U28 Limited function/disability urinary (ICD-10:Z73.6)

Introduction

Limited function/disability urinary refers to a condition where there is a decrease in the normal function of the urinary system, leading to difficulties in urination and potential disability. This condition can significantly impact a person’s quality of life and daily activities^[1]. The aim of this guide is to provide an overview of the symptoms, causes, diagnostic steps, possible interventions, and lifestyle modifications that can help manage limited function/disability urinary.

Codes

• ICPC-2 Code: U28 Limited function/disability urinary
• ICD-10 Code: Z73.6 Limitation of activities due to disability

Symptoms

• Difficulty initiating urination
• Weak urine stream
• Frequent urination
• Incomplete emptying of the bladder
• Urinary incontinence
• Urinary retention^[2]

Causes

• Benign prostatic hyperplasia (BPH)
• Urinary tract infections (UTIs)
• Bladder stones
• Neurological disorders (e.g., multiple sclerosis, spinal cord injury)
• Medications (e.g., anticholinergics, alpha-blockers)
• Prostate cancer
• Urethral stricture
• Pelvic organ prolapse^[3]

Diagnostic Steps

Medical History

• Gather information about the patient’s symptoms, including the duration, severity, and any triggering factors.
• Inquire about any previous medical conditions, surgeries, or medications that may be contributing to the limited function/disability urinary.
• Assess the patient’s overall health and lifestyle, including any habits that may affect urinary function (e.g., smoking, alcohol consumption)^[4].

Physical Examination

• Perform a thorough physical examination, including a genital and rectal examination in males to assess the prostate gland.
• Evaluate the abdomen for any signs of distension or masses.
• Assess the neurological system to identify any potential underlying neurological disorders^[5].

Laboratory Tests

• Urinalysis: To check for the presence of infection, blood, or other abnormalities in the urine.
• Urine culture: If a urinary tract infection is suspected, a urine culture can help identify the specific bacteria causing the infection and determine the appropriate antibiotic treatment.
• Blood tests: To assess kidney function and rule out any underlying medical conditions (e.g., diabetes, kidney disease).
• Prostate-specific antigen (PSA) test: To screen for prostate cancer in males^[6].

Diagnostic Imaging

• Ultrasound: To visualize the urinary tract and assess for any structural abnormalities, such as bladder stones or prostate enlargement.
• Cystoscopy: A thin tube with a camera is inserted into the urethra to examine the bladder and urethra for any abnormalities or blockages.
• Urodynamic testing: Measures the pressure and flow of urine during urination to assess bladder function^[7].

Other Tests

• Uroflowmetry: Measures the rate and volume of urine flow to evaluate the strength and efficiency of urination.
• Post-void residual (PVR) measurement: Determines the amount of urine left in the bladder after urination to assess for urinary retention^[8].

Follow-up and Patient Education

• Schedule regular follow-up appointments to monitor the progress of the condition and adjust treatment as needed.
• Provide education to the patient about their condition, including lifestyle modifications and self-care measures to manage limited function/disability urinary effectively^[9][10].

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Limited function/disability urinary:

1. Alpha-blockers (e.g., Tamsulosin, Terazosin):
   • Cost: Generic versions can be $10-$50/month.
   • Contraindications: Hypersensitivity to alpha-blockers, severe liver disease.
   • Side effects: Dizziness, low blood pressure, retrograde ejaculation.
   • Severe side effects: Priapism (prolonged erection), allergic reactions.
   • Drug interactions: Other medications that lower blood pressure.
   • Warning: Take medication at bedtime to minimize dizziness.
2. Anticholinergic medications (e.g., Oxybutynin, Tolterodine):
   • Cost: Generic versions can be $10-$50/month.
   • Contraindications: Urinary retention, gastric retention, narrow-angle glaucoma.
   • Side effects: Dry mouth, constipation, blurred vision.
   • Severe side effects: Urinary retention, confusion, hallucinations.
   • Drug interactions: Other medications with anticholinergic effects.
   • Warning: Avoid alcohol and activities requiring mental alertness.
3. 5-alpha reductase inhibitors (e.g., Finasteride, Dutasteride):
   • Cost: Generic versions can be $10-$50/month.
   • Contraindications: Hypersensitivity to 5-alpha reductase inhibitors, women of childbearing potential.
   • Side effects: Decreased libido, erectile dysfunction, breast tenderness.
   • Severe side effects: High-grade prostate cancer, allergic reactions.
   • Drug interactions: None significant.
   • Warning: May take several months to see the full effect.
4. Mirabegron:
   • Cost: $100-$200/month.
   • Contraindications: Severe uncontrolled hypertension, severe hepatic impairment.
   • Side effects: Increased blood pressure, urinary tract infection, headache.
   • Severe side effects: Angioedema, severe allergic reactions.
   • Drug interactions: Other medications that increase blood pressure.
   • Warning: Monitor blood pressure regularly.
5. Botulinum toxin injections (e.g., OnabotulinumtoxinA):
   • Cost: $1000-$2000 per treatment.
   • Contraindications: Urinary tract infection, allergy to botulinum toxin.
   • Side effects: Urinary retention, urinary tract infection, muscle weakness.
   • Severe side effects: Difficulty breathing, allergic reactions.
   • Drug interactions: None significant.
   • Warning: Requires repeated injections every few months.

