Druvith/medqa1 huggingface dataset:
Question:  What causes Cystocele ?
Answer: A cystocele occurs when the muscles and supportive tissues between a womans bladder and vagina weaken and stretch, letting the bladder sag from its normal position and bulge into the vagina or through the vaginal opening. In a cystocele, the bladder tissue remains covered by the vaginal skin. A cystocele may result from damage to the muscles and tissues that hold the pelvic organs up inside the pelvis. A womans pelvic organs include the vagina, cervix, uterus, bladder, urethra, and small intestine. Damage to or weakening of the pelvic muscles and supportive tissues may occur after vaginal childbirth and with conditions that repeatedly strain or increase pressure in the pelvic area, such as
                
- repetitive straining for bowel movements  - constipation  - chronic or violent coughing  - heavy lifting  - being overweight or obese
                
A womans chances of developing a cystocele increase with age, possibly because of weakening muscles and supportive tissues from aging. Whether menopause increases a womans chances of developing a cystocele is unclear.
Question:  What are the symptoms of Cystocele ?
Answer: The symptoms of a cystocele may include
                
- a vaginal bulge  - the feeling that something is falling out of the vagina  - the sensation of pelvic heaviness or fullness  - difficulty starting a urine stream  - a feeling of incomplete urination  - frequent or urgent urination
                
Women who have a cystocele may also leak some urine as a result of movements that put pressure on the bladder, called stress urinary incontinence. These movements can include coughing, sneezing, laughing, or physical activity, such as walking. Urinary retentionthe inability to empty the bladder completelymay occur with more severe cystoceles if the cystocele creates a kink in the womans urethra and blocks urine flow.
                
Women with mild cystoceles often do not have any symptoms.
Question:  How to diagnose Cystocele ?
Answer: Diagnosing a cystocele requires medical tests and a physical exam of the vagina. Medical tests take place in a health care providers office, an outpatient center, or a hospital. The health care provider will ask about symptoms and medical history. A health care provider uses a grading system to determine the severity of a womans cystocele. A cystocele receives one of three grades depending on how far a womans bladder has dropped into her vagina:
                
- grade 1mild, when the bladder drops only a short way into the vagina  - grade 2moderate, when the bladder drops far enough to reach the opening of the vagina  - grade 3most advanced, when the bladder bulges out through the opening of the vagina
                
If a woman has difficulty emptying her bladder, a health care provider may measure the amount of urine left in the womans bladder after she urinates. The remaining urine is called the postvoid residual. A health care provider can measure postvoid residual with a bladder ultrasound. A bladder ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off the bladder to create an image and show the amount of remaining urine. A specially trained technician performs the procedure, and a radiologista doctor who specializes in medical imaginginterprets the images. A woman does not need anesthesia.
                
A health care provider can also use a cathetera thin, flexible tubeto measure a womans postvoid residual. The health care provider inserts the catheter through the womans urethra into her bladder to remove and measure the amount of remaining urine after the woman has urinated. A postvoid residual of 100 mL or more is a sign that the woman is not completely emptying her bladder. A woman receives local anesthesia.
                
A health care provider may use a voiding cystourethrograman x-ray exam of the bladderto diagnose a cystocele as well. A woman gets a voiding cystourethrogram while urinating. The x-ray images show the shape of the womans bladder and let the health care provider see any problems that might block normal urine flow. An x-ray technician performs a voiding cystourethrogram, and a radiologist interprets the images. A woman does not need anesthesia; however, some women may receive sedation. A health care provider may order additional tests to rule out problems in other parts of a womans urinary tract.
Question:  What are the treatments for Cystocele ?
Answer: Cystocele treatment depends on the severity of the cystocele and whether a woman has symptoms. If a womans cystocele does not bother her, a health care provider may recommend only that she avoid heavy lifting or straining, which could worsen her cystocele. If a woman has symptoms that bother her and wants treatment, the health care provider may recommend pelvic muscle exercises, a vaginal pessary, or surgery.
                
Pelvic floor, or Kegel, exercises involve strengthening pelvic floor muscles. Strong pelvic floor muscles more effectively hold pelvic organs in place. A woman does not need special equipment for Kegel exercises.
                
The exercises involve tightening and relaxing the muscles that support pelvic organs. A health care provider can help a woman learn proper technique.
                
More information about pelvic muscle exercises is provided in the NIDDK health topic, Kegel Exercise Tips.
                
A vaginal pessary is a small, silicone medical device placed in the vagina that supports the vaginal wall and holds the bladder in place. Pessaries come in a number of shapes and sizes. A health care provider has many options to choose from to find the most comfortable pessary for a woman.
                
