tv In Good Shape - Incontinence Deutsche Welle March 11, 2018 1:30pm-2:00pm CET
welcome to in good shape here's what's coming up. radiation in the kitchen our microwave ovens a health risk. posed up problems the side effects of prostate surgery. and tightening up the pelvic floor to combat incontinence and here's your host dr costin local tight hello and welcome to in good shape. my little costar.
there are some topics people don't like to talk about out in the open. but we in good shape we have no to bruce we talk about everything like today we're going to talk about during every incontinence some people always with their pants and others just when the car sneeze or laugh and what you can do about it this is what i'm going to talk about with dr to be as particular here at the event as clinic. nobody should walk around with what trolls us for almost everyone who is incontinent blue solution. you should always drink plenty of water but many of my patients are afraid to do so because they got a weak. and what they're also afraid off is telling the doctor but there's.
the false standard for the name. in front of the big. tip when choosing a physiotherapist helped forty three year old yvonne busch bell to strengthen her pelvic floor she had a baby ten months ago and sought help soon after but it didn't do enough you're in would still leak from her bladder when she was out running the grass years eve on his first child and at four and a half kilograms she was larger than average the birth stretched and strained the muscles in her mother's pelvic area. this is just. you know. i'm a bit older so maybe that's why it happened also the length of the birth pushing for so many hours. i think that had something to do with it when the want to.
target exercises can tighten up we can pelvic floor muscles. this in china the most important thing is to be able to coordinate the pelvic floor to get it under control when patients first start learning they have to make a conscious effort when they're doing things like lifting bending sneezing coughing blowing their nose anything that creates pressure down there. and once you've learned it your brain remembers. despite how awful it up straight to stabilize from bottom to top from the sides from your back and abdomen. yvonne now has her pelvic floor muscles back under control along with her blood a. bladder is a more common problem than people think. i would just feel don't want to many people only associate it with the elderly but that's incorrect as it also affects lots of young women especially after childbirth things like. coughing sneezing
laughing in jogging can make people urinate spontaneously and not getting appropriate treatment like physiotherapy can have long term consequences eventually surgery might be the only option but follow can demand and when all parties. are like a klein is one of the patients who needed an operation as an incontinence clinic and bone surgeons successfully inserted a small band that supports the research from below when pressure is put on the pelvic floor. it works like a hammock. uses many bond is this small band helps replace the natural band structures you have in the pelvic floor and these natural bands normally keep the year we through a stable and ensure your and doesn't leak out but they can become damaged for a variety of reasons especially childbirth. what when you think about how extreme stretching is and the birth canal during birth you can
imagine the body's own structures overstretching and losing function. like a client has fond memories of her son's birth twenty five years ago. but over time she became unable to cough or laugh or lift a laundry basket without urinating. the twenty minute operation has given her back control of her bladder and her freedom. you know my kind of now i can have fun again. and i don't have to worry about whether laughing will make me wet myself. what she knew was that. it's a happy ending for yvonne busch belle as well the physiotherapy has saved her from a life of chronic incontinence. and perfect. heat in the event. in berlin and i will talk to dr to be
a spot and head of the rose department for reconstructive. we going to talk about a week later but actually it's not the letter which gets weak it's more like the fashion. you're all of you talk about incontinence but the office will verge of official catalogue it's not by the weakness it's not perfect there's all together the president's are not working together the pro if the president of the bladder is higher than the president the perfect floor it will overflow and one will be incontinent one is using your in at a time it's not appropriate what about the fish is growing and we could all three reasons especially in female patients first is lots of to live or is birth because of the child's head is good for the perfect florence abiding it and the second one is hysterectomies women which have been removed have removed some ligaments which are fixing the leather and the third thing is getting older getting
older connective tissue the fresher getting weaker and weaker and it's not possible to train them we can train muscles but not professional and there are different types of incontinence. yes there are two big groups of incontinence the first one as stress incontinence stresses here the pressure stress not the earth not the psychic stress that's when the stress which is produced by the pressure of the bladder so it's an anatomical incontinence and the other thing is urgent continence because of different sensations which are going to be discord you need to call them the brain doesn't feel exactly what the bladder does and the other way around so if you suffer from those kinds of encountered in syria should see a urologist and especially women sometimes afraid of seeing this kind of doctor so what do you do in the us in the nation. it's everything not not painful. first we
do is we make questionnaires together with the patients we have some questions which are very important to differentiate between the urgent continence and the stress incontinence we have to work down different question as for that the second thing is ultrasound we do more and more examinations by ultrasound than in the years before because the devices for force from the graphologists on are getting better and better anymore and then the third step may be that's the thing where people are afraid of but today we use flexible instruments which can be with that which are very thin we make a nest of local anesthesia the off the reef it's not painful we get a picture of the problem and then we can treat it and holding it. in pure stress incontinence most women are treated to the so-called tapes business this is a tape there's a pulley properly in tape but there are other types of. od so there's
