#REDIRECT [[Bladder Considerations with Spinal Cord Injury]]
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...y muscle fibers (detrusor muscles), it contracts at urination to empty the bladder.
== Anatomical Surface of The Bladder ==
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...ition, also known as urination, is the process of expelling urine from the bladder. The purpose of urination is to eliminate metabolic products and toxic wast
...ch contains the kidneys and ureters, and the lower tract consisting of the bladder and urethra. The lower tract is involved in the micturition reflex.
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...nvoluntary, sudden and unpredicted loss of urine. Loss continues until the bladder is completely empty even if giggling ceases. Essentially, voiding does not
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...ambulatory test carried outside the clinical setting and based on natural bladder filling<ref name=":0">Vignoli G. [https://link.springer.com/chapter/10.1007
* Bladder pain
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== Bladder ==
Increased dysfunction with aging includes reduction in bladder capacity.
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...managing bladder dysfunction after spinal cord injury for the Plus course: Bladder and Bowel Considerations with Spinal Cord Injury.
== Bladder Dysfunction in Spinal Cord Injury ==
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...-levels and complete SCIs.<ref name=":1">Hagen EM, Rekand T. Management of bladder dysfunction and satisfaction of life after spinal cord injury in Norway. Th
Bladder dysfunction also decreases psychological and social well-being in individua
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...incter relaxes during this process, and the detrusor contracts to push the bladder's urine into the urethra. The pontine micturition centre, a specialised reg
...result in hydronephrosis, renal scarring, a low compliant and thick-walled bladder, elevated retrograde pressures in the ureter and pelvis, and terminal kidne
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...s full and gets smaller when empty. If your urinary system is healthy, the bladder can hold up to 16 ounces (2 cups) of urine comfortably for 2 to 5 hours
* Bladder control problems like [[Urinary Incontinence]], overactive bladder, or interstitial cystitis
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The [[Bladder Anatomy|bladder]] wall is composed of four layers, each with its unique structure and funct
...e '''urothelium''', also known as transitional epithelium, which lines the bladder, kidneys, ureters, and urethra. This layer consists of specialized cells te
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..., Dmochowski R. The burden of overactive bladder on US public health. Curr Bladder Dysfunct Rep. 2016;11(1):8-13.</ref>
...rmally the PFM are contracted to tighten these passages but relax when the bladder and rectum are full to release urine or faeces.
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...weakness, paralysis, parasthesia, neuropathic pain, spasticity, as well as bladder, bowel and sexual dysfunction.
...s, paresthesias or banding or girdling, and almost all have some degree of bladder dysfunction.
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* surgery for bladder or bowel problems;
...t may result from surgery for prostate cancer, an overactive bladder, or a bladder that doesn't contract.
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...er considered physiological. Although varied with age and between genders, bladder control often stabilizes within the 3rd to 6th year of life.<ref name=":0">
...trusor overactivity and lack of relaxation resulting in a lower functional bladder capacity.<ref name=":2" /> Finally, high arousal threshold can be a contrib
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...the closure pressure of the urethra is greater than the pressure from the bladder above it. This requires a complex interaction between the [[Autonomic Nervo
...h would result in stress incontinence. There can also be problems with the bladder itself which could result in frequency, urgency and urge incontinence. Male
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...riated muscle. This quality is important in organ systems like the urinary bladder, where the preservation of contractile tone is a necessity.<ref name=":0">K
...tone and subsequent [[Bladder Management in Spinal Cord Injury|neurogenic bladder]] disease, which hugely effects a person's [[Quality of Life|quality of li
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...cture and protection to the urogenital organs in both sexes, including the bladder, uterus, ovaries, prostate, and testes.<ref name=":0">Very well health [htt
The main function of the pubis is to protect the intestines, bladder, and internal sex organs.
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...a term that describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faec
...the closure pressure of the urethra is greater than the pressure from the bladder above it. It requires the complex interaction between the autonomic nervous
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* holding up the bladder
...loor Exercises|Pelvic floor exercises]] strengthen the muscles around your bladder, bottom, and vagina or penis.
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...neuropathic pain]]; and to treat [[Overactive Bladder Syndrome|overactive bladder syndrome OAB]].
* Overactive bladder in children.
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...side of the bladder. The bladder stores urine. Your kidneys, ureters, and bladder are part of the urinary tract<ref name=":1">NIH Your Kidneys & How They Wor
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...thetic sacral stimulation causes contraction of the detrusor muscle of the bladder, increasing the emptying pressure and ureteral peristalsis, the release of
* Overactive bladder and [[Urinary Incontinence]]
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...Metabolism Clinics]. 2011 Sep 1;40(3):565-75.</ref> The urethra exits the bladder and passes through the prostate.