A heath care provider may recommend surgery to repair the vaginal wall support and reposition the womans bladder to its normal position. The most common cystocele repair is an anterior vaginal repairor anterior colporrhaphy. The surgeon makes an incision in the wall of the womans vagina and repairs the defect by folding over and sewing together extra supportive tissue between the vagina and bladder. The repair tightens the layers of tissue that separate the organs, creating more support for the bladder. A surgeon who specializes in the urinary tract or female reproductive system performs an anterior vaginal repair in a hospital. The woman receives either regional or general anesthesia. The woman may stay overnight in the hospital, and full recovery may take up to 4 to 6 weeks.
Question:  What to do for Cystocele ?
Answer: Researchers have not found that eating, diet, and nutrition play a role in causing or preventing a cystocele.
Question:  What to do for Cystocele ?
Answer: - A cystocele, also called a prolapsed or dropped bladder, is the bulging or dropping of the bladder into the vagina.  - A cystocele occurs when the muscles and supportive tissues between a womans bladder and vagina weaken and stretch, letting the bladder sag from its normal position and bulge into the vagina or through the vaginal opening.  - Diagnosing a cystocele requires medical tests and a physical exam of the vagina.  - Cystocele treatment depends on the severity of the cystocele and whether a woman has symptoms.
Question:  What is (are) Whipple Disease ?
Answer: Whipple disease is a rare bacterial infection that primarily affects the small intestine. The infection may spread to any organ in the body; however, it more commonly affects the
                
- joints  - central nervous system, which includes the brain, the spinal cord, and nerves located throughout the body  - heart  - eyes  - lungs
                
Left untreated, Whipple disease gets worse and is usually life threatening.
Question:  What is (are) Whipple Disease ?
Answer: The small intestine is part of the upper gastrointestinal (GI) tract and is a tube-shaped organ between the stomach and large intestine. The upper GI tract also includes the mouth, esophagus, stomach, and duodenum, or the first part of the small intestine.
                
Most food digestion and nutrient absorption take place in the small intestine. The small intestine measures about 20 feet long and includes the duodenum, jejunum, and ileum. Villitiny, fingerlike protrusionsline the inside of the small intestine. Villi normally let nutrients from food be absorbed through the walls of the small intestine into the bloodstream.
Question:  What causes Whipple Disease ?
Answer: Bacteria called Tropheryma whipplei (T. whipplei) cause Whipple disease. T. whipplei infection can cause internal sores, also called lesions, and thickening of tissues in the small intestine. The villi take on an abnormal, clublike appearance and the damaged intestinal lining does not properly absorb nutrients, causing diarrhea and malnutrition. Diarrhea is frequent, loose, and watery bowel movements. Malnutrition is a condition that develops when the body does not get the right amount of vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function. Over time, the infection spreads to other parts of the persons body and will damage other organs.
Question:  What are the symptoms of Whipple Disease ?
Answer: Signs and symptoms of Whipple disease can vary widely from person to person. The most common symptoms of Whipple disease are
                
- diarrhea  - weight loss caused by malabsorption
                
A person may not have diarrhea. Instead, other signs and symptoms of Whipple disease may appear, such as
                
- abnormal yellow and white patches on the lining of the small intestine  - joint pain, with or without inflammation, that may appear off and on for years before other symptoms  - fatty or bloody stools  - abdominal cramps or bloating felt between the chest and groin  - enlarged lymph nodesthe small glands that make infection-fighting white blood cells  - loss of appetite  - fever  - fatigue, or feeling tired  - weakness  - darkening of the skin
                
People with a more advanced stage of Whipple disease may have neurologic symptomsthose related to the central nervous systemsuch as
                
- vision problems.  - memory problems or personality changes.  - facial numbness.  - headaches.  - muscle weakness or twitching.  - difficulty walking.  - hearing loss or ringing in the ears.  - dementiathe name for a group of symptoms caused by disorders that affect the brain. People with dementia may not be able to think well enough to do normal activities such as getting dressed or eating.
                
