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Index
Cover Title Page Dedications Epigraph Contents Acknowledgements Preface Foreword How to use this book Chapter 1: You are not alone: bladder problems are very common
How common are bladder problems (‘bladder dysfunction’)? People who do not have bladder dysfunction Why do some people have problems with their bladder? Why is it that bladder problems are hard to talk about?
A question of dignity
Bladder cancer Communication and information Body image Sexuality Quality of life Pain Sleep Social support Summary and conclusion
Notes
Chapter 2: The bladder – what is it and what does it do?
The bladder The urinary system
The kidneys Nephrons
Common kidney problems
The ureters The bladder The sphincters The urethra The pelvic floor muscles
How many times a day should I empty my bladder? Summary and conclusion
Notes
Chapter 3: How does the bladder communicate with the brain?
Central and peripheral nervous systems
Somatic nervous system Autonomic nervous system
Sympathetic nervous system Parasympathetic nervous system
Enteric nervous system Working together
Micturition
Micturition reflex
Involuntary action Voluntary action
Muscles involved in micturition
Problems that can occur in brain–bladder communication
Nerves Sensors
Neurological conditions that affect bladder function Summary and conclusion
Notes
Chapter 4: Brain-gut interactions and microbiota (gut and urinary)
The gut microbiota The brain–gut axis (BGA) Stress and the microbiota The microbiota and the gastrointestinal tract (GIT) ‘Good’ and ‘bad’ bacteria A unique environment Microbiotic family ties Working in partnership – the brain and the gut How can we nurture the gut microbiota? Urinary microbiota Summary and conclusion
Notes
Chapter 5: Urinary incontinence, overactivity and retention
Incontinence
Types of incontinence Stress incontinence
What causes stress incontinence?
Urge incontinence
What causes urge incontinence?
Overactive bladder syndrome (OAB)
What causes OAB? Overflow incontinence
What causes overflow incontinence?
Total incontinence
What causes total incontinence?
Functional incontinence
What causes functional incontinence?
Summary and conclusion
Notes
Chapter 6: Cystitis and interstitial cystitis
Cystitis/urinary tract infection (UTI)
What causes cystitis? What are the symptoms of cystitis? How is cystitis treated? How do I prevent cystitis?
Does cranberry juice ‘cure’ cystitis? Antibiotics – to use or not to use?
Interstitial cystitis (IC)
Is IC the same as OAB? How common is IC? What causes IC?
Inflammation ‘Leaky’ bladder
Neurogenic theory Pelvic floor dysfunction Autoimmune theory Other explanations Does IC run in families? Why is IC so hard to diagnose? How is IC diagnosed?
Summary and conclusion
Notes
Chapter 7: Bladder cancer
How is bladder cancer diagnosed? Who gets bladder cancer? How common is bladder cancer? What are the survival rates for bladder cancer?
Understanding risk factors
What are the risk factors for bladder cancer?
Modifiable risk factors for bladder cancer
Smoking Chemicals (at work, in hair dye and water disinfectant) Food and drink Body weight Exercise
Unmodifiable risk factors for bladder cancer
Family history Other cancer treatments Other medical conditions Infections
Does the experience of bladder cancer differ from other cancers? Summary and conclusion
Notes
Chapter 8: Medical investigations
What should you expect when you go to see your doctor? Bladder diary Cystoscopy
What conditions can be identified with a cystoscopy? How do I prepare for a cystoscopy? What will happen on the day of the cystoscopy? What will the doctor do during the cystoscopy? What additional procedures might be carried out during a cystoscopy? Is a cystoscopy painful? Will there be any after effects following a cystoscopy? What are the risks associated with a cystoscopy?
Urodynamic testing
What conditions can be identified with urodynamic testing? How do I prepare for urodynamic testing? What will happen on the day of the urodynamic testing?
Flow rate Cystometry
What will the nurse do during the urodynamic testing? Is urodynamic testing painful? Will there be any after effects following urodynamic testing? What are the risks associated with urodynamic testing?
