Neurogenic bladder วิจัย

Neurogenic bladder - PubMe

Neurogenic bladder is a condition caused by the nerves along the pathway between the bladder and the brain not working properly. This can be due to a brain disorder or bladder nerve damage... What Is Neurogenic Bladder? Neurogenic bladder is when a problem in your brain, spinal cord, or central nervous system makes you lose control of your bladder. You may pee too much or too little... Neurogenic bladder is the name given to a number of urinary conditions in people who lack bladder control due to a brain, spinal cord or nerve problem. This nerve damage can be the result of diseases such as multiple sclerosis (MS), Parkinson's disease or diabetes Neurogenic bladder disorder means an individual is having problems with urination. Neurogenic involves the nervous system and the nerve tissues that supply and stimulate the organs and muscles to function and operate correctly Neurogenic bladder dysfunction after SCI is almost universal. 46, 47 Although several management strategies exist, the preferred method is intermittent catheterization, usually combined with anticholinergic therapy to moderate detrusor hyperreflexia. For the diver with SCI, immersion diuresis, common in divers without SCI, is especially troublesome. Exuberant diuresis, possibly exaggerated by.

Neurogenic Bladder Johns Hopkins Medicin

  1. UTIs are a frequent complication of neurogenic bladder and may present with atypical signs and symptoms Noxious stimulation to the bladder, including bladder distension, is the most common cause of Autonomic Dysreflexia (AD), which is a life threatening condition
  2. neurogenic bladder, 272 adult patients with SCI were evalu-ated. Although no threshold wall thickness was predictive of urodynamic findings, BWTwas significantly increased in in-dividuals with neurogenic detrusor overactivity associated with detrusor sphincter dyssynergia (NDO/DSD) or impaired bladder compliancecomparedtothose withoutDSD [19].On the other hand, in the actively managed.
  3. 1. Prog Urol. 2007 May;17(3):417-23. [Stones and neurogenic bladder]. [Article in French] Ruffion A(1), Traxer O, Chartier-Kastler E. Author information: (1)Service d'urologie Lyon Sud, Centre Hospitalier Lyon Sud, UCBL Lyon 1, France. alain.ruffion@chu-lyon.fr Stones of the upper and lower urinary tract are frequently observed in spinal cord injury patients
  4. Neurogenic bladder refers to a loss of bladder control due to complications with the brain, spinal cord, or nerves that control the bladder. It can be caused by a head or spinal cord injury, or other conditions such as multiple sclerosis, diabetes or stroke. Treatment for neurogenic bladder depends upon the underlying cause, but includes behavioral therapy to improve bladder control.
  5. Neurogenic bladder's a condition in which some sort of nerve damage causes bladder dysfunction in the form of overflow or urge in... What is neurogenic bladder
  6. Neurogenic bladder 1. DEFINITION•refers to dysfunction of the urinary bladderdue to disease of the central nervoussystem or peripheral nerves involved in thecontrol of micturition (urination). 2. FLACCID BLADDER•A flaccid, or hypotonic, bladder ceases to contractfully, causing urine to dribble out of the body. Besidesthe complications that stem from urine dripping,rashes can occur in the.

Neurogenic Bladder and Bowel loss of use Loss of Bowel control SMC S1 Entitled to special monthly compensation under 38 U.S.C. 1114, subsection (s) and 38 CFR 3.350(i) on account of degenerative disc disease, lumbar spine, with radicular symptoms right lower extremity a single disability upon which a total individual unemployability rating is based and additional service-connected disability. Viele übersetzte Beispielsätze mit neurogenic bladder - Deutsch-Englisch Wörterbuch und Suchmaschine für Millionen von Deutsch-Übersetzungen Neurogenic bladder is a form of diabetic neuropathy in which selective damage leads to autonomic neuropathy where the nerves affected result in decreased urination frequency. Urination dysfunction has long been a problem associated with diabetes, and bladder problems can often be more severe in people with diabetes WASHINGTON (dpa-AFX) - Allergan, an AbbVie (ABBV) company, announced the FDA has approved BOTOX for the treatment of detrusor (bladder muscle) overactivity associated with a neurologic conditio When the nerves that control the bladder are not working correctly, it can cause the bladder to lose control. This can lead to children having urinary tract infections, daytime and nighttime..

