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Archive for the ‘Female Incontinence’ Category

Dr Arabin Cerclage pessaries for preventing preterm birth in asymptomatic singleton pregnant women

Dr Arabin Cerclage Pessary

Dr Arabin Cerclage Pessary

Vaginal progesterone, cerclage or cervical pessary for preventing preterm birth in asymptomatic singleton pregnant

women with a history of preterm birth and a sonographic short cervix.
Reference: Ultrasound Obstet Gynecol 2013; 41: 146–151 Published online 17 January 2013 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/uog.12300
Z. ALFIREVIC*, J. OWEN†, E. CARRERAS MORATONAS‡, A. N. SHARP*, J. M. SZYCHOWSKI§
and M. GOYA‡
*Department of Women’s and Children’s Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK; †Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division, University of Alabama, Birmingham, AL, USA; ‡Maternal Fetal Medicine Unit, Department of Obstetrics, Hospital Universitari Vall d’Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain; §Department of Biostatistics, University of Alabama, Birmingham, AL, USA
ABSTRACT
Objective To compare the outcome of pregnancy in cohorts of women with singleton pregnancy and history of preterm birth and sonographic short cervix managed with different treatment protocols, namely cerclage, vaginal progesterone or cervical pessary.
Methods
This was a comparison of three management protocols for women with singleton pregnancy and a high risk of preterm birth because of a prior spontaneous preterm birth before 34 weeks and a shortened cervical length detected by transvaginal ultrasound. The study included 142 women who were initially treated with cerclage (USA), 59 with vaginal progesterone (UK) and 42 with cervical pessary (Spain). Perinatal outcomes were compared between the three cohorts.
Results
There were no statistically significant differences in perinatal losses, neonatal morbidity and preterm births among the three groups, apart from a higher rate of preterm birth before 34 weeks’ gestation after treatment with vaginal progesterone in comparison with treatment with cervical pessary (32% vs 12%; relative risk (RR)=2.70; 95% CI, 1.10–6.67). When only the
subgroups of women with cervical length <25 mm, irrespective of gestational age, were compared, the difference between these two cohorts was not statistically significant (RR=2.21; 95% CI, 0.83–5.89).
Conclusion
Cerclage, vaginal progesterone and pessary appear to have similar effectiveness asmanagement strategies
in women with singleton pregnancy, previous spontaneous preterm birth and short cervix. Direct randomized comparisons of these strategies, or combinations thereof, are needed to determine optimal management.
Cerlage Dr Arabin in position

Feel like you’re coughing your guts out?

APOPS new logo jpgCredit to Sherrie Palm founder Associateion for Pelvic Organ Prolapse Support

It’s flu season; you’re hacking and hacking until you feel like your bottom end is going to blow out. And it just might be. if you’re like me you start to ramp up the germ-phoebe aspect of your personality around this time of year. We all start paying more attention to washing our hands, get nervous about grabbing the door at stores we shop at, walk the other way when we hear someone  coughing. No one wants to get the flu. Yet despite the extra protective measures we take, we somehow manage to contract it. The majority of us are exposed to hundreds of germ infested surfaces every day; there’s just no way to get around it beyond wrapping ourselves in one of those protective bubbles. Not a very user friendly way to avoid getting sick.

I recently returned from a trip overseas and had concerns about being in airplanes and airports, knowing that the odds of my catching a bug were increased by being exposed to so many people in an enclosed environment. Every time someone coughed on the plane I thought to myself “keep your hands off your face, keep your hands off your face,” reciting it to myself like some kind of magical mantra that would protect me. Although I felt badly for the young child coughing non-stop a few rows up from me on the airbus, I equally worried that somehow the germs would float back to me in the recycled air of the plane.

Somehow I managed to make the long journey in both directions and come home with my body flu-free. Lucky me, I figured now I could relax. Then the inevitable happened-……read more (more…)

The Cramer Pessary for Stress incontinence and pelvic organ prolapse.

Pessaries can play an important part in getting back a reasonable quality of life if you happen to suffer with stress incontinence (SUI)  and/or pelvic organ prolapse.

Today, pessary expert and advocate for women who suffer stress incontinence and pelvic organ prolapse Gaynor Morgan speaks about the Cramer Pessary.

Gaynor Morgan works with medical professionals and leading retailers all over Europe to help raise the awareness about the importance of getting incontinence and pelvic organ prolapse issues to the forefront and pushing for more education about these subjects.

Over 45% of women worldwide suffer with some type of pelvic organ prolapse and/ or incontinence. The World Health Organisation had deemed this as an epidemic that needs addressing.

