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Urology

Urology

Some of the most common diseases of the urinary system are related to infections of the urinary system and prostate neoplasms.

The infections of the urinary system constitute a great challenge for the physician who should treat the duration and the symptomatology which affect everyday life of the patients.

The Benign Prostatic Hyperplasia (BPH) is the most common urological problem in elderly men affecting nearly half male population over 50 years old. The symptoms of BPH grow with the age and it is responsible for important deterioration of life quality for millions of men worldwide.

The symptoms of lower urinary system due to Benign Prostatic Hyperplasia are either obstructive or irritative. The obstructive symptoms include difficulty of starting a urine stream, repeated start-stop urination, feeling that the bladder is not completely empty, prolonged urination e.t.c., while as the irritative symptoms include diuria, nocturia, urge to urinate and incontinence.

The development of medical therapies during the last decade offer new solutions for treating symptomatic BPH. The medical therapy includes mainly alpha-adrenergic receptor antagonists, 5-alpha reductase inhibitors,as well as combined therapy.

The Prostate Cancer is nowadays the most common cancer for men in the developed countries of the western world and constitutes at the same time the second leading cause of cancer death. Despite the high attack rate of the disease, we are aware that there are cases of Prostate Cancer which rest non-diagnosed, as they do not cause symptoms forcing the patients to advise an urologist.

The Overactive Bladder Syndrome (OAB) term was first used in 1988. It is urodynamically  defined as a chronic hyperactivity of the Uterine Bladder detrusor muscle  and is characterized by repeated involuntary bladder contractions during the filling phase.

Incontinence is the situation in which, unlike the will of the person, the urine comes out of the urethra either continuously or in an intermittent way.

Urge incontinence (UUI) is the symptom of involuntary urinary leakage accompanied with an urgent feeling or follows immediately after it.

 

Appears in ..

• Men mainly with neurological problems, Parkinson's disease, neurogenic bladder, diabetic neuropathy, multiple sclerosis, stroke, malignancy that can induce pressure incontinence (Overflow Incontinence), urge incontinence and effort incontinence

• Women over 40 years of age with anatomical problems in the bladder or after surgery, neurological diseases and diabetes, that due to the nature of the problem, usually do not reach the specialist, which may induce effort incontinence, urge incontinence and mixed cases.

• Elderly patients with incontinence under pressure, with the usual cause being detected in the progressive loss of the frontal lobe brain effect in the center of urination, located in the brain stem.

 

OAB patients

• They have a social cost with everyday life exclusion

• Βurden their intimates with their care

• Βurden the Health System with a cost for hospitalizations and complications management

Bibliography:

  • BJU Int 2001, Milsom I, Abrams P, Cardoso L et al, 87:760-6
  • World J Urol 2003, Stewart W, Van Rooyen JB, Cundiff GW et al, 20:327-36
  • New perspectives on Benign Prostatic Hyperplasia, Miller P. Merit, Publishing Int., 2007
  • Ουρολογία, Κ. Δημοπούλου, 1998, (Urology, K. Dimopoulos, 1998)

International Health Organizations:

European Association of Urology (EAU)

American Urological Association

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