Flaccid Neurogenic Transgender Case Study

The hierarchy of needs was first introduced by Abraham Maslow and he believed that all humans have needs and that we all strive to fulfil these needs. Maslow organised these needs and labelled them deficiency needs and growth needs, in order to move onto the next set of needs he believed that they must be at the very least partially achieved. The first set of needs are the basic set of needs to stay alive for example food, water and security and then safety and security for example stability and not fearing for your life, and then love and belonging which allows us to build relationships and giving or receiving acceptance and love. The next set of needs is Esteem, this relates to respect and independence, these needs are deficit needs. The needs which need to be met after these needs are growth needs, these consist of cognitive and aesthetic needs, self-actualisation and transcendence which is all about realising your full potential and to experience meaning and beauty. (Miller and Gibb,

A normal healthy bladder can hold up to 600 mL of urine (Elmissiry et al., 2014) (where in this Kanai paper is this mentioned?). The smooth muscles which builds the bladder wall remain relaxed when urine is occupying the bladder and contracts when it is filled to capacity. Signals are sent to the brain to expel urine when the bladder reaches its capacity to hold urine and is emptied from bladder via urethra, located at bottom of bladder (Kanai et al., 2014). (where in this Kanai paper is this mentioned?)

Continuing on with overflow incontinence; this is when the bladder becomes too full and is not able to fully empty. This type of incontinence is more common in men who have risk factors such as, benign prostatic hyperplasia, tumors, take certain medication or nerve damage. Medications such as alpha-adrenergic blockers can be prescribed and work by relaxing the muscle at the base of the urethra and allow urine to pass from the bladder. Subsequently, surgery may be needed if overflow incontinence is caused by a blockage or as a result of an enlarged

As the prostate enlarges it squeezes down on the urethra. The bladder wall becomes thicker and eventually weakens losing the ability to empty completely. This causes urine to be left in the bladder. The narrowing of the urethra and urinary retention cause many of the problems associated with BPH. It is common in men and almost half of the men 51 to 60 have it while almost

Syndrome bladder overactive is a urologic condition defined by a set of symptoms - such as the urgent need to urinate - NOT depend on other diseases with similar events (including bladder tumors , infections or obstructive diseases of the urinary tract ).increased frequency of urination may be accompanied by incontinence and occur throughout the day (in this case one speaks of pollakiuria ) or only at night ( nocturia

This activity puts “stress” on the body and the urethral sphincter and or pelvic floor muscles cannot hold urine within the bladder. Overactive bladder is when the one feels the want to take a restroom break even though the bladder is not full. This is caused by muscles of the bladder send signals to the brain that it is full and needs to be emptied. When both SUI or OAB occur together it is called mixed incontinence and can prove to be tough to handle. Overflow incontinence is seen more so in men, although it can affect women, and is when the bladder does not ever fully empty. The bladder is unable to empty due to a blockage that closes the urethra. Functional incontinence occurs when a person has some sort of ailment that affects their urinary tract. For example, one may have a lack of awareness to use the restroom because their medication impedes their thinking processes. Reflex incontinence is a consequence of neurological damage. This nerve damage impedes the ability of the bladder to send signals to the brain. The bladder contracts and as a result urine trickles. (Publishing)

Spasm give the indication of the need to go, one is either incontinent or not of urine.

Approximately seventy percent of people experience urinary incontinence (UI) as a result of being admitted into the hospital. Urinary incontinence is more prevalent in elderly people, and predominantly affects women more often than men. Urinary incontinence can be is described as the uncontrolled loss of urine, and can be broken down into five different types. The first type of urinary incontinence is stress incontinence, which occurs when there is involuntary emission of urine due to coughing, sneezing, or applying any increased pressure to the abdominal region. The second type is urge incontinence, which is when a person has a strong need to void, the bladder then spasms, and the person experiences a spontaneous loss of urine. The third type of incontinence that a person may experience is referred to as mixed incontinence. A person may experience a combination of symptoms from any of the five types of incontinence. The fourth type of incontinence is overflow incontinence. Typically a person’s bladder fills completely, often without the urge to void, resulting in urinary dribbling. Lastly, there is functional incontinence. During this type of incontinence a person is generally aware of the urge to void, but due to some physical or mental deficit, a person has the inability to make it to the restroom. This poses many problems for both the patient and for the hospitals. As the numbers for UI continue to rise, the risk for falls will increase, as well as increasing the amount

This is a 50-year-old gentleman with a history of urinary retention who had been placed on Flomax and intermittent catheterization once at night. He had video urodynamics done which showed a large volume in his bladder of 2340 mL. He had markedly decreased sensation to void, which occurred at 673 mL, and he had an urge to void at 1435 mL with a stronger urge at 1750 mL. However, he was unable to mount a contraction and the bladder neck and sphincter remained closed. The patient subsequently was able to void on his own and he was catheterized for a volume of 1140 mL.

catheterization. One should not be confused with overflow incontinence in chronic retention as normal urination, as stated by the patient.

Urinary bladder distension (UBD) was performed as previously described8. Briefly, under inhaled isoflurane (4% induction, 2% maintenance), wire electrodes (0.003” diameter; Grass Technologies, West Warwick, RI) were implanted into the abdominal musculature and the bladder was catheterized intravesically via the urethra. Anesthesia was lowered until hind limb reflexes, but not escape behaviors, were present (~0.9% isoflurane). Body temperature was maintained at approximately 37C. Gas flow from a compressed nitrogen tank was manually adjusted and monitored using a dual-stage low delivery pressure regulator (Matheson-Linweld, Kansas City, MO) and delivered via a custom-made distension control device (The University of Iowa Medical Instruments, Iowa City, IA). Following verification of stable responses to 60mmHg, each pressure (15,

When a person has this disorder, he or she urinates even when they do not want to, because his or her urinary sphincter is weakened. The main symptom of urinary incontinence is unintentional release, or leakage, of urine. Medications, like anticholinergics, topical estrogen, and imipramine, helps to recover. The disorder could be also treated by bladder treatment or surgery.

To comprehend how interstitial cystitis affects patients diagnosed, one must understand normal bladder function. A normal bladder is relaxed with little function. The bladder swells until it reaches maximum capacity. At this point, the bladder sends communication to the brain that it’s time to relieve

Micturition is the passing of urine. The control of mistruation is storing and letting go of urine between the bladder, urethra, urethral sphincter and nervous system. The bladder holds at least 400 to 500 ml, by relaxing the bladder muscles. The urine is stored in the bladder, the sympathetic and somatic function. The sympathetic is the filling of the bladder.

Dribbling and leaking of urine. Forcing the bladder muscles to work can make the bladder lose elasticity and control. This can result in dribbling or leaking, as the bladder can let go of residual urine without warning.