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BLADDER DISORDERS

UNDERSTANDING THE PROBLEM

The urinary bladder is a muscular sac in the pelvis, just above and behind the pubic bone. When empty, the bladder is about the size and shape of a pear.

Urine is made in the kidneys, and travels down two tubes called ureters to the bladder. The bladder stores urine, allowing urination to be infrequent and voluntary. The bladder is lined by layers of muscle tissue that stretch to accommodate urine. The normal capacity of the bladder is 400 to 600 mL.

During urination, the bladder muscles contract, and two sphincters (valves) open to allow urine to flow out. Urine exits the bladder into the urethra, which carries urine out of the body. Because it passes through the penis, the urethra is longer in men (8 inches) than in women (1.5 inches).

Some of the main bladder disorders include:

  • Cystitis
  • Urinary stones
  • Obstruction in the bladder:
  • Bladder cancer:
  • Urinary incontinence
  • Overactive bladder
  • Haematuria:
  • Urinary retention
  • Cystocele
  • Dysuria
  • Diverticulum of the bladder:
  • Vesicoureteral reflux
UNDERSTANDING WHO SUFFERS

Bladder disorders are common as we age. In fact, many people think they are normal and live with their condition even if it begins to limit their activities. Over 35 million Americans suffer from bladder disorders.

However the female population is more prone to this than their male counterparts due to the fact that they have a shorter uterus and this makes it easier for bacteria to reach the bladder. The female urethras are also close to the rectum. This is also the case for Urinary Incontinence (loss of bladder control) has a prevalence among women of 3-17% (with a much higher range between age 70 and 80) and 3-11% in males.

Other factors causing bladder disorders can include:

  • Immobility.
  • Insufficient fluid intake.
  • Surgical procedure within the urinary tract
  • Urinary catheter.
  • Urinary obstruction, a blockage inside the bladder or urethra.
  • Urinary tract abnormality, caused by birth defects or injuries.
  • Urinary retention, difficulty emptying the bladder.
  • Narrowed urethra.
  • Enlarged prostate.
  • Bowel incontinence.
  • Pregnancy.
  • Diabetes.
POTENTIAL SIGNS AND SYMPTOMS

Bladder Disorder Symptoms
Symptoms of the different bladder and incontinence conditions vary.
These can include:
Bladder Cancer

  • Blood in the urine
  • Pain during urination
  • Changes in urination habits such as a strong need to urinate or difficulty urinating

Bladder Outlet Obstruction Symptoms

  • Abdominal pain
  • Feeling of a full bladder continuously
  • Difficulty urinating
  • Frequent urination
  • Pain in urination
  • Slow urine flow
  • Urinary tract infection
  • Urine stream starts and stops
  • Overflow Incontinence
  • Urine stream starts and stops
  • Accidental release of small amounts of urine
  • Weak urine stream
  • Straining while urinating
  • Feeling of a full bladder continuously
  • The need to urinate frequently at night
  • Loss of urine while asleep

Stress Incontinence Symptoms

  • Urine that leaks when coughing, laughing, lifting heavy objects, straining and changing posture position

Urge Incontinence Symptoms

  • Sudden urge to urinate
  • Sudden accidents with a significant amount of urine
  • The need to urinate frequently, especially at night"
EXAMINATIONS USUALLY REQUIRED

The diagnosis process starts with a thorough physical exam. Depending on the symptoms, doctors may want to perform additional tests. These could include some of the following:

  • Urine analysis and urine culture: A sample of urine can be analysed to look for infection or blood in the urine.
  • Postvoid residual: A test, performed with either an ultrasound or a catheter, to ensure that not too much urine is left in the bladder after emptying.
  • Urodynamics: A test to determine how well the bladder is functioning, how much it can hold, and the pressures in the bladder during filling and emptying.
  • Uroflowmetry tests urine flow: how much and how fast. It is performed by emptying the bladder in a toilet that's fitted with a measuring device and a pan. This is done in a private room. Results are given in a graph.
  • Cystometry measures bladder pressure during the storage and evacuation (emptying) phases. A catheter (thin tube) is inserted into the bladder through the urethra.
  • Intravenous pyelogram helps see into the kidneys, bladder and ureters. It's used to check for abnormalities, such as stones (small hard masses). Dye is injected into a vein and makes its way to the kidneys, ureters and bladder. X-rays are taken as the dye progresses through the system giving detailed pictures that help specialists see the organs.
  • Cystoscopy: A procedure in which a tiny camera (thin tube with a light and a miniature fibre-optic telescope) is used to examine the inside of the bladder.
  • Cystography is a test that also uses X-rays and dyes, but it's used to look at the bladder and the structures around it. A catheter is put into the bladder and dye is injected into it. X-rays of the bladder when full and during stages of emptying are taken.
  • Ultrasound and magnetic resonance imaging (MRI) are other ways to look at the bladder, kidneys and ureters. Ultrasound uses the echoes from sound waves against structures such as organs to build up pictures of the body's interior. MRI uses magnets and radio waves to create pictures. Neither involves radiation.
PROPOSING TREATMENT AND WHY AIMIS

