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Monthly Archives: May 2012

A problem down there… the Prostate question!

Gavin LeSueur - May 28, 2012

A peak scientific body (the US Preventative Services Tast Force) that reviews the evidence for many screening recommendations recently released their current advice on Prostate screening.

The following advice has been given to Doctors to consider:

“Prostate cancer is a serious health problem that affects thousands of men and their families. But before getting a PSA test, all men deserve to know what the science tells us about PSA screening: there is a very small potential benefit and significant potential harms. We encourage clinicians to consider this evidence and not screen their patients with a PSA test unless the individual being screened understands what is known about PSA screening and makes the personal decision that even a small possibility of benefit outweighs the known risk of harms”

What this means is that if you have no prostate symptoms and no family history of Prostate cancer then you should probably not have that ‘PSA’ test added to your routine blood tests.

Prostate symptoms include poor urine flow, difficulty starting, difficulty stopping (dribbling) and having to urinate overnight. These symptoms need investigation and should be discussed with your Doctor.

Hanging on. Bladder problems. Gotta Go…

Gavin LeSueur - May 1, 2012

Urinary incontinence – involuntary loss of bladder control – is a common problem amongst adult women and recent research has conclusively shown that a type of exercise called pelvic floor muscle training is effective for treating the condition. The report also found that drug-based treatments can be effective, but the degree of benefit is low and side effects are common.

Urinary incontinence has an impact both physically, psychologically and socially. It is extremely common in adult women, affecting approximately 25 percent of young women, up to 57 percent of middle-aged and postmenopausal women, and approximately 75 percent of older women in nursing homes. The condition can impose significant, potentially debilitating lifestyle restrictions. The cost of incontinence care in the United States averaged $19.5 billion in 2004, and by one estimate the annualized cost of women’s nursing home admissions due to urinary incontinence was $3 billion. Six percent of nursing home admissions of older women are attributable to urinary incontinence.

Researchers concentrated on two kinds of incontinence: stress incontinence, or the inability to retain urine during coughing or sneezing; and urgency incontinence, which is an involuntary loss of urine associated with the sensation of a sudden, compelling urge to urinate that is difficult to defer. Both types usually occur when the urinary sphincter fails, often as a result of weak pelvic floor muscles, which support the uterus, bladder, and other pelvic organs.

Exercises to strengthen the pelvic floor muscles, similar to Kegel exercises, were found to be effective in increasing women’s ability to hold their urine. Pelvic floor muscle training combined with bladder training improved mixed (stress and urgency) incontinence, the report found. Estrogen treatment was found to be effective in treating stress incontinence, but with some side effects.

A good review of the problem and exercises can be found at

It can be difficult to remember to do these exercises and it is doing them daily that makes a difference. Given the statistical chance of developing incontinence I advise all my women patients to start doing pelvic floor exercises in their early 20’s. How to remember? Go to the stationary store and buy a packet of small dot stickers. Put one on the mobile phone, one on your steering wheel, one on the TV remote etc. Every time you see a sticker do a few exercises. Simple prompt, life long gain. No problems hanging on!

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