Neurogenic Bladder Management and Nursing Care Ausme

Neurogenic bladder dysfunction - Wikipedi

Neurogenic Bladder. Home; Nurse CE; Nurse-Urologic Registered; Neurogenic Bladder; Take this Activity. Overview; Reviews (0) Neurogenic Bladder: Credits: 1.00 Post-Assessment Questions: 5. Release Date: 5 Oct 2020 Expiration Date: 31 Jan 2022 Last Reviewed: 31 Jan 2021 Estimated Time To Finish: 60 Minutes. Need Help? If you have a system or content concerns, please contact support@statpearls. Neurogenic bladder disorder means an individual is having problems with urination. Neurogenic involves the nervous system and the nerve tissues that supply and stimulate the organs and muscles to function and operate correctly. Neurogenic bladder dysfunction causes the nerves that control the bladder and muscles in urination to be overactive or underactive. Symptoms. Constant bathroom visits.

Neurogenic Bladder: Symptoms, Causes, Tests and Treatmen

Neurogenic bladder is a form of diabetic neuropathy in which selective damage leads to autonomic neuropathy where the nerves affected result in decreased urination frequency. Urination dysfunction has long been a problem associated with diabetes, and bladder problems can often be more severe in people with diabetes. However, according to research from Adeline M.Yerkes, BSN, MPH, published in. The Neurogenic Bladder Research Group was founded by a team of urologists from across the country with a focus on improving the lives of individuals living with neurogenic bladder. Our Mission Statement. The goal of NBRG is to improve patient care through application of patient centered outcomes research. Our mission is to optimize quality of life, surgical outcomes, and clinical care of. A neurogenic bladder is a term for the lack of bladder control caused by an injury to the spine, brain, or nerves affecting afferent or efferent signaling. These nerves carry messages between the. Neurogenic bladder is a condition where a person is unable to control their bladder due to a brain, spinal cord, or nerve problem. There are a variety of potential causes of neurogenic bladder, including: Diabetes ; Heavy metal poisoning; Infection of the brain; Infection of the spinal cord ; Major pelvic surgery; Multiple sclerosis (MS) Parkinson's disease ; Spinal cord injury ; Spina.

Upper motor neuron neurogenic bladder dysfunction is characterized by detrusor-sphincter dyssynergia (DSD), wherein simultaneous detrusor and urinary sphincter contractions produce high pressures in the bladder (up to 80-90 cm H 2 O) leading to vesicoureteral reflux that can produce renal damage Neurogenic bladder refers to dysfunction of the urinary bladder secondary to diseases of the nervous system that result in problems with urine storage, micturition, or both. The most common causes are multiple sclerosis and spinal cord injury. Patients commonly present with recurrent UTIs, obstructive uropathies, and urinary retention. Without proper treatment, neurogenic bladder may result in. A neurogenic bladder is the loss of normal bladder function caused by damage to part of the nervous system. It may result from a disease, an injury, or a birth defect affecting the brain, spinal cord, or nerves leading to the bladder, its outlet (the opening into the urethra from the bladder), or both. Intravesical transurethral bladder stimulation is a diagnostic and rehabilitative technique.

Neurogenic Bladder Problems. Gefällt 648 Mal · 1 Personen sprechen darüber. Neurogenic Bladder Problems a community support group to help others. It is not to replace medical advice nor treatment. We.. Neurogenic bladder occurs when an illness or injury damages the nerves of your urinary tract. When this happens, your nerves and muscles do not communicate correctly, and your bladder does not fill or empty properly. Signs You Should Get Help for Neurogenic Bladder. When you have neurogenic bladder, you urinate too much or not enough, which can lead to worrisome problems, including the. The bladder's parasympathetic efferent nerve supply, which governs the contraction of the bladder, originates from the sacral cord at S2-S4 and travels to the bladder via the pelvic nerve. The effect of parasympathetic stimulation is detrusor contraction. The sympathetic efferent nerve, which increases bladder storage, originates at T11-L2 and travels to the bladder and urethra via the hypogastric nerve. The β-adrenergic receptors in the body of the bladder cause relaxation of smooth muscle.

