A drug or agent added to another drug or agent to enhance its medical effectiveness.
An adjuvant is a substance that helps and enhances the pharmacological effect of a drug or increases the ability of an antigen to stimulate the immune system
Something that is added on. For example, adjuvant cryotherapy is cryotherapy added on to another form of therapy.
the surgical union of parts and especially hollow tubular parts anastomosis of the ureter and colon is surgically practicable.
The connection of normally separate parts or spaces so they intercommunicate. An anastomosis may be naturally occurring or artificially constructed and be created during the process of embryonic development or by surgery, trauma or pathological means.
A pharmaceutical that kills certain types of bacteria.
Daily treatment with antibiotics to prevent infection.
A drug often prescribed for those with indwelling catheters to reduce spasms of smooth muscle, including the bladder. Blocking impulses from the part of the nervous system that controls heartbeat, blood pressure and other responses to stress. A drug that interferes with the effects of acetylcholine. These drugs assist with bladder storage by increasing bladder contractions and are used to treat urge incontinence. Anticholinergics block certain receptors (acetylcholine), resulting in inhibition of certain nerve impulses (parasympathetic).
Brand names include Daricon, ProBanthine, Urispas, Ditropan, and Cystospaz. Side effects may include constipation, nausea, dry mouth, and blurred vision. Caution: combined with alcohol, anticholinergics can cause extreme drowsiness.
A condition in which the body stops making urine.
Artificial Sphincter. Artificial Urinary Sphincter (AUS)
Device used for treatment of urinary incontinence. Consists of three components: a pump, balloon reservoir and a cuff that encircles the urethra and prevents urine from leaking out.
Sometimes complicated cases of incontinence require implantation of a device known as an artificial urinary sphincter. People who might benefit from this treatment include those who are incontinent after surgery for prostate cancer or stress incontinence, trauma victims and people with congenital defects in the urinary system. The artificial sphincter has three components, including a pump, balloon reservoir, and a cuff that encircles the urethra and prevents urine from leaking out. The cuff is connected to the pump, which is surgically implanted in the scrotum (in men) or labia (in women). The pump can be activated (usually by squeezing or pressing a button) to deflate the cuff and permit the bladder to empty. After a brief interval, the cuff refills itself and the urethra is again closed. Because the artificial sphincter is an implant, it is subject to the risks common to implants, such as infection, erosion (breaking down of tissue) and mechanical malfunction. Yet with appropriate pre-surgical evaluation, operative techniques and postoperative follow-up, many problems can be avoided and incontinent patients can experience an improved quality of life with this device.
The lack of recognizable symptoms of a particular disorder.
Makes the bladder larger, most often by adding a section of the patient's small intestine, a tube-like structure that absorbs and transports nutrients from food for use by the body. With this treatment, scarred, ulcerated and inflamed sections of the patient's bladder are removed, leaving only healthy tissue and the base of the bladder. A piece of the patient's small intestine is removed, reshaped, and attached to what remains of the bladder. After the incisions heal, the patient may be able to void normally. Even in carefully selected patients-those with small, contracted bladders-the pain, frequency, and urgency may remain or return after surgery and the patient may have additional problems with infections in the new bladder and difficulty absorbing nutrients from the shortened intestine. Some patients are incontinent while others cannot void at all and must insert a catheter into the urethra to empty urine from the bladder. Also known as bladder augmentation.
Autonomic Dysreflexia (Hyperreflexia)
A syndrome attributed to interruption of spinal cord sympathetic pathways. It is a condition that can occur in anyone who has a spinal cord injury at or above the T6 level. It is related to disconnections between the body below the injury and the control mechanisms for blood pressure and heart function. It causes the blood pressure to rise to potentially dangerous levels.
The presence of live bacteria in the bloodstream
Infection by minute, one-celled organisms which multiply by dividing in one or more directions.
The human organ in which urine is collected and stored. A hollow, muscular, balloon-shaped organ that stores urine until it is excreted
A term used for the bladder to determine its ability to stretch or expand. Persons can have a "poorly compliant bladder" which means that the bladder doesn't stretch as well and holds smaller amounts of urine.
Operation that uses a piece of the intestine (bowel) to enlarge the bladder.
This is a procedure in which a piece of the bowel, stomach or ureter (the tube that carries urine from the kidney to the bladder) is used to enlarge the bladder. This allows the bladder to hold more urine at lower pressure.
Goals of bladder augmentation and incontinence surgery:
Bladder augmentation is an operation performed to increase the size of the bladder. This type of surgery is for patients whose bladder is not large enough to hold the usual amount of urine made by the kidneys. In some patients, the urine may leak from the bladder, causing wetting (incontinence). For other patients, the bladder muscle may lose its ability to stretch (expand). If this happens, pressure within the bladder can become too high. This increased pressure may be harmful to the kidneys because urine may not drain properly. This may also cause the urine to back up through the ureters all the way to the kidneys. This backup is called reflux. Bladder augmentation is performed to decrease the pressure within the bladder, to increase the size of the bladder or to improve its ability to stretch (expand).
- increase bladder capacity
- decrease bladder pressure
- prevent kidney damage
- stop urinary leakage
- improve quality of life
Medicine administered directly into the bladder.
Bladder stones are large pieces of minerals formed and retained in the urinary bladder.
Method by which the bladder is trained to empty (micturition) without the use of an indwelling catheter. Involves drinking measured amounts of fluid, and allowing the bladder to fill and empty at timed intervals. See intermittent catheterization. A behavioral modification technique used to resist or inhibit the urge to urinate unpredictably.