...a during ejaculation to prevent retrograde ejaculation (sperm entering the bladder). The distal sphincter is made of more striated muscle and damage to this s
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...n]] is an infection in any part of your urinary system, which includes the bladder, urethra, ureters (urine tubes) and [[Kidney|kidneys]]. If untreated, UTIs
...e kidneys and the ureters, while the lower urinary tract is made up of the bladder and urethra <ref name="Rowe" />.
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...ons of unsafe abortions; and surgical trauma (most commonly, injury to the bladder at caesarean section) <ref name=":1">Wall LL, Arrowsmith SD, Briggs ND, Las
...1" />. The fistula involves an abnormal opening between the vagina and the bladder (a vesicle-vaginal fistula or VVF) or the vagina and the rectum (a recto-va
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=== Bladder ===
Issues with incontinence, urgency, frequency or any other bladder problems frequently occur after prostate cancer treatment.<ref name=":1">Ho
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...ionately more motor impairment of the upper than of the lower extremities, bladder dysfunction, usually urinary retention, and varying degrees of sensory loss
=== Bowel, bladder, and sexual ===
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...aralysis of both legs and bowel/[[Bladder Management in Spinal Cord Injury|bladder]] dysfunction.
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...me tight. Reduced range of motion in the pelvic floor can affect bowel and bladder function, sexual pleasure, core support, and athletic performance.<ref name
...g, coughing, sneezing, laughing (i.e. anything that places pressure on the bladder)
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=== Bladder Dysfunction ===
A variety of bladder problems can occur, including urine retention, hyperreflexia and urge incon
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...597398/ Changes in the Q-tip angle in relation to the patient position and bladder filling]. BMC urology. 2015 Dec;15(1):1-5.</ref>. Q- tip test may be used a
...nto the urethra till no further resistance means the Q-tip has entered the bladder.
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...scles: ischiocavernosus and bulbospongiosus. Hence, it maintains bowel and bladder continence through the voluntary control of both external sphincters and en
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...econdary as the cancer has spread from other sites such as cervix, uterus, bladder, or other nearby organs to the vagina or be primary in origin and it is rar
...the surrounding soft tissue structures of the pelvis (parametria, urethra, bladder, and rectum).
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* Bladder urgency and frequency
* Bladder hesitancy/underactive bladder
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...ttp://www.canadiancontinence.ca/EN/index.php ]Providing information about bladder health for both patients and healthcare providers
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...matic reviews. 2014(5).</ref><ref>Wallace SA, Roe B, Williams K, Palmer M. Bladder training for urinary incontinence in adults. Cochrane Database of systemati
...ehavioral incontinence self-management techniques (pelvic floor exercises, bladder training), and the yoga group was provided with additional Iyengar-based yo
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* Vesicoureteral reflux – an abnormal flow of urine from the bladder back into the ureters and potentially reaching the kidneys
* Megaureter/megacystis - abnormally enlarged or dilated ureter/bladder
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...e bladder. The active component mainly controls the pressure distal to the bladder neck, which is important for urethral closure during stress conditions. The
...ddition, they were likely to have greater pain in the lower abdomen as the bladder became full with fluid as well as an increase in nocturia and frequency of
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...lvic Floor Anatomy|pelvic floor]] involves pelvic organ support, bowel and bladder control and sexual functioning.<ref name=":1">Eickmeyer SM. [https://www.pm
...r. The pudendal nerve is involved in external genital sensation, bowel and bladder continence, orgasm, and ejaculation.<ref name=":1" />
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== Interstitial Cystitis / Painful Bladder Syndrome ==
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* Painful bladder syndrome
* Over active bladder
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...ssages between the lower limbs and the pelvic organs, which consist of the bladder, the rectum, and the internal genital organs.
...n to the viscera of the pelvic cavity and perineum, including the urinary bladder, descending and sigmoid colon, rectum and both the internal and ex
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# Support: of pelvic organs (bladder, bowel; female: uterus and vaginal canal; men: prostate)
Individuals with bladder or [[Anal Cancer|anal cancer]], women with gynaecological cancers ([[Endome
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...nih.gov/health-information/urologic-diseases/interstitial-cystitis-painful-bladder-syndrome National Institute of Diabetes and Digestive and Kidney Diseases (
...entifiable cause. The use of the term interstitial cystitis and/or painful bladder syndrome are both commonly used in the United States.<br>
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...nal combined IMPACT tool, can be used to determine the impact of bowel and bladder dysfunction, and pelvic organ prolapse symptoms
* Bladder and bowel retraining
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# <span class="sui sui-pencil"></span>Urinary (kidneys, ureters, bladder)
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=== Bladder ===
For more information on incontinence, urgency, frequency or any other bladder problems related to men's health physiotherapy, please read [[Male Urinary
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...nberg R, Flock F. [https://europepmc.org/article/MED/20215766 Influence of bladder volume on pelvic organ prolapse quantification results.] Gynecologic and ob
...Ap, and Bp). However, no influence is seen on GH, PB and TVL with an empty bladder<ref name=":8" />.
