Urinary retention

Jumat, 12 Juli 2013

Incomplete emptying of the bladder

Defining Characteristics:

  • Measured urinary residual >150 to 200 ml or 25% of total bladder capacity; 
  • obstructive lower urinary tract symptoms (poor force of stream, intermittency of stream, hesitancy of urination, postvoiding dribbling, feelings of incomplete bladder emptying); 
  • irritative lower urinary tract symptoms (urgency to urinate, diurnal frequency of urination, nocturia); 
  • overflow incontinence (dribbling urine loss caused when intravesical pressure overwhelms the sphincter mechanism)

Related Factors:
  • Bladder outlet obstruction: benign prostatic hyperplasia, prostate cancer, prostatitis, urethral stricture, bladder neck dyssynergia, bladder neck contracture, detrusor striated sphincter dyssynergia, obstructing cystocele or urethral distortion, urethral tumor, urethral polyp, posterior urethral valves, postoperative complication
  • Deficient detrusor contraction strength: sacral level spinal lesions, cauda equina syndrome, peripheral polyneuropathies, herpes zoster or simplex affecting sacral nerve roots, injury or extensive surgery causing denervation of pelvic plexus, medication side effect, complication of illicit drug use, impaction of stool
NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Labels
  • Urinary Elimination
  • Urinary Continence
Client Outcomes
  • Completely and regularly eliminates urine from the bladder; measured urinary residual volume is <150 to 200 ml or 25% of total bladder capacity (voided volume plus urinary residual volume) 
  • Correction or relief from obstructive symptoms 
  • Correction or alleviation of irritative symptoms
  • Client is free of upper urinary tract damage (renal function remains sufficient; absence of febrile urinary infections)
NIC Interventions (Nursing Interventions Classification)

Suggested NIC Labels
  • Urinary Catheterization

Nursing Interventions and Rationales

1. Obtain focused urinary history emphasizing character and duration of lower urinary symptoms, remembering that the presence of obstructive or irritative voiding symptoms is not diagnostic of urinary retention. Query the patient about episodes of acute urinary retention (complete inability to void) or chronic rentention (documented elevated postvoid residual volumes).
A focused nursing history provides clues to the likely etiology of retention and its management (Gray, 2000a).

2. Question the client concerning specific risk factors for urinary retention including:
  • Disorders affecting the sacral spinal cord such as spinal cord injuries of vertebral levels T12 to L2, disk problems, cauda equina syndrome, tabes dorsalis
  • Acute neurological injury causing sudden loss of mobility such as spinal shock
  • Metabolic disorders such as diabetes mellitus, chronic alcoholism, and related conditions associated with polyuria and peripheral polyneuropathies
  • Heavy metal poisoning (lead, mercury) causing peripheral polyneuropathies
  • Advanced stage AIDS
  • Medications, including antispasmodics/parasympatholytics, alpha-adrenergics, antidepressants, sedatives, narcotics, psychotropic medications, illicit drugs
  • Recent surgery requiring general or spinal anesthesia
  • Bowel elimination patterns, history of fecal impaction, encopresis
Urinary retention is related to multiple factors affecting either detrusor contraction strength or urethral (bladder outlet) resistance of flow (Gray, 2000a; Kruse, Bray, deGroat, 1995; Pertek, Haberer, 1995; Anders, Goebel, 1998; Ginsberg et al, 1998).

3. Perform a focused physical assessment or review the results of a recent physical including perineal skin integrity; neurological examination, inspection, percussion, and palpation of the lower abdomen for obvious bladder distension; neurological examination including perineal skin sensation and the bulbocavernosus reflex; and vaginal vault examination in women/digital rectal examination in men.
The physical assessment provides clues to the likely etiology of urinary retention and its management.

4. Determine the urinary residual volume by catheterizing the patient immediately after urination, or by obtaining a bladder ultrasound following micturition.
Catheterization provides the most accurate method to determine urinary residual volume, but the procedure is invasive, carries a risk of infection, and may be uncomfortable for the patient. A bladder ultrasound is not as accurate as catheterization; nonetheless it is adequate for clinical judgments and is noninvasive (Bent, Nahhas, Mclennan, 1997; Lewis, 1995).

5. Complete a bladder log, including patterns of urine elimination, patterns of urine loss (if present), nocturia, and volume and type of fluids consumed for a period of 3 to 7 days.
The bladder log provides an objective verification of urine elimination patterns and allows comparison between fluids consumed and urinary output in a 24-hour period (Nygaard, Holcomb, 2000).