Also referred to as bladder scan. A method of measuring the urine that remains in the bladder. This is a test that is used to diagnose incomplete bladder emptying. An ultrasound uses sound waves to measure the urine volume--its painless and doesn't involve the use of radiation like X-rays.
The use of an X-ray picture to examine the bladder and urethra. An X-ray is taken during urination while a radiactive substance is in the bladder.
(BOTOX®) Botulinum Toxin Injection (bladder)
A purified toxin made from a bacterium is injected into bladder muscles to treat overactive bladder symptoms.
The cleaning of the bowels or intestines prior to abdominal surgery.
Hard, dense, stonelike material that forms in numerous areas throughout the body, including arteries (plaque), veins (phleboliths), kidneys (stones), and gallbladder (gallstones).
Calcium Oxalate Stones:
Most common kidney stones, made up of hard crystalline compound, often mixed with calcium phosphate.
About 70% to 80% of all kidney stones are composed of hard crystals of either calcium oxalate or insoluble phosphate salt, or a combination of both. Calcium stones are the most common type experienced by people of Anglo-Saxon descent. They occur in people who have hypercalciuria, a condition characterized by excessive calcium in the urine. Calcium is a normal part of a well-balanced diet, responsible for maintaining the health of teeth and bones. In most people, excess calcium is flushed out by the kidneys and excreted in the urine. People with hypercalciuria build up excess calcium in their kidneys, where it joins with other waste products to form a stone. In about 40% of people who develop calcium stones, this buildup is caused by an inherited metabolic disorder whose cause is unknown. In rare cases, a tumor on the parathyroid gland may trigger an overproduction of parathyroid hormone, the chemical that regulates calcium metabolism. Certain drugs, such as the diuretic furosemide, antacids and steroids, can produce hypercalciuria. It also can be brought on by certain intestinal diseases, excessive amounts of vitamin A or D, or a diet too high in purine, typically associated with meat, fish and poultry consumption. Calcium oxalate stones also are commonly associated with having too little vitamin B or too much vitamin C in one's diet.
Also known as a stone. Abnormal hard formation of minerals in the body. Stones that may form in either kidney or bladder.
Funnel-shaped hollow in the pelvis of the kidney through which urine passes to the ureter.
CAT Scan, CT Scan
Also known as computerized tomography, computerized axial tomography or CT scan. A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images of the body. Shows detailed images of any part of the body, including bones, muscles, fat and organs. CT scans are more detailed than general X-rays. A specialized x-ray examination that is often used to visualize the brain and spinal structures, chest, abdomen, and pelvis.
A thin tube that is inserted through the urethra into the bladder to allow urine to drain or for performance of a procedure or test, such as insertion of a substance during a bladder X-ray. A flexible rubber or plastic tube for withdrawing or introducing fluids into a cavity of the body, usually the bladder.
Insertion of a slender tube through the urethra or through the anterior abdominal wall into the bladder, urinary reservoir, or urinary conduit to allow urine drainage. Insertion of a catheter.
Destruction through the use of chemicals; chemical injection treatment to dissolve kidney stones.
Certain types of kidney stones can be dissolved with the application chemicals. Uric acid stones, for example, can be dissolved with a solution of sodium bicarbonate in saline. Cystine stones may be treated successfully with a combination of acetylcysteine and sodium bicarbonate in saline. Struvite and carbon apatite stones can be treated with an acidic solution of hemiacidrin. The procedure involves infusing the chemical solution into the affected area by means of a ureteral catheter in a series of treatments over time until the stone is dissolved. The patient's urine must be cultured regularly throughout the course of treatment to guard against urinary infection and prevent the buildup of excessive chemical levels, particularly magnesium, which can cause other health problems.
Chronic Bacterial Prostatitis
An uncommon form of prostatitis caused by bacteria traveling up the urethra and the backward flow of infected urine into the prostatic ducts causing recurrent infections.
As in cases of CBP, the initial bacterial infection may be caused by bacteria traveling up the urethra and reflux of infected urine into the prostatic ducts. This can be brought on by the use of a urinary catheter, enlargement of the patient's prostate, a bladder infection or bacteria acquired by engaging in anal intercourse.
Chronic Non-Bacterial Prostatitis
A condition affecting patients who have symptoms of prostatitis without a positive result after urine culture or expressed prostate secretion (EPS) culture.
Clean Intermittent Catheterization (CIC)
Periodic insertion of a clean catheter into the urethra after washing your hands to drain the urine from the bladder.
Tubular structure from the stomach to the anus that consists of the small intestine and the large intestine.
External urine collecting device used by males. A device or cone-shaped condom catheter that is placed over the penis to allow for urine drainage in men who have urinary incontinence. These devices are attached to the shaft of the penis by some form of adhesive and are connected to urine collecting bags by a tube.
The creation of various intestinal conduits to the skin.
Continent Cutaneous Reservoir
With a continent cutaneous reservoir, an internal pouch stores urine. The patient uses a catheter or plastic tube to empty urine through the stoma.
If your urethra is preserved during the operation, you may be able to have a urinary diversion that does not require a stoma or catheter.
Cutaneous continent urinary diversion
Cutaneous continent urinary diversion refers to use of the gastrointestinal tract to create a new bladder, which is attached to the skin inside the body. This form of urinary diversion does not require the use of a collection appliance, however the patient is required to place a catheter or small plastic tube into their new bladder four to five times per day to empty the reservoir.