 

Treatment for a bladder disorder will depend on the cause and severity of the condition. If surgery is required, you may be a candidate for a minimally invasive approach - da Vinci Surgery.

AIMIS is an expert in Robotic Surgery (Cystectomy, Partial or segmental cystectomy) and other Robotic Assisted Urologic Surgery involving the best American and International surgeons who are experts in the field.

Da Vinci Surgery uses state-of-the-art technology to help your doctor perform a range of delicate operations for bladder disorders and offers several potential benefits over traditional open and laparoscopic surgery, including: By taking advantage of the da Vinci robot, surgeons are able to dissect and reconstruct the bladder with relative ease.

  • Enhanced ability to preserve the neurovascular bundles (dependent on patient)
  • More rapid return of Bowel function and quicker return to a normal diet.
  • Less pain
  • Minimal scarring
  • Lower risk of complications and significantly reduced risk of major complications
  • Shorter hospital stay
  • Less chance of hospital readmission or follow-up surgery
  • Less risk of deep vein thrombosis (life-threatening condition where a blood clot forms deep in the body)
  • Faster recovery and return to normal activities

By taking advantage of the da Vinci robot, surgeons are able to dissect and reconstruct the bladder with relative ease.

To see the procedures we undertake with Robotic Xi Surgery, please click here

GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
  • Can I get more information before I commit to this?
  • Can I get a second opinion from you before I commit to this?
  • How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:

AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.

AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.

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AFFORDABILITY

AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.

 

FURTHER INFORMATION ON THE PROBLEM:
  • Cystitis: Inflammation or infection of the bladder causing acute or chronic pain or discomfort or urinary frequency or hesitancy.
  • Urinary stones: Stones (calculi) may form in the kidney and travel down to the bladder. If calculi block urine flow to or from the bladder, they can cause severe pain.
  • Obstruction in the bladder: Bladder outlet obstruction (BOO) is a blockage at the base of the bladder. It reduces or prevents the flow of urine into the tube that carries urine out of the body (urethra).
  • Bladder cancer: A tumor in the bladder is usually discovered after blood is noticed in the urine. Cigarette smoking and workplace chemical exposures cause most cases of bladder cancer.
  • Urinary incontinence: Involuntary urination, which may be chronic. Urinary incontinence can result from a variety of causes, stress, urge and pregnancy.
  • Overactive bladder: The bladder muscle (detrusor) contracts involuntarily, causing some urine to leak out. Detrusor over activity is a common cause of urinary incontinence.
  • Haematuria: Blood in the urine. Haematuria may be benign, or may be caused by infection or a serious condition like bladder cancer.
  • Urinary retention: Urine does not exit the bladder normally due to obstruction or suppressed bladder muscle activity. The bladder may swell to hold more than a quart of urine.
  • Cystocele: Weakened pelvic muscles (usually from childbirth) allow the bladder to press on the vagina. Problems with urination can result.
  • Dysuria (painful urination): Pain or discomfort during urination due to infection, irritation, or inflammation of the bladder, urethra, or external genitals.
  • Diverticulum of the bladder: A diverticulum is an outpouching in the bladder. It can be either congenital (born with) or acquired. ... Acquired bladder diverticula are often due to bladder outlet obstruction from an enlarged prostate, urethral stricture (scar tissue in the tube which we urinate out), or neurologic disease.
  • Vesicoureteral reflux: Vesicoureteral reflux can be primary or secondary. Children with primary vesicoureteral reflux are born with a defect in the valve that normally prevents urine from flowing backward from the bladder into the ureters. Secondary vesicoureteral reflux is due to a urinary tract malfunction, often caused by infection. Children may outgrow primary vesicoureteral reflux, Treatment, normally includes medication or surgery, to preventing kidney damage. The choice of specific treatment will depend on the severity of the symptoms and the extent that the symptoms interfere with lifestyle. Dependent on condition, there are three main approaches to treatment: medication, retraining and surgery.
  • Medications in case of infection, to help reduce stones or relaxants for urge incontinence for example
  • Management of urge incontinence usually begins with a bladder retraining program. Using electrical stimulation and biofeedback therapy in conjunction with bladder retraining.
  • For the majority of conditions, surgery is the preferred or required option. Robotic surgery introduced with the development of the da Vinci® System, is being used by an increasing number of surgeons worldwide for bladder surgery and other urologic procedures to treat cancer, bladder diverticulum, urachal cysts or other bladder conditions. This minimally invasive approach, utilizing the latest in surgical and robotics technologies, is ideal for delicate urologic surgery and generally results in a better surgical experience and faster recovery.
FURTHER INFORMATION ON INCREASED RISK GROUPS

