Stability

Normally, the bladder stores increasing volumes of urine without a significant increase in pressure because of compliance and absence of involuntary detrusor contractions. The bladder should contract only during the voluntary act of voiding. Under certain circumstances, the bladder may show involuntary contractions, which may be associated with symptoms (Figure 3-2.7). These involuntary contractions are divided into two categories by the ICS: idiopathic and neurogenic detrusor overactivity. Idiopathic detrusor overactivity is defined as involuntary contractions not associated with an underlying neurologic lesion. The cause of this overactivity may be idiopathic, aging, infection, inflammation, or bladder outlet obstruction. Neurogenic detrusor overactivity is defined as involuntary contractions associated with a known neurologic lesion, typically an upper motor neuron lesion. Idiopathic and neurogenic detrusor overactivity may be indistinguishable on CMG.1 The terms idiopathic and neurogenic overactivity are defined strictly by the patient's neurologic status rather than the appearance on CMG. While recording the contractions, the clinician must ensure that they are involuntary, because patients may become confused during the study. During the involuntary contractions, the patient's symptoms must be reproduced (e.g., urgency), and the bladder volume as well as any leakage should be recorded. Absence of involuntary contractions does not exclude the existence of contractions, especially if the patient's symptoms are not reproduced during testing.

Figure 3-2.7. Neurogenic overactive bladder with low compliance and uninhibited contraction.

Figure 3-2.7. Neurogenic overactive bladder with low compliance and uninhibited contraction.

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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