Pelvic Dysfunction in Men Diagnosis and Treatment of Male Incontinence and Erectile Dysfunction

by Dorey, Grace

• ISBN13: 9780470028360
• ISBN10: 047002836X
• Edition: 1st
• Format: Paperback
• Copyright: 2006-08-25
• Publisher: WILEY

Summary

Following on from the first book entitled 'Conservative treatment of Male Urinary Incontinence and Erectile Dysfunction' this book has been expanded to include seven new chapters and existing chapters have been extensively updated. It is written primarily for those specialist continence physiotherapists who are unsure of the treatment for male patients with lower urinary tract symptoms. The classification of male urinary incontinence has been restructured in line with the International Continence Society standardisation of terminology. The subjective and objective physiotherapy assessment is covered chronologically, to enable the clinician to conduct a meaningful investigation and arrive at a logical diagnosis.

Author Biography

Professor Grace Dorey Phd FCSP, UK.  Professor of Physiotherapy (Urology), University of the West of England, Bristol, UK .

Table of Contents

List of Figures	xiii
List of Tables	xvii
Preface	xix
Acknowledgements	xxi
1 History of the Male Pelvic Floor	1	(8)
Introduction	1	(1)
Physiotherapy development	1	(1)
Assessment of the male pelvic floor	2	(1)
Pelvic floor exercises	3	(1)
Posture	3	(1)
Detrusor underactivity	3	(1)
Detrusor overactivity	4	(1)
Nocturnal enuresis	5	(1)
Post-prostatectomy incontinence	5	(1)
Post-micturition dribble	6	(1)
Constipation	6	(1)
Faecal incontinence	7	(1)
Erectile dysfunction	7	(1)
Conclusion	8	(1)
2 Lower Urinary Tract Symptoms	9	(6)
Male lower urinary tract symptoms	9	(1)
Male questionnaires	10	(2)
Prevalence of lower urinary tract symptoms	12	(1)
Summary	13	(2)
3 Anatomy and Physiology of the Lower Urinary Tract	15	(14)
Male lower urinary tract	15	(2)
Prostate gland	17	(1)
Pelvic floor muscles	18	(4)
Penis	22	(1)
Nerve supply to the urinary system	22	(2)
Congenital abnormalities	24	(3)
Summary	27	(2)
4 Nervous Control of Lower Urinary Tract Function	29	(8)
Introduction	29	(1)
Urinary continence	29	(1)
Micturition cycle	29	(2)
Neurological control of the bladder	31	(2)
Integral bladder storage and voiding reflexes	33	(2)
Summary	35	(2)
5 Prostate Conditions and their Treatment	37	(6)
Investigations for prostate conditions	37	(1)
Benign prostatic hyperplasia	38	(2)
Prostate cancer	40	(1)
Prostatitis	41	(1)
Summary	41	(2)
6 Urinary Incontinence	43	(10)
Definition of urinary incontinence	43	(1)
Prevalence of urinary incontinence in men	43	(1)
Incidence of urinary incontinence following transurethral resection of the prostate	44	(1)
Incidence of urinary incontinence following radical prostatectomy	44	(1)
Classification of lower urinary tract symptoms	45	(1)
Storage symptoms	45	(2)
Voiding symptoms	47	(1)
Post-micturition symptoms	47	(1)
Signs suggestive of lower urinary tract dysfunction	47	(3)
Urodynamic terminology	50	(1)
Summary	51	(2)
7 Pelvic Pain in Men	53	(10)
Introduction	53	(1)
Definitions of pelvic pain	53	(1)
Acute pelvic pain	54	(1)
Chronic pelvic pain syndromes	54	(1)
Penile pain	54	(1)
Prostatitis	55	(1)
Sexual pain	55	(1)
Incidence of pelvic pain	55	(1)
Aetiology of acute pelvic pain	56	(1)
