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Basic Urology - Coggle Diagram

- - - - Smooth Muscle Cells Enlarge and increase in connective tissue
  - - - Frequence
        Urgency
        Nocturia
    - - Weak Stream
        Intermittent Stream
        Straining
        Incomplete Emptying and terminal dribbling
    - - Hematuria
        Dysuria
    - - Weakness
        Lethargy
        Pain
- - - - Coordinated bladder smooth muscle musculature
        Lowering resistance at the level of smooth/striated sphincter
  - - - Hypogastric Nerve T10-L2
    - - Pelvic Nerve S2-S4
    - - Pudendal Nerve S2-S4
  - - - Due to Bladder
        
        Detrusor Hyperactivity
        
        Decreased compliance
        
        Detrusor hypersensitivty
      - Due to Outlet
        
        Stress incontinence
        
        Nonfunctional Bladder
    - - Due to Bladder
        
        Neurologic
        
        Myogenic
        
        Psychogenic
        
        Idiopathic
        
        Pharmacologic
      - Due to Outlet
        
        Anatomic
        
        Functional
- - - - Lifestyle
        
        Avoid caffeine, alcohol, spicy food, acidic food
        
        Decrease fluid intake/Avoid diuretics in evening
        
        Avoid substances that worsen bladder contraction or obstruction
      - Phytotherapy
      - Pharmacologic
        
        Alpha blockers: Cause relaxation of smooth muscle in prostate and bladder neck
        
        5-alpha-reductase inhibitors: Prevent conversion of testosterone to dihydrotestosterone (DHT)
        
        Tadalafil (Cialis)
  - - - Behavioural Therapy
        
        Avoid activities that cause incontinence
        Voiding diary
        Timed voiding
        Fluid management
        Avoid bladder irritants
        Weight loss
        Avoid constipation and smoking
      - Pelvic Floor physiotherapy
        
        Taught to control and strengthen pelvic floor muslces
      - Urethral bulking agents
        
        Injected into submucosa of urethra to provide support
      - Transurethral radiofrequency collagen microremodeling
        
        Remodel bladder neck and proximal urethra to less elastic configuration
      - Surgical Treatment
        
        Anterior Repair
        
        Reinforcing the periureteral fascia under bladder neck and urethra
        
        Suspension
        
        Sutures placed in periurethral or perivesical tissues are fixed to pubic or suprapubic structures
        
        Sling
        
        Strip of material is suspended under urethra to provide
        
        Artificial urinary sphincter
        
        inflatable cuff placed around bladder neck
- - - - Dehydration, sepsis, drugs, decrease CO
    - - Drugs, chemotherapies, hepatorenal syndromes, vascular disease, glomeruloneprhitis, interstitial cystism acute tubular necrosis