Pelvic Dysfunction in Men: Diagnosis and Treatment of Male Incontinence and Erectile Dysfunction / Edition 1

Pelvic Dysfunction in Men: Diagnosis and Treatment of Male Incontinence and Erectile Dysfunction / Edition 1

by Grace Dorey
ISBN-10:
047002836X
ISBN-13:
9780470028360
Pub. Date:
08/25/2006
Publisher:
Wiley
ISBN-10:
047002836X
ISBN-13:
9780470028360
Pub. Date:
08/25/2006
Publisher:
Wiley
Pelvic Dysfunction in Men: Diagnosis and Treatment of Male Incontinence and Erectile Dysfunction / Edition 1

Pelvic Dysfunction in Men: Diagnosis and Treatment of Male Incontinence and Erectile Dysfunction / Edition 1

by Grace Dorey

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Overview

Following on from the first book entitled ‘Conservative treatment of Male Urinary Incontinence and Erectile Dysfunction’ this book has been expanded to include seven new chapters and existing chapters have been extensively updated. It is written primarily for those specialist continence physiotherapists who are unsure of the treatment for male patients with lower urinary tract symptoms.

The classification of male urinary incontinence has been restructured in line with the International Continence Society standardisation of terminology. The subjective and objective physiotherapy assessment is covered chronologically, to enable the clinician to conduct a meaningful investigation and arrive at a logical diagnosis.


Product Details

ISBN-13: 9780470028360
Publisher: Wiley
Publication date: 08/25/2006
Series: Wiley Series in Nursing , #1
Pages: 256
Product dimensions: 6.00(w) x 8.90(h) x 0.60(d)

About the Author

Professor Grace Dorey Phd FCSP, UK.  Professor of Physiotherapy (Urology), University of the West of England, Bristol, UK .

Table of Contents

List of Figures xiii

List of Tables xvii

Preface xix

Acknowledgements xxi

1 History of the Male Pelvic Floor 1

Introduction 1

Physiotherapy development 1

Assessment of the male pelvic floor 2

Pelvic floor exercises 3

Posture 3

Detrusor underactivity 3

Detrusor overactivity 4

Nocturnal enuresis 5

Post-prostatectomy incontinence 5

Post-micturition dribble 6

Constipation 6

Faecal incontinence 7

Erectile dysfunction 7

Conclusion 8

2 Lower Urinary Tract Symptoms 9

Male lower urinary tract symptoms 9

Male questionnaires 10

Prevalence of lower urinary tract symptoms 12

Summary 13

3 Anatomy and Physiology of the Lower Urinary Tract 15

Male lower urinary tract 15

Prostate gland 17

Pelvic floor muscles 18

Penis 22

Nerve supply to the urinary system 22

Congenital abnormalities 24

Summary 27

4 Nervous Control of Lower Urinary Tract Function 29

Introduction 29

Urinary continence 29

Micturition cycle 29

Neurological control of the bladder 31

Integral bladder storage and voiding reflexes 33

Summary 35

5 Prostate Conditions and their Treatment 37

Investigations for prostate conditions 37

Benign prostatic hyperplasia 38

Prostate cancer 40

Prostatitis 41

Summary 41

6 Urinary Incontinence 43

Definition of urinary incontinence 43

Prevalence of urinary incontinence in men 43

Incidence of urinary incontinence following transurethral resection of the prostate 44

Incidence of urinary incontinence following radical prostatectomy 44

Classification of lower urinary tract symptoms 45

Storage symptoms 45

Voiding symptoms 47

Post-micturition symptoms 47

Signs suggestive of lower urinary tract dysfunction 47

Urodynamic terminology 50

Summary 51

7 Pelvic Pain in Men 53

Introduction 53

Definitions of pelvic pain 53

Acute pelvic pain 54

Chronic pelvic pain syndromes 54

Penile pain 54

Prostatitis 55

Sexual pain 55

Incidence of pelvic pain 55

Aetiology of acute pelvic pain 56

Aetiology of chronic pelvic pain 57

Assessment of pelvic pain 58

Treatment of acute pelvic pain 58

Treatment of chronic pelvic pain 58

Summary 61

8 Patient Assessment 63

Introduction 63

Subjective assessment 63

Bowel activity 65

Objective assessment 69

Urodynamics 70

Summary 74

9 Conservative Treatment 75

Conservative treatment for men with lower urinary tract symptoms 75

Stress urinary incontinence 77

Urge urinary incontinence 87

Post-prostatectomy incontinence 90

Post-micturition dribble 91

Chronic retention of urine 91

Extra-urethral urinary incontinence 93

Functional incontinence 94

Follow-up treatment 94

Treatment outcomes 94

Prevention of urinary incontinence 94

Pads 94

Appliances 96

Skin care 96

Research opportunities 97

Case studies: Questions and answers 98

Summary 100

10 Literature Review of Treatment before and after Prostatectomy 101

Introduction 101

Literature search 102

Results 103

Conclusions 111

11 Treatment of Post-prostatectomy Patients 113

Introduction 113

Assessment 113

Treatment 114

Post-prostatectomy complications 117

Post-prostatectomy erectile dysfunction 119

Summary 120

Frequently asked questions 120

12 Medication 123

Introduction 123

Pharmacotherapy for detrusor overactivity 124

Pharmacotherapy for stress urinary incontinence 126

Pharmacotherapy for nocturnal enuresis 127

Medication for nocturia 127

Medication which may have an adverse effect on lower urinary tract function 128

Medication which reduces the size of the prostate gland 130

Medication which relaxes the smooth muscle of the bladder neck 130

Medication for prostate cancer 130

Medication for hypocontractile bladder 131

Medication for erectile dysfunction 131

Medication which changes the colour of the urine 131

Summary 131

13 Faecal Incontinence 133

Introduction 133

Digestive system 133

Defaecation 134

Pelvic floor muscles 134

Causes of faecal leakage 137

Treatment for faecal leakage 138

Summary 144

14 Male Sexual Dysfunction 145

Introduction 145

Low libido 145

Erectile dysfunction 146

Orgasmic and ejaculatory disorders 153

Anorgasmia 154

Anejaculation 154

Retrograde ejaculation 155

Retarded ejaculation 156

Premature ejaculation 157

Aspermia 158

Haemospermia 158

Low-volume ejaculate 159

Painful ejaculation 159

Anhedonia 159

Sexual pain 160

Summary 160

15 Treatment of Male Sexual Dysfunction 161

Introduction 161

Low libido 161

Erectile dysfunction 162

Literature review of physical therapy for erectile dysfunction 163

Premature ejaculation 174

Conclusions 176

16 Setting up a Continence Service 177

Introduction 177

Integrated continence services 177

Director of continence services 179

Contacts for specialist groups 182

Suppliers 183

Helplines for men in the UK 183

Books and videos for professionals 185

Books for patients 186

Video for patients 187

Summary 187

Appendix: Male Continence Assessment Form 189

Glossary 197

References 201

Index 217

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