Vaginal Lawsuit Info
Vaginal Lawsuit : Early work wouLd suggest that some SERMs in development, eg levormeloxifene and idoxifene, might increase the risk of urogenital prolapse,53although there were some methodological problems noted in the study. However, in another analysis of three randomized, doubleblind, placebo-controlled trials investigating raloxifene in 6926 postmenopausal women. Oestrogens are known to have an important physiological effect on the female Lower genital tract throughout adult life, leading to symptomatic, histological and functional changes. Urogenital atrophy is the manifestation of oestrogen withdrawal following the menopause, presenting with vaginal and/or urinary symptoms. The use of oestrogen replacement therapy has been examined in the management of lower urinary tract symptoms as well as in the treatment of urogenital atrophy. Only recently has this treatment been subjected to randomized placebo-controlled trials and meta-analysis.
Oestrogen therapy alone has been shown to have little effect in the management of USI. When considering the irritative symptoms of urinary urgency, frequency and urge incontinence, oestrogen therapy may be of benefit, although this may simply represent reversal of urogenital atrophy rather than a direct effect on the lower urinary tract. drugs appeared to have a protective effect – fewer treated women had surgery for urogenital prolapse. Finally, low-dose vaginal oestrogens have been shown to have a role in the treatment of urogenital atrophy in postmenopausal women and would appear to be as effective as systemic preparations.
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Incontinence can be cured or significantly improved in most women providing they are appropriately investigated and treated. However, some women may not wish to undergo medical or surgical intervention. There are also a number of women for whom a cure may be impossible. For this group, containment with pads, devices or even catheters may be the most appropriate therapy. Reported figures1 estimate the overall cost of incontinence to the NHS at £354 million, with the cost continuing to rise.2 Continence products are one of the biggest expenditures for the NHS today.
Products available are numerous, but it is important to match the product to the individual’s personal needs, wishes and social circumstances. It is difficult even for a specialist continence nurse to keep up with the choice available. Companies are constantly changing and developing their products, endeavouring to ensure that their products suit the requirements of the users. The pad is the most common and the most readily available form of containment. The market of reusable and disposable products has grown tremendously. In 1974 Bill Kylie, an Australian, launched an oblong absorbent pad that became the forerunner of the disposable pad industry. There are few quality trials to assess pads, and many products have frequently been replaced before the results are published.
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Pads should not be used as an alternative to effective continence promotion strategies. They should really be a temporary measure while investigations are undertaken or treatment is awaited. Pads should only be used as treatment in the severely incontinent person where containment will be a priority. Pads can either be disposable or reusable. There is no strong evidence that one is more effective than the other. The advantages and limitations of reusable and disposable products are outlined in Table 12.1. The commonest problem with disposable pads is that they can become bulky and the covering can even become separated if they are not replaced when needed.
The decision whether or not to use reusable incontinence products rather than disposables is a complex one that will depend on individual needs and preferences. The availability of suitable laundry facilities is an important factor. Over a thousand items, ranging from special toilet seats to assist toilet training to odour-control products are listed in The United Kingdom Continence Foundation Product Directory.
In recent years there has been a wide variety of new continence devices developed.7 Although interest continues with clinicians and patients, many of the devices have never made it onto the market or have been removed from the market shortly after release. Some products are available on the Internet, but until these products become more widely available, they will continue to be limited to specialist units in controlled trials.
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Vaginal Lawsuit