The neurogenic bladder: medical treatment

Neurogenic bladder sphincter dysfunction (NBSD) can cause severe and irreversible renal damage and bladder-wall destruction years before incontinence becomes an issue. Therefore, the first step in adequate management is to recognize early the bladder at risk for upper- and lower-tract deterioration and to start adequate medical treatment proactively. Clean intermittent catheterization combined with anticholinergics (oral or intravesical) is the standard therapy for NBSD. Early institution of such treatment can prevent both renal damage and secondary bladder-wall changes, thereby potentially improving long-term outcomes. In children with severe side effects or with insufficient suppression of detrusor overactivity despite maximal dosage of oral oxybutynin, intravesical instillation is an effective alternative. Intravesical instillation eliminates systemic side effects by reducing the first-pass metabolism and, compared with oral oxybutynin, intravesical oxybutynin is a more potent and long-acting detrusor suppressor. There is growing evidence that with early adequate treatment, kidneys are saved and normal bladder growth can be achieved in children so they will no longer need surgical bladder augmentation to achieve safe urinary continence in adolescence and adulthood

Mineral equilibria and geothermometry of the Dalaman-Köycegiz thermal springs, southern Turkey

The Dalaman and Köycegiz thermal springs are from karstic limestones belonging to Upper Cretaceous to Burdigalian BeydaglarI autochthon and Carboniferous to Lutetian Lycian nappes. They have measured temperatures of 24- 41°C, specific electrical conductivities of 14,310-45,600 µS/cm, and are dominated by Na (1550-8500 mg/kg) and Cl (2725-15,320 mg/kg). The heat source of the geothermal systems of the area is tectonic related and the occurrence of the thermal springs is related to the young normal faults. Meteoric waters and seawaters recharge the reservoir rocks, are heated at depth with increasing geothermal gradient, and move up to the surface through the fractures and faults by convection trend and emerge as thermal springs. While thermal waters move up to the surface, they mix with different proportions of seawater and cold fresh waters. The seawater contribution to the thermal waters varies from 24% to 78%. Lake waters in the area are connected with thermal waters. Consequently, their chemical composition is influenced by the chemistry of thermal waters. Chemical equilibrium modelling based on measured outlet temperatures and measured pH shows that all the waters are oversaturated with respect to quartz and K-mica and undersaturated with respect to Al(OH)3, anorthite, gypsum, siderite and SiO2(a). Albite, alunite, aragonite, Ca-montmorillonite, calcite, chalcedony, chlorite, dolomite, Fe(OH)3(a), fluorite, gypsum, illite, K-feldspar, kaolinite and sepiolite minerals are mostly oversaturated or undersaturated. Mineral saturation studies of the thermal springs indicate that dolomite, chalcedony and quartz are most likely to cause scaling at outlet conditions. Assessments from various chemical geothermometers, and Na-K-Mg ternary and mineral equilibrium diagrams suggest that the reservoir temperature is around 65-90°C. The temperatures obtained from quartz, quartz-steam loss, Mg/Li geothermometers and mineral equilibrium diagrams give the most reasonable results. © 2005 Elsevier Ltd. All rights reserved

springs, southern Turkey

The Dalaman and Koycegiz thermal springs are from karstic limestones belonging to Upper Cretaceous to Burdigalian Beydaglan autochthon and Carboniferous to Lutetian Lycian nappes. They have measured temperatures of 24- 41 degrees C, specific electrical conductivities of 14,310-45,600 mu S/cm, and are dominated by Na (1550-8500 mg/kg) and Cl (2725-15,320 mg/kg). The heat source of the geothermal systems of the area is tectonic related and the occurrence of the thermal springs is related to the young normal faults. Meteoric waters and seawaters recharge the reservoir rocks, are heated at depth with increasing geothermal gradient, and move up to the surface through the fractures and faults by convection trend and emerge as thermal springs. While thermal waters move up to the surface, they mix with different proportions of seawater and cold fresh waters. The seawater contribution to the thermal waters varies from 24% to 78%. Lake waters in the area are connected with thermal waters. Consequently, their chemical composition is influenced by the chemistry of thermal waters. Chemical equilibrium modelling based on measured outlet temperatures and measured pH shows that all the waters are oversaturated with respect to quartz and K-mica and undersaturated with respect to AI(OH)(3), anorthite, gypsum, siderite and SiO2(a). Albite, alunite, aragonite, Ca-montmorillonite, calcite, chalcedony, chlorite, dolomite, Fe(OH)(3)(a), fluorite, gypsum, illite, K-feldspar, kaolinite and sepiolite minerals are mostly oversaturated or undersaturated. Mineral saturation studies of the thermal springs indicate that dolomite, chalcedony and quartz are most likely to cause scaling at outlet conditions. Assessments from various chemical geothermometers, and Na-K-Mg ternary and mineral equilibrium diagrams suggest that the reservoir temperature is around 65-90 degrees C. The temperatures obtained from quartz, quartz-steam loss, Mg/Li geothermometers and mineral equilibrium diagrams give the most reasonable results. (c) 2005 Elsevier Ltd. All rights reserved