Changes in lifestyle may help decrease the risk of some (but not all) bladder disorders.

  • Losing weight can reduce pressure on the pelvic floor and urine leakage. Even women who do not achieve their ideal body weight can see an improvement in bladder function with a 5% decrease in weight.
  • Quitting smoking

*Keeping away from chemicals used in the textile, rubber, leather, dye, paint, and print industries

  • Dietary changes: Reducing the intake of caffeine, fizzy drinks, and alcohol, which are bladder irritants, may help alleviate symptoms.
  • Monitoring fluid intake: Decreasing fluids, especially in the evening, can ease leaking and trips to the bathroom.
  • Biofeedback therapy: This therapy strengthens or relaxes the pelvic floor muscles. It can help improve bowel and bladder functions.
FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

Depending on the symptoms, doctors may want to perform additional tests. These could include some of the following:

  • Urine analysis and urine culture: A sample of urine can be analysed to look for infection or blood in the urine.
  • Postvoid residual: A test, performed with either an ultrasound or a catheter, to ensure that not too much urine is left in the bladder after emptying.
  • Urodynamics: A test to determine how well the bladder is functioning, how much it can hold, and the pressures in the bladder during filling and emptying.
  • Uroflowmetry tests urine flow: how much and how fast. It is performed by emptying the bladder in a toilet that's fitted with a measuring device and a pan. This is done in a private room. Results are given in a graph.
  • Cystometry measures bladder pressure during the storage and evacuation (emptying) phases. A catheter (thin tube) is inserted into the bladder through the urethra.
  • Intravenous pyelogram helps see into the kidneys, bladder and ureters. It's used to check for abnormalities, such as stones (small hard masses). Dye is injected into a vein and makes its way to the kidneys, ureters and bladder. X-rays are taken as the dye progresses through the system giving detailed pictures that help specialists see the organs.
  • Cystoscopy: A procedure in which a tiny camera (thin tube with a light and a miniature fibre-optic telescope) is used to examine the inside of the bladder.
  • Cystography is a test that also uses X-rays and dyes, but it's used to look at the bladder and the structures around it. A catheter is put into the bladder and dye is injected into it. X-rays of the bladder when full and during stages of emptying are taken.
  • Ultrasound and magnetic resonance imaging (MRI) are other ways to look at the bladder, kidneys and ureters. Ultrasound uses the echoes from sound waves against structures such as organs to build up pictures of the body's interior. MRI uses magnets and radio waves to create pictures. Neither involves radiation.
WHY AIMIS FOR THIS SURGERY

AIMIS is an expert in Robotic Surgery (Cystectomy, Partial or segmental cystectomy) and other Robotic Assisted Urologic Surgery involving the best American and International surgeons who are experts in the field.

Da Vinci Surgery uses state-of-the-art technology to help your doctor perform a range of delicate operations for bladder disorders and offers several potential benefits over traditional open and laparoscopic surgery, including: By taking advantage of the da Vinci robot, surgeons are able to dissect and reconstruct the bladder with relative ease.

  • Enhanced ability to preserve the neurovascular bundles (dependent on patient)
  • More rapid return of Bowel function and quicker return to a normal diet.
  • Less pain
  • Minimal scarring
  • Lower risk of complications and significantly reduced risk of major complications
  • Shorter hospital stay
  • Less chance of hospital readmission or follow-up surgery
  • Less risk of deep vein thrombosis (life-threatening condition where a blood clot forms deep in the body)
  • Faster recovery and return to normal activities

By taking advantage of the da Vinci robot, surgeons are able to dissect and reconstruct the bladder with relative ease.

OTHER SERVICES PROVIDED BY AIMIS

In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.

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