Includes either a rectal reservoir or continent cutaneous diversion.
Another method of storing and eliminating urine is the continent diversion. In this method, the surgeon creates a pouch, or reservoir, inside your body from a section of your stomach or small or large intestine. The ureters carry urine to the pouch, where it is stored. Depending on the type of continent diversion, you may or may not have a stoma.
As with the creation of a continent rerservoir (internal pouch), this operation requires skill and experience on the part of the surgical team. The patient must also be in relative good health and able to withstand the longer operation and recovery period
Continent Urinary Diversion, Continent Urinary Reservoirs
The continent urinary reservoir is the newest form of Urinary Tract Diversion. With this technique, a piece of colon (large intestine) is removed and used to form an internal pouch to store urine. The pouch is specially refashioned to prevent back-up of urine into the ureters (one of two tubes that pass urine out of the kidneys and into the bladder) and kidneys. The patient—whether male or female—can urinate as before, without the need for an external bag or collection device. The urinary reservoir procedure is associated with some complications, such as bowel (intestine) obstruction, blood clots, pneumonia (lung inflammation), ureteral reflux (back-flow), and ureteral blockage.
Urinary diversion is a term used when the bladder is removed or the normal structures are being bypassed and an opening is made in the urinary system to divert urine. The flow of urine is diverted through an opening in the abdominal wall. Individuals who might require urinary diversion would be those whose bladders were non-functional or needed to be removed due to cancer or injury.
Continent urinary diversion describes all forms of urinary diversion that enable the patient to urinate at his or her own discretion without the use of any form of appliance or collecting device. This form of urinary diversion can be broadly divided into two categories: cutaneous and orthotopic.
Involves the creation of a pouch or bladder inside the body, usually using part of the digestive tract.
Involves the creation of an internal pouch from loops
of intestine that is connected to the surface of the abdomen.
There is a “one-way” passage between the opening on the abdomen (stoma) and the internal pouch so that urine is contained in the pouch. The urine is drained by passing a catheter through the stoma and into the pouch every three to four hours.
A 24-hour urine collection test to assess how the kidneys are functioning.
A technique of pressing down and inward over the bladder to facilitate voiding. Pronounced "cruh-day." This practice is no longer recommended.
Computerized tomography of the abdomen and pelvis in which no oral or intravenous dyes are used, which is often used to detect conditions such as acute appendicitis, renal or ureteral stones, and diverticulitis.
Computerized axial Tomography is a cross-sectional X-ray enhancement technique that greatly benefits diagnosis with high-resolution video images.
Relating to the skin.
Surgical removal of the bladder. Different methods can be used to reroute urine once the bladder has been removed. In most cases, the ureters are attached to a piece of bowel that opens onto the skin of the abdomen, called a stoma. Urine empties through the stoma into a bag outside the body. This procedure is called a urostomy. Some urologists are using a technique that also requires a stoma but allows urine to be stored in a pouch inside the abdomen. At intervals throughout the day, the patient puts a catheter into the stoma and empties the pouch. Patients with either type of urostomy must use very clean, or sterile, steps to prevent infections in and around the stoma. With a third method, a new bladder is made from a piece of the patient's bowel (large intestine) and attached to the urethra in place of the removed bladder. After a time of healing, the patient may be able to empty the bladder by voiding at scheduled times or may insert a catheter into the urethra. Few surgeons have the special training and expertise needed to perform this procedure. Even after total bladder removal, some patients still experience variable symptoms of IC. Therefore, the decision to undergo a cystectomy should only be undertaken after serious deliberation on the potential outcome.
A rare form of kidney stone consisting of the amino acid cystine.
Cystine is one of the body's chemical building blocks, an amino acid that helps make up nerves, muscles and other body tissues. A rare genetic defect called cystinuria can cause excessive cystine buildup in the urine, leading to the development of cystine stones in the kidneys. Cystine stones are relatively rare, occurring in about 1% to 2% of persons who experience kidney stone disease. Because it is genetically inherited, the condition often runs in families.
A condition in which urine contains high levels of the amino acid cystine. If cystine does not dissolve in the urine, it can build up to form kidney stones.
A bacterial infection of the lower urinary tract or bladder. Inflammation of the bladder, causing pain and a burning feeling in the pelvis or urethra.
People with interstitial cystitis (IC) have an inflamed, or irritated, bladder wall. This inflammation can lead to scarring and stiffening of the bladder, decreased bladder capacity, glomerulations (pinpoint bleeding) and, in rare cases, ulcers in the bladder lining.
A herniation of bladder into vagina.
An X-ray examination of the bladder utilizing contrast material injected into the bladder. X-ray taken after injecting dye into bladder.
This is a test used to evaluate the bladder's ability to store and release urine. It uses a device to pump water into the bladder. The device then measures the amount of fluid that goes into the bladder when you first feel the desire to void, when you are able to sense fullness, and when your bladder is completely full.
The cystometrogram is the most important of the urodynamic tests. It is used to examine the different phases of bladder function, such as filling and voiding. During cystometry, the intra-abdominal pressure (pressure within the pelvic cavity) and the detrusor pressure (downward-pushing pressure of the bladder) are electronically recorded and subtracted. In tests of filling cystometry, the bladder is filled to capacity, then tested for volume, sensation, involuntary instability (contraction, or muscle squeezing) and compliance (yielding to pressure). Any change in detrusor pressure may indicate an abnormality, especially if it mimics the patient's symptoms, such as urgency and increased frequency of urination. The patient is asked to cough and strain with a full bladder. Urine leakage without a change in detrusor pressure may indicate a diagnosis of stress incontinence. By contrast, patients with urge incontinence may experience detrusor contractions, with urine leak during filling and a related sensation of urgency. Voiding cystometry tests usually are normal in patients with stress incontinence, urge incontinence, and mixed incontinence. However, patients with intrinsic sphincter deficiency may lose urine without any indication of detrusor contraction. In addition, patients with an acontractile (noncontracting, nonsqueezing) bladder -- for example, patients with diabetes, spinal cord injury or prior pelvic surgery -- will have a low detrusor pressure during voiding and a pattern of straining.