a lot of women can be can be healed with this simple operation but there are even bigger operation sleeve to perform because in the summer in some cases it's not only the pelvic floor the refurbish is wrong but also the sink the muscle it serves its intrinsic. think of officials fear movies patients want us to make artificial you're not as free and about this artificial you're nursing to we continue our talk in just a moment because this applies to men too they don't like to speak the body during their symptoms but they suffer from it too especially after protecting the. prostate cancer is one of the most common cancers among men prostatectomy or surgical removal of the prostate can cause serious problems but the upside since the operation i've been completely incontinent it's not pleasant in fruits of all there was a big shock it's not what you hoped for really hit my life hard. all three men became incontinent after
a cross to take to me the rethrow passes through the prostate gland the operation can damage both the you re threat and the bladder sphincter which keeps the year in the bladder till one chooses to your innate this damage can result in bladder control problems. on the basis of recent developments we're now operating on older men with aggressive tumors or conceiving to move from kansas are in five to ten percent of all cases and continents and zoos including and start with the artificial urinary sphincter is a treatment for severe incontinence it's a device comprised of a calf that goes around the wreaths a chub a pump inserted into the scrotum and a small balloon reservoir in the abdomen for the fluid that fills the cuff it takes a surgical procedure to install it all. the lymph and isn't the problem is that the patient has to operate it manually he has to work the pump and there are
alternative treatments involving billions slings and concessions. script there's no one perfect solution it depends on the diagnosis that requires a psych tosca p. to evaluate the damage or defect that. introduced about fifteen years ago involves artificial compression devices that still burn has been kitted out with such a system to silicon balloons filled with liquid squeeze the you re threat to keep it closed and thus prevent leakage. if it's a minor procedure takes five or ten minutes under general anesthesia with a little gas this is usually enough to make the patient sufficiently consonant so that he's content called immense amount as it's a free. fear because from foreman takes four or five weeks for the balloons to take up position. so they exert the right pressure.
after about three months i had almost no leakage. of. the pressure the balloons exert sometimes decreases but they can then be refilled with liquid in fitzgibbon's case one was displaced in a bike accident because of the risk that the balloons might tear or move they tend not to be the method of choice these days this is. the problem of balloon failure can however be dealt with you simply replace it that's a minor procedure with little impact. when i think it certainly feasible. to fuel. and has undergone balloon replacement five times. with this method the patient just needs to push with a modest amount of effort in order to your innate a new method uses a year we thrill sling and a cushion. trance camps which to that
a year ago from balloons they proved not to be right for him. he said. i was disappointed because it had seemed so promising at the start it went very well. it turned out his you rethrow had shifted a sling of soft mesh repositions the rethrow a cushion exerts pressure on the muscles surrounding it and functions as a substitute sphincter. to my shoe these are fond of for this is an excellent arch and because the sling moves the your rethrow back where it should be. if incontinence remains an issue the question can be adjusted at any time. through a port liquid can be pumped into the cushion or it can be drained off to increase or reduce the pressure as needed. funds companies had such a device for a year and has now got used to it. it's
a foreign body they put inside you but it's getting better and i'm quite pleased with the result. another option is a sling without a cushion here to the sling of mash restores the year rethread to its proper position that's often not enough to keep patients dry who have a problem with bladder control at night instead a sling plus cushion has proved more effective as in the case of man fed to unpack . we've been using this system for ten years for patients with moderate incontinence and. we found that they benefit from a sling system that also exerts pressure off and walk. in the months after the device was installed mantra durned that when back to have the pressure in the cushion adjusted a couple of times. they've been knocked out at night i remain almost dry during the day less so. i was i think that's normal
i feel quite optimistic about the future. it's a process of ration the most common cause for in canton in syria. yes most men with an incontinent head of prostate surgery for want arms for the surgery for the benign prosthetic. but this operation is done in the most cases endoscopic only. twenty thirty years ago all these devices were to use were. we had to look with our bare eyes through it today we have cameras we have huge screens where we can watch the surgery so we only have read only the condition that the patient is in condition after the benign prostate operation it's completely different after reading prosthetic to mean prostate cancer because of his operations the prostate
has to be removed completely and that has to be divided. from the muscle it's a part of the of the. junction between your rethrow and prostate and in some cases it's not possible to preserve it because the cancer is growing inside of the muscle then we have to remove the senseless operation but what can we do after this is that ok just to train the pelvic floor muscles that's routine though it should be routine that every patient who had a prosthetic to me goes through rehabilitation for three to four weeks we can train muscles but we can train all the muscles not the connective tissue between the different stricter structures and so in some cases the muscle training does not work so in this is when you need to operate again in to put in an artificial swing to this ride for these patients we have artificial urine or is think those devices like. they have all the cuff around the rethrow are as though you read through such