Alternative Drugs:

• Desmopressin: Used for nocturnal enuresis (bedwetting) in children.
• Imipramine: Tricyclic antidepressant with anticholinergic effects used for nocturnal enuresis.
• Trospium: Anticholinergic medication used for overactive bladder.

Surgical Procedures:

• Transurethral resection of the prostate (TURP): Removes excess prostate tissue that may be causing urinary obstruction. Cost: $10,000-$20,000.
• Prostatectomy: Surgical removal of the prostate gland, usually performed for prostate cancer. Cost: $20,000-$40,000.
• Bladder neck suspension: Surgical procedure to support the bladder neck and prevent urinary incontinence. Cost: $10,000-$20,000.

Alternative Interventions

• Acupuncture: May help improve bladder function and reduce urinary symptoms. Cost: $60-$120 per session.
• Pelvic floor muscle exercises (Kegel exercises): Strengthening the pelvic floor muscles can improve urinary control. Cost: Free.
• Biofeedback therapy: Teaches patients to control their pelvic floor muscles using visual or auditory feedback. Cost: $100-$200 per session.
• Herbal supplements: Some herbs, such as saw palmetto and pumpkin seed extract, may have potential benefits for urinary symptoms. Cost: Varies depending on the specific supplement.
• Hypnotherapy: Can help manage stress and anxiety related to urinary symptoms. Cost: $100-$200 per session.

Lifestyle Interventions

• Fluid management: Limiting fluid intake, especially before bedtime, can reduce urinary frequency and nocturia. Cost: Free.
• Dietary modifications: Avoiding bladder irritants, such as caffeine and alcohol, can help alleviate urinary symptoms. Cost: Varies depending on dietary choices.
• Weight management: Losing weight can reduce pressure on the bladder and improve urinary symptoms. Cost: Varies depending on weight loss methods.
• Bladder training: Gradually increasing the time between urinations can help improve bladder control. Cost: Free.
• Stress management techniques: Managing stress through techniques like meditation or yoga can help reduce urinary symptoms. Cost: Varies depending on chosen method.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions. It is recommended to consult with a healthcare professional for personalized treatment options and cost estimates.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – U28 Limited function/disability urinary (ICD-10:Z73.6)

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Limited function/disability urinary effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Limited function/disability urinary. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. Abrams, P., et al. (2002). The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourology and Urodynamics, 21(2), 167-178.
2. Chapple, C. R., & Milsom, I. (2012). Urinary incontinence and pelvic prolapse: epidemiology and pathophysiology. Campbell-Walsh Urology, 10, 1871-1895.
3. Gratzke, C., et al. (2015). EAU guidelines on the assessment of non-neurogenic male lower urinary tract symptoms including benign prostatic obstruction. European Urology, 67(6), 1099-1109.
4. Coyne, K. S., et al. (2009). The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU International, 104(3), 352-360.
5. Bickley, L. S., Szilagyi, P. G., & Hoffman, R. M. (2017). Bates’ guide to physical examination and history taking. Wolters Kluwer.
6. Nitti, V. W. (2005). Pressure flow urodynamic studies: the gold standard for diagnosing bladder outlet obstruction. Reviews in Urology, 7(Suppl 6), S14.
7. Dmochowski, R. R. (2005). Bladder outlet obstruction: etiology and evaluation. Reviews in Urology, 7(Suppl 6), S3.
8. Abrams, P. (2006). New words for old: lower urinary tract symptoms for “prostatism”. BMJ, 308(6934), 929-930.
9. Gormley, E. A., et al. (2012). Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. The Journal of Urology, 188(6 Suppl), 2455-2463.
10. Irwin, D. E., et al. (2011). Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU International, 108(7), 1132-1138.