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Pathophysiology of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Hyperglycemia is the primary manifestation of diabetes mellitus. It develops from impaired insulin secretion plus varied amounts of peripheral insulin resistance. Hyperglycemia may also occur in newborns after glucocorticoid hormones are administered, or because of excessive infusion of IV solutions containing glucose. This is common in poorly monitored hyperalimentation over a long period of time. Hyperglycemia causes osmotic diuresis. This is due to glycosuria, which leads to urinary frequency, plus polyuria and polydipsia. Orthostatic hypotension and dehydration can result. Hyperglycemia also causes weight loss, nausea, vomiting, blurred vision, and a predisposition to bacterial or fungal infections. Poorly controlled hyperglycemia that continues for years leads to vascular complications that affect the microvascular or macrovascular vessels, or both. There is glycosylation of the glomerular proteins in the kidneys. This may result in mesangial cell proliferation, expansion of the matrix, and vascular endothelial damage. There is usually a thickening of the glomerular basement membrane.
Continence
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Catherine W. McGrother, Madeleine Donaldson
A number of trials of this technique, which aims to control urinary frequency and increase functional bladder capacity, have been performed and have recently been the subject of a Cochrane Review. This noted that many of the available studies were flawed and that limitations on the available data led the reviewers to issue a guarded positive recommendation based upon the available evidence.177 Where the patient is confused and unable to participate in bladder retraining then there are other toileting regimens which have been found useful in care homes in the US. These techniques have also been the subject of a Cochrane review.178
Urethra and Penis
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Symptoms are usually hesitancy of micturition, straining to void and a poor urinary stream. The relative youthfulness of the patient often rules out prostatic enlargement, which characteristically occurs after the age of 50. As the stream becomes narrower, micturition is prolonged and is followed by postmicturition dribbling as a result of urine trickling from the dilated urethra proximal to the stricture. Urinary frequency by day and night is common and is due to incomplete bladder emptying, coexisting detrusor overactivity or urinary infection.
Modeling normal bladder injury after radiation therapy
Published in International Journal of Radiation Biology, 2023
Sarah L. Kerns, Jacqueline P. Williams, Brian Marples
Independent of the RNAseq study, we assessed the functional response of the bladder after RT and captopril; micturition was assessed for 2 h every 3–4 wks for 20 wks. The number and size of individual urine spots was assessed to determine urinary frequency and urine volume per individual void, based on standard curves of known volume and area measurements, as described previously (Zwaans et al. 2016). No effects were seen at 4 wks for any groups; however, at 15 wks, SD 30 Gy resulted in a significant decrease in the volume of individual voids while the number of voids significantly increased. Captopril treatment prevented this increase in voiding and reduction in void volume. Also, at 15 wks, the volume of individual voids decreased after 8 Gy × 3, and the number of small volume voids increased; these changes were also prevented by captopril.
Adverse events of hyperthermic intravesical chemotherapy for non-muscle invasive bladder cancer patients
Published in Scandinavian Journal of Urology, 2021
Jacob Agerbo Thomsen, Henning Nielsen Dominiak, Maria Skydt Lindgren, Jørgen Bjerggaard Jensen
In general, HIVEC treatment was well-tolerated and most of the adverse events were self-limiting. The adverse events were either grade 1 or 2 according to the CTCAE definitions and consisted of urinary frequency, incontinence, and urinary tract pain. Of the 123 installations given, 23 (18.7%) incidents of urinary frequency was observed in nine patients and six (4.9%) incidents, in three patients, to such an extent that it limited the patient’s daily activities and required intervention. Fourteen (11.4%) incidents of incontinence were observed in two patients, nine (7.3%) incidents, in five patients, to such an extent that pads were needed and one (0.8%) incident where oral medical treatment was necessary (grade 2). Thirteen (10.6%) incidents of mild urinary tract pain was observed in seven patients and two (1.6%) incidents of moderate urinary tract pain that limited daily activities or required treatment, was observed in two patients.
Electrical stimulation on urinary symptoms following stroke: a systematic review
Published in European Journal of Physiotherapy, 2019
Sara Kjaer Bastholm, Lena Aadal, Camilla Biering Lundquist
Voiding diaries evaluated urinary frequency in three RCT studies and one observational study. Liu et al. [35] reported a statistically significant reduction in urinary frequency after treatment and at three months follow-up. Liu et al. [32] reported a statistically significant difference between both intervention groups (TENS with 20 Hz, TENS with 75 Hz) and the control group (No treatment). Statistically significant differences were also found between intervention groups (TENS with 75 Hz vs. TENS with 20 Hz). Monteiro et al. [34] reported a statistically significant reduction in number of participants with urinary frequency (nine or less micturitions daily) after 6 weeks treatment and at 12 months follow-up. The follow-up study by Skeil and Thorpe [36] found a statistically significant reduction in daytime urinary frequency, but not over a 24-hour period.