6. Consult with the physician concerning eliminating or altering medications suspected of producing or exacerbating urinary retention.
Medication side effects may cause or greatly exacerbate urinary retention in susceptible individuals (Gray, 2000a, 2000b).

7. Assess the severity of retention and its impact on quality of life using a symptom score such as the AUA Prostate
Symptom Score (BPH Guideline Panel, 1994). A symptom allows rating of the severity of obstructive and irritative symptoms, providing baseline assessment and evaluation of the efficacy of management.

8. Teach the patient with mild to moderate obstructive symptoms to double void by urinating, resting in the rest room for 3 to 5 minutes, then making a second effort to urinate.
Double voiding promotes more efficient bladder evacuation by allowing the detrusor to contract initially, then rest and contract again (Gray, 2000b).

9. Teach the patient with urinary retention and infrequent voiding to urinate by the clock.
Timed or scheduled voiding may reduce urinary retention by preventing bladder overdistension (Gray, 2000b).
 

10. Advise the male patient with urinary retention related to benign prostatic hyperplasia (BPH) to avoid risk factors associated with acute urinary retention by doing the following:
  • Avoiding over-the-counter cold remedies containing a decongestant (alpha-adrenergic agonist)
  • Avoiding over-the-counter dietary medications (which frequently contain alpha-adrenergic agonists)
  • Discussing voiding problems with a health care provider before beginning any new prescription medications
  • After prolonged exposure to cool weather, warming the body before attempting to urinate
  • Avoiding overfilling the bladder by adhering to regular urination patterns and refraining from excessive intake of alcohol
These manageable factors predispose the patient to acute urinary retention by overdistending the bladder and compromising detrusor contraction strength, or by increasing outlet resistance (Gray, 2000b).

11. Teach the elderly male client with BPH to self-administer finasteride or an alpha-adrenergic blocking agent such as doxazosin, terazosin, or tamsulosin as directed. Provide careful instruction concerning the dosage, administration schedule, and side effects of these drugs, including possible adverse effects when multiple doses are inadvertently missed.
Finasterid is a 5-alpha reductase inhibitor that reduces the risk of acute urinary retention when taken by men with BPH for a prolonged period (McConnell et al, 1998). The magnitude of obstruction associated with BPH is also reduced by routine administration of alpha-adrenergic blocking agents including tamsulosin, terazosin, or doxazosin. However, these agents must be taken regularly to reduce the risk of side effects, including postural hypotension (Narayan, Tewari, 1998; Lepor et al, 1997, 1998).

12. Teach the client who is unable to void specific strategies to manage this potential medical emergency including:
  • Drinking a cup of hot tea or coffee
  • Attempting urination in complete privacy
  • Placing the feet solidly on the floor
  • If unable to void using these strategies, taking a warm sitz bath or shower and voiding (if possible) while still in the tub or the shower
  • If unable to void within 6 hours, or if bladder distension is producing significant pain, seeking urgent or emergency care
A warm cup of coffee or tea stimulates the bladder and may promote voiding. Attempting urination in complete privacy and placing the feet solidly on the floor help relax the pelvic muscles and may encourage voiding. Warm water also stimulates the bladder and may produce voiding, while the cooling experienced by leaving the tub or shower may again inhibit the bladder (Gray, 2000b).
13. Remove the indwelling urethral catheter at midnight in the hospitalized patient to reduce the risk of acute urinary retention.
Removal of indwelling catheters offers several advantages to morning removal, including a larger initial voided volume (Crowe et al, 1994) or early hospital discharge with no increased risk for readmission when compared with those undergoing morning removal (McDonald, Thompson, 1999).

14. Consult the physician about bladder stimulation in the patient with urinary retention caused by deficient detrusor contraction strength.
Electrical stimulation of the bladder neck has been reported to provide beneficial results among persons with urinary retention resulting from deficient detrusor contraction strength (Moore et al, 1993).

15. Teach the client with significant urinary retention to perform self-intermittent catheterization as directed.
Intermittent catheterization allows regular, complete bladder evacuation without serious complications (Horsley, Crane, Reynolds, 1982).

16. Advise the person managed by intermittent catheterization that bacteria are likely to colonize the urine but that this condition does not indicate a clinically significant urinary tract infection.
Bacteriuria frequently occurs in the patient managed by intermittent catheterization; only symptoms producing infections warrant treatment (Maynard, Diokno, 1984).

17. Insert an indwelling catheter for the individual with urinary retention who is not a suitable candidate for intermittent catheterization.
An indwelling catheter provides continuous drainage of urine; however, the risk of serious urinary complications with prolonged use are significant (Anson, Gray, 1993; Stickler, Zimakoff, 1994).

