each. just to. the renaissance for. starters people twenty seven. w. . welcome to in good shape here's what's coming up. radiation in the kitchen are 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 kostin. 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. we talk about everything like today in going to talk about during every incontinence some people always with their pads and others just when the cough sneeze or laugh and what you can do about it this is what i'm going to talk about with dr to be as partick here at the event as clinic in. nobody should walk around with her 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 the. god we are and what they're also afraid off is

telling the doctor but there is help. in my life falls to me for those names when talking in front of the big. one she loses a physiotherapist helped forty three year old yvonne bush bell to strengthen her pelvic floor she had a baby ten months ago and sought help soon after but it didn't do enough urine would still leak from her bladder when she was out running. grassy is yvonne's 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 a weakened pelvic floor muscles. this in china back to 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. just by shut off we sit up straight and stabilize from bottom to top twenty from the sides from your back and abdomen. yvonne now has her pelvic floor muscles back under control along with her bladder but weak bladder is a more common problem than people think. i would just feed a lot 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 it fire can demand and when the whole party feel. like it klein is one of the patients who needed an operation at an incontinence clinic in 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 but not all. the others use 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 rethrow stable and ensure your and doesn't leak out but they can become damaged for a variety of reasons especially childbirth or fish a dish. 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. my kind if i thought we don't spar now i can have fun again. and i don't have to worry about whether laughing will make me wet myself. give side 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 the work ethic. in the event is spinning in berlin and i will talk to dr to be part

of the rose department for reconstructing iraq we're going to talk about a week later but actually it's not the bill letter which gets weak it's more like the fashion. and you're already will talk about incontinence but the officer wrote of official catalog it's not the weakness it's not perfect there's all together the presidents are not working together but 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 other fish is going and we could all three reasons especially in female patients first lots of deliveries both because of a child's head is good for the perfect floor and surviving it and the second one is hysterectomies women which have been removed have removed some

ligaments which are fixing the bladder and the third thing is getting older getting older connective tissue the fresher they're 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 dress incontinence dresses here the pressure stress not the earth not the psychic stress the stress which is produced by the pressure off the bladder so it's an anatomical incontinence and the other thing is urgent continence because of different sensations which are going to be discordant need to hold 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 neurologist and especially women sometimes afraid of seeing this kind of doctor so to do in the same a nation that it's 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 darn different question is for that the second thing is ultrasound we do more and more examinations by song than in the years before because of the devices for forceful not graphologists on are getting better and better and more and then the third step may be could be that's 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. it's not painful we get a picture of the problem and then we can treat it and how do you treat it. in pure stress incontinence most women are treated to the so-called tapes this is a tape there's a pulley properly in tape but there are other types of tissue also there's

a lot of women can be can be healed of this simple operation but there are even bigger operations see if to perform because in the summer in some cases it's not only the pelvic floor the refurbish is wrong but also the sink to muscle it serve its intrinsic. think of efficiency in movies patients want to make artificial you're going to think about this artificial you're nervous when do we continue our talk in just a moment because this implies to me to say don't like to speak the body during those symptoms but they suffer from it too especially after protecting the. prostate cancer is one of the most common cancers among men across the tech to me or surgical removal of the prostate can cause serious problems when you 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 hope for really hit my life hard. all

three men became incontinent after a cross to take to me the rethread passes through the prostate gland the operation can damage both the re threat and the bladder sphincter which keeps the urine in the bladder till one chooses to hear an eight this damaged commiserates in bladder control problems. on the basis of recent developments we're now operating on older men with aggressive tumors are crecy from to move from kansas are in five to ten percent of all cases and continents. including and start with the artificial urinary stink is a treatment for severe incontinence it's a device comprised of a cough that goes around the year we throw a chupa a pump inserted into this quote him 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 to empty the cuff of

the liquid that keeps the tide loosening the car then lets him pass water. for mild to moderate incontinence there are alternative treatments involving billions slings and cushions. script there's no one perfect solution it depends on the diagnosis that requires a cite or skippy to evaluate the damage or defect picked. a therapy introduced about fifteen years ago involves artificial compression devices let's has been kitted out with such a system to silicon balloons filled with liquid squeeze the you're a threat to keep it closed and thus prevent leakage. and 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 continent so that he's content quentin and some others it's a free. field with food for all 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. of. the pressure the balloons exert sometimes decreases 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 with some minor procedure with little impact. i think it certainly feasible good to feel. 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 no. 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 ceiling of soft mesh repositions the rethrow a cushion exerts pressure on the muscles surrounding it and functions as a substitute sphincter darby the seats of 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 . continents 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. compass handsets 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 a threat to its proper position that's 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 one of our followers and 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 and. 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. not. night i remain almost dry during the day less so. i think that's normal i feel quite optimistic about the future. it's a prostate operation the most common cause for in canton in searing men. yes most men with an incontinent head of prostate surgery for want arms for the surgery for the benign prosthetic. the operation is done in the most cases endoscopic only and. twenty thirty years ago all these devices we had 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 these operations the prostate has to be removed completely and that has to be divided. from the sphincter 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 sense there's 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 to rehabilitation for three to four weeks we can train muscles but we can train all the muscles not the connective tissue between the different strip structures and so in some cases the muscle turning does not work so

this is when you need to operate again in to put in an artificial swing to this ride for these patients we have artificial uro's think those devices like. they have all the cuff around the rethrow are as though you read through the cuff of such another for your finger they have a system to produce pleasure like a balloon like a pump and they. well it's possible to empty this car for years or so but its release of the euro 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 this one. only two parts this is the. there's of the pump system which is in the straw to him and another system is it's a little different here you can see a pump of the straw to. the car for the roof and two balloons to

produce the treasure is a very difficult operation. operation that's. just below the skin so it's not deep operation like gastric operations over in. the structures are 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 aeration go through all that. so-called high volume centers have better results than centers who do it only twice or three times a year in fact harm can 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 some then one has to replace it again and is it a problem the sexual activity after those implants. nor sexual activity maybe deteriorated by the prosthetic surgery. but that does not happen in all patients

a lot of them are to have a normal. function and it's not. not deteriorated by the potations of. things that are protect for answering questions and if you suffer from any symptoms of incontinence don't be shy and go and see a doctor and don't be shy. and writers. on an upcoming show will be looking at fertility some couple struggle to have a baby what can stand in the way of conception and what treatments are there if you have a question send it to in good shape at e.w. dot com just right for tila the treatment 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 through education 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 or decent to find out more the university of arkansas research is collecting all the available scientific studies that examine the connection between electromagnetic waves off field and human health as in kind of stored in because i'm 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 meat 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 is for life that want to see 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 site 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 go on 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 micro way like broccoli for example. one spanish study that's been circulating online reported that microwaving broccoli destroyed most of its flab annoyed if true that would be problematic. as there is evidence that secondary phytochemicals 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. asked 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. does heating food in a microwave destroys certain nutrients. 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 starke it doesn't work quite as well for example provide them an 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. after all off the surface there are spots where there broccoli is too dry or where it's overcooked and 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 to 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 in good shape.

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