Topics people dont like to talk about out in the open. But we in good shape we have no. We talk about everything like today im going to talk about during every incontinence some people always wet their pants and others just when the cough sneeze or love and what you can do about it this is what im going to talk about with dr to be here at the inventors clinic and. Nobody should walk around with the trousers for almost everyone who is incontinent the roof solution. You should always drink plenty of water but many of my patients are afraid to do so because god. What theyre also afraid off is telling the doctor but theres. Ones in my false stand for those named when talking in front of the big. When choosing a physiotherapist helped forty three year old yvonne bush tell to strengthen her pelvic floor she had a baby ten months ago and sought help soon after but it didnt do enough so youre in with still leaks from her bladder when she was out running you know just last years eve on the first child and at four and a half kilograms she was larger than average the birth stretched and strained the muscles in her mothers pelvic area this is just. You know. Im a bit older so maybe thats why it happened also the length of the birth pushing for so many hours. I think that had something to do with the. Target exercises can tighten up weakened pelvic floor muscles. This in china benefit 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 theyre doing things like lifting bending sneezing coughing blowing their nose anything that creates pressure down there. And once youve learned it your brain remembers. Despite head off we sit up straight and stabilize from bottom to top from the sides from your back and abdomen. Yvonne now has a pelvic floor muscles back under control along with her bladder and weak bladder is a more common problem than people think. I was deaf you dont want to many people only associate it with the elderly but thats 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 it fire can demand and when hoppity. Do you like to klein is one of the patients who needed an operation as an incontinence clinic in bone surgeon successfully inserted a small band that supports the research from below when pressure is put on the pelvic floor it works like a hammock. All. These as many bunt is and this small band helps replace the natural band structures you have in the pelvic floor and these natural bands normally keep the your wreath with stable and ensure your and doesnt leak out but they can become damaged for a variety of reasons especially childbirth or if you push a dish. Out when you think about how extreme stretching years and the birth canal during birth you can imagine the bodys own structures overstretching and losing function. Like a klein has fond memories of her sons birth twenty five years ago but over time she became unable to cough or laugh or lift a Laundry Basket without youre an eating. The twenty minute operation has given her back control of her bladder and her freedom. You know my kind its i thought we dont spar now i can have fun again. And i dont have to worry about whether laughing will make me wet myself. Give side what she knew was that. Its a happy ending for Yvonne Busch Bell as well the physiotherapy has saved her from a life of chronic incontinence. And perfect. Here in the event as in britain and i will talk to dr to be part of the Rose Department for reconstructive. Were going to talk about a week later but actually its not the big letter which gets week its more like the fashion. And youre all of you to talk about incontinence but the officer wrote of official catalog its not bladder weakness its not perfect theres all together the president not working together the proof 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 its not appropriate what about the fish is growing and we get on there are three reasons especially in female patients first lots off to liver is birth because of a childs head is good for the perfect florence abiding it and the second one is hysterectomies women which have their uterus removed have removed some ligaments which are fixing the bladder and the third thing is getting old or getting older connective tissue the fresher theyre getting weaker and weaker and its not possible to train them we can train muscles but not the fish 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 its the stress which is produced by the pressure of the bladder so its an anatomical incontinence and the other thing is urgent continentals because of different sensations which are going to be discordant need to hold the brain doesnt 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 neurologist and especially women sometimes a freight ive seen this kind of doctor so to do in her seventies. Its everything not not painful. First you 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 forceful negra few father son are Getting Better and better anymore and then the third step may be could be thats the thing where people are afraid of but today we use flexible instruments which can be very thin we make a nest of local anesthesia the off the. Its 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 socalled tapes this is a tape theres a pulley properly in tape but there are other types of. Tissue also theres a lot of women can be can be healed with this simple operation but there are even bigger operations to have to perform because in the summer in some cases its not only the pelvic floor at the refurbish was wrong but also the sink to muscle it surveyed socalled intrinsics think that efficiency in these Patients Want us to make artificial your notice figure and about this artificial urine there is. We continue our talk in just a moment because this is applies to men too they dont 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 crossed a tech to me or surgical removal of the prostate can cause Serious Problems like your chart since the operation ive been completely incontinent its not pleasant in fruits of all there was a big shock its not what you hoped for really hit my life hard. All three men became incontinent after a cross to take to me the real threat passes through the prostate gland the operation can damage both the re threat and the blood just think which keeps the year when the bladder till one chooses to your innate this damage can result in bladder control problems. On the basis of recent developments were now operating on older men with aggressive tumors or chrissy from to move from kansas are in five to ten percent of all cases and continents. Including and. The artificial urinary sphincter is a treatment for severe incontinence its a device comprised of a cough that goes around the wreath 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 blame for it isnt the problem is that the patient has to operated manually he has to work the pump in his scrotum to empty the cuff of the liquid they keeps a tight loosening the car then lets him pass water. For mild to moderate incontinence there are alternative treatments involving balloons slings and cushions. The script theres no one perfect solution it depends on the diagnosis that requires a cite on skippy. To evaluate the damage or defect that. Therapy introduced about fifteen years ago involves artificial compression devices that stephen has been kitted out with such a system to silicon balloons filled with liquid squeeze the your rethread to keep it closed and thus prevent leakage. And if its 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 hes content quentin and some others its a free. Fear based firm for what it 