18. Advise the person managed by an indwelling catheter that bacteria in the urine is an almost universal finding after the catheter has remained in place for a period of weeks or months and that only symptomatic infections warrant treatment.
The indwelling catheter is associated with frequent bacterial colonization. Most bacteriuria does not produce significant infection and attempts to eradicate bacteriuria often produce subsequent morbidity because resistant bacteria are encouraged to reproduce while more easily managed strains are eradicated (Moore, Rayome, 1995; White, Ragland, 1995).

Geriatric

1. Aggressively assess the elderly client for urinary retention, particularly the client with dribbling urinary incontinence, urinary tract infection, or related conditions.
Elderly women (and men) may experience retention of urine of 1500 ml or more with few or no apparent symptoms; a urinary residual volume and related assessments are necessary to determine the presence of retention in this population (Williams, Wallhagen, Dowling, 1993)

2. Assess the elderly client for impaction when urinary retention is documented or suspected.
Impaction is a common and reversible factor associated with urine loss and retention among elderly persons (Urinary Incontinence Guideline Panel, 1996).

3. Assess the elderly male client for retention related to BPH or prostate cancer.
The incidence of urinary retention related to BPH and prostate cancer increase with aging (BPH Guideline Panel, 1994).

Client/Family Teaching

1. Teach techniques for intermittent catheterization including use of clean rather than sterile technique, washing using soap and water or a microwave technique, and reuse of the catheter.

2. Teach the person with an indwelling catheter to assess the tube for patency, maintain the drainage system below the level of the symphysis pubis, and to routinely cleanse the bedside bag.

3. Teach the person managed by an indwelling catheter or intermittent catheterization the symptoms of a significant urinary infection, including hematuria, acute onset incontinence, dysuria, flank pain, or fever.

28 komentar:

Unknown mengatakan...

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Anonim mengatakan...

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Unknown mengatakan...

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Unknown mengatakan...

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ROSA mengatakan...

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stay bless
RENNA JONES.



My name is RENNA JONES a single mum from the UNITED STATE OF AMERICA (TEXAS ) i never thought i will see today if not the help of Dr. Aluda i was pregnant for over 2yrs and some months the doctor told me i have HIV aids and that the baby was affected also and also i have cancer the doctor also was about going to performe surgery on my left breast i was so fruastrated i thought of killing my self then i ran into an old college friend of mine then i narated my story to her she burst into tears and confrot me then she told me that there was these great man who would give me herbs and root and myself and the baby will be alright as good, and she told me that it will only cost me some funds to get the herbs from Dr ALUDA, money was never the problem i never thought of it but i said to myself i will be heal i cotacted him at once after some process i got the herbs he told me how to use it daily and am going to use the herbs for just 1months and after that 1months i should go for check up in the hospital i followed instructions very carfully and could you believe me it has not gotten to 1months and behold i was back again please another year is coming you should not let ailment follow you to next year contact doctor ALUDA on (DR.ALUDASPELLTEMPL@GMAIL.com) he is ever ready and happy to render you service.
contact him at....(DR.ALUDASPELLTEMPL@GMAIL.com OR YOU CAN CALL OR WHATSAPP HIM +2349050141109)
stay bless
RENNA JONES.

ROSA mengatakan...

My name is RENNA JONES a single mum from the UNITED STATE OF AMERICA (TEXAS ) i never thought i will see today if not the help of Dr. Aluda i was pregnant for over 2yrs and some months the doctor told me i have HIV aids and that the baby was affected also and also i have cancer the doctor also was about going to performe surgery on my left breast i was so fruastrated i thought of killing my self then i ran into an old college friend of mine then i narated my story to her she burst into tears and confrot me then she told me that there was these great man who would give me herbs and root and myself and the baby will be alright as good, and she told me that it will only cost me some funds to get the herbs from Dr ALUDA, money was never the problem i never thought of it but i said to myself i will be heal i cotacted him at once after some process i got the herbs he told me how to use it daily and am going to use the herbs for just 1months and after that 1months i should go for check up in the hospital i followed instructions very carfully and could you believe me it has not gotten to 1months and behold i was back again please another year is coming you should not let ailment follow you to next year contact doctor ALUDA on (DR.ALUDASPELLTEMPL@GMAIL.com) he is ever ready and happy to render you service.
contact him at....(DR.ALUDASPELLTEMPL@GMAIL.com OR YOU CAN CALL OR WHATSAPP HIM +2349050141109)
stay bless
RENNA JONES.

Karen Greg mengatakan...

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Anneke Sergio mengatakan...