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'''Bladder management''':
# Urinary retention -cannot control the bladder sphincter muscle, so cannot void on command - experiences leakage
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...innervation to the lower limbs, and sphincter,controls the function of the bladder and distal bowel and sensation to the skin around the bottom and back passa
...the nerves below the spinal cord are compressed causing compromise to the bladder and bowel. The most common cause of CES is a prolapse of a lumbar disc but
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...ion, poor body image, and lower quality of life due to associated bowel or bladder incontinence.<ref name=":0">Chen CJ, Thompson H. [https://www.statpearls.co
...ges, indicating how far it has descended. Other pelvic organs (such as the bladder or bowel) may also be prolapsed into the vagina.
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...ellon MJ. Current management strategies for autonomic dysreflexia. Current Bladder Dysfunction Reports 2018; 13(4): 224-229</ref>:
# Bladder (catheter blockage, distension, stones, infection, spasms)
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...jaculation contraction of the smooth muscles of the prostate gland and the bladder neck occur, as well as relaxation of the urethral sphincter.
...nd bladder retraining - active pelvic floor muscle contractions to inhibit bladder contraction. This will prevent the detrusor urinae muscle contraction<ref n
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...ious factors such as cardiovascular, metabolic, pulmonary, skin, bowel and bladder changes among others. <ref name=":0" />
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...parasympathetic and the somatic nervous systems, which are responsible for bladder storage and emptying. The results of genitourinary dysfunction include:<ref
** bladder and bowel dysfunction
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...cit pelvic floor contractions in men are “shorten the penis”, “elevate the bladder”, “elevate the scrotum”, “stop the flow of urine” and “tighten
==== Goal 3: Bladder training<ref name=":7" /> ====
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* Bladder pain syndrome
#* Bladder pain syndrome
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...licit male pelvic floor contractions are “shorten the penis”, “elevate the bladder”, “elevate the scrotum”, “stop the flow of urine” and “tighten
...ysfunction must be managed as this negatively impacts the pelvic floor and bladder
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...oor, it is located anterior to the rectum and posterior to the urethra and bladder.[[File:Reproductive system.png|thumb]]
...eflexion position anterior to the rectum and posterior and superior to the bladder.
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# Has complete loss of motor function (bladder and bowel function are usually also lost)
===== Bladder Management =====
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=== Bladder Management ===
...bc21b34 Consortium for Spinal Cord Medicine’s Clinical Practice Guideline: Bladder Management for Adults with Spinal Cord Injury.]
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...l Tract|vagina]], vestibule, urethra, and trigone of the [[Bladder Anatomy|bladder]] contain receptors a and b for estrogen. However, both receptors can be fo
* Idiopathic overactive bladder.
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...Arrhythmias|heart rate]], erectile dysfunction, and [[Urinary Incontinence|bladder control]].
...r control problems, eg a sudden urge to urinate or difficulty emptying the bladder<ref name=":4" />.
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...sistance exercises|resistance exercise]] therapy (PRET), [[Bladder Anatomy|bladder]] training, neurodevelopmental therapy (NDT), striking, [[Balance Training|
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...from the perineal region below. This cavity encloses the pelvic viscera - bladder, intestines, and uterus(in females).<ref>Bharucha AE. Pelvic floor: anatomy
*Pubovesical ligaments - attach bladder to pubic symphysis
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* Bladder and Bowel Management
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...to generate power, [[sensation]], and the ability to control the bowel and bladder. Rehabilitation efforts concentrate on preventing secondary complications a
...injuries. He formed dedicated spinal cord injury units managing the spine, bladder, bowel, [[skin]], and providing education, and rehabilitation. Conservative
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...te numbness or tingling in the lower extremities, or cause a loss bowel or bladder control.
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...e from:https://www.continence.org.au/pages/pelvic-floor-men.html</ref> and bladder, bowel and uterus in women.<ref name=":3">Pelvic Floor First. 2016. ''The
** Anterior vaginal / cystocele (bladder prolapse)
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** [[Bladder Anatomy|Bladder]] or [[Bowel Management in Spinal Cord Injury|bowel]] problems<ref name=":1
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Possible improvements are in bladder and bowel function, pain, spasticity, bone density, lean body mass, muscle
...actions such as grasp, overhead reach, trunk posture, standing, stepping, bladder/bowel/sexual, and respiratory functions. <ref name=":4">Kilgore KL, Anderso
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# Anterior compartment containing urinary bladder (cystocele)
*Cystocele: prolapse of the bladder into the vagina <ref name="WebMD">Iglesia CB, Smithling KR. Pelvic Org
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*Overactive bladder (OAB, urgency) syndrome is a urinary urgency, usually accompanied by freque
...pelvic floor musculature and vaginal connective tissue to the urethra and bladder neck can lead to incontinence.<ref>Pirpiris A, Shek KL, Dietz HP. [https://
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...ed outside the uterus but not to the inner lining of the rectum or urinary bladder, lymph nodes or distant sites.
