Gamal M.Ghoniem

It is important for a physician evaluating pelvic floor disorders to differentiate between functional and anatomical abnormalities.Impressive genitourinary bulges very often do not explain a patient's symptoms. Many women with a large prolapse may not complain of a bulge, but of other symptoms such as urinary or fecal incontinence.

The goal of physical examination and subsequent investigation is to explain the symptoms, identify the causative mechanism and its risk factors, and finally propose treatment. Using sophisticated testing, it may be possible to even predict outcomes. For example, a patient with impaired bladder contractility on preoperative urodynamics, who is undergoing a sling procedure for stress urinary incontinence, may need to be taught clean self-catheterization after surgery. Preoperative counseling to predict such specific outcomes can help to avoid unsatisfied patients. Because pelvic floor disorders are mainly quality-of-life issues, it is imperative that physicians discuss with their patients their goals and expectations for the treatments offered to them.

The following chapters cover multitudes of evaluation.The history and physical examination are the starting building blocks to what investigation is needed next.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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