Alco called cystometrogram. A test used to assess the function of the bladder by measuring the pressure/volume as the bladder is slowly being filled. Cystometry is used to assess bladder, urge sensation, capacity and compliance. There are different variations of the test depending on the problem being investigated but regardless of the technique, the test always involves insertion of a catheter into the bladder. An exam measuring the pressure of forces to empty, or resisting to empty, the bladder.
An optical instrument (a scope) that is inserted through the urethra into the bladder. A cystoscope has two ports. Aside from the optical port that permits one to see inside the bladder, there is an additional port in the instrument for insertion of various instruments designed for biopsy (removal of tissue samples), treatment of small bladder tumors, removal of stones from the bladder, and removal of the prostate (prostatectomy).
A procedure in which the doctor inserts a lighted instrument called a cystoscope into the urethra (the tube that carries urine from the bladder to the outside of the body) in order to look inside the urethra and bladder. Also known as cystourethroscopy. An examination with a narrow, flexible tube-like instrument passed through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.
Also called a voiding cystogram. A specific X-ray that examines the urinary tract. A catheter (hollows tube) is placed in the urethra (tube that drains urine from the bladder to the outside of the body)and the bladder is filled with a liquid dye. X-ray images are taken as the bladder fills and empties. The X-rays will show if there is any reverse flow of urine into the ureters and kidneys.
Decreased Bladder Compliance
A failure to store urine in the bladder caused by the loss of bladder wall elasticity and of bladder accommodation. This condition may result from radiation cystitis or from inflammatory bladder conditions.
Detrusor-External Sphincter Dyssynergia (DESD)
Lack of coordination between the bladder and the external sphincter muscle, resulting in the inability to empty the bladder completely, which may cause severe urinary tract damage and life-threatening consequences.
Detrusor Hyperactivity with Impaired Bladder Contractility (DHIC)
A condition characterized by involuntary detrusor contractions in which patients either are unable to empty their bladder completely or can empty their bladder completely only with straining due to poor contractility of the detrusor
Contracting muscle in the bladder that helps to expel urine
Detrusor-Sphincter Dyssynergia (DSD)
Damage to the nervous system can create a lack of coordination between the bladder and the external sphincter muscle. As a result, the bladder cannot empty completely which creates buildup of urinary pressure. DSD is the combination of these two factors and can lead to severe urinary tract damage.
Direct Vision Internal Urethrotomy (DVIU)
Surgical procedure using a camera and endoscopic instrument to cut a urethral stricture and fix the abnormal narrowing of the urethra.
A pouch or sac in the lining of the mucous membrane of an organ.
Painful or difficult urination. This includes burning on urination. Dysuria is most commonly due to bacterial infection of the urinary tract causing inflammation of the bladder ( cystitis ) or kidney ( pyelonephritis ). Urination that is painful or in some way problematic
Efferent: Carrying away; efferent limb: the part of the urinary or colorectal diversion that leads to the stoma.
A treatment that is an application of an electric current or impulse to the pelvic floor muscles and bladder to cause a muscle contraction. This treatment is used in people who have nerve damage to the bladder or pelvis.
Electrohydraulic Lithotripsy (EHL)
A technique that uses small shock waves to break up small kidney stones. This technique uses a special probe to break up small stones with shock waves generated by electricity. Through a flexible ureteroscope, the physician positions the tip of the probe 1 mm from the stone. Then, by means of a foot switch, the physician projects electrically generated hydraulic shock waves through an irrigating fluid at the stone until it is broken into small fragments. These can be passed by the patient or removed through the previously described extraction methods. EHL has some limitations: It requires general anesthesia, and is generally not used in close proximity to the kidney itself, as the shock waves can cause tissue damage. Fragments produced by the hydraulic shock also tend to scatter widely, making retrieval or extraction more difficult.
A lighted medical instrument consisting of a long tube inserted into the body, usually through a small incision. It is used for diagnostic examination and surgical procedures
Surgical removal of a body part with the use of an endoscope.
A surgically-created permanent opening into the intestine through the abdominal wall.
The surgical removal of tissue for pathological analysis.
Excretory Urogram (IVP)
Also known as intravenous pyelogram. A test that uses X-rays and contrast dye to take pictures of the kidneys, ureter and bladder.
A test to evaluate the kidneys, urinary tract and bladder. Medicine is given through an intravenous line (IV). This medicine moves through the body and is ultimately concentrated in the kidneys. A series of X-rays are taken, and are viewed by the radiologist to evaluate the kidneys, urinary tract and bladder.
External Continence Device (ECD)
Male external urine control device that attaches to tip of penis.
Extracorporeal Shock-Wave Lithotripsy (ESWL)
Extracorporeal shock wave lithotripsy uses highly focused impulses projected from outside the body to pulverize kidney stones. A non-surgical procedure using shock waves to break up kidney stones.
Highly focused electrical impulses that are projected from outside the body to pulverize kidney stones.