Aetiology of chronic pelvic pain	57	(1)
Assessment of pelvic pain	58	(1)
Treatment of acute pelvic pain	58	(1)
Treatment of chronic pelvic pain	58	(3)
Summary	61	(2)
8 Patient Assessment	63	(12)
Introduction	63	(1)
Subjective assessment	63	(2)
Bowel activity	65	(4)
Objective assessment	69	(1)
Urodynamics	70	(4)
Summary	74	(1)
9 Conservative Treatment	75	(26)
Conservative treatment for men with lower urinary tract symptoms	75	(2)
Stress urinary incontinence	77	(10)
Urge urinary incontinence	87	(3)
Post-prostatectomy incontinence	90	(1)
Post-micturition dribble	91	(1)
Chronic retention of urine	91	(2)
Extra-urethral urinary incontinence	93	(1)
Functional incontinence	94	(1)
Follow-up treatment	94	(1)
Treatment outcomes	94	(1)
Prevention of urinary incontinence	94	(1)
Pads	94	(2)
Appliances	96	(1)
Skin care	96	(1)
Research opportunities	97	(1)
Case studies: Questions and answers	98	(2)
Summary	100	(1)
10 Literature Review of Treatment before and after Prostatectomy	101	(12)
Introduction	101	(1)
Literature search	102	(1)
Results	103	(8)
Conclusions	111	(2)
11 Treatment of Post-prostatectomy Patients	113	(10)
Introduction	113	(1)
Assessment	113	(1)
Treatment	114	(3)
Post-prostatectomy complications	117	(2)
Post-prostatectomy erectile dysfunction	119	(1)
Summary	120	(1)
Frequently asked questions	120	(3)
12 Medication	123	(10)
Introduction	123	(1)
Pharmacotherapy for detrusor overactivity	124	(2)
Pharmacotherapy for stress urinary incontinence	126	(1)
Pharmacotherapy for nocturnal enuresis	127	(1)
Medication for nocturia	127	(1)
Medication which may have an adverse effect on lower urinary tract function	128	(2)
Medication which reduces the size of the prostate gland	130	(1)
Medication which relaxes the smooth muscle of the bladder neck	130	(1)
Medication for prostate cancer	130	(1)
Medication for hypocontractile bladder	131	(1)
Medication for erectile dysfunction	131	(1)
Medication which changes the colour of the urine	131	(1)
Summary	131	(2)
13 Faecal Incontinence	133	(12)
Introduction	133	(1)
Digestive system	133	(1)
Defaecation	134	(1)
Pelvic floor muscles	134	(3)
Causes of faecal leakage	137	(1)
Treatment for faecal leakage	138	(6)
Summary	144	(1)
14 Male Sexual Dysfunction	145	(16)
Introduction	145	(1)
Low libido	145	(1)
Erectile dysfunction	146	(7)
Orgasmic and ejaculatory disorders	153	(1)
Anorgasmia	154	(1)
Anejaculation	154	(1)
Retrograde ejaculation	155	(1)
Retarded ejaculation	156	(1)
Premature ejaculation	157	(1)
Aspermia	158	(1)
Haemospermia	158	(1)
Low-volume ejaculate	159	(1)
Painful ejaculation	159	(1)
Anhedonia	159	(1)
Sexual pain	160	(1)
Summary	160	(1)
15 Treatment of Male Sexual Dysfunction	161	(16)
Introduction	161	(1)
Low libido	161	(1)
Erectile dysfunction	162	(1)
Literature review of physical therapy for erectile dysfunction	163	(11)
Premature ejaculation	174	(2)
Conclusions	176	(1)
16 Setting up a Continence Service	177	(10)
Introduction	177	(1)
Integrated continence services	177	(2)
Director of continence services	179	(3)
Contacts for specialist groups	182	(1)
Suppliers	183	(1)
Helplines for men in the UK	183	(2)
Books and videos for professionals	185	(1)
Books for patients	186	(1)
Video for patients	187	(1)
Summary	187	(2)
Appendix: Male Continence Assessment Form	189	(8)
Glossary	197	(4)
References	201	(16)
Index	217