HOW I GOT CURED OF HERPES VIRUS.

Hello everyone out there, i am here to give my testimony about a herbalist called dr imoloa. i was infected with herpes simplex virus 2 in 2013, i went to many hospitals for cure but there was no solution, so i was thinking on how i can get a solution out so that my body can be okay. one day i was in the pool side browsing and thinking of where i can get a solution. i go through many website were i saw so many testimonies about dr imoloa on how he cured them. i did not believe but i decided to give him a try, i contacted him and he prepared the herpes for me which i received through DHL courier service. i took it for two weeks after then he instructed me to go for check up, after the test i was confirmed herpes negative. am so free and happy. so, if you have problem or you are infected with any disease kindly contact him on email drimolaherbalmademedicine@gmail.com. or / whatssapp --+2347081986098.
This testimony serve as an expression of my gratitude. he also have
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Lucy Morgan mengatakan...

I  got diagnosed with HIV, and reading this actually made me feel like crawling and crying like a baby. The outbreak I have right now is genital and in my throat and mouth, I talked to the doctor who did the blood test on me and said over time that it would eventually get much better. She said that what I’m having is a massive outbreak and is unusual, but that it may be due to the fact that I stressed myself out over it so much. She also told me even though I have it in the genital area that It doesn't mean that I needed “private to private” contact to acquire it. But this did make me feel a whole lot better about the whole situation. For anyone else to have HIV after all this stress and pains am passing and the doctor saying all such of crap i was not convince by his Theory so i decided to go on the internet and saw this comments by Rose who testify about how she get cured by root and herbs by Dr KHAM, when i first bump into it i didn't believe the comments at first so i decided to confront her on Facebook and really know what and how did it work because my doctor told me there is no cure for herpes, so i really contacted DR KHAM, he responded in A minute the only thing he ever ask for was just the items of which he will use to prepare for the herbs, after all this he send the herbs through courier Services, within a week i was cure just like that without no struggle or stress, if you are out there in need of cure contact him with his email address: dr.khamcaregiver@gmail.com OR WHATSAPP +2348159922297

Tara Omar mengatakan...

Hiv disease for the last 3 years and had pain hard to eat and cough are nightmares,especially the first year At this stage, the immune system is severely weakened, and the risk of contracting opportunistic infections is much greater. However, not everyone with HIV will go on to develop AIDS. The earlier you receive treatment, the better your outcome will be.I started taking ARV to avoid early death but I had faith in God that i would be healed someday.As a Hiv patent we are advise to be taking antiretroviral treatments to reduce our chance of transmitting the virus to others , few weeks ago i came on search on the internet if i could get any information on Hiv treatment with herbal medicine, on my search i saw a testimony of someone who has been healed from Hiv her name was Achima Abelard and other Herpes Virus patent Tasha Moore also giving testimony about this same man,Called Dr Itua Herbal Center.I was moved by the testimony and i contacted him by his Email.drituaherbalcenter@gmail.com . We chatted and he send me a bottle of herbal medicine I drank it as he instructed me to.After drinking it he ask me to go for a test that how i ended my suffering life of Hiv patent,I'm cured and free of Arv Pills.I'm forever grateful to him Drituaherbalcenter.Here his contact Number +2348149277967...He assure me he can cure the following disease..Hiv,Cancer,Herpes Virus,Hpv,Pile,Weak Erection,Lyme Disease,Epilepsy,Glaucoma.,Brain Tumor,psoriasis, Cataracts,Macular degeneration,Cardiovascular disease,Chronic Diarrhea,Lung disease.Enlarged prostate,Osteoporosis.Alzheimer's disease,
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joy nelson mengatakan...


I’m here to testify about what Dr Okosun did for me. I have been suffering from (GENITAL HERPES VIRUS) disease for the past 4 years and had constant pain and inching, especially in my private part. During the first year, I had faith in God that i would be cured someday.This disease started circulating all over my body and I have been taking treatment from my doctor, few weeks ago I came across a testimony of Rose Smith on the internet testifying about a Man called Dr Okosun on how he cured her from 7 years HSV 2. And she also gave the email address of this man, advise anybody to contact him for help on any kind of diseases that he would be of help, so I emailed him telling him about my (HSV 2) he told me not to worry that I was going to be cured!! Well, I never doubted him I have faith he can cure me too,, Dr Okosun prepared and sent me Healing Oil, Soap, roots and herbs which I took. In the first one week, I started experiencing changes all over me, after four weeks of using his Roots/ Herbs, Oil and Soap, I was totally cured. no more inching , pain on me anymore as Dr Okosun assured me. After some time I went to my doctor to do another test behold the result came out negative. So friends my advise is if you have such disease or know anyone who suffers from it or any other disease like HPV, HBV, HIV, ALS, HBP, CANCER etc. you can contact Dr.Okosun for help via drokosun55@gmail or whatsapp +2348124363791

Success James mengatakan...