Process of passing urine
Outside the bladder.
relating to a fever.
An abnormal passageway in the body. The fistula may go from the body surface into a blindpouch or into an internal organ or go between two internal organs. in urologic terms, often includes a vesico-enteric fistula (between the bladder and the bowel) and vescio-vaginal (between the bladder and the vagina)
A flexible plastic tube with a small balloon on one end. Inserted into the bladder to provide continuous urinary drainage. A rubber tube placed in the urethra, extending to the bladder, in order to empty the bladder. It is held in place with a small fluid-filled balloon.
Leakage of urine due to a difficulty reaching a restroom in time because of physical conditions like arthritis or paralysis.
Furosemides Renal Scan
Kidney scan using a diuretic
The combined genital and urinary systems. This is also known as the genitourinary tract.
Blood in the urine (microscopic or gross). Blood in the urine, which can be a sign of a kidney stone or other urinary problem. Gross hematuria is blood that is visible to the naked eye. Microscopic hematuria cannot be seen but is detected on a urine test. Blood in the urine, visible or microscopic.
Surgical removal of part of the kidney.
The medical findings from a biopsy.
The study of tissue, usually conducted by a pathologist or a histologist.
Dilation of the kidney, often from obstruction. Swelling of the top of the ureter, usually because something is blocking the urine from flowing into or out of the bladder. A kidney distended with urine to the point that its function is impaired. Can cause uremia, the toxic retention of blood nitrogen.
Swelling at the top of the ureter, usually because something is blocking the urine from flowing into or out of the bladder.
Abnormally large amounts of calcium in the urine.
Unusually large amounts of oxalate in the urine, leading to kidney stones.
Excess excretion of uric acid in the urine.
an excessive low potassium level in the blood,
A surgical techinque used to create a diversion for urine after removal of the urinary bladder. To create an ileal conduit, the surgeon takes a short segment of the small intestine and reconnects the remaining intestine so that it functions normally. One end of the removed short segment of intestine is placed at the skin surface to create the stoma. The ureters, which normally carry urine from the kidneys to the bladder, are then attached to the other end of the segment of intestine. The urine travels through the newly formed ileal conduit and the stoma into an external collecting pouch. The pouch has an outlet for releasing urine into a toilet without removing it from your stoma.
The Ileal Conduitis a small urine reservoir that is surgically created from a small piece of the patient's bowel. During this procedure, the ureters are attached to one end of the bowel piece; the other end is brought out onto the surface of the body to make a stoma. The patient then attaches an external, urine-collecting bag to the stoma. This bag needs to be worn at all times. Complications of the ileal conduit procedure include bowel obstruction, urinary tract infection (UTI), blood clots, pneumonia, upper urinary tract damage, and skin breakdown around the stoma.
Ileal Conduit (urostomy)
The bladder is removed or bypassed. A conduit is made
out of a section of small intestine or colon that carries the
urine to an opening on the abdomen. The urine is collected
in a drainable pouch that is secured to the abdomen.
The ileal conduit remains the standard for urinary diversion after cystectomy in the elderly and in persons with advanced cancers or other medical complications which would preclude long surgical procedures; this surgery is usually less than 4 hours.
Two main alternatives to the ileal conduit have become steadily more available: the catheterizable (through an abdominal stoma) continent reservoir (internal pouch) such as the Indiana or Mainz pouch, and the orthortopic neobladder such as the Studer or Kock neobladder.
Where the ileum of the small intestine meets the cecum of the large intestine.
Leaking of or inability to control any substance, commonly refers to urine. Lack of bowel and/or bladder control.
Catheterizable (through an abdominal stoma) continent reservoir (internal pouch)
A flexible tube retained in the bladder, used for continuous urinary draining to a leg bag or other device. Catheter that are inserted into the bladder to allow for continuous draining of urine.
Intermittent Catheterization (ICP)
Periodic insertion of a narrow tube through the urethra or through the front of the abdominal wall into the bladder to allow urine drainage. Using a catheter for emptying the bladder on a regular schedule. See self-catheterization.
Intermittent catheterization should be performed every 3 to 8 hours or as recommended by your physician.
InterStim Continence Control Therapy:
A therapy used in treating urge incontinence. A device, about the size of a pacemaker, that is implanted into the sacral nerves of the lower spine, where it delivers electrical impulses that help regulate bladder function. A small device that is implanted into the sacral nerves of the lower spine where it delivers electrical impulses that help regulate bladder function.
Within a particular organ.
Chronic inflammatory condition of the bladder that causes scarring, frequent, urgent, and painful urination, and pelvic pain. A disorder that causes the bladder wall to become swollen and irritated, leading to scarring and stiffening of the bladder, decreased bladder capacity, and, in rare cases, ulcers in the bladder lining. IC is also known as painful bladder syndrome.
Medication administered via the urethra, the tube that carries urine outside the body from the bladder.
Intravenous Pyelogram (IVP)
Also referred to as IVP, intravenous urography or excretory urogram. An X-ray of the urinary tract. A dye is injected to make urine visible on the X-ray and show any blockage in the urinary tract.
Intravenous Pyelography (IVP)
A succession of X-ray films of the urinary tract following the injection into a vein of a contrast medium. An IVP tests kidney function and reveals the presence of stones, tumors, or obstruction in the urinary tract.
Also referred to as IVP, intravenous pyelogram or excretory urogram. An X-ray of the urinary tract. A dye is injected to make urine visible on the X-ray and show any blockage in the urinary tract.