Gaynor heads up the European side of the non profit organisation, APOPS – Association for pelvic organ prolapse support founded by award winning author of the book: Pelvic Organ Prolapse the silent epidemic. Ms Sherrie Palm.

Image

The Cramer pessary:
Material : Medical grade silicone with a steel spring inside for stabilization

Size range: Diameter 50mm and increases in 5mm increments to the largest size 90mm

Use : for the management of stress incontinence, cystocele and uterine prolapse.

DO NOT USE IF: You have had prior surgery and this includes vaginoplasty. Reason being, the pelvic floor must be somewhat stable to retain this pessary.

Usage: Fit in the morning and remove in the evening. Lubricant is advisable if the vagina is very dry. Recommended lubricants are yes and ladysoft

Fitting: The Dr or physiotherapist should show you and get you to practise insertion and removal. Ensure the two thick ends are right against the urethra and do not pinch.

The Cramer will lift and support the bladder neck which controls the involuntary loss of urine in SUI (Stresss Urinary Incontinence)
The pelvic floor must be in tact for this pessary to be successful. It hasn’t been very successful in the management of rectocele but is very good in the management of a cystocele where the patient also presents a uterine prolapse grade 1 or 2.

Care of the Cramer: Wash under clean water and allow to airdry. (Drying with a towel or paper towel can leave debris behind to stick to the pessary which can be introduced into the vaginal lining and may cause problems. Cleaning with a pessary sanitiser such as IncoClean (without alcohol) can also be used. Autoclaving is possible.
DO NOT microwave or boil this pessary due to the metal spring inside.

If you still leak urine after it has been fitted, it is possible that you have not positioned it correctly. Remove and reposition.

They are not available on the NHS prescription at this time.

For more information please go to www.incostress.com and go to the free downloads.

What is a Kylie bed pad?

What Is A Kylie® Bed Pad?

It’s exactly how it sounds. A Kylie® Bed Pad is placed on top of the sheets, but under the duvet, and is highly Kylie® Bed Padsabsorbent, washable and with a waterproof backing. This allows you to keep your mattress clean and cut down on time consuming sheet washing and changing.

I worked in a nursing home very briefly after leaving school before starting my first job. The residents at the nursing home would all sleep on a Kylie® Bed Pad. It’s clear why such a product would find a place in a nursing home. Roughly, there are 3 great benefits for anyone:

  • The Kylie® absorbs urine away from the skin which keeps skin healthy
  • The Kylie® can be quickly changed and washed, cutting down on time consuming bedding changes
  • Kylie® Bed Pads are washable and reusable, so save lots of money over their life

READ MORE…

What is Estim?

Estim is known under a few descriptions, Erotic Stimulation, Erotic Electro Stimulation and Electric Stimulation.

Depending what your needs are there are plenty of devices to chose from and it is always best to discuss the types of devices with your medical advisor prior to investing.

Estim is also known as EMS Electrical muscle stimulation or neuromuscular electrical stimulation (NMES)

What ever you chose to call it or which ever product you decide to use all of them come down to one thing, which is forcing the of muscles to contract through electric impulses.

Women with weak pelvic floor muscles may see this as an easy option for pelvic floor exercising, but  with every good idea there is always a down side, which is why it is so important to discuss any alternative pelvic floor therapy with your medical advisor and physiotherapist. Over use of an electrical stimulation on muscles and cause over tightening of the muscles which can lead to fatigue.

Using Estim with a physiotherapist.

The physiotherapist may place electrodes on the skin in various locations or insert a probe into the vagina to be able to stimulate a single or group of muslces.

These controled contractions via electrical stimulation helps strengthen the affected muscles. The physiotherapist can chnage the settings to allow for a strong or gentle muscle contraction. Along with increasing muscle strength, the contraction of the muscle also promotes blood supply to the area that assists in healing.

EMS machines can be beneficial as a strengthening training device towards healthy muscles and ligaments. It can also be used effectively as a rehabilitation method in patients that have little or no sensation of the muscles.

The machines used in physiotherapy practises are more powerful and tend to reach deeper into the muscle mass than the home devices.

There are several types of EMS devices and are used in different ways but all end up with the same purpose: to contract and stimulate muscles through the delivery of electrical impulses.

EMS can be particularly helpful for stroke patients.

For more information about EMS, Estim and other muscle rehabilitation products please see the specialists www.win-health.com

Dribbly women don’t dance – incontinence and exercise.