Summary and conclusion
Notes
Chapter 9: Behavioural treatments
Bladder training
Delayed emptying Scheduled bladder trips (timed voiding) Pelvic floor muscle training (Kegel exercises)
Urge suppression techniques Night time What you shouldn’t do Summary and conclusion
Notes
Chapter 10: Food and drink
What may cause problems
Foods to avoid
Meat and fish Dairy products Vegetables Fruit Spices General foodstuffs
Drinks to avoid
Individual differences Exclusion diets Probiotics and prebiotics Probiotics Probiotic supplements Prebiotics Foods and drinks in relation to alkalisation Urine testing
Which foods are alkaline?
Water Summary and conclusion
Notes
Chapter 11: Lifestyle changes
Fluid intake
How much should I drink a day? Does alcohol count as fluid intake? Should I limit fluid intake if I have bladder problems?
Stress and anxiety
Why is it important for people with bladder problems to reduce stress?
Smoking
What about passive smoking? How do I stop smoking?
Body weight
What’s the best way to lose weight?
Constipation
How do I deal with constipation?
Laxatives
Exercise Summary and conclusion
Notes
Chapter 12: Medications for bladder conditions
Medications for controlling bladder contractions
Anticholinergic/antimuscarinic medication Options with fewer side effects Transdermal oxybutynin
Dealing with dry mouth caused by anticholinergic medication
How effective are anticholinergic medications for the treatment of bladder conditions?
Betmiga (mirabegron) Botox injections for OAB and IC
How effective is Botox for the treatment of bladder conditions? How is Botox administered? Will there be any after effects following Botox? What are the risks associated with Botox?
Medications for nocturia and bedwetting
Desmopressin
Pain medicines Antidepressants
Amitriptyline Duloxetine
Antihistamines (for IC)
Hydroxyzine Cimetidine
Rebuilding the bladder wall – Elmiron Intravesical medications (for IC) Summary and conclusion
Notes
Chapter 13: Other medical devices and surgery
Catheterisation
Intermittent catheters In-dwelling catheters
Surgical procedures
Tape procedures Colposuspension Sling procedures
Other surgical procedures
Artificial urinary sphincter Augmentation cystoplasty Urinary diversion Urethral bulking agents
Neuromodulation therapy
How does neuromodulation therapy work? What does neuromodulation therapy feel like? How effective is neuromodulation therapy? What are the disadvantages of neuromodulation therapy?
Summary and conclusion
Notes
Chapter 14: Complementary and alternative medicine (CAM)
Research in CAM Why do people use CAM, then? Acupuncture Hypnotherapy Green tea
What is ‘oxidative stress’?
Herbs
Gosha-jinki-gan (Japanese herbs) Horsetail
Honey Pomegranate Pumpkin seed oil Quercetin Selenium Vitamin D Summary and conclusion
Notes
Chapter 15: Additional tips for coping with bladder conditions
Incontinence products
Pads Pants
Finding and accessing toilets easily
Just Can’t Wait toilet card Toilet apps for smartphones Radar key
Stress and illness
Why is it important to reduce stress? How to stop negative thinking patterns Breathing exercises
Alternate nostril breathing exercise
Guided imagery
Support of others Sleep problems Summary and conclusion
Notes
A final word Appendix 1: Useful addresses
General
Bladder Health UK Bladder & Bowel Community OAB Outlook (Ireland)
Bladder cancer
Action Bladder Cancer UK (ABC UK) Cancer Research UK Macmillan Cancer Support Irish Cancer Society
Disability services
National Key Scheme – Disability Rights UK
Complementary and alternative medicine
The British Acupuncture Council The Hypnotherapy Association UK The National Hypnotherapy Society The General Hypnotherapy Standards Council (GHSC) and General Hypnotherapy Register (GHR) Complementary and Natural Healthcare Council
Appendix 2: Top 10 tips for a healthy bladder Index About the Authors Copyright
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