as long as the managers are good today nothing would change you know the banks minds and so watch the language of the bankers running. for speaking the truth global news that matters g.w. made for mines. 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 costin. 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 to bruce we talk about everything like today i'm 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 particular here at the event as clinic. and. nobody should walk around with what trolls us 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 they go. we are and what they are also

afraid off is telling the doctor but. once in my life the false stand before the. funny big. when she loses 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 didn't do enough urine would still leak from her bladder when she was out running. grass year's eve on the first child and at four and a half kilograms she was larger than average the bird 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 the.

target exercises can tighten up 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 that your brain remembers. just by shut off we sit up straight and stabilize from bottom to top from the sides from your back and abdomen. yvonne now has her pelvic floor muscles back under control along with her bladder and weak bladder is a more common problem than people think. i would just feel want to many people only associate it with the elderly but that's incorrect. 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 but follow can demand a party for. he liked it klein is one of the patients who needed an operation as an incontinence clinic and 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 but no. orders use as many bunt is this small band helps replace the natural band structures you have in the pelvic floor and these natural bands normally keep the year we through a stable and ensure your and doesn't leak out but they can become damaged for a variety of reasons especially childbirth or if you're shady. world 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 you're an aging. the twenty minute operation has given her back control of her bladder and her freedom. you know 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 i think. in the event this in berlin and i will talk to dr to be

a spot and head of the rose department for reconstructive. we're going to talk about a week later but actually it's not the bladder which gets weak it's more like the fashion. in your old you talk about incontinence that official word of official catalogue it's not bladder weakness it's not perfect floor weakness there's all together the treasures are not working together 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 about the fish is growing and we could all there are three reasons especially in female patients first lots of delivery of birth. because of a child's head is good for the perfect florence abiding it and the second one is hysterectomies women which have been uterus removed have removed

ligaments which are fixing the leather 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 professor and there are different types of incontinence yes there are two big groups of incontinence the first one is stress incontinence stresses. you're the pressure stress not the earth not the psychic stress that's when the stress which is produced by the pressure of the bladder so it's 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 doesn't feel exactly what the letter does and the other way around so if you suffer from those kinds of encounter then sewage should see a neurologist and especially women sometimes afraid of seeing this kind of doctor so what do you do in the same nation that it's everything not not painful and 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 force. on the getting better and better anymore and then the third step may be just could be that's the thing where people are afraid of but today we use flexible instruments which can be with that which are 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 holding 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 with this suspect simple operation but there are even bigger operations see if to her feet in the summer in some cases it's not only the pelvic floor of the reef which is wrong but also the muscle it serves its so-called intrinsics think that if you can see in these patients one has to make an artificial your notice finger and about this artificial human there is. we continue our talk in just a moment because this is applies to men too they don't like to speak the body during their symptoms but they suffer from it too especially after protectively. prostate cancer is one of the most common cancers among men across the tech to male surgical removal of the prostate can cause serious problems but you have tried 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 rethrow passes through the prostate gland the operation can damage both the re threat and the bladder sphincter which keeps the year in the bladder till one chooses to your innate this damage can result in bladder control problems. on the basis of recent developments we're now operating on older men with aggressive tumors or crecy from to move from cancers are in five to ten percent of all cases and continents. including and start with the artificial urinary sphincter is a treatment for severe incontinence it's a device comprised of a calf that goes around the u. 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 bleeding from these and the problem is that the patient has to operate it manually he has to work the pump in his scrotum

to empty the cuff of the liquid they keeps at tide loosening the car past water. for mild to moderate incontinence there are alternative treatments involving balloons slings and cushions. was good there's no one perfect solution it depends on the diagnosis that requires a psycho skippy to evaluate the damage or defect. 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 year rethread 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 other sorts of. fear but

firm for whom 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. the first of. the pressure the balloons exert sometimes decreases but 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. is. the problem of balloon failure can however be dealt with you simply replace it with a minor procedure with little impact. i think it certainly feasible goodwill to fuel. 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. thrall sling and a cushion. trance camps which 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 ceiling of soft mesh repositions the rethrow a cushion exerts pressure on the muscles surrounding it and functions as a substitute sphincter. to mushroom these is fond of for this is an excellent arch and because the sling moves the your rethrow back where it should be. i mean the 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. once companies had such 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 you re threat to its proper position that's often not enough to keep patients dry who have a problem with bladder control at night instead a sling plus cushion has proved more effective as in the case of man fed to unpack all their 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. 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 that's normal i feel quite optimistic about the future. it's a prostate operation the most common cause for in canton in syria in. the us most men with an incontinent head of prostate surgery in former times this was the surgery for the benign prosthetic. but this operation is done in the most cases endoscopic only 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 it's completely different of radical prostatectomy and prostate cancer because of these operations the prostate has to be removed completely and it has to be divided. from the 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 it or it's a senseless 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 rude to you 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 stricter structures and so in some cases the muscle training 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 your. devices like like the use they have all the cuff around the rethrow are as though you read through the cuff of such not every noise filter they have a system to produce pleasure like a balloon or like a palm and they. inside the school to where it's possible to empty this car fear that it's 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 this one. only two parts this is the. there's of the pump tank system which is in the straw to him and another system is it's a little different here you can see the pump of the scrotum. the cuff for the roof and two balloons to produce the pressure is

a very difficult operation. special operation that's. just below the skin so it's not deep operation like gastric operations. but 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 let me know that. the so-called high volume centers have better results than centers who do it only twice or three times a year in fact halakhah in 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 all patients

a lot of them are to have a normal. function and it's not. a rate about implantation of. thanks dr patrick for answering all my questions and if you suffer from any symptoms of incontinence don't be shy and go and see your doctor and don't be shy. and writers. on an upcoming show will be looking at fertility some couples 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 waifs 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 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 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 meet 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 smoke from high voltage power lines and in that area the evidence of possible harm is more persuasive things 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 funneling out 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 asked god to answer that question she's a science writer a 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 microwave like broccoli for example. one spanish study that's been circulating online reported that microwaving broccoli destroyed most of its flat annoyed if true that would be problematic. there's evidence that secondary fighter chemicals 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 or 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 doesn't happen even early in the 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 stock it doesn't work quite as well for example 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. on the surface there are spots where the broccoli is too dry or where it's 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 you're just reheating food and not cooking it the microwave can be a good option and a practical one. so when you want it 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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this is t w news alive and fighting rages near libya's capital tripoli with schools already dead the united nations calls for thousands of refugees course in the crossfire to be evacuated well off what options they had last fall say coming up thousands in sudan press that demand for an immediate return to civilian rule saying the new military rulers pledge to hand over power within two years isn't enough.