Less common symptoms of Whipple disease may include
                
- chronic cough.  - chest pain.  - pericarditisinflammation of the membrane surrounding the heart.  - heart failurea long-lasting condition in which the heart cannot pump enough blood to meet the bodys needs. Heart failure does not mean the heart suddenly stops working.
Question:  What are the complications of Whipple Disease ?
Answer: People with Whipple disease may have complications caused by malnutrition, which is due to damaged villi in the small intestine. As a result of delayed diagnosis or treatment, people may experience the following complications in other areas of the body:
                
- long-lasting nutritional deficiencies  - heart and heart valve damage  - brain damage
                
A person with Whipple disease may experience a relapsea return of symptoms. Relapse can happen years after treatment and requires repeat treatments.
Question:  What are the treatments for Whipple Disease ?
Answer: The health care provider prescribes antibiotics to destroy the T. whipplei bacteria and treat Whipple disease. Health care providers choose antibiotics that treat the infection in the small intestine and cross the blood-brain barriera layer of tissue around the brain. Using antibiotics that cross the blood-brain barrier ensures destruction of any bacteria that may have entered the patients brain and central nervous system.
                
The health care provider usually prescribes IV antibiotics for the first 2 weeks of treatment. Most patients feel relief from symptoms within the first week or two. A nurse or technician places an IV in the patients arm to give the antibiotics. IV antibiotics used to treat Whipple disease may include
                
- ceftriaxone (Rocephin)  - meropenem (Merrem I.V.)  - penicillin G (Pfizerpen)  - streptomycin (Streptomycin)
                
After a patient completes the IV antibiotics, the health care provider will prescribe long-term oral antibiotics. Patients receive long-term treatmentat least 1 to 2 yearsto cure the infection anywhere in the body. Oral antibiotics may include
                
- trimethoprim/sulfamethoxazole (Septra, Bactrim)a combination antibiotic  - doxycycline (Vibramycin)
                
Patients should finish the prescribed course of antibiotics to ensure the medication destroyed all T. whipplei bacteria in the body. Patients who feel better may still have the bacteria in the small intestine or other areas of the body for 1 to 2 years. A health care provider will monitor the patient closely, repeat the blood tests, and repeat the upper GI endoscopy with biopsy during and after treatment to determine whether T. whipplei is still present.
                
People may relapse during or after treatment. A health care provider will prescribe additional or new antibiotics if a relapse occurs. Some people will relapse years after treatment, so it is important for patients to schedule routine follow-ups with the health care provider. Most patients have good outcomes with an early diagnosis and complete treatment.
                
Health care providers treat patients with neurologic symptoms at diagnosis or during relapse more aggressively. Treatment may include
                
- a combination of antibiotics  - hydroxychloroquine (Plaquenil)an antimalarial medication  - weekly injections of interferon gammaa substance made by the body that activates the immune system  - corticosteroidsmedications that decrease inflammation
Question:  How to prevent Whipple Disease ?
Answer: Experts have not yet found a way to prevent Whipple disease.
Question:  What to do for Whipple Disease ?
Answer: A person with Whipple disease and malabsorption may need
                
- a diet high in calories and protein  - vitamins  - nutritional supplements
Question:  What to do for Whipple Disease ?
Answer: - Whipple disease is a rare bacterial infection that primarily affects the small intestine. Left untreated, Whipple disease gets worse and is usually life threatening.  - Bacteria called Tropheryma whipplei (T. whipplei) cause Whipple disease. T. whipplei infection can cause internal sores, also called lesions, and thickening of tissues in the small intestine.  - Anyone can get Whipple disease. However, it is more common in Caucasian men between 40 and 60 years old.  - Signs and symptoms of Whipple disease can vary widely from person to person. The most common symptoms of Whipple disease are      - diarrhea    - weight loss caused by malabsorption    - People with Whipple disease may have complications caused by malnutrition, which is due to damaged villi in the small intestine.  - The health care provider prescribes antibiotics to destroy the T. whipplei bacteria and treat Whipple disease.  - The health care provider usually prescribes intravenous (IV) antibiotics for the first 2 weeks of treatment. Most patients feel relief from symptoms within the first week or two.  - After a patient completes the IV antibiotics, the health care provider will prescribe long-term oral antibiotics.  - Most patients have good outcomes with an early diagnosis and complete treatment.
Question:  Who is at risk for Sexual and Urologic Problems of Diabetes? ?
Answer: Risk factors are conditions that increase the chances of getting a particular disease. The more risk factors people have, the greater their chances of developing that disease or condition. Diabetic neuropathy and related sexual and urologic problems appear to be more common in people who
                
- have poor blood glucose control  - have high levels of blood cholesterol  - have high blood pressure  - are overweight  - are older than 40  - smoke  - are physically inactive
Question:  How to prevent Sexual and Urologic Problems of Diabetes ?
Answer: People with diabetes can lower their risk of sexual and urologic problems by keeping their blood glucose, blood pressure, and cholesterol levels close to the target numbers their health care provider recommends. Being physically active and maintaining a healthy weight can also help prevent the long-term complications of diabetes. For those who smoke, quitting will lower the risk of developing sexual and urologic problems due to nerve damage and also lower the risk for other health problems related to diabetes, including heart attack, stroke, and kidney disease.
                
