sometimes used as part of the IC rescue cocktail in place of heparin. This name comes from the fact that the bladder lining or urothelium is 7 layers of cells thick. This was discontinued when it was found that after 10 years or so these people developed colon cancer due to the interaction of the urine and the bacteria housed in the normal bowel movement.
The yellow pad on the dipstick turns to progressively darker shades of green in the presence of hemoglobin or blood. X-ray examinations of the upper urinary tract can be accomplished with a CT urogram or an intravenous pyelogram (IVP).
All people with blood in their urine should be evaluated by a urologist as soon as symptoms present.
In this situation, the insertion point of the ureter into the bladder is abnormal, and urine flows backwards into the kidney during urination.
Since the urethra is shorter in women than men, it is easier for the bacteria to ascend into the bladder. This compression first affects the right kidney, and then a few weeks later it affects the left side. The most common bacteria to cause a UTI are the enteric bacteria that grow on the perineum. The increased density of bacteria in that area leads to more opportunities for the bacteria to get into the bladder.
Without this moisture and its antibodies, infections may increase in both number and severity. After stopping estrogen replacement therapy, there is an increase in UTIs.
Epithelial cells are a sign of vaginal contamination and may invalidate a positive dipstick urinalysis.
If serial cultures show the same bacteria over and over again, then it is thought that the original UTI has never cleared. The medical definition of infertility is the inability for normal people to get pregnant after one year of stopping birth control. While some of these chemicals are toxic, many of these chemicals act as estrogen-like compounds. On entering these glands, the microbes cause an inflammatory reaction followed by obstruction of the prostate ducts. These side effects are the main complaint of patients visiting their urologist to urgently seek help. The loss may be anywhere from a few drops of urine to the complete emptying of the bladder. They report getting up after sitting to find that the chair or sofa is wet, and they never felt the leakage. These medications attach to the muscarinic receptors and block these bladder receptors thus blocking the bladder spasms. Weight loss lessens the downward pressure the abdominal contents put on the pelvis and bladder.
Before the permanent device is implanted, a temporary device is used for 4-5 days to see if the treatment is right for you. There are rare reports of needle biopsy causing local spread of an otherwise contained cancer.
Men come in when there has been a recent, sudden increase in frequency or intensity of the symptoms.
The heparin is an anticoagulant injection that in this case is used to coat the inside of the bladder. Clorpactin or oxychlorosene was also used for the same purpose, though these treatments have not been used in 10-20 years. The main complaint from people using it was the strong odor of garlic their body emitted for 24-48 hours after each treatment. The bottom layers are rounder and transition (or change) into flatter cells at the surface of the bladder. While infection, stones, and prostate enlargement are more common than cancer, it is most important to find a cancer early. The contrast is excreted in the urine and outlines the internal collecting system of the kidney, ureters, and bladder.
Beta-carotene from carrots and supplements and high-dose vitamin C may cause the urine to be orange.
They look for blood, pus, protein, nitrite, and several other factors commonly found in urine. It is currently thought that the filtration process in the kidney is breaking open RBCs, and the internal hemoglobin is released and dissolves.
They are also called urine infection, bladder infection, kidney infection, and urinary tract infection (UTI). The pressure of the enlarged uterus upon the ureters at the pelvic brim creates hydronephrosis or back up on both kidneys. In rare occasions, your doctor may give you an antibiotic to keep on hand to be taken immediately after intercourse.
Other organisms include Klebsiella, Serratia, Providencia, Proteus, Enterococcus, Enterobacter, Pseudomonas, Staphylococcus, and Streptococcus. If there are different bacteria on successive cultures, then it is felt that this is most likely a repeat infection. With one hand, the vaginal lips or labia are held apart, and the cup is held in the other hand.
If the woman has incomplete emptying, a history of failing to clear in 3 days, is diabetic or estrogen deficient, or is on immunosuppressant drugs, the treatment may be 5-7-10 or even 14 days. This article is here to discuss conditions in men that contribute to problems with conception.
Then the pathogens which are difficult to excrete start multiplying and cause fibrosis of the periglandular tissue.
However, when prostatitis is recurring or lasts for three months or longer, it is considered a chronic condition. Flu-like symptoms may occur, as well, but are likely to be less severe than in cases of acute bacterial prostatitis.