Neurogenic Bladder - Urologist

Neurogenic bladderC&P Bladder - Diagnostic Medical Sonography 60d withBladder dysfunction in different neurological diseases

Neurogenic bladder 1. DEPARTMENT OF UROLOGY EDUCATION Production Team Dr Abraham Benjamin - Manager Medical Informatics Mr. Naresh Kumar - Coordinator Medical Informatics Neurogenic Bladder 2. What is Neurogenic Bladder? Neurogenic bladder is the loss of normal bladder function caused by damage to part of the nervous system. The damage can cause the bladder to be underactive, in which it is. People with spastic neurogenic bladder may have damage to other nerves that causes weakness, muscle spasms, and/or loss of sensation in the legs. People with neurogenic bladder are at risk for urinary tract infections and stones in the urinary tract. People are also at risk of hydronephrosis (see Figure: Hydronephrosis) when urine retained in the bladder causes urine to back up in the kidneys.

Neurogenic Bladder - SlideShar

Neurogenic bladder is a condition in which the nerves and muscles of the urinary system don't function properly together. It's most often associated with the brain, spinal cord, or nerve dysfunction or damage, and usually results in a loss of control over your ability to urinate. How a Healthy Bladder Works . A healthy bladder is essentially an expandable sac that stores urine and then.

Neurogenic bladder - wikidocWhat Are The Symptoms Of Neurogenic Bladder? | Bladder

Neurogenic bladder is a bladder control problem that is caused by a nerve, brain or spinal cord condition. Neurogenic bladder may occur in people who have had a stroke or who have Parkinson's disease, multiple sclerosis (MS), a brain or spinal cord injury or infection, spina bifida or other conditions. It also can result from diabetes or as a complication of major pelvic surgery eBook Shop: Essentials of the Adult Neurogenic Bladder als Download. Jetzt eBook herunterladen & bequem mit Ihrem Tablet oder eBook Reader lesen

Neurogenic bladder is a condition that causes loss of bladder function after a spinal cord injury (SCI). After a SCI, you may not be able to feel that your bladder is full. You also may not be able to stop your bladder from emptying. Your bladder may get overfull and stretch. Urine may back up into your kidneys. What can I do about neurogenic bladder? Healthcare providers can teach you how to. Neurogenic Bladder If you or someone you care about is experiencing a neurogenic bladder - a bladder dysfunction caused by neurologic damage - turn to the urologists at Jefferson. We maintain a team of physicians and advanced practice nurses who specialize in the care and management of neurourologic problems, such as neurogenic bladder

Define neurogenic bladder. neurogenic bladder synonyms, neurogenic bladder pronunciation, neurogenic bladder translation, English dictionary definition of neurogenic bladder. Noun 1. neurogenic bladder - a urinary bladder disorder caused by a lesion in the nervous system bladder disorder - a disorder of the urinary bladder Based... Neurogenic bladder - definition of neurogenic bladder by The. A doctor will do an exam and may order several tests of the nervous system and the bladder to diagnose neurogenic bladder: These include: Urodynamic studies: These bladder function tests measure how much urine the bladder can hold, the pressure within the bladder, how well urine flows, and how well the bladder empties when it is full. Special sensors may be placed on the skin near the urethra (the tube through which urine passes) or rectum to see if the muscles and nerves in those parts of.

Diagnosis of a neurogenic bladder. It is important to remember that the late diagnosis of a neurogenic bladder is dangerous because of irreversible changes in the anatomical and functional state of the bladder and upper urinary tract, therefore, diagnosis and subsequent treatment of neurogenic disorders of the function of the lower urinary tract should be started as early as possible There are several types of neurogenic bladder disorders. The new term that's being used now in this field is neurogenic lower urinary tract dysfunction. And as you can see in the first column, I had the different types of bladder dysfunction. And in the second column on the right is how it affects a bladder and what the causes are. So I'd like to go through these in a little bit more detail. What is Neurogenic Bladder? Neurogenic bladder is a bladder dysfunction resulting from improper functioning of the nerves which carry messages between the brain and the bladder muscles to facilitate urination. Proper bladder function depends on these nerves to sense the fullness of the bladder and to retain or release urine