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. Most of. The pressure the balloons exert sometimes decreases but they can then be refilled with liquid in fitzgibbons 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 with some minor procedure with little impact. I think its certainly feasible. To fuel. Burn 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 a method uses a u. V. Thrill sling and a cushion. Trance camp switched 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 muscle surrounding it and functions as a substitute sphincter darby to see to mushroom farm before this is an excellent archon because the sling moves the your rethrow back where it should be. When i mean the thing continence 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. Its a foreign body they put inside you but its Getting Better and im 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 thats often not enough to keep patients dry who have a problem with bladder control that night instead a sling plus cushion has proved more effective as in the case of man fed to unpack. Weve 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. In the months after the device was installed mantra do and that when back to have the pressure in the cushion adjusted a couple of times. If not. Night i remain almost dry. During the day less so. I think thats normal i feel quite optimistic about the future. Is a process of ration the most common cause for incontinence here in. Years most men with an incontinence have a prostate surgery and for want arms as well the surgery for the b nine prosthetic hyperplasia this operation is done in the most cases endoscopic a lead and. Twenty thirty years ago all these devices we had to use were not supportive of 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 its completely different of radical prostatectomy in Prostate Cancer because in these operations the prostate has to be removed completely and it has to be divided. From the sphincter muscle its a part of the of the. Junction between your rethrow and prostate and in some cases its not possible to preserve it because the cancer is growing inside of the muscle then we have to remove it or the senseless operation but what can we do after this is that ok just to train the pelvic floor muscles thats routine though it should be rude to you that every patient who had a prosthetic to me goes to rehabilitation camp for 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 strive for these patients we have artificial your nose fingers devices like like these they have all. Cuff around the wreath rugs there you rethrow the cuff of such not a feather your finger they have a system to produce pleasure like a balloon like a pump and they have a pump inside the straw to where its possible to empty this fear that its release of you and the patient. Void the bladder is a lot of devices but this is more than one of more than one very different to show you here the. Only two parts this is the. Theres of the pump tank system which is in the straw to him and another system is its a little different here you can see a pump of the scrotum. Cover for the reef and two balloons to produce the pressure as a very difficult operation. Operation of. Just below the skin so its not deep operation like gastric operations over it. But the structures are very subtle one has to make good preparation. For this we are specialized in these operations so its better to go to a center whos doing a lot of aeration go through all that. Socalled high Volume Centers have better results than centers who do it only twice or three times a year and for those devices who are made in the body they remain between twelve and fifteen years and then the silicone is worked out and its going to hold someone then one has to replace it again. But that does not happen in all patients a lot of them are to have a model of. Function and its not. Not deteriorated by the importation of a lot of you notice into things like to protect for answering all my questions and if you suffer from any symptoms of incontinence dont be shy and go and see your doctor and dont be shy. I and writers. On an upcoming show will be looking at very dangerous when these blood vessels lose elasticities it can lead to varicose veins and even life threatening thrombosis whats the best treatment if you have any questions on the topic so them to be in good shape at d w dot com just right healthy veins in the subject line look forward to hearing from you. Ive no idea how this microwave oven works im a physician not a physicist and usually you can sap your food within minutes but as a doctor im interested in how michael waifs dangerous for us is 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 in kind of stored in because im not aware of any studies that show that microwave ovens are harmful to human Health Things most but you do have to make sure that microwaves meet Safety Standards and dont exceed allowable radiation limits for god but there is a concept of. The controversy over the possible Health Effects of electromagnetic waves are nothing new but people are usually more worried about cell phones and electro smoke from high voltage power lines and in that area the evidence of possible harm is more persuasive i like things like that one time the difference might be that when youre talking on the phone youre holding the cell phone to your ear the entire time. Time so youre exposed to the microwaves for longer because thats been for the length of that side so if youre 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 isnt 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 were talking about microwaves refer to electromagnetic fields. So its food heated in a microwave healthy to eat. We are asked to answer that question shes a Science Writer and nutrition expert who works in the field of consumer protection. It depends on what kind of food youre preparing in the microwave microwave ovens arent inherently good or bad. What happens when foods that are good for you are heated in a micro way like broccoli for example. One spanish study thats been circulating online reported that microwaving broccoli destroyed most of its flight annoyed if true that would be problematic. As there is evidence that secondary fighter chemicals can help prevent cancer so of course we want to preserve them and. The karata know if they give plants their vibrant colors are plentiful in fresh fruit and vegetables. And. Asked to examine the study hes 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 destroy certainly prince. And his Research Team found no evidence of that. But they did discover that broccoli heated in a 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 doesnt happen even early in the microwave. Microwave energy is focused on areas where theres water wherever theres less water like deeper inside the food or in the thick broccoli stock it doesnt work quite as well for example a levels are higher when broccoli is steamed or boiled then when its 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 isnt 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 its overcooked and no longer identical 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 youre just reheating food and not cooking it the microwave can be a good option and a practical one. When you want it fast a microwave oven is a good compromise for optimal flavor you might want to cook the conventional way or just. Well i dont have a microwave i dont need it because im married but we do have a t. V. Set in the kitchen so my wife can watch me on t. V. Next week. 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