Inside the bladder.
Refers to the pressure within the bladder.
Intrinsic Sphincter Deficiency (ISD):
Weakening of the urethra sphincter muscles. As a result of this weakening the sphincter does not function normally regardless of the position of the bladder neck or urethra. This condition is a common cause of stress urinary incontinence.
When one section of intestine slips over the next, like a sheath.
Involuntary Detrusor Contraction
A bladder contraction that isn't under voluntary control.
Involuntary contractions of muscles in the bladder, which can cause lack of control of urination.
Isotope Renal Scan
An examination that uses small amounts of radioactive materials to measure the function of the kidneys.
X-ray of the kidneys utilizing intravenous dye injection. Also referred to as intravenous pyelogram, intravenous urography or excretory urogram. An X-ray of the urinary tract. A dye is injected to make urine visible on the X-ray and show any blockage in the urinary tract.
One of two bean-shaped organs that filter wastes from the blood and discharge these waste products in urine. The kidneys are located on either side at the level of the 12th ribs toward the back. The kidneys send urine to the bladder through tubes called ureters.
Also called pyelonephritis. Urinary tract infection involving the kidney. Typical symptoms include abdominal or back pain, fever, malaise and nausea or vomiting.
A stone that develops from crystals that form in urine and build up on the inner surfaces of the kidney, in the renal pelvis or in the ureters. (Also see nephrolithiasis.). Hard mass composed of urine elements that form in the kidneys.
An X-ray of the abdomen, showing the kidneys, ureters, and bladder.
Removal of a kidney by using a laparoscope, an instrument in the shape of a tube that is inserted through the abdominal wall to give an examining doctor a view of the internal organs.
Repairing kidney blockage by using a laparoscope, an instrument in the shape of a tube that is inserted through the abdominal wall to give an examining doctor a view of the internal organs.
Surgery performed with an instrument in the shape of a tube that is inserted through small cuts. Using a small video camera and a few customized instruments, the surgeon can work in many body cavities without dividing skin from muscle thus reducing recovery time and complications.
A technique that allows internal organs to be observed directly through a piece of optical equipment (laparoscope) inserted into the body through a small surgical incision. Generally less invasive surgery that uses a laparoscope to visualize internal organs through a small incision.
An operation in which the abdominal cavity is opened and inspected directly.
External bag which is strapped to the leg for collection of urine.
A zone of tissue with impaired function as a result of damage by disease or wounding. Examples are scars, abscesses, tumors and ulcers.
The removal of kidney or bladder stones by surgery.
A procedure done to break up stones in the urinary tract using ultrasonic shock waves, so that the fragments can be easily passed from the body. A non-invasive treatment for kidney stones. Shock waves, generated under water by a spark plug, crumble stones into pieces that will pass with urine.
Lower Pole Stones
Lower Urinary Tract Calculi.
Magnetic Resonance Imaging (MRI)
A diagnostic procedure that uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body. A high-tech diagnostic tool to display tissues unseen in X-rays or by other techniques. A diagnostic test that uses electromagnetic energy to produce soft-tissue images of the central nervous and musculoskeletal systems.
catheterizable (through an abdominal stoma) continent reservoir (internal pouch)
Narrowing at the end of the urine channel at the tip of the penis.
Incision for the enlargement of the urethral opening at the tip of the penis
The opening of the urethra.
Monti [Yang-Monti Ileovesicostomy]
The term describing a test result that does not show the presence of a substance for which the test was carried out.
In addition to
A new bladder. The neobladder allows select patients to void naturally through the urethra.
The neobladder, also known as 'continent orthotopic urinary reconstruction', appeals especially to younger patients who wish to avoid a stoma on the abdomen and/or wearing an ostomy bag. In many cases those with neobladders learn how to completely empty their bladders and do not require intermittent catheterization. However, this is a learned response and not a guarantee. In cases where 100% continence is not realized, regular or intermittent self-catheterization may be necessary.
Most neobladder recipients regain daytime continence, although nocturnal incontinence may present a problem in up to 25%.
It may occur that obstacles to the creation of a neobladder are only discovered during surgery, which would cause the surgeon to opt for another technique. Tumor involving the urethra requiring urethrectomy excludes the possibility of orthotopic reconstruction.
In general, anyone who is an appropriate candidate for cystectomy is also an appropriate candidate for neobladder surgery provided that urethral and bladder neck biopsies are negative for cancer. Prior radiation or chronologic age should not be considered an absolute contraindication for continent diversion, but time for recovery and achieving urinary continence is longer than for younger patients (Studer & Zingg, 1997).
Additional selection criteria for women include a normally functioning urethra and adequate manual dexterity for possible self-catheterization following neobladder construction (Nieh, 1997).
Neobladder patients should perform pelvic floor exercises daily. They should also be prepared to accept a certain degree of nocturnal leakage. Failure to empty and a need for intermittent self-catheterization are also possibilities. Overall, though, patients express a very high degree of satisfaction with the function achieved with orthotopic neobladders.
Key points in postoperative management include:
The neobladder is a bladder substitute; it does not work
- education to ensure that a normal functional capacity is achieved by gradually increasing the voiding interval in the early postoperative period;
- regular residual-free voiding by pelvic floor relaxation to avoid overdistension; increased fluid intake, salt supplementation, and regular metabolic assessment; and cancer surveillance
just like a regular bladder.
A normal bladder does two things: it stretches to store and
it contracts (squeezes) to empty urine. A neobladder will
stretch to store urine, but it does not have the ability to
This means that an individual will urinate in a slightly
different way. The “new” bladder is emptied by relaxing the
sphincter muscle and contracting the abdominal muscles.