Bladder dysfunction improved with therapeutic intervention

The word neurogenic means caused by the nerves or nervous system.. Therefore, if the nerves that communicate with the bladder are damaged by illness or injury, then it'll alter how the bladder is controlled. Now, you should also know that all nerves aren't the same Neurogenic bladder dysfunction was excluded in 7 patients (1%). VUD is useful for the investigation of the lower urinary tract function together with X-ray morphology. The advantage of these. Neurogenic bladder affects many Americans and occurs when there is a problem with the way your brain communicates with your bladder. People who have a neurogenic bladder usually experience a bladder that is either overactive (spastic) or underactive (flaccid). What are the symptoms of a neurogenic bladder? There are many symptoms of a neurogenic bladder. These include 3.7 Typical manifestations of neurogenic lower urinary tract dysfunction 26 3.8 References 26 4. TREATMENT 29 4.1 Introduction 29 4.2 Non-invasive conservative treatment 29 4.2.1 Assisted bladder emptying 29 4.2.2 Lower urinary tract rehabilitation 29 Bladder rehabilitation including electrical stimulation 2

Neurogenic Bladder: Symptoms, Causes, and Treatment

Neurogenic Bladder is a common condition involving a number of medical conditions of the urinary tract. This condition is caused as a result of some type of a problem with the nerves whose function is to control the bladder. Some of the medical conditions which come under Neurogenic Bladder are overactive bladder, urine incontinence, and bladder obstruction. Many people may have problems with Neurogenic Bladder including those who have an underlying medical condition involving the. Neurogenic or atonic bladder signs with a flaccid bladder involve overflow incontinence. People retain urine and have constant overflow dribbling. Many men also suffer from erectile dysfunction. Good bladder function depends on normal nerve signals at all neurological levels from the brain, spinal cord and in the peripheral nerves. Any interruption in these complex nerve pathways transmitting messages to and from the bladder and urethra may result in a neurogenic bladder. Classification of Neurogenic Bladder

Neurogenic Bladder: Causes, Symptoms, Diagnosis, and Treatmen

Neurogenic bladder after stroke is a commonly encountered medical condition which slows down the recovery process and exacerbates the functional status of the patient. The neurogenic bladder may possibly affect the quality of life of patients with stroke. Objectives: The aim of this study is to investigate the relationship between the quality of life and the neurogenic bladder in Turkish. PTNS patients without neurogenic bladder but with OAB where used as controls. Our group of neurogenic bladder patients contained a variety of neurological diseases. The severity of the neurogenic disease was staged by a neurologist before starting and after discontinuing PTNS for probable bias purposes. We used the Expanded Disability Status Scale (EDDS) for multiple sclerosis patients, modified Rankin Scale (mRS) for post-CVA and the Hoehn and Yahr Scale (HY) for Parkinson's disease.

Neurogenic Bladder

Neurogenic Bladder: Symptoms, Diagnosis & Treatment

Thirty‐two neurogenic bladder patients were included in this study. YM correlated with Pves (r = .72, p < .0001) better than with modified dynamic compliance (r = −0.43, p < .0001). The correlation of YM with Pves was even higher than that with the calculated bladder wall's modulus (r = .52, p < .0001). Conclusion. YM measured by SWE associates with Pves better than with compliance. Neurogenic bladder is when your bladder isn't working the way it should be due to a brain, spinal cord, or nerve problem. These problems can affect the nerves of your bladder and your ability to urinate (pee). People with neurogenic bladder: Aren't able to hold in their urine (pee). Have to urinate many times during the day or night. Feel an urgency to urinate, but then aren't able to.

Textbook of the Neurogenic Bladder provides physicians-whether qualified or in training-with excellent instruction for conducting thorough, efficient, and beneficial examinations of both ad. TABLE OF CONTENTS . chapter | 2 pages Introduction . Edited By Jacques c, Eric Schick. chapter | 2 pages Part I The normal genito-urinary tract . Edited By Jacques c, Eric Schick. chapter 1 | 8 pages. It is important for patients to receive proper care to manage neurogenic bladder to help prevent complications such as urinary tract infections or even kidney disease. Our neuro-urology specialists provide state-of-the-art treatments for patients with neurogenic bladder and related pelvic floor problems. UT Southwestern was the first in North Texas to offer botulinum toxin injections (Botox. Neurogenic bladder means the bladder doesn't work normally because of nerve damage. It causes a child to have problems with holding or releasing urine. The muscles and nerves of the urinary system work together to hold urine in the bladder and then release it at the right time. Nerves carry messages from the bladder to the brain. And they carry messages from the brain to the bladder muscles. These messages tell the bladder muscles either to tighten or release. With neurogenic bladder, the. Neurogenic bladder is a urinary tract dysfunction in which the bladder doesn't empty, properly due to a neurological condition or spinal cord injury. The condition may be caused by a birth defect, usually one involving the spinal cord, or it may be acquired as the result of a different problem. While neurogenic bladder can't be cured, necessarily, it can most definitely be managed. Most.

