Paruresis
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Paruresis
Paruresis, also known as shy bladder syndrome, is a type of phobia in which a person is unable to urinate in the real or imaginary presence of others, such as in a public restroom. The analogous condition that affects bowel movement is called parcopresis or shy bowel. Signs and symptoms Some people have brief, isolated episodes of urinary difficulty in situations where other people are in close proximity. Paruresis, however, goes beyond simple shyness, embarrassment, fear of exposure, or fear of being judged for not being able to urinate. Other people may find that they are unable to urinate while in moving vehicles, or are fixated on the sounds of their urination in quiet restrooms or residential settings. In severe cases, a person with paruresis can urinate only when alone at home or through the process of catheterization. Causes One possible cause of paruresis is undergoing a voiding cystourethrography (VCUG) in the past. "Complications that can occur in both sexes incl ...
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Internal Urethral Sphincter
The internal urethral sphincter is a urethral sphincter muscle which constricts the internal urethral orifice. It is located at the junction of the urethra with the urinary bladder and is continuous with the detrusor muscle, but anatomically and functionally fully independent from it., page 29Preview Amazon It is composed of smooth muscle, so it is under the control of the autonomic nervous system, specifically the sympathetic nervous system. Function This is the primary muscle for maintaining continence of urine, a function shared with the external urethral sphincter which is under voluntary control. It prevents urine leakage as the muscle is tonically contracted via sympathetic fibers traveling through the inferior hypogastric plexus and vesical nervous plexus. Specifically, it is controlled by the hypogastric nerve, predominantly via the alpha-1 receptor. During urination, the preganglionic neurons of this sympathetic pathway are inhibited via signals arising in the pontine ...
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Psychiatry
Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psychiatric assessment of a person typically begins with a case history and mental status examination. Physical examinations and psychological tests may be conducted. On occasion, neuroimaging or other neurophysiological techniques are used. Mental disorders are often diagnosed in accordance with clinical concepts listed in diagnostic manuals such as the ''International Classification of Diseases'' (ICD), edited and used by the World Health Organization (WHO) and the widely used '' Diagnostic and Statistical Manual of Mental Disorders'' (DSM), published by the American Psychiatric Association (APA). The fifth edition of the DSM (DSM-5) was published in May 2013 which re-organized the larger categories of various diseases and expanded upon the p ...
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Diagnostic And Statistical Manual Of Mental Disorders
The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria and is the main book for the diagnosis and treatment of mental disorders in the United States and is considered one of the "Bibles" of psychiatry along with the ICD, CCMD and the Psychodynamic Diagnostic Manual. It is usedmainly in the United Statesby researchers, psychiatric drug regulation agencies, health insurance companies, pharmaceutical companies, the legal system, and policymakers. Mental health professionals use the manual to determine and help communicate a patient's diagnosis after an evaluation. Hospitals, clinics, and insurance companies in the United States may require a DSM diagnosis for all patients with mental disorders. Health-care researchers use the DSM to categorize patients for research purp ...
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American Urological Association
The American Urological Association (AUA) is a professional association in the United States for urology professionals. It has its headquarters at the William P. Didusch Center for Urologic History in Maryland. AUA works with many international organizations, representing urologists from across the world. These groups offer full or half day sessions, covering a variety of topics, during the annual meeting. Awards * Hugh Hampton Young Award: Presented annually to an individual for outstanding contributions to the study of genitourinary tract disease. This award is sponsored by Karl Storz Endoscopy-America, Inc. * Ramon Guiteras Award: Awarded annually to an individual who is deemed to have made outstanding contributions to the art and science of urology. This award is sponsored by Bard Urological Division. *Distinguished Contribution Award: Presented annually to individuals who have made outstanding contributions to the science and practice of urology, including contributions made ...
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Incapacity Benefit
Incapacity Benefit was a British social security benefit that was paid to people facing extra barriers to work because of their long-term illness or their disability. It replaced Invalidity Benefit in 1995. The government began to phase out Incapacity Benefit in 2008 by making it unavailable to new claimants, and later moved almost all the remaining long-term recipients onto Employment and Support Allowance. History 1995 In 1995, the Conservative Secretary of State for Social Security, Peter Lilley, abolished Invalidity Benefit for fresh claims and replaced it with Incapacity Benefit after the Prime Minister of the day, John Major, had complained about the burgeoning caseload, saying: "Frankly, it beggars belief that so many more people have suddenly become invalids, especially at a time when the health of the population has improved". A new feature of Incapacity Benefit was that officials could ask for claimants' disabilities to be confirmed using a bespoke testing procedure ...
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Barrington's Nucleus
The Pontine micturition center (PMC, also known as Barrington's nucleus) is a collection of neuronal cell bodies located in the rostral pons in the brainstem involved in the supraspinal regulation of micturition. When activated, the PMC relaxes the urethral sphincter allowing for micturition to occur. The PMC coordinates with other brain centers, including the medial frontal cortex, insular cortex The insular cortex (also insula and insular lobe) is a portion of the cerebral cortex folded deep within the lateral sulcus (the fissure separating the temporal lobe from the parietal and frontal lobes) within each hemisphere of the mammalian bra ..., hypothalamus and periaqueductal gray (PAG). The PAG acts as a relay station for ascending bladder information from the spinal cord and incoming signals from higher brain areas. Regulation In humans and other mammals, neurons in the PMC send descending excitatory projections to spinally located parasympathetic neurons controlling the detrus ...