When the abdominal muscles are contracted, pressure is
put on the bladder and this helps to push the urine out.
Orthotopic continent urinary diversion, commonly referred to as neobladder, most closely resembles the normal urinary anatomy. The intestinal tract is used to fashion a new bladder, which is then attached to the urethra in the pelvis. Patients then urinate spontaneously via the urethra and may be required to catheterize to ensure complete bladder emptying. This form of continent urinary diversion has been used in both men and women requiring cystectomy.
Removal of an entire kidney.
Inflammation of the kidney.
A surgical excision of kidney stones via the back or abdomen in which the kidney may be opened. It is the most invasive procedure for removing kidney stones. Because it is so traumatic, most kidneys can withstand no more than two such operations. Deep anesthesia is required, after which the surgeon makes a large (10-20 centimeter) incision in the patient's back or abdomen, depending upon where the stone is located. Either the ureter or the kidney isopened and the stone extracted. Most patients require prolonged hospitalization afterward, and recovery may take up to two months.
A surgical incision into a kidney.
Also called neuropathic bladder. Loss of bladder control caused by damage to the nerves controlling the bladder. Any bladder disturbance due to an injury of the nervous system.
Incontinence may be related to defects in the nervous system, which conducts urination signals between the bladder and the brain. Such cases of neurogenic bladder -- for example, in patients with diabetes, Parkinson's disease, or myelomeningocele (bulging out of the spinal cord through a defect in the spine) -- may not be associated with the severe irritative symptoms seen in bladder infections. Instead, patients may have severe, total incontinence, a rigid bladder and a nonfunctional sphincter mechanism.
The condition of passing small amounts (under 500ml) of urine per day.
Open Abdominal Surgery
Sometimes incontinence surgery takes place via an incision through the abdomen. Two standard suspension procedures that require abdominal incisions are the Marshall Marchetti Krantz procedure and the Burch procedure. The Marshall Marchetti Krantz (MMK) procedure is still offered in many medical centers throughout the United States, but it is no longer a favored technique. This is because the sutures (stitches) in the procedure are placed around the urethra, creating the potential for obstruction; in addition, the surgical entryway limits the physician's ability to correct cystocele (herniation of the bladder into the vagina). During the MMK procedure, the bladder neck and urethra are separated from the back surface of the pubic bone. Sutures are placed on either side of the urethra and bladder neck, which are then elevated to a higher position. The free ends of the sutures are anchored to the surrounding cartilage and pubic bone. The Burch procedure, also known as Burch colposuspension (vaginal suspension), often is performed when the abdomen is already open for another purpose, such as abdominal hysterectomy (removal of the uterus). During the suspension procedure, the sutures are placed laterally (sideways), which avoids urethral obstruction and allows the physician to repair any small cystoceles that may be present. The bladder neck and urethra are separated from the back surface of the pubic bone. The bladder neck then is elevated by means of lateral sutures that pass through the vagina and Cooper's (pubic) ligaments. The vaginal wall and ligaments are brought together without tension, and the sutures are tied.
The most invasive surgical procedure for removing kidney stones.
Is the most invasive procedure for removing kidney stones. Because it is so traumatic, most kidneys can withstand no more than two such operations. Deep anesthesia is required, after which the surgeon makes a large (10-20 centimeter) incision in the patient's back or abdomen, depending upon where the stone is located. Either the ureter or the kidney isopened and the stone extracted. Most patients require prolonged hospitalization afterward, and recovery may take up to two months.
In the normal or usual position.
Of or relating to the grafting of tissue in a natural position; transplant, substitute or replacement
Orthotopic neobladder, Orthotopic continent urinary diversion
Orthotopic” means “in the same place” and “neobladder” means new bladder. So an orthotopic neobladder is a substitute or “new” bladder that is placed in the same location as
the “old” bladder.
The major advantages of this procedure are:
• An external collection pouch is not required.
• An abdominal stoma is not required.
• Most individuals are able to empty the neobladder by
It is a A SURGICAL OPTION FOR BLADDER DIVERSION [ex- Studer or Kock neobladder.]
A surgical procedure such as a colostomy or ileostomy, in which an artificial opening for excreting waste matter is created. An opening in the skin to allow for a suprapubic cystostomy (catheter drainage), for elimination of intestinal contents (colostomy or ileostomy) or for passage of air (tracheostomy).
Bag that collects urine draining from an artificial opening into the urinary or gastrointestinal canal.
A condition characterized by involuntary bladder muscle contractions during the bladder filling phase which the patient cannot suppress. A condition in which the patient experiences two or all three of the following conditions: urinary urgency, urge incontinence or urinary frequency--defined for this condition as urination more than seven times a day or more than twice at night.
Overflow Urinary Incontinence
Leakage of small amounts of urine from a bladder that is always full.
A chemical that combines with calcium in urine to form the most common type of kidney stone (calcium oxalate stone).
A part of the autonomic nervous system. Parasympathetic activity causes contraction of the bladder and assists in the urination process.
stretched out urethra
To place or perform a procedure underneath the skin. No incision (cutting) is necessary.
Draining of fluid by a catheter via the skin.