FINALLY FREE FROM HERPES VIRUS
I thought my life had nothing to offer anymore because life
became meaningless to me because I had Herpes virus, the
symptoms became very severe and bold and made my family
run from and abandoned me so they won't get infected. I gave
up everything, my hope, dreams,vision and job because the
doctor told me there's no cure. I consumed so many drugs but
they never cured me but hid the symptoms inside me making
it worse. I was doing some research online someday when I
came across testimonies of some people of how DR Ebhota
cured them from Herpes, I never believed at first and thought
it was a joke but later decided to contact him on the details
provided and when I messaged him we talked and he sent me
his herbal medicine and told me to go for a test after two
weeks. Within 7 days of medication the symptoms
disappeared and when I went for a test Lo and behold I was
NEGATIVE by the Doctor Who tested me earlier. Thank you DR
Ebhota because I forever owe you my life and I'll keep on
telling the world about you. If you are going through same
situation worry no more and contact DR Ebhota via
drebhotasolution@gmail. com or WhatsApp him via +2348089535482.
he also special on cureing 1. HIV/AIDS2. HERPES 3. CANCER 4.
ALS 5. HEPATITIS B 6.DIABETES 7. HUMAN PAPILOMA VIRUS DISEASE(HPV)8. 
ALZHEIMER 9. LUPUS (Lupus Vulgaris or LupusErythematosus 

Glen Charles mengatakan...

I am 58 years old, and was diagnosed with heart failure over a year ago. My main symptoms was fatigue, shortness of breath, and a general sense that these symptoms will keep me out of normal life activities, my symptom was not being able to breathe when lying down basically . I’ve kind of resigned to the fact that this is how life will be for me back until I found herbs that stop this CHF easily and relief all the airways. My wife and her caregiver assume I can't be as active, and thus I was excused from normal life responsibilities but natural herbs from www. totalcureherbsfoundation. com really helped a but sometimes I think is God prodigy that I was able to treat my congestive heart failure but total cure herbs foundation herbal formula has a big impact on my recovery because my heart condition has been fully eliminate, during your order you have choose the AATD herbal remedy on their website order list to get the right treatment for Congestive heart failure . They do things for me, and was too happy to comply with their service. This is a equitable of a way to get of your heart failure.

Natasha lanos mengatakan...

FINALLY FREE FROM HERPES VIRUS.
what a miracle i never believe there is cure because my doctor tested me herpes positive and she told me there is no cure, i’m very happy today that i’m having a free life without this herpes virus, i can remember some months ago when i was crying all through the night and day that i can’t get cured from this herpes, i found this herbal man called Dr sunnyna on internet when i was doing research on cure for shingle i contacted him to found out if i can get help from this herpes virus, i was so surprise when he told me that he have the herbs cure to it and he sent me the herbal in less down 5 days i was so happy when i get someone giving me hope that he can cured me i took the herbal for just 2 weeks, when i went for test after taking the herbal i found out that i am cured i was so happy and surprise, i want to use this opportunity to inform you that there is cured to herpes virus you can also contact him for his help as soon as possible so that you can get rid of this herpes once and for all you can reach him through this email: drsunnyna@gmail.com or whatsApp him on +2348077875210 You can also contact him on any disease and virus in this he all have the herbal cure to it.
1 HIV/AIDS
2 HERPES
3 CANCER
4 ALS
5 HEPATITIS
6 DIABETES
7 LOVE SPELL
8 INFECTIONS
9 HIGN BLOOD PRESSURE,.....
THANKS TO DR SUNNYNA FOE THE GOOD WORK IN LIFE YOU ARE TRULY A BLESS.....  

Success James mengatakan...

I am here to give my testimony about Dr Ebhota who helped me.. i want to inform the public how i was cured from (HERPES SIMPLEX VIRUS) by salami, i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Dr Ehbota cured them. when i contacted him he gave me hope and send a Herbal medicine to me that i took for just 2 weeks and it seriously worked for me, my HERPES result came out negative. I am so happy as i am sharing this testimony. My advice to you all who thinks that there is no cure for herpes that is Not true just contact him and get cure from Dr Ebhota healing herbal cure of all kinds of sickness you may have like
(1) CANCER,
(2) DIABETES,
(3) HIV&AIDS,
(4) URINARY TRACT INFECTION,
(5) CANCER,
(6) IMPOTENCE,
(7) BARENESS/INFERTILITY
(8) DIARRHEA
(9) ASTHMA
(10)SIMPLEX HERPES AND GENITAL
(11)COLD SORE
HERPES. he also cure my friend from cervical cancer Email: drebhotasoultion@gmail.com or whatsapp him on +2348089535482

Unknown mengatakan...

