जिद्दी/ REFRACTORY OAB : Step wise treatment strategy скачать в хорошем качестве

जिद्दी/ REFRACTORY OAB : Step wise treatment strategy

Overactive bladder is primarily treated with fluid adjustments, lifestyle modifications, pelvic floor exercises and bladder training. Bladder relaxants and quieteners are the next line of treatment and are effective in improving the quality of life.The patients whose symptoms progress even on two types of medication are categorized as refractory OAB. Though medicines are effective but because the disease generally requires a long term management, there is a high discontinuation rate because of side effects, poor compliance or recurring costs. Patients with refractory OAB require repeated injections in the bladder (BOTOX) or Neuromodulation (Interstim) OAB (अतिसक्रिय मूत्राशय) का इलाज मुख्य रूप से द्रव समायोजन, जीवनशैली में संशोधन, पेल्विक फ्लोर व्यायाम और मूत्राशय प्रशिक्षण से किया जाता है। मूत्राशय को आराम देने वाले और शांत करने वाले उपचार की अगली पंक्ति हैं और जीवन की गुणवत्ता में सुधार करने में प्रभावी हैं। जिन रोगियों के लक्षण दो प्रकार की दवा लेने पर भी बढ़ते हैं, उन्हें जिद्दी ( REFRACTORY) OAB के रूप में वर्गीकृत किया जाता है। हालांकि दवाएं प्रभावी हैं, लेकिन चूंकि बीमारी के लिए आम तौर पर दीर्घकालिक treatment की आवश्यकता होती है, इसलिए साइड इफेक्ट्स, खराब अनुपालन या लागत के कारण दवा बंद करने की दर अधिक होती है। जिद्दी/ REFRACTORY OAB वाले मरीजों को मूत्राशय में बार-बार इंजेक्शन (बोटॉक्स) या न्यूरोमॉड्यूलेशन (इंटरस्टिम) की आवश्यकता होती है। 00.00 Introduction 02:03 First Line treatment A: behavior and Lifestyle Modifications 02:51 First Line Treatment B: Pelvic Floor Muscle Training 04:26 First Line Treatment C Bladder Training 06:26 natural course of OAB. Will OAB heal on its own? 07:38 Second Line treatent : Bladeer relaxants (Anticholinergics) 09:10 What is Refractory OAB ? 09:35 Third Line treatment Surgeries for OAB (Botox and SNM) references: 1. https://pubmed.ncbi.nlm.nih.gov/19389... Garnett S, Swithinbank L, Ellis-Jones J, Abrams P. The long-term natural history of overactive bladder symptoms due to idiopathic detrusor overactivity in women. BJU Int. 2009 Oct;104(7):948-53. doi: 10.1111/j.1464-410X.2009.08535.x. Epub 2009 Apr 15. PMID: 19389015. 2. https://pubmed.ncbi.nlm.nih.gov/21661... Heidler S, Mert C, Temml C, Madersbacher S. The natural history of the overactive bladder syndrome in females: a long-term analysis of a health screening project. Neurourol Urodyn. 2011 Nov;30(8):1437-41. doi: 10.1002/nau.21093. Epub 2011 Jun 9. PMID: 21661037. 3. https://www.cochranelibrary.com/cdsr/... Todhunter-Brown A, Hazelton C, Campbell P, Elders A, Hagen S, McClurg D. Conservative interventions for treating urinary incontinence in women: an Overview of Cochrane systematic reviews. Cochrane Database of Systematic Reviews 2022, Issue 9. Art. No.: CD012337. DOI: 10.1002/14651858.CD012337.pub2. Accessed 15 December 2023. About Dr Nikhil Khattar Dr Nikhil Khattar has worked as Professor of Urology at ABVIMS and Dr RML Hospital, New Delhi (2008-2017), Associate Director Reconstructive Urology, Female Urology and Neurourology, Medanta The Medicity, Gurugram (2017-2022). Presently Visiing Consultant at Holy Family Hospital (New Delhi), Artemis Hospital (Gurgaon) and National Heart Institute (New Delhi) More Info www.nikhilkhattar.in Female Urology/ Urogynaecology/ Stricture Urethra/ urethroplasty/ Urosurgeon/ Urologist/ Best Urologist/ Urinary Incontinence/