Spinal Injury Could Cause Neurogenic Bladder Dysfunctio

Neurogenic bladder is a condition that affects how the bladder stores and empties urine. Ideally, a child's bladder stores urine until it is full and then empties. In a normal bladder, the urine is stored at a safe, low pressure and the bladder can empty completely without assistance What is neurogenic bladder? Neurogenic bladder is a condition that impairs your control over your bladder. Normally, when you need to urinate, your brain sends signals to the muscles in your bladder to release or contract, enabling you to empty your bladder. With neurogenic bladder, those signals don't transmit properly, causing you to urinate too much or not enough Treatments for Neurogenic Bladder. There are several strategies to manage a Neurogenic Bladder, and they are decided based on your age, overall health and medical history, the cause of the nerve damage, the type and severity of symptoms, and your tolerance for certain drugs, procedures or therapies

Neurogenic overactive bladder in spinal cord injury and multiple sclerosis: role of onabotulinumtoxinA KD Ethans,1,2 AR Casey,1,2 RJ Bard,1,3 MP Namaka1 1University of Manitoba, 2Section of Physical Medicine and Rehabilitation, Health Sciences Centre, 3Section of Urology, Health Sciences Centre, Winnipeg, Manitoba, Canada Abstract: People with neurogenic overactive bladder from either multiple. Neurogenic Bladder Medications. Your neurogenic bladder treatment plan may include medication to help you manage symptoms. They are typically anticholinergic or Beta-3 agonist medications, which work by altering the action of bladder neurotransmitter. As a result, these medication prevent involuntary bladder muscle movements. Botox injection Neurogenic bladder is a condition that causes loss of control of bladder function after a spinal cord injury (SCI). After a SCI, you may not be able to feel that your bladder is full. You also may not be able to stop your bladder from emptying. Your bladder may get overfull and stretch. Urine may back up into your kidneys Neurogenic Bladder is found with those who have Brain Injuries, Spinal cord injuries, Muscular Dystrophy, Multiple Sclerosis if accompanied with incontinence of BM also, is often seen in those who are paraplegic. I do not test postitive for MS/MD or BM incontinence.these are good things. I was just diagnosed with this in Jan 2015 (one year later after the wreck). I have spent this whole.

Hydronephrosis - Radipedia

Neurogenic Bladder - an overview ScienceDirect Topic

With neurogenic bladder, patients experience either: Overactive bladder - Patients have little or no control urinating, resulting in urinary incontinence and urine leakage. Individuals often experience a sudden urge to urinate or find they are urinating more frequently. Underactive bladder/urinary retention - The bladder loses the ability to empty properly, resulting in a buildup of urine. Neurogenic bladder describes lost bladder function due to brain, spinal cord, or nerve conditions or disorders such as: Alzheimer's disease; Birth defects of the spinal cord; Brain or spinal cord tumors; Cerebral palsy; Encephalitis (swelling of the brain) Attention deficit hyperactivity disorder (ADHD) Multiple sclerosis ; Parkinson's disease; Spinal cord injury; Stroke recovery. Neurogenic bladder and bowel are highly common conditions that can result in people of all ages who have sustained traumatic spinal cord injuries (SCIs) or other neurological damage. These conditions are issues that many spinal cord injury survivors experience but are too embarrassed to talk about with family members or their doctors

Neurogenic Bladder :: Royal National Orthopaedic Hospita

Neurogenic bladder occurs when transmissions between the brain and the bladder are delayed or interrupted. While some people are born with neurogenic bladder issues, in the case of MS patients the. Neurogenic bladder is diagnosed by carefully recording fluid intake and urinary output and by measuring the quantity of urine remaining in the bladder after voiding (residual urine volume). This measurement is done by draining the bladder with a small rubber tube (catheter) after the person has urinated. Kidney function also is evaluated by regular laboratory testing of the blood and urine Neurogenic bladder is a problem in which a person lacks bladder control due to a brain, spinal cord, or nerve condition. Alternative Names. Neurogenic detrusor overactivity; NDO; Neurogenic bladder sphincter dysfunction; NBSD. Causes. Several muscles and nerves must work together for the bladder to hold urine until you are ready to empty it. Nerve messages go back and forth between the brain. Neurogenic Bladder Neurogenic bladder is a condition characterized by the loss of bladder function, which prevents people from completely emptying the bladder which leads to urinary retention. It can affect both males and females. For normal bladder function to occur, it involves a complex communication system between nerves and muscles to work together to tighten..