I have been a herpes carrier for 6 years and I tried every possible means of curing but all of no useful until I saw a health promotion on a herbalist from Africa who prepares herbal medicines to cure all sorts of diseases including cancer and many others sickness, I first doubted It was not true but decided to try, when I contacted this herbal physician via his e-mail, I purchased herpes herbal medicine and received it within 7 days and used it as prescribed, I tested negative within 3 weeks use, do not loose hope to contact him early If you need help, you can WhatsApp at +2348119247891 all you can contact him on his email drdanremedy@gmail.com convinced he can help you too

Patricia Desmond mengatakan...

Dr. Riaria cured my herpes virus that have been in my body since two years, ever since then my life has been incomplete, I have used so many drugs that was prescribed to me by doctors, but it didn't cure my herpes virus, i was checking for solution on the internet then I miraculously came across Dr. Riaria the powerful herbalist that  can cure herpes infection, then I contacted him through his email, I explained everything to him and he prepared a herbal medicine and sent it to me through FedEx, which I took for 14 days with the instruction he gave me, and when I did a test in the hospital my result came out negative it was the happiest day of my life that am cure from HSV 2,  are you also suffering from same virus or another diseases you can simply contact him via email: drriaria@gmail.com  you can also call or WhatsApp him on: +2349134987375.  

Florence mengatakan...

I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their email at ultimatehealthhome@gmail.com . I can breath much better and It feels comfortable!

victoria wilson mengatakan...

HERPES INFECTION CURE IS 100% AVAILABLE WITH THE HELP OF DR OGBERAESE HERBAL MEDICINE.Joy and happiness is all i can see around ever since i came in contact with this great man Called Dr Ogberaese. i complained bitterly to him about me having herpes only for him to tell me it’s a minor stuff. He told me he has cured thousands of people but i did not believe until he sent me the herbal medicine and i took it as instructed by this great man, only to go to the hospital after two weeks for another test and i was confirmed negative. For the first time in four years i was getting that result. i want to use this medium to thank this great man. His name is Dr Ogberaese , i came in with his email through a friend in USA called Edith Rose and ever since then my live has been full with laughter and great peace of mind. i urge you all with herpes or HSV1&2 to contact him if you are willing to give him a chance. you can contact him through his email drogberaese54@gmail.com or you can also WhatsApp him +2348073818653

MATINA mengatakan...

I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
liver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.

Mary Frankly mengatakan...

I never believed that their could be any complete cure for Herpes 2, Mrs JANE introduce me to DR.ehiaguna a herbal doctor, who brought him back to life again. so i had to try it too and you can,t believe that in just two weeks i started using the herbal medicine he sent to me i was perfectly ok and . Right now i can tell you that few months now i have not had any symptoms of Herpes and i have just went for text last week and the doctor confirmed that there is no trace of any Herpes in my body system. Glory be to God for leading me to this genuine DR.ehiaguna I am so happy as i am sharing this testimony. My advice to you all who thinks that their is no cure for HSV that is Not true ,just contact him and get cure from DR.ehiaguna via his Email drehiaguna@gmail.com and you will be free and free forever, Try it and you will not regret it because it truly works. One thing i have come to realize is that you never know how true it is until you try...email him drehiaguna@gmail.com.. OR WhatsApp +2348073908953 THIS IS THE TYPE OF HERBAL MEDICATION HE HAVE1 Cancer 2 Hiv 3 Low sperm count 4 Barrenness 5 Hvp 6 Herpes 7 Genital Wart 8 Rare disease 9 Hepatitis 10 Syphilis 11 DiabetesGod bless you sir for your good work that you done.....

sarah rita mengatakan...

