Specialist office in functional urology: your point of reference for the prevention and treatment of urinary and sexual dysfunctions
Functional urology is a specialized field of medicine that focuses on the diagnosis and treatment of urinary tract disorders that affect the normal functioning of the bladder and other structures of the lower urinary tract. These conditions may include overactive bladder, urinary incontinence, pelvic floor dysfunction, and neurogenic bladder, among others. The goal of functional urology is to restore normal urinary function and improve the quality of life of patients suffering from these often complex and debilitating conditions.
Dr. Med. Roberto Carando
​Overactive Bladder (OAB)
Urination
frequent​
Incontinence and urine loss​
Causes and risk factors
Overactive bladder (OAB) is characterized by a sudden, strong urge to urinate that is difficult to control. People with OAB may find themselves going to the bathroom more than eight times a day, which can significantly disrupt their daily activities and quality of life.
In addition to frequent urination, OAB is often accompanied by a sudden, intense urge to urinate that is difficult to ignore. This can lead to involuntary loss of urine, a condition known as urge incontinence, which can be embarrassing and socially limiting for those affected.
OAB can be caused by a variety of factors, including aging, neurological conditions, pelvic floor disorders, and certain medications. Risk factors include obesity, diabetes, and other bladder irritants such as caffeine and alcohol. Understanding the underlying cause is critical to effective treatment.
Urinary incontinence
Involuntary loss of urine
Urinary incontinence is the involuntary loss of urine, a common and often embarrassing condition that can significantly impact a person's quality of life. It can range from occasional small leaks to a complete loss of bladder control, and is more common in women, especially those who have had children or are going through menopause.
​Impacts on Daily Life​
Urinary incontinence can make it difficult for people to participate in social activities, exercise, or even leave the house with confidence. Constant worry about leaks and the need to plan for bathroom access can lead to social withdrawal, depression, and a reduced sense of independence.
Request
Medical Assistance
Fortunately, there are many effective treatments for urinary incontinence, ranging from lifestyle changes and pelvic floor therapy to medications and surgery. Patients should not feel embarrassed to discuss their symptoms with a healthcare provider, as open communication is key to finding the right solution and regaining control of bladder function.
Pelvic floor dysfunction
What is Pelvic Floor Dysfunction?
Pelvic floor dysfunction refers to a group of problems that affect the muscles and connective tissues that support the pelvic organs, including the bladder, uterus, and rectum. This can lead to problems such as incontinence, pelvic pain, and difficulty with bowel or urinary function. Pelvic floor dysfunction is more common in women, especially those who have had children or are going through menopause, but it can affect people of all genders.
Causes and Symptoms
​I muscoli del pavimento pelvico deboli o danneggiati possono essere causati da gravidanza, parto, obesità, stipsi cronica o anche sollevamento di pesi eccessivo. I sintomi possono includere incontinenza urinaria o fecale, sensazione di pressione o peso pelvico, dolore durante i rapporti sessuali e difficoltà nello svuotamento della vescica o dell'intestino. Questi problemi possono avere un impatto significativo sulla qualità della vita e sulle attività quotidiane.
Interstitial Cystitis/Bladder Pain Syndrome
Diagnosis
Management Strategies
​La cistite Interstiziale/sindrome da dolore vescicale (CI/SDV) è una condizione complessa e spesso fraintesa, caratterizzata da dolore pelvico cronico e pressione nella vescica. La diagnosi della CI/SDV può essere impegnativa, in quanto non esiste un singolo test definitivo. I professionisti sanitari possono utilizzare una combinazione di anamnesi, esame fisico, test urinarie e biopsie vescicali per escludere altre possibili cause dei sintomi.
Living with the chronic pain and discomfort of IC/SDV can be emotionally and mentally challenging. Patients are advised to engage in self-care activities, such as stress management techniques, pelvic floor exercises, and participation in support groups. These strategies can help individuals manage the challenges of this condition and improve their overall well-being.
Therapeutic Approaches
Treatment of IC/SDV typically involves a multimodal approach, with the goal of managing pain and improving quality of life. Options may include oral medications, bladder instillations, pelvic floor therapy, dietary modifications, and even minimally invasive procedures or surgery in more severe cases.
Neurogenic Bladder
Cause
Neurological
Neurogenic Bladder is a condition in which the normal function of the bladder is impaired due to a problem with the nervous system. This can be caused by a variety of neurological conditions, such as spinal cord injury, multiple sclerosis, Parkinson's disease, or even diabetes. The disruption in communication between the brain, spinal cord, and bladder leads to difficulty in storing and releasing urine effectively.