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Micturition
Urination, also known as micturition, is the release of urine from the urinary bladder through the urethra to the outside of the body. It is the urinary system's form of excretion. It is also known medically as micturition, voiding, uresis, or, rarely, emiction, and known colloquially by various names including peeing, weeing, and pissing. In healthy humans (and many other animals), the process of urination is under voluntary control. In infants, some elderly individuals, and those with neurological injury, urination may occur as a reflex. It is normal for adult humans to urinate up to seven times during the day. In some animals, in addition to expelling waste material, urination can mark territory or express submissiveness. Physiologically, urination involves coordination between the central, autonomic, and somatic nervous systems. Brain centres that regulate urination include the pontine micturition center, periaqueductal gray, and the cerebral cortex. In placental mam ...
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Pons
The pons (from Latin , "bridge") is part of the brainstem that in humans and other bipeds lies inferior to the midbrain, superior to the medulla oblongata and anterior to the cerebellum. The pons is also called the pons Varolii ("bridge of Varolius"), after the Italian anatomist and surgeon Costanzo Varolio (1543–75). This region of the brainstem includes neural pathways and tracts that conduct signals from the brain down to the cerebellum and medulla, and tracts that carry the sensory signals up into the thalamus.Saladin Kenneth S.(2007) Anatomy & physiology the unity of form and function. Dubuque, IA: McGraw-Hill Structure The pons is in the brainstem situated between the midbrain and the medulla oblongata, and in front of the cerebellum. A separating groove between the pons and the medulla is the inferior pontine sulcus. The superior pontine sulcus separates the pons from the midbrain. The pons can be broadly divided into two parts: the basilar part of the pons (ventral ...
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Reflex Pathway
A reflex arc is a neural pathway that controls a reflex. In vertebrates, most sensory neurons do not pass directly into the brain, but synapse in the spinal cord. This allows for faster reflex actions to occur by activating spinal motor neurons without the delay of routing signals through the brain. The brain will receive the input while the reflex is being carried out and the analysis of the signal takes place after the reflex action. There are two types: autonomic reflex arc (affecting inner organs) and somatic reflex arc (affecting muscles). Autonomic reflexes sometimes involve the spinal cord and some somatic reflexes are mediated more by the brain than the spinal cord. During a somatic reflex, nerve signals travel along the following pathway: # ''Somatic receptors'' in the skin, muscles and tendons # ''Afferent nerve fibers'' carry signals from the somatic receptors to the posterior horn of the spinal cord or to the brainstem # An ''integrating center'', the point at which ...
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Detrusor
The detrusor muscle, also detrusor urinae muscle, muscularis propria of the urinary bladder and (less precise) muscularis propria, is smooth muscle found in the wall of the bladder. The detrusor muscle remains relaxed to allow the bladder to store urine, and contracts during urination to release urine. Related are the urethral sphincter muscles which envelop the urethra to control the flow of urine when they contract. Structure The fibers of the detrusor muscle arise from the posterior surface of the body of the pubis in both sexes (musculi pubovesicales), and in the male from the adjacent part of the prostate. These fibers pass, in a more or less longitudinal manner, up the inferior surface of the bladder, over its apex, and then descend along its fundus to become attached to the prostate in the male, and to the front of the vagina in the female. At the sides of the bladder the fibers are arranged obliquely and intersect one another. The 3 layers of muscles are arranged lon ...
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Pubococcygeus
The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the lesser pelvis, and these unite to form the greater part of the pelvic floor. The coccygeus muscle completes the pelvic floor, which is also called the ''pelvic diaphragm''. It supports the viscera in the pelvic cavity, and surrounds the various structures that pass through it. The levator ani is the main pelvic floor muscle and painfully contracts during vaginismus. It also contracts rhythmically during orgasm. Structure The levator ani is made up of 3 parts: * Iliococcygeus muscle * Pubococcygeus muscle * Puborectalis muscle The iliococcygeus arises from the inner side of the ischium (the lower and back part of the hip bone) and from the posterior part of the tendinous arch of the obturator fascia, and is attached to the coccyx an ...
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Levator Ani
The levator ani is a broad, thin muscle group, situated on either side of the pelvis. It is formed from three muscle components: the pubococcygeus, the iliococcygeus, and the puborectalis. It is attached to the inner surface of each side of the lesser pelvis, and these unite to form the greater part of the pelvic floor. The coccygeus muscle completes the pelvic floor, which is also called the ''pelvic diaphragm''. It supports the viscera in the pelvic cavity, and surrounds the various structures that pass through it. The levator ani is the main pelvic floor muscle and painfully contracts during vaginismus. It also contracts rhythmically during orgasm. Structure The levator ani is made up of 3 parts: * Iliococcygeus muscle * Pubococcygeus muscle * Puborectalis muscle The iliococcygeus arises from the inner side of the ischium (the lower and back part of the hip bone) and from the posterior part of the tendinous arch of the obturator fascia, and is attached to the coccyx and a ...
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