Prostate Restored
Photo: Kamaji Ogino
A healthy bladder works best if the body just relaxes so that the bladder muscles naturally contract to let the urine flow, rather than using the abdominal muscles to bear down as with a bowel movement. In men, the need to push urine may be a sign of bladder outlet obstruction, which is commonly due to BPH.
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Read More »One more trip to the bathroom before rushing out the door may seem like smart planning, but it can backfire. The danger is that you can end up “training” the bladder to respond to small volumes, which can lead to overactive bladder symptoms—the sensation of needing to urinate more frequently than is normal, explains Dr. Rickey. “Going too often at night can also be a problem for men who then can’t fall back to sleep,” says Stanton Honig, MD, director of Male Urology, adding that this condition, called nocturia, can affect quality of life. “If this is bothersome to patients, there are treatment [medications] for it,” says Dr. Honig. Other problems can also cause increased urinary frequency, such as an infection along the urinary tract. Therefore, if you find that you need to visit the bathroom far more often than you used to, talk to your primary care physician or urologist. You may need a urinalysis (urine test) to rule out a UTI, as well as to check for blood in the urine (hematuria), which can happen to a small number of people with an overactive bladder who have a bladder tumor, Dr. Brito says. “Blood in the urine is never normal and usually requires further testing to determine its cause,” Dr. Brito says. Diet can also be a factor for people who notice an uptick on their need to pee. “The bladder is increasingly sensitive as we age,” says Dr. Brito, “and urinary frequency can be due to certain ‘irritative’ foods and beverages such as caffeine, alcohol, carbonated beverages, chocolate, spicy foods, and acidic foods.” Some people may also visit the bathroom frequently in an attempt to avoid leakage. Although urinary incontinence (an unintended loss of urine) is common and affects a large number of women, it is not something you should just live with,” says Dr. Rickey. “Directed pelvic floor muscle exercises [physical therapy] can resolve these symptoms.” Other treatments such as medications and minimally invasive procedures are available, too, to help with urinary frequency, urgency, and incontinence.
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Read More »False-negative results occur when a drug or metabolite is present at such low levels that it is not detected. Confirmatory testing is essential to distinguish a true negative from a false negative. Contaminants can also interfere with the immunoassay's ability to detect the presence of drugs.
Urine drug testing is an essential component of monitoring patients who are receiving long-term opioid therapy, and it has been suggested for patients receiving long-term benzodiazepine or stimulant therapy. Family physicians should be familiar with the characteristics and capabilities of screening and confirmatory drug tests. Immunoassays are used for initial screening and can give false-positive and false-negative results. All results are considered presumptive until confirmatory testing is performed. False-positive results have significant implications for a patient's pain treatment plan, and false-negative results can be a missed opportunity to detect misuse. Urine drug testing is an essential component of monitoring patients who are receiving long-term opioid therapy, and it has been suggested for patients receiving long-term benzodiazepine or stimulant therapy. Family physicians should be familiar with the characteristics and capabilities of screening and confirmatory drug tests. Immunoassays are qualitative tests used for initial screening of urine samples. They can give false-positive and false-negative results, so all results are considered presumptive until confirmatory testing is performed. Immunoassays for opioids may not detect commonly prescribed semisynthetic and synthetic opioids such as methadone and fentanyl; similarly, immunoassays for benzodiazepines may not detect alprazolam or clonazepam. Immunoassays can cross-react with other medications and give false-positive results, which have important implications for a patient's pain treatment plan. False-negative results can cause missed opportunities to detect misuse. Urine samples can be adulterated with other substances to mask positive results on urine drug testing. Family physicians must be familiar with these substances, the methods to detect them, and their effects on urine drug testing.
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