I have be living with Oral herpes for over 4 years now and it has be a big problem for me.I have been looking for solution because i can't leave with it, One day i came across a woman testimony on a forum saying she got cured of her Herpes with the help of Dr OBUDU an herbal doctor from African with herbal medicine. At first i did not believe because i was not sure herbs can really take this virus away,but i have no choice than to give it a try and contacted him with his emails, i explain my problems,.. then he told me not to worry that he will prepare the a cure with herbal mixture and send it to me, i got the medicine after 4 days delivery and i use as instructed. After 21 days when the herb got almost finish i went to a medical doctor, i did a test and discover that the virus was gone, and my test result were HSV 1%2 negative,i was so surprise and happy! then i wrote Dr OBUDU and thank him for getting me cured from herpes. I advice you to contact this great herbal doctor OBUDU as he have cure for different kinds of diseases.i decided to share this testimony to let others who also suffer from herpes know about this and give hope to others, you can reach him via Email drobuduherbalhome@gmail.com also https://drobuduherbalhome.wixsite.com/welcometoobuduherbal WhatsAPP number +2349023428871
.....

Becky D mengatakan...

I was excused from normal life responsibilities but natural herbs from multivitamincare org really helped a but sometimes I think is God prodigy that I was able to treat my Chronic obstructive pulmonary disease but multivitamin care herbal formula has a big impact on my recovery because my heart condition has been fully reversed . They do things for me, and were too happy to comply with their service. This is an equitable way to get off your COPD emphysema .

Tommy mengatakan...

I am amazed by Ohikhobo's remedy. I Have had herpes for over 6 years with frequent outbreaks. Sometimes I average 2-3 times per month. Before one breakout could end, the next would begin. Nothing has helped me. I came online in search for a possible way to see how I can fight this virus so I found Ohikhobo here online after seeing a lot of testimonies of how he cured herpes and other diseases with natural herbs so I decided to give it a try I only took his remedy for two weeks and I was completely cured. I recommend Ohikhobo's remedy to anyone suffering from herpes that wants to be completely cured too.

Email: drohikhoboherbalcenter @ gmail com

WhatsApp +1740-231-2427

william Isabella mengatakan...

THE MAN GOD SENT TO HELP ME IS DR EBOSELE.

It is said that when someone has done good for you he or she has to be appreciated this is why am here to appreciate and share a good news about DR EBOSELE for curing me from the Genital Herpes. AM ISABELLA and i have been dealing with HSV1 AND SINCE 2019 until 2021 when i can to contact the God sent man DR EBOSELE who gave 2 weeks treatment and suddenly all the pox on my skin has left and am herpes free with the cure from EBOSELE SOLUTIONS . with this great happiness in my heart i wanna ask ya all to join me thank him and if anyone need help to cure any kind of disease or anything prayers kindly contact him today via his details below:
Email; eboselesolutions@gmail.com,
Whatsapp/call; +2348146646995


famous Animation mengatakan...

Happiness is all i see now big thanks to Dr. Ubarlo from West Africa (NIGERIA), I never thought that I will live on earth before the year runs out. I have been suffering from a deadly disease herpes Virus for the past 2 years now; I had spent a lot of money going from one place to another, hospitals have been my home every day. Constant checks have been my hobby not until this blessed day, I was searching through the Internet, I saw a testimony on how Dr. Ubarlo. from West Africa (NIGERIA) helped someone in curing his herpes Virus . quickly I copied his Whatsapp Contact: +2348119508814 just to give him a test I spoke to him, he asked me to do some certain things which I did,he told me that he is going to provide the herbal cure to me, which he did, then he asked me to go for medical checkup after some days after using the herbal medication, I was free from the deadly disease, he only asked me to post the testimony through the whole world, faithfully am doing it now, please brothers and sisters, he is great, I owe him in return. if you are having a similar problem just contact him by Email: at drubarlohome@gmail.com whatsapp him on +2348119508814 HIS HAVE THE CURE TO THIS FOLLOWING DEADLY DISEASE [1] Ischemic heart disease [2] Cerebrovascular disease [3] Lower respiratory infections [4] Chronic obstructive pulmonary disease [5] Diarrhea diseases [6] Trachea, bronchus, lung cancers [7] Tuberculosis [8] Diabetes mellifluous [9] Hypertension heart disease [10] HIV/AIDS

Kylan Gentry mengatakan...

