Interviews were conducted with 13 male ostomates under the age of 70 years to investigate the sexuality and marital relationships of male ostomates. The aim was to consider ways to support male ostomates who have sexual dysfunction and their spouses. From the interviews, 8 categories expressing the sexuality of male ostomates were extracted：unstable self-perception, acceptance of one's current situation,bonds of matrimony,things that provide support,difficulty of talking about the sexual act,fluctuations in husband-wife intimacy,thoughts toward the sexual act,and sense of values with regard to the sexual act.The marital relationship tended to be unchanged by changes in sexual function;rather,the bonds were maintained by support from the wife.In the future,family education that can promote language and behavior by the wife to support the ostomate is needed.In addition,sensitive awareness of sexual concerns and method of expression counseling, as well as coordination as an intermediary between the ostomate and his wife will be necessary.

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Purpose： We investigated care after postoperative creation of a temporary stoma in rectal cancer patients who have total blindness as a visual impairment．A nursing care plan was made for the purpose of providing guidance on self-management under the conditions of total lack of vision．
（1） Creation of a vinyl stoma model and conduct of image training with the fingertips from the preoperative stage．
（2） Teaching and guidance on the position and shape of the stoma and the shape and method of the use of equipment；
（3） Collaboration between ET nurses and this department’s nurses for in-home nursing care．
Results： We were able to provide guidance and education on all information on now to handle the stoma and pouch with the fingertips，to nurses for in-home nursing care．

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We report here a 79-year-old man with a sinking stoma which made ostomy care difficult who was successfully treated by plastic surgery.
Abdominoperineal resection of the rectum for rectal cancer and relaparotomy and reconstruction of the stoma for postoperative bowel necrosis were performed 12 years ago.Thereafter, he had a depressed stoma in the left lower abdomen, and had performed ostomy care by the irrigation method. He had a traffic accident 3 years ago. After the accident, he could not walk, nor do his own ostomy care.
Therefore, he gave up the irrigation, and gained weight 8 kg over 2 years.
Gradually, his stoma was sinking with skin ptosis, and his ostomy care was becoming difficult. The problem of the ostomy care was discussed in a stomal clinic with a plastic surgeon. Then, excision and traction of the left upper abdominal skin was performed by plastic surgeons under local anesthesia. After the operation his ostomy care and quality of life were improved.
Collaboration with plastic surgery may be one of the useful options in ostomy rehabilitation, especially in a patient with difficulty of ostomy control.

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The aim of the present study was to evaluate the efficacy of sacral surface therapeutic electrical stimulation (SS-TES) for residents with OAB in a geriatric health services facility.
This study included 13 female residents with OAB.As result of the evaluation prior to treatment, 13 female residents were diagnosed with OAB dry in 3, OAB wet in 10. Electrical stimulation was performed twice daily for one month in their bed with a portable electrical stimulator. The surface electrodes were placed bilaterally at the level of the sacral root from S2 to S4.Evaluation of lower urinary tract dysfunction was performed before and after treatment using 24-hour monitoring wireless wetness sensing system.
As result of the evaluation after treatment, 13 female residents were diagnosed with OAB dry in 2, OAB wet in 7, nocturia in 1,and stress urinary incontinence in 3. Of 13 female residents, 4 varied from the OAB diagnostic criteria.
In conclusion,our results suggest that SS-TES is effective for urinary incontinence and urinary urgency among elderly female residents in geriatric health services facilities.

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In the present study,we developed a care system incorporating a tool that enabled the prediction of the type of urinary incontinence as well as the assessment of dysuria based on data from voiding diaries, which from the basis of voiding assessment, with the objective of improving the expertise of care for dysuria. Verification of this system showed that it enabled individualized care through a detailed understanding of voiding condition and led to elinination of the need for diapers, reduction of care and guidance, enhancement of motivation in life,and expansion of ADL. ln addition,the system enabled comprehensive nursing care that considered the desires of patients and their families. Moreover, the information obtained through observation contributed to treatment and the assessment ability of nurses improved through cooperation with doctors, thus indicating the effectiveness of the care system.

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A method for emergency supplies of ostomy appliances in case of disasters and the coordination with the relief activities
We are hereby proud to present the result of our successful involvement in emergency supplies of ostomy appliances in Niigata Pref., Japan, which was hit by two major earthquakes in 2004 (Chuetsu Earthquake) and 2007 (Chuetsu Offshore Earthquake).
In some of the areas most severely damaged by the quakes, the disrupted transportation systems inhibited the shipping of ostomy appliances by transportation companies. Thus the volunteers including the author of this document participated in relief supply activity to examine the damage to the traffic systems and to deliver the relief supplies to ostomates (to 36 ostomates in 2004, 13 ostomates in 2007) We evaluated this activity as it contributed to assisting the ostomates mentally as well if not only physically. and reviewed the importance of such activities for a contingency as a "safety net".
The result of our evaluation suggests that the activity should be effective as a method of relief supply in such disasters at a regional scale.

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In general, rehabilitation to improve continence focuses on behavioral training associated with activities in daily life rather than that specifically directed at good continence.In this study 10 patients with rectal constipation undergoing training for improving defecation at the Coloproctology Center, Takano Hospital were examined and assessed the relation of defecation and posture on a portable toilet observed with defecometry during straining.
Patients with bad defecatory posture showed low rectal pressure and high anal pressure resulting in defecatory difficulties.By a physiotherapist's guidance for proper defecatory posture, their rectal pressure increased and anal pressure was reduced which suggests that improvement of pelvic function and abdominal pressure due to the changes in defecatory posture can lead to smoother defecation.

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Fecal incontinence is distressing symptom. Since many doctors have more been interested in anorectal functional disorders, fecal incontinence has now been recognized as a'disease'. The causes of fecal incontinence were mainly sphincter damage due to episiotomy, anal surgery and traffic accident. Clinical, physiological and anatomical assessments using defecography have been carried out for fecal incontinence. Surgical intervention is indicated when conservative managements are found to be ineffective. According to the preoperative assessments sphincter repair, postanal repair, graciloplasty and construction of stoma have been performed.

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Urinary incontinence in adult person is a great bother for their quality of life, especially for their social activity．It also distresses them hygienically and psychologically．Incontinence enforces nursing staffs or family members of patients in need of nursing care, to devote their mental and physical effort for taking care of the urinary problem．Therefore good care and treatment of urinary incontinence should be a great benefit for patients and family members as well． This paper reports basic understanding about lower urinary tract function and urological strategies for treating urinary incontinence.

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Lower urinary tract dysfunction involves difficulties in urination and retention in the bladder. Attention has only recently been paid to urinary incontinence and frequent urination-symptoms of urinary retention dysfunction. Although it is assumed that there are potentially a large number of patients with these symptoms, only a small percentage of them consult a physician. While there has been an increasing need for medical institutions and workers to address the issue of urinary retention dysfunction, few or no appropriate measures have been suggested. The present paper, in consideration of the psychological and social distress of patients as well as their expectations for the future, discusses continence care and related knowledge acquired through outpatients and health activities in the community. It is important to take into account the following to provide quality care services:1)The impact of urinary incontinence and frequent urination on daily activities:2)Pathological conditions and assessment of urinary incontinence:3)Treatment and care methods according to the type of urinary incontinence: and 4)Treatment and care according to the underlying cause. The paper describes the key points regarding specific care strategies including bladder diary, bladder training,and pelvic floor muscles exercise.

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