Symptoms and Challenges
People with Neurogenic Bladder may experience a range of symptoms, including frequent urination, incontinence, difficulty starting or stopping urine flow, and even the inability to urinate at all. These problems can significantly impact a person's quality of life, leading to social isolation, skin problems, and an increased risk of urinary tract infections and other complications.
Full Evaluation
Diagnosis and management of Neurogenic Bladder requires a comprehensive evaluation by a Functional Urology specialist. This may involve various tests, such as bladder function studies, imaging scans, and neurological evaluations, to determine the underlying cause and develop a personalized treatment plan. The goal is to restore bladder control, prevent complications, and improve the patient's overall quality of life.
Urinary tract infections
Causes and symptoms
​Fattori di rischio
IVU
Urinary tract infections (UTIs) are a common and often recurring problem caused by bacteria that enter the urinary system. Symptoms can include a burning sensation during urination, increased frequency and urgency to urinate, pelvic pain, and even blood in the urine. UTIs are more common in women due to anatomical differences, but they can affect people of all ages and genders.
Develop IVU
Certain factors can increase your risk of developing a UTI, such as poor hygiene, sexual activity, pregnancy, diabetes, and catheter use. Older adults and people with weakened immune systems are also more susceptible to these infections. Addressing underlying causes and implementing preventative measures is key to managing recurrent UTIs.
Diagnosis and Treatment
Treating UTIs
Diagnosing a UTI usually involves a urine test to identify the presence of bacteria. Health care professionals may also order additional tests, such as imaging tests or cystoscopy, to rule out other underlying conditions. Treatment usually involves antibiotics, although antibiotic resistance is a growing problem. In some cases, alternative therapies such as cranberry supplements or bladder instillations may be prescribed to help prevent or manage recurrent UTIs.
Benign Prostatic Hyperplasia (BPH)
Enlarged Prostate
Benign prostatic hyperplasia (BPH) is a noncancerous enlargement of the prostate gland, a common condition that affects many men as they age. This growth in the size of the prostate can lead to a variety of urinary symptoms, such as difficulty starting or stopping the flow of urine, frequent urination, and a feeling of incomplete bladder emptying.
Annoying Symptoms
An enlarged prostate can press on the urethra, the tube that carries urine from the bladder out of the body, causing a variety of uncomfortable symptoms that can significantly impact a man's quality of life. These symptoms can worsen over time if left untreated, making it increasingly difficult to completely empty the bladder.
Full Evaluation
Diagnosing BPH often involves a combination of history, physical examination, and diagnostic tests, such as a prostate-specific antigen (PSA) test, digital rectal examination, and potentially imaging tests. Understanding the underlying cause and severity
of the condition is essential to developing an effective treatment plan.
Diagnostic Tests in Functional Urology in the Office of Dr. Med Roberto Carando
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Anamnesi
Physical Exam
The first step in diagnosing functional urinary tract conditions is a thorough history. Dr. Med Roberto Carando will ask detailed questions about the patient's symptoms, including frequency, severity, and impact on daily life. Information about past medical conditions, surgeries, and medications are also crucial in determining the underlying cause of urinary problems.
Diagnostic Tests
A complete physical examination, including a pelvic exam for women and a rectal exam for men, helps Dr. Med Roberto Carando assess the function of the pelvic floor, bladder, and prostate. This manual assessment can provide valuable clues about the nature and extent of the urinary problem.
Depending on the suspected condition, various diagnostic tests may be performed, such as urinalysis, bladder function studies, imaging scans, or cystoscopy (a visual examination of the bladder). These tests help identify the specific cause of the urinary disorder and guide the development of an effective treatment plan.
In our office in Minusio we indicate treatment options in Functional Urology
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Making changes to your daily routine, such as monitoring your fluid intake, avoiding bladder irritants, and performing pelvic floor exercises, can often be your first line of defense in managing functional urinary tract conditions.
Lifestyle Changes
Drugs
Prescription medications, including anticholinergics, beta-agonists, and alpha-blockers, can help relax bladder muscles, improve storage capacity, and relieve symptoms associated with overactive bladder, incontinence, and benign prostatic hyperplasia.
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Minimally Invasive Procedures
For more severe or persistent urogynecological problems, various minimally invasive procedures, such as Botox injections, nerve stimulation, or laser treatments, may be recommended to address the underlying causes and provide long-term relief.
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Surgical Interventions
In some cases, more complex surgical options, such as bladder augmentation, sling procedures, or prostate resection, may be necessary to effectively manage advanced urogynecological problems and restore normal bladder and urinary tract function.