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The most-watched medical videos on MedicalVideos.com — ranked by views from our community of medical students, healthcare professionals, and patients learning how the body works.

Pelvic Floor Exercise & Bladder Scans Surgeon 23,867 Views • 3 years ago

Surgery to treat men with prostate cancer is often followed by months of difficulty controlling urine flow, a condition known as urinary incontinence. But new research suggests that this problem may go away more quickly if the men perform certain exercises to strengthen their pelvic floor muscles.
Researchers from the Kaiser Permanente Medical Center in Los Angeles, California, found that men who were taught how to perform pelvic floor exercises before and after surgery were more likely to have regained continence three months later.

Men Doing Pelvic Exercises Recover Earlier

In the current study, the researchers randomly assigned 38 men scheduled for radical prostatectomy to either a treatment group or a control group. The men in the treatment group were referred to a physical therapist. They were instructed how to do Pelvic Floor Exercises both before and after surgery, using biofeedback to ensure they were using the proper muscles. The control group did not receive any formal instruction. All of the men completed questionnaires regarding bladder function at regular intervals over the next year.
Overall, 82% of the patients had regained continence (defined as not needing to use any absorbent pads) by the end of the year, including about equal numbers in both groups. But on average the men who had been educated about Pelvic exercises regained continence about one month earlier than those in the control group (at 12 weeks vs. 16 weeks).
Most of the men who did not regain continence within a year were still using at least three absorbent pads a day, indicating continued severe incontinence. The study authors explained that these men probably had extensive damage to the bladder sphincter or severe dysfunction of the bladder after surgery, and the exercises alone were unable to compensate for this.
But the exercises seemed to be effective. Pelvic floor exercise and education initiated prior to surgery is an effective noninvasive intervention useful for improving early return of urinary continence, the authors concluded. It would certainly have a positive impact on our patients undergoing radical prostatectomy in an effort to improve quality of life after major urological surgery.

The results of the study were published in the Journal of Urology (Vol. 170, No. 1: 130-133)

Treat HEMORRHOIDS samer kareem 2,969 Views • 3 years ago

Most of the time, treatment for hemorrhoids involves steps that you can take on your own, such as lifestyle modifications. But sometimes medications or surgical procedures are necessary. Medications If your hemorrhoids produce only mild discomfort, your doctor may suggest over-the-counter creams, ointments, suppositories or pads. These products contain ingredients, such as witch hazel or hydrocortisone, that can relieve pain and itching, at least temporarily. Don't use an over-the-counter cream or other product for more than a week unless directed by your doctor. These products can cause side effects, such as skin rash, inflammation and skin thinning. Minimally invasive procedures If a blood clot has formed within an external hemorrhoid, your doctor can remove the clot with a simple incision, which may provide prompt relief. For persistent bleeding or painful hemorrhoids, your doctor may recommend another minimally invasive procedure. These treatments can be done in your doctor's office or other outpatient setting. Rubber band ligation. Your doctor places one or two tiny rubber bands around the base of an internal hemorrhoid to cut off its circulation. The hemorrhoid withers and falls off within a week. This procedure — called rubber band ligation — is effective for many people. Hemorrhoid banding can be uncomfortable and may cause bleeding, which might begin two to four days after the procedure but is rarely severe. Injection (sclerotherapy). In this procedure, your doctor injects a chemical solution into the hemorrhoid tissue to shrink it. While the injection causes little or no pain, it may be less effective than rubber band ligation. Coagulation (infrared, laser or bipolar). Coagulation techniques use laser or infrared light or heat. They cause small, bleeding, internal hemorrhoids to harden and shrivel. While coagulation has few side effects, it's associated with a higher rate of hemorrhoids coming back (recurrence) than is the rubber band treatment. Surgical procedures If other procedures haven't been successful or you have large hemorrhoids, your doctor may recommend a surgical procedure. Surgery can be performed on an outpatient basis or you may need to stay in the hospital overnight. Hemorrhoid removal. During a hemorrhoidectomy, your surgeon removes excessive tissue that causes bleeding. Various techniques may be used. The surgery may be done with a local anesthetic combined with sedation, a spinal anesthetic or a general anesthetic. Hemorrhoidectomy is the most effective and complete way to treat severe or recurring hemorrhoids. Complications may include temporary difficulty emptying your bladder and urinary tract infections associated with this problem. Most people experience some pain after the procedure. Medications can relieve your pain. Soaking in a warm bath also may help. Hemorrhoid stapling. This procedure, called stapled hemorrhoidectomy or stapled hemorrhoidopexy, blocks blood flow to hemorrhoidal tissue. Stapling generally involves less pain than hemorrhoidectomy and allows an earlier return to regular activities. Compared with hemorrhoidectomy, however, stapling has been associated with a greater risk of recurrence and rectal prolapse, in which part of the rectum protrudes from the anus. Talk with your doctor about what might be the best option for you.