I'm from Paris, I was diagnosed with second-stage liver cancer and brain fog following a scheduled examination to monitor liver cirrhosis. I had lost a lot of weight. A CT scan revealed three tumors; one in the center of my liver in damaged tissue and two in healthy portions of my liver. No chemotherapy or radiotherapy treatment was prescribed due to my age, the number of liver tumors. One month following my diagnosis I began taking 12 (350 point) Salvestrol supplements per day, commensurate with my body weight. This comprised six Salvestrol Shield (350 point) capsules and six Salvestrol Gold (350 point) capsules, spread through the day by taking two of each capsule after each main meal. This level of Salvestrol supplementation (4,000 points per day) was maintained for four months. In addition, I began a program of breathing exercises, chi exercises, meditation, stretching and stress avoidance. Due to the variety of conditions that I suffered from, I received ongoing medical examinations. Eleven months after commencing Salvestrol supplementation But all invalid so I keep searching for a herbal cure online that how I came across a testimony appreciating Dr Itua on how he cured her HIV/Herpes, I contacted him through email he listed above, Dr Itua sent me his herbal medicine for cancer to drink for two weeks to cure I paid him for the delivering then I received my herbal medicine and drank it for two weeks and I was cured until now I'm all clear of cancer, I will advise you to contact Dr Itua Herbal Center On Email...drituaherbalcenter@gmail.com. Www.drituaherbalcenter.com If you are suffering from Diseases listed below,

Cancer

HIV/Aids

Herpes Virus

Bladder cancer

Brain cancer

Colon-Rectal Cancer

Breast Cancer

Prostate Cancer

Esophageal cancer

Gallbladder cancer

Gestational trophoblastic disease

Head and neck cancer

Hodgkin lymphoma
Intestinal cancer

Kidney cancer

Leukemia

Liver cancer

Lung cancer

Melanoma

Mesothelioma

Multiple myeloma

Neuroendocrine tumors

Non-Hodgkin lymphoma

Oral cancer

Ovarian cancer

Sinus cancer

Skin cancer

Soft tissue sarcoma

Spinal cancer

Stomach cancer

Testicular cancer

Throat cancer

Thyroid Cancer

Uterine cancer

Vaginal cancer

Vulvar cancer

Hepatitis

Chronic Illness

Lupus

Diabetes

Fibromyalgia

Men/Women Infertility

Menstrual Cramp.

Tom Neil mengatakan...

Hi, there. I am Tom Neil and I wish to describe how life had been for my younger brother living with schizophrenia and how he had been permanently able to overcome this debilitating disease via a naturopathic, herbal method.

Maicon - my kid brother was twenty years old when he was brought to the emergency room by the campus police of the college from which he had been suspended several months ago. A professor had called and reported that he had walked into his classroom, accused him of taking his tuition money, and refused to leave.

Although he had much academic success as a teenager, his behavior had become increasingly odd during the past year. He quit seeing his friends and no longer seemed to care about his appearance or social pursuits. He began wearing the same clothes each day and seldom bathed. He lived with several family members but rarely spoke to any of them. When he did talk to them, he said he had found clues that his college was just a front for an organized crime operation. He had been suspended from college because of missing many classes. My sister said that she had often seen him mumbling quietly to himself and at times he seemed to be talking to people who were not there. He would emerge from my room and ask my family to be quiet even when they were not making any noise.

My father and sister told the staff that Maicon's great-grandmother had had a serious illness and had lived for 30 years in a state hospital, which they believed was a mental hospital. Our mother left the family when Maicon was very young. She has been out of touch with us, and they thought she might have been treated for mental health problems.

Maicon agreed to sign himself into the psychiatric unit for treatment. The whole family except I had agreed to have Maicon transferred to a mental asylum. I knew inwardly there was still some plausible means by which my kid brother could overcome this condition. I knew botanical means of treatment will be more favorable than any other type of treatment, and as such, I had taken a keen interest in the research of naturopathic alternative measures suitable for the treatment of schizophrenia. I had pleaded for some little patience from the family in the delay of the transfer, I was looking forward to proving a point to the entire family, of a positive botanical remedy for this situation.

It was during my ceaseless exploration on the internet I had been fortunate enough to come across Dr. Utu Herbal Cure: an African herbalist and witch doctor whose professional works had majored on the eradication of certain viral conditions, especially schizophrenia, ( improving the memory capacity positively), via a traditional, naturopathic process and distinguished diet plan. It was by the administration of this herbal specialist that my brother had been able to improve his condition for better.

Before the naturopathic remedy - Maicon's story had reflected a common case, in which a high-functioning young adult goes through a major decline in day-to-day skills. Although family and friends may feel this is a loss of the person they knew, the illness can be treated and a good outcome is possible.

My brother Maicon is just like many other patients out there suffering from this disease. Although he was able to overcome this condition via a naturopathic herbal remedy administered by this African herbal physician and saved completely thus, rekindling the lost joy which had been experienced by the family members.

I wish to use this opportunity to reach across to anyone who may happen to be diagnosed with this disastrous condition to spread the hope of an everlasting herbal remedy that is capable of imposing a permanent end to this disease.

For more information concerning this naturopathic herbal remedy, feel free to contact this African herbal practitioner via email:
drutuherbalcure@gmail.com

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