Diary of a Mad Bladder | MultipleSclerosis

Neurogenic bladder. Neurogenic bladder, or neurogenic bladder dysfunction, is a urologic condition in which normal bladder control is impacted by some form of neurologic damage, disease, or physical deformity. This condition involves problems with the nervous system: brain, spinal cord, and/or nerves. Individuals with neurogenic bladder may have difficulty holding or emptying urine. Depending. Hinman F, Jr. Nonneurogenic neurogenic bladder (the Hinman syndrome)--15 years later. J Urol 1986;136(4):769-77. 3. Allen TD. The non-neurogenic neurogenic bladder. J Urol 1977;117(2):232-8. 4. Hoebeke P, Van Laecke E, Van Camp C, et al. One thousand video-urodynamic studies in children with non-neurogenic bladder sphincter dysfunction. BJU Int 2001;87(6):575-80. 5. Jorgensen TM, Djurhuus JC. What is neurogenic bladder. Neurogenic bladder is a problem in which a person lacks bladder control due to a brain, spinal cord, or nerve condition 1).A spinal cord injury may interrupt communication between the nerves in the spinal cord that control bladder and bowel function and the brain, causing bladder- and bowel-function problems Often the first line therapy for patients that have urgency, frequency, and leakage from neurogenic bladder is the use of several medicines known as anti-cholinergic medicines. These medicines act to relax the bladder and decrease leakage and urgency of urination from bladder spasms or overactivity. Anti-cholinergic medicines are notorious for causing side effects and often patients need to be.

[Stones and neurogenic bladder]

Ho M, Stothers L, Lazare D, Tsang B, Macnab A. Evaluation of educational content of YouTube videos relating to neurogenic bladder and intermittent catheterization. Can Urol Assoc J . 2015 Sep-Oct. The neurogenic bladder | | ISBN: | Kostenloser Versand für alle Bücher mit Versand und Verkauf duch Amazon. Wählen Sie Ihre Cookie-Einstellungen. Wir verwenden Cookies und ähnliche Tools, um Ihr Einkaufserlebnis zu verbessern, um unsere Dienste anzubieten, um zu verstehen, wie die Kunden unsere Dienste nutzen, damit wir Verbesserungen vornehmen können, und um Werbung anzuzeigen. Neurogenic Lower Urinary Tract Dysfunction 249 Drug treatment to decrease bladder outlet resistance Selective and non-selective alpha-blockers have been partially successful in decreasing bladder outlet resistance, residual urine and autonomic dysreflexia. Catheterisation Intermittent, self- or third-party, catheterisation (IC) is th Neurogenic bladder is bladder dysfunction (flaccid or spastic) caused by neurologic damage. Symptoms can include overflow incontinence, frequency, urgency, urge incontinence, and retention. Risk of serious complications (eg, recurrent infection, vesicoureteral reflux, autonomic dysreflexia) is high. Diagnosis involves imaging and cystoscopy or urodynamic testing. Treatment involves. The criteria of inclusion for this study were: adult patients with neurogenic bladder treated with intradetrusor injections of BoNTA for either detrusor overactivity or low bladder compliance between 2003 and 2015. The use of urodynamic studies for the followup of neurogenic bladders treated with onabotulinumtoxinA . The researchers found that patients with neurogenic orthostatic hypotension.

Neurogenic Bladder Treatment - Urologist

Neurogenic bladder. Cleveland Clinic explained what the disorder is and said: Neurogenic bladder is a condition in which problems with the nervous system affect the bladder and urination. Neurogenic bladder may be prevented only by preventing the primary medical and surgical conditions that cause it. For patients diagnosed with multiple sclerosis, the 10 year interval before signs of neurogenic bladder starts will give enough time for them to do pelvic floor strengthening exercises (Kergel exercises) to improve incontinent problems

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