a lot of illinois they have a system to produce pleasure like a balloon like a pump and they. well it's possible to end this fear that it's release of the patient. void the bladder is a lot of devices but this is more than one this is the one very different to show you here this one. only two parts this is the. this is the pump tank system which is in the straw to him and another system is it's a little different like here you can see the pump of the scrotum. cover for the reef and two balloons to produce the pressure is a very difficult operation. special operation of this. just below the skin so it's not deep operation like gastric operation and so the over is
a. very. good preparation. for this we are specialized in these operations so it's better to go to a center who's doing a lot of racial stuff go through let me know that. so-called high volume centers have better results than centers who do it only twice or three times a year and for those devices who remain in the body they remain between twelve and fifteen years and then the silicone is worked out and it's going to hold. then one has to replace it again and is it a problem the sexual activity after this implant. nor sexual activity maybe deteriorated by the prosthetic surgery. but that does not happen all patients a lot of them are to have a normal. function and it's not. not deteriorate about implantation of
a lot of you notice into thanks dr patrick for answering on the questions and if you suffer from any symptoms of incontinence don't be shy and go and see your doctor and don't be shy. and writers. on an upcoming show will be looking at things when these drug vessels lose elasticities it can lead to varicose veins and even life threatening thrombosis what's the best treatment if you have any questions on the topic of the two in good shape at d w dot com just write healthy veins in the subject line we look forward to hearing from you. i've no idea how this microwave oven works i'm a physician not a physicist and usually you can sap your food within minutes but as a doctor i'm interested in how michael waves dangerous for us is the relation harmful this is what we found out.
about seventy percent of german households have a microwave the remaining thirty percent include many people who worry about microwave radiation are they right can microwave ovens harm your health. we paid a visit to south of decent to find out more the university of arkansas research is collecting all the available scientific studies that examine the connection between electromagnetic waves of fields and human health as a kind of story and because i'm not aware of any studies that show that microwave ovens are harmful to human health things last month but you do have to make sure that microwaves meet safety standards and don't exceed allowable radiation limits for god but there is a concept of. controversy over the possible health effects of electromagnetic waves are nothing new but people are usually more worried about cell phones and electro smog from high voltage power lines and in that area the evidence of possible harm
is more persuasive i like things for life that the difference might be that when you're talking on the phone you're holding the cell phone to your ear the entire time. so you're exposed to the microwaves for longer because that's been for the length of that fight so if you're worried about electromagnetic radiation you might want to consider limiting your time on the cell phone. by comparison the risk of microwave ovens appears to be well within acceptable parameters contrary to what some people believe food heated in a microwave isn't irradiated only ionizing radiation such as x. rays or gamma rays can do that. microwaves are a type of non ionizing radiation actually we scientists when we're talking about microwaves refer to electromagnetic fields. so is food heated in a microwave healthy to eat. we are asked to answer that question
she's a science writer and nutrition expert who works in the field of consumer protection . it depends on what kind of food you're preparing in the microwave microwave ovens aren't inherently good or bad. what happens when foods that are good for you are heated in a microwave like broccoli for example. one spanish study that's been circulating online reported that microwaving broccoli destroyed most of its flat annoyed if true that would be problematic. as there is evidence that secondary fighting chemicals can help prevent cancer so of course we want to preserve them and. the karata know it's that give plants their vibrant colors are plentiful in fresh fruit and vegetables. and. to
examine the study he's an expert on food processing at the university of. studied exactly what happens to broccoli in a microwave oven. electromagnetic waves in a microwave supposedly only affect one component found in broccoli the water it contains. so does heating food in a microwave destroyed certainly prince. and his research team found no evidence of that. but they did discover that broccoli heated in the microwave contains less fat soluble vitamins than if the vegetable is steamed or boiled the heating process that takes place during cooking releases the broccolis fat soluble vitamins and that doesn't happen even in a microwave. microwave energy is focused on areas where there is water wherever there's less water like deeper inside the food or in the thick broccoli stock it doesn't work quite as well for example pro vitamin a levels are higher when
broccoli is steamed or boiled then when it's cooked in a microwave. that leaves us with one more question does food cooked in a microwave taste different in some way. after all microwaving food isn't usually considered the height of carbon or a refinement. so is there any truth to that or is it just snobbery. has also investigated how microwaving food affects its flavor and consistency here to be an even warming has an effect. on the surface there are spots where the broccoli is too dry or where it's overcooked no longer al dente. looking at the color and texture and the mouthfeel microwaving food produces what you might call an acceptable result but certainly not an outstanding one. but if you're just reheating food
and not cooking it the microwave can be a good option and a practical one. so when you want it fast a microwave oven is a good compromise but for optimal flavor you might want to cook the conventional way or just dinner roll. well i don't have a microwave i don't need it because i'm married but we do have a t.v. set in the kitchen so my wife can watch me on t.v. thank you next week on.
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