We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Benign prostatic hyperplasia is the most common benign neoplasm in males in the United States. It is characterized by lower urinary tract symptoms: weak stream, urinary frequency, urgency, incomplete emptying, hesitancy, nocturia, and acute urinary retention. These symptoms are generally slowly progressive and left untreated can cause irreversible bladder damage. Diagnosis is mostly clinical and based on symptomatology; however, the use of some objective tests can be helpful. Treatment options include lifestyle modification as well as a variety of different pharmacologic agents.
More than one-third of American adults fail to achieve the 7–9 hours of sleep recommended by the American Academy of Sleep Medicine and the Sleep Research Society needed for optimal health and well-being. In addition to primary sleep disorders, such as sleep apnea, insomnia, and restless legs syndrome, many modern societal factors are also thought to contribute to chronic sleep deficiency, such as technology and work-related factors. Interruptions in the natural sleep–wake cycle can be associated with shift work and numerous chronic health conditions. A few studies have investigated the impact of nonstandard shift work on male reproductive health, and a compelling association between sleep and male urogenital health has been demonstrated. This chapter will review the literature on the effect of sleep and shift work on ED, LUTS, hypogonadism, male infertility, and how improved sleep quality can possibly improve common men’s health conditions.
This chapter provides an overview of incontinence and lower urinary tract symptoms in normal pressure hydrocephalus (NPH), and covers areas including dementia and incontinence, differential diagnosis, physiology and pathophysiology, symptoms, evaluation, and treatment. The relationship between gait disturbances, dementia, and incontinence has profound importance because of the potential heightened risk of falls. In the central nervous system, there are two main areas involved in the motor control and reciprocal coordination of lower urinary tract function. Our understanding of lower urinary tract dysfunction in NPH is limited by a lack of detailed knowledge of the supraspinal pathways involved in the control of micturition. Urodynamic studies may be the most important investigative procedures performed in patients with significant urinary symptoms and idiopathic NPH (iNPH), as the results will help identify etiologies and guide treatments. Patients may be treatment refractory to standard doses or may require higher than recommended doses or combination therapies.
Ambulatory urodynamic monitoring (AUM), using micro-tip pressure transducers and a digital solid-state recorder, is a useful additional test for women in whom conventional urodynamics fails to reproduce or explain the lower urinary tract symptoms of which they complain. This system allows information to be recorded digitally, downloaded and reviewed at the end of the test. AUM is performed in accordance with the International Continence Society (ICS) Standardisation of Ambulatory Urodynamic Monitoring. The care and observation of a patient undergoing AUM is as important in the diagnosis as the objective measurements and neither should be carried out in isolation. Checks on signal quality are highly important at the start, during the test and again before the test terminates. AUM has a role in monitoring voiding function. It allows women to pass urine in a flowmeter in a private setting as and when they desire.
The bladder diary is an important tool in the investigation of patients with lower urinary tract symptoms and voiding dysfunction. There are different methods for recording information on voiding patterns. A frequency-volume chart is the simplest method and collects information on volumes voided and micturition times. A voiding or bladder diary provides a more detailed record. The paper diary is the most common as it is easy to produce and store, inexpensive and convenient to post or hand directly to the patient. The electronic bladder diary such as the UroDiary uses an intelligent character recognition programme and calculates a centile ranking for results, correcting for age and 24-hour voided volume. Bladder diaries are more accurate than recall when recording urinary symptoms. The bladder diaries guide many aspects of conservative treatment, especially timing and types of fluids.
Recommend this
Email your librarian or administrator to recommend adding this to your organisation's collection.