Percutaneous Lithotripsy (per=through, cutis=skin)
The stone in the kidney is reached with a scope through a small wound in the skin and through the tissues of the kidney. The exact location of the stone is monitored with the ultrasound device. Like in the transurethral lithotripsy the stone is then disintegrated with an oscillating device. This technique is used in cases of large stones, when a treatment with the external lithotryptor would take too much time and too many sessions and/or in cases of obstruction of the outlet of the kidney in which the kidney could be damaged if it takes too long to treat the stone. General anesthesia is necessary, although patient and kidney generally very well tolerate the treatment.
Percutaneous Nephrolithotomy (PCN):
Manual extraction of kidney stones "through the skin". Percutaneous means "though the skin." In PCN, the surgeon or urologist makes a 1-centimeter incision under local anesthesia in the patient's back, through which an instrument called a nephroscope is passed directly into the kidney and, if necessary, the ureter. Smaller stones may be manually extracted. Large ones may need to be broken up with ultrasonic, electrohydraulic or laser- tipped probes before they can be extracted. A tube may be inserted into the kidney for drainage.
Also known as PNL. A method for removing kidney stones through keyhole surgery through the back using an instrument called a nephroscope.
Related to the area between the anus and the scrotum in males and the area between the anus and the vagina in females.
Inflammation of the membrane that lines the abdomen.
Periurethral Bulking Injections
A surgical procedure in which injected implants are used to "bulk up" the area around the neck of the bladder allowing it to resist increases in abdominal pressure which can push down on the bladder and cause leakage.
"goose bumps" May be a sign of or present with autonomic dysreflexia (AD).
Taking folds or tucks in the walls of an organ.
Post-Void Residual (PVR) Volume:
A diagnostic test which measures how much urine remains in the bladder after urination. Specific measurement of PVR volume can be accomplished by catheterization, pelvic ultrasound, radiography, or radioisotope studies. The volume left in bladder after the patient voids (urinates).
Inflammation of the pouch created as treatment of a patient with ulcerative colitis or for urinary diversions made out of intestine
Pressure Flow Study
Pressure-flow is one of the most important and difficult urodynamic studies to perform and interpret. Yet pressure-flow measurement is essential for the proper understanding of altered mechanisms in urinary incontinence. In particular, pressure-flow study can help to define problems such as bladder outlet obstruction (blockage), which is a major factor in the treatment of men with Benign Prostatic Hyperplasia (noncancerous overgrowth of the prostate) and in the pre-operative assessment of women who are considering surgery for incontinence. To conduct the test, the patient is catherized with a pressure sensor and the bladder is filled. When the patient feels a strong desire to urinate, he or she is asked to void around the catheter into the uroflowmeter (combining a uroflow with a cystometrogram). Soon afterward, technicians measure the amount of urine remaining in the patient's bladder. The patient may undergo placement of a rectal catheter (a tube-like instrument positioned in the anus, the opening of the large intestine). The pressure-flow recording is made when the patient feels the urge to urinate. As previously noted, the analysis of a patient's pressure flow results can help to diagnose bladder outlet obstruction. Pressure flow study plays an important role in the evaluation of male patients with lower urinary tract symptoms (LUTS). Pressure flow study in women is not as clear-cut as in men, because women tend to void in a different manner and at different pressures. Moreover, women may respond to obstruction by reducing their urine flow, rather than by raising detrusor (bladder muscle) pressure. Therefore, some experts recommend pressure flow studies in female LUTS patients only after prior incontinence therapy or surgical repair of the urinary tract.
Prosthetic Occluding Devices
Prosthetic occluding devices can be used to block the flow of urine by squeezing the urethra shut. For men, such mechanical devices include penile clamps (for example, the Cunningham clamp) and compression rings. The penile clamp is a V-shaped casing with a foam cushion that fits over and under the penis. When closed, the penile clamp should stop the flow of urine without causing discomfort. Compression devices are adjustable rings that surround the penis and, when inflated with air, pinch off the urine flow. Individuals usually reserve occluding devices for temporary use with intrinsic sphincter deficiency. These devices must be removed at regular 2- to 3-hour intervals to empty the bladder. Therefore, only mentally competent individuals who are able to adjust them by hand and who are able to remember the bladder-emptying schedule should use them. Improper use of penile clamps and compression devices can result in penile and urethral erosion, penile edema (swelling), pain and obstruction.
The presence of high levels of protein in the urine, indicating that the kidneys may not be working properly
X-ray study of the kidney especially showing the pelvis (urine-collecting basin) of the kidney and the ureter
Also referred to as kidney infection usually caused by a germ that has traveled up through the urethra, bladder and ureters from outside the body. Typical symptoms include abdominal or back pain, fever, malaise and nausea or vomiting.
Bacterial infection of the kidney. Pyelonephritis can be acute (sudden) or chronic (slow, subtle, and stubborn). It is most often due to the ascent of bacteria from the bladder up the ureters to infect the kidneys. Pyelonephritis can be acute (sudden) or chronic (slow, subtle, and stubborn). It is most often due to the ascent of bacteria from the bladder up the ureters to infect the kidneys.
The symptoms of pyelonephritis include flank (side) pain, fever, shaking chills, sometimes foul-smelling urine, urgency (to urinate), frequency (urinating), and general malaise. Tenderness is elicited on gently tapping over the kidney with a fist (percussion).
The laboratory examination of the urine (the urinalysis) reveals white blood cells (pyuria, i.e. pus in the urine) and bacteria in the urine (bacteriuria). There is usually also an increase in circulating white cells in the blood (leucocytosis).
Treatment involves appropriate antibiotics.
The presence of pus in the urine; usually an indication of kidney or urinary tract infection. Inflammatory cells in the urine, often indicating infection.