...e spread to some nearby tissues, but is not growing into the inside of the bladder or rectum and has also spread to pelvic lymph nodes but not to lymph nodes
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...he pelvic floor supports abdominal and pelvic viscera, maintains bowel and bladder continence, and functions in voiding, defecating, sexual activity, and chil
...using the bathroom, as this may lead to difficulty with fully emptying the bladder.
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...ome disruptive.<ref>Vodusek DB. Boller F. editors. Neurology of Sexual and Bladder Disorders. Vol 130. Oxford: Elsevier. 2015</ref>
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* Previous Bowel and Bladder habits and the findings should be related to current situations
...al pressure and increases urinary bladder capacity and can also facilitate bladder emptying <ref name=":0" />
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...dicinal cannabis products may be effective for pain, spasticity, sleep and bladder function. The other half had inconclusive results.<ref name=":0" />
|Bladder function
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...nly by blocking the cystic duct lead to inflammation and edema in the gall bladder wall. Occlusion of the common bile duct such as in neoplasms or strictures
Image 2: Gall Bladder
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...ds to the scales previously mentioned) considering symptoms related to the bladder or urine, vagina or pelvis, and bowel or rectum and their effect on functio
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...d beyond the true pelvis or has involved (biopsy proven) the mucosa of the bladder or rectum<ref name=":0" />
...cur to the central nervous system (CNS), pulmonary system, urinary system (bladder), gastrointestinal system (rectum), retroperitoneal lymph nodes, paracervic
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...complishing self-care and personal routine tasks like menstrual, bowel and bladder care, eating, personal grooming and dressing. Self-care tools include showe
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...pper posterior portion of the pubic symphysis and elevates the neck of the bladder to increase the outflow resistance during voiding. <ref name=":1" />
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...nomic dysreflexia , movement and sexual impairments, neuropathic pain, and bladder and bowel dysfunction<ref name=":2" />.
...ure complications. Limitations in mobility and activities of daily living, bladder, bowel and sexual dysfunction including impairments during hospitalization
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...sacral nerve root injury]] that results in sexual dysfunction and bowel or bladder [[Urinary Incontinence]], which may present as peripheral numbness and decr
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* Changes in bladder/bowel habits<ref name=":6">Finucane L. An Introduction to Red Flags in Seri
...ina Syndrome]]''' - spinal and leg pain, neurological symptoms, changes in bladder/bowel, or saddle anaesthesia.<ref name=":1" />
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* Bladder management
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Causes of bladder incontinence:
...ar sacral fibers results in a loss of voluntary (supraspinal) control over bladder contractions; later on, dementia may increase the risk of incontinence.<ref
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# Bowel and bladder functions: urinary retention, urgency and bowel dysfunction
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# Decreased bowel and bladder control
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# Bladder health<ref>Shah J. The Impact of Urinary Incontinence on Men’s Health. In
# Incontinence issues involving both bowel and bladder
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...ith symptoms that include difficulty walking and difficulty with bowel and bladder control<ref>Yonenobu K, Hosono N, Iwasaki M, Asano M, Ono K. Neurologic com
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* '''Kegel Exercises''' help strengthen the muscles that support the bladder, uterus, and bowels. By strengthening these muscles during your pregnancy,
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*Many foods and beverages can affect the pelvic floor and bladder such as alcohol, caffeine, acidic foods, concentrated sugars, artificial sw
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...ic reactions such as eye coordination, jaw and tongue movements, bowel and bladder coordination, sucking, swallowing and breathing. <ref name=":0" />
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...trachea, liver, oral cavity, colon, [[Thyroid Cancer|thyroid]], prostate, bladder, [[Renal Cancer|kidney]] and lymphatic tumours; to a lesser extent, multipl
...central nervous system (but not medullary) cancer and, to a lesser extent, bladder cancer.
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0 POINTS: Is partially or totally incontinent of bowel or bladder.
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...involve the inner pelvic structures such as the [[Bladder Anatomy|urinary bladder]] and cervix. <ref name=":7" /><ref name=":6" />
* Bowel and bladder history: Constipation, diarrhoea, urgency, frequency
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...deep tendon reflexes within a few weeks or much later with the recovery of bladder reflexes within 2 months of injury. <ref name=":6" /><ref name=":7">Harvey
...motion, and extreme hot weather with the most common causes resulting from bladder and bowel related problems. <ref name=":2" />
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