Evaluation of the Contamination from Geothermal Fluids upon Waters and Soils in Alaşehir Environs, Turkey

1st Springer Conference of the Arabian Journal of Geosciences, CAJG-1 2018 -- 12 November 2018 through 15 November 2018 -- 277309The thermal and mineral waters, with high mineral contents from the geothermal fields of Alaşehir, Turkey, and which are discharged onto the ground surface, can cause contamination in surface water, in ground water, and in soil. Because of the fact that the water resources of the region are used for drinking and irrigational purposes, the evaluation of water quality is perfected in this study. Additionally, the surface soil samples are analyzed for their boron, arsenic and other contaminating substances to depict the measurement of the contamination. The results acquired from the analysis of the water samples suggest that some of the components (particularly B, and As) in some of the samples exceed the drinking-water limits. Also, some of the soil samples collected near the geothermal fields are contaminated with B, As, S, Hg, and other contaminants sourced from geothermal fluids, in a moderate to extreme degree. Further, contaminants in soil and water are expected to enlarge in the future unless effective sewage collection and treatment are present in the geothermal fields. This paper discusses the geochemical evaluations of the availability of B, As, and other contaminants derived from the geothermal activities within soil and water in Alaşehir and its environs. Proper re-injection of the thermal and mineral waters into the geothermal reservoirs is the best way to dispose of the geothermal fluids and cope with contamination problems. © Springer Nature Switzerland AG 2019

the Alasehir-Kavaklidere area (Manisa-Turkey)

Alasehir graben is located in the southern edge of the Gediz graben, which is an important graben for geothermal activity. Thermal waters are hosted by Menderes massif metamorphic rocks, which are made of gneisses, schists and marbles. Impermeable clayey units of the neogene sediments are cap rocks of the geothermal system. Presence of geothermal waters is closely related to normal fault systems and graben tectonic. Meteoric waters recharging the reservoir rocks are heated at depth with geothermal gradient. The AK-2 and KG-1 wells have the third and fourth highest temperatures of Turkey, respectively. Reservoir temperatures of the geothermal system are estimated to vary between 125 and 225 degrees C by mineral equilibria geothermometer, vary between 160 and 240 degrees C by Giggenbach triangular diagram and vary between 150 and 250 degrees C by silica enthalpy-mixture model. Cold water contributions to thermal waters vary from 75 to 95%. Na-HCO(3) water type is dominant for thermal water. Major reaction of the thermal water to change facies is softening reaction. The temperatures obtained from silica enthalpy model, mineral equalibria geothermometers, Na/K, Na/Li geothermometers are more useful than others in the study area. Scaling tendencies of the thermal water are examined. The major environmental problem in the groundwater is high boron concentration which is harmful for agricultural irrigation

Review of water and soil contamination in and around Salihli geothermal field (Manisa, Turkey)

The town of Salihli is situated in Gediz Graben in the western Anatolia. This region is important in terms of industry, mining, geothermal energy, water sources, and agricultural production. Geothermal flow and anthropogenic activities in Salihli threaten the surrounding environment due to the contamination of cold groundwater, surface water, and soil. The goal of the present study is to determine the environmental effects of the geothermal and anthropogenic activities in Salihli on soil, stream sediments, and water. Stream sediments and farm soil have been contaminated by substances derived from geothermal and industrial effluents. To this end, the quality review of the water was completed and the heavy metal levels in stream sediment samples were measured to determine the extent of contamination. The elements As, B, Br, Fe, and Ni are the major contaminants present in surface water and groundwater in the study area. The concentrations of these elements excess tolerance limits of international water standards. Gibbsite, K-mica, kaolinite, sepiolite, halite, sulfur, willemite, and Pb(OH)2 might be precipitated as scales at low temperatures on the soil; this could be interpreted as a resultant from soil contamination. The concentrations of 17 elements (As, Ba, B, Cd, Co, Cr, Cu, Fe, Hg, Li, Mo, Mn, Ni, Pb, Sb, Sr, and Zn) were measured in samples from stream sediments and surface soils. In the study area, especially geothermal and anthropogenic activities give rise to environmental pollution. © 2017, Saudi Society for Geosciences

Reservoir and hydrogeochemical characterizations of geothermal fields in Salihli, Turkey

Geothermal and hydrochemical characteristics of thermal waters