The commonly available medications are Detrol (Tolterodine), Ditropan and Gelnique (Oxybutynin), Enablex (Darifenacin), Levsin (Hyoscyamine), Sanctura (Trospium), Toviaz (Fesoterodine), and VESIcare (Solifenacin). If you get relief, then the permanent generator is placed under the skin just like a pacemaker. Transitional Cell Carcinoma is similar to bladder cancer and is discussed under that section of the web site. Elmiron may take up to 6 months to work, and most people are impatient and come off of the Elmiron before it has a chance to work. The other drawback is the cost of over $400 per month. Related drugs such as Pamelor or Nortriptyline may be better tolerated if the Amitriptyline is too sedating. The CT can also evaluate the bladder wall thickness and look for any signs of a tumor spreading to the pelvic lymph nodes. In some people, the consumption of high-dose B vitamins and asparagus may occasionally turn the urine green. The darker the shade the indicator color turns the more of that substance there is in the urine. If there is no associated protein increase in the urine or if there is a history of difficult to control hypertension, monitoring this alone with serial microscopic urinalyses is all that is needed.
Unless associated with some other urologic problem such as recurrent infections, stones, or history of bladder problems, no cystoscopy or CT scan is usually required. Trimethoprim-sulfamethoxazole (Bactrim or Septra) and ciprofloxacin (Cipro) are commonly used. As a result a barrier is formed preventing antibiotics from reaching the necessary concentrations for the eradication of microbes. Antibiotics may not cure the condition completely, but will likely reduce the duration and severity of flare-ups. The patient may also experience urinary symptoms or flu-like symptoms, as well as sexual problems, including impotence or painful ejaculation. Some women urinate as often as every hour by day and every several hours at night in the most severe cases. In mild to moderate cases of IC, the patients will see relief of their pain in 15-20 minutes, and it may last for many hours. IVP only looks at the collecting system and not the lymph nodes or adjacent pelvic structures.
If the hematuria is associated with proteinuria and hypertension, it may need to be evaluated by the medical kidney doctor, the nephrologist. This single dose of antibiotic lowers the risk of yeast infection as well as any interference that antibiotics may cause with your birth control pills. The midstream 2-3 ounces of urine are then caught in the specimen cup, with the remaining urine voided into the toilet. In men, these medications are almost always used in combination with an alpha blocker such as Flomax (Tamsulosin) to prevent retention. In severe cases of IC, there may be relief, a little relief, no relief, or rarely temporary worsening of the pelvic pain.
Biofeedback helps some people learn to relax their pelvic muscles, and this lessens the urgency.
As the disease progresses, the pelvic pain increases as does the frequency and urgency to urinate.
A positive culture from a voided specimen should contain 10 to the 5th power of colony forming units of a singe organism. Occasionally, the dry mouth causes you to drink more, and this increased fluid intake worsens OAB. Multiple organisms call into question that the specimen was contaminated and not a valid specimen. Even when the primary symptoms of infection have been treated, bacteria may continue to thrive in the prostate.
If the swollen prostate restricts urine flow through the urethra, the bladder may not empty. You need to ask your doctor for a trial of all medications available until you find one that works for you without excessive dry mouth or constipation.
Once you find one with acceptable side effects, it will take several months for your system to fully calm down the OAB. Often, their doctor has called them back and told them nothing grew on the culture but to continue the antibiotics.
Many of these women want to be on continuous antibiotics, but this is not an appropriate treatment. See your doctor if you have any of the following symptoms: blood in the urine or semen pain or burning with urination pain with ejaculation pain with bowel movement pain in the low back, between the genitals and anus, above the pubic bone, and in the testicles foul-smelling urine Serious complications can arise if an infection is not properly treated.
Complications include: inability to urinate sepsisa€”bacteria spreads into the bloodstream prostate abscesses (collection of pus that causes inflammation) How is Chronic Bacterial Prostatitis Diagnosed? During this test, your doctor will insert a lubricated and gloved finger into your rectum to look for signs of infection, such as a soft or enlarged prostate. Other tests that may be performed include: testing fluid from the urethra for bacteria tests to rule out an STI urine test How Are Bacterial Infections of the Prostate Treated?
However, because the infection can return, you may need to take antibiotics for 12 weeks or longer. Your doctor will schedule a follow-up exam once you have completed treatment to ensure that the infection is completely gone.




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