Evaluation

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.

Herbal Remedies For Acid Reflux

Herbal Remedies For Acid Reflux

Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.

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