More information about preventing diabetes complications is provided in the NIDDK health topic, Prevent diabetes problems: Keep your diabetes under control, available from the National Diabetes Information Clearinghouse at 1-800-860-8747.
Question:  What to do for Sexual and Urologic Problems of Diabetes ?
Answer: The nerve damage of diabetes may cause sexual or urologic problems.
                
- Sexual problems in men with diabetes include      - erectile dysfunction    - retrograde ejaculation    - Sexual problems in women with diabetes include      - decreased vaginal lubrication and uncomfortable or painful intercourse    - decreased or no sexual desire    - decreased or absent sexual response    - Urologic problems in men and women with diabetes include      - bladder problems related to nerve damage, such as overactive bladder, poor control of sphincter muscles, and urine retention    - urinary tract infections    - Controlling diabetes through diet, physical activity, and medications as needed can help prevent sexual and urologic problems.  - Treatment is available for sexual and urologic problems.
Question:  What causes Nerve Disease and Bladder Control ?
Answer: Nerves that work poorly can lead to three different kinds of bladder control problems.
                
Overactive bladder. Damaged nerves may send signals to the bladder at the wrong time, causing its muscles to squeeze without warning. The symptoms of overactive bladder include
                
- urinary frequencydefined as urination eight or more times a day or two or more times at night  - urinary urgencythe sudden, strong need to urinate immediately  - urge incontinenceleakage of urine that follows a sudden, strong urge to urinate
                
Poor control of sphincter muscles. Sphincter muscles surround the urethra and keep it closed to hold urine in the bladder. If the nerves to the sphincter muscles are damaged, the muscles may become loose and allow leakage or stay tight when you are trying to release urine.
                
Urine retention. For some people, nerve damage means their bladder muscles do not get the message that it is time to release urine or are too weak to completely empty the bladder. If the bladder becomes too full, urine may back up and the increasing pressure may damage the kidneys. Or urine that stays too long may lead to an infection in the kidneys or bladder. Urine retention may also lead to overflow incontinence.
Question:  What causes Nerve Disease and Bladder Control ?
Answer: Many events or conditions can damage nerves and nerve pathways. Some of the most common causes are
                
- vaginal childbirth  - infections of the brain or spinal cord  - diabetes  - stroke  - accidents that injure the brain or spinal cord  - multiple sclerosis  - heavy metal poisoning
                
In addition, some children are born with nerve problems that can keep the bladder from releasing urine, leading to urinary infections or kidney damage.
Question:  What are the treatments for Nerve Disease and Bladder Control ?
Answer: The job of the sphincter muscles is to hold urine in the bladder by squeezing the urethra shut. If the urethral sphincter fails to stay closed, urine may leak out of the bladder. When nerve signals are coordinated properly, the sphincter muscles relax to allow urine to pass through the urethra as the bladder contracts to push out urine. If the signals are not coordinated, the bladder and the sphincter may contract at the same time, so urine cannot pass easily.
                
Drug therapy for an uncoordinated bladder and urethra. Scientists have not yet found a drug that works selectively on the urethral sphincter muscles, but drugs used to reduce muscle spasms or tremors are sometimes used to help the sphincter relax. Baclofen (Lioresal) is prescribed for muscle spasms or cramping in patients with multiple sclerosis and spinal injuries. Diazepam (Valium) can be taken as a muscle relaxant or to reduce anxiety. Drugs called alpha-adrenergic blockers can also be used to relax the sphincter. Examples of these drugs are alfuzosin (UroXatral), tamsulosin (Flomax), terazosin (Hytrin), and doxazosin (Cardura). The main side effects are low blood pressure, dizziness, fainting, and nasal congestion. All of these drugs have been used to relax the urethral sphincter in people whose sphincter does not relax well on its own.
                
Botox injection. Botulinum toxin type A (Botox) is best known as a cosmetic treatment for facial wrinkles. Doctors have also found that botulinum toxin is useful in blocking spasms like eye ticks or relaxing muscles in patients with multiple sclerosis. Urologists have found that injecting botulinum toxin into the tissue surrounding the sphincter can help it to relax. Although the FDA has approved botulinum toxin only for facial cosmetic purposes, researchers are studying the safety and effectiveness of botulinum toxin injection into the sphincter for possible FDA approval in the future.