Dribbly women don’t dance – incontinence and exercise by Elaine Miller physiotherapist

 If you are reading this you are not my audience.  Sorry.  The fact that you are reading something to do with incontinence suggests that you already have an understanding about the condition, are comfortable getting information about it, and are keen to learn more. So, you either are, or, will be, alright.

The people I fret about are the millions of women who are living with their leaking and not yet seeking help.  They just put up with having poor bladder control, pad up, and feel a bit disappointed.

Well, I say “feel a bit disappointed”.  In fact is that a third of them go on to develop clinical depression.  Of course, exercise is commonly recommended for managing mood disorders – but, if you leak when you run, well, you’re not going to go for a run, are you?

And, therein lies the huge public health rub.

Diseases of inactivity, like coronary heart disease, kill women.  One in eight UK women die from heart disease.  Exercise isn’t just about being able to keep up with the kids, or beating the blue, it’ll keep us alive.

But, speaking as someone who peed herself during zumba…it is very difficult to be physically active and avoid impact on your pelvic floor.

When I rule the world, some pieces of gym equipment will carry “pelvic floor warning” signs.  Rowing machines, reclining bikes, a loaded leg press – yep, wouldn’t want anyone with a prolapse on those things.  Oh, or trampolines, those things can have a label on them.  And, the plank, star jumps, tennis, lunges, I could go on.

In fact, I’d force incontinence pad manufacturers to print pelvic health advice on their packaging.  And, while we’re at it, they can fix that awful glue which comes unstuck and allows the pad to attach itself to your labia instead of your gusset…ouch.

So, we’ve got a classic Catch 22.  In order to reduce your risk of pelvic organ prolapse and your symptoms of stress incontinence you need to keep your weight under control.  But, you wet yourself at zumba, so aren’t keen…

Pelvic floor friendly exercises have reduced impact forces – like swimming, cycling, pilates (when it’s well taught and you are absolutely sure your technique is good), speed/power/Nordic pole/hill walking, aqua-aerobics and low-intensity cross trainers.

However, runners?  They wanna run, not walk, they want to run. That’s when internal support can be helpful, Sherrie Palm (she knows everything there is to know about pelvic floors) says that pessaries like incostress should be used when a woman is participating in acvities with impact.

Now, that does not mean that you can shove in a grade 4 prolapse with an incostress and get back to athletics training…but, it does mean that if you have a mild prolapse, or mild stress incontinence symptoms, and you are complying with a pelvic floor strengthening regime which your physiotherapist has given you, AND you use internal support – well, you just might manage to get back to zumba.

Ask me how I know.

Credited to  Elaine Miller Gussie Grippers

Elaine Miller on of the UKs leading physiotherapists who has a post-grad in sports medicine. She focuses her energy on helping women overcome pelvic floor disorders and incontinence and breaks down the taboo through her humour and pelvic floor parties where she has a one hour solo show entitled ‘Gusset Grippers’. Look out for Gusset Grippers at Edinburgh Fringe Festival this August. An amazing lady who fears no pelvic floor!

Find out more about Gusset Grippers on the Gusset Grippers website 

Elaine’s blog and more information on where to see Elaine at the Edinburgh Festival

PELVIC ORGAN PROLAPSE

Sherrie Palm shares her innermost secrets, experience and advice in her award winning book Pelvic Organ Proalpse the silent epidemic

Find out why so many medical professionals are passing this book onto their patients.

Order Pelvic Organ Prolpase today and help support women with pelvic organ prolapse issues

Click here to order your copy today 

Pelvic Organ Prolapse the silent epidemic

Pelvic Organ Prolapse the silent epidemic by Sherrie Palm
An award winning fantastic book which gives women down to earh plain speaking advice, diagnosis and how to deal with Pelvic organ prolapse.

Pelvic organ prolapse is an extremely common female health issue that ALL WOMEN need to know about. Symptoms of pelvic organ prolapse (POP) can be confused and mistaken for other health conditions. Symptoms of POP are:

pelvic/back/vaginal/rectal pain
Urinary or fecal incontinence
pain with intercourse
chronic constipation
lack of sexual sensation
vaginal/rectal pressure

and many others.

Vaginal childbirth and menopause are the two leading causes of POP. Unfortunately, most women first hear about pelvic organ prolapse AFTER they are diagnosed with POP.

If you suffer from any of the above symptoms, you may be suffering from a cystocele, rectocele, or type of POP and should talk with your physician about pelvic organ prolapse now.

Our goal is to increase awareness and recognition of POP symptoms, causes, and treatments. Pelvic organ prolapse impacts millions of women around the world physically, emotionally, socially, sexually, and financially. We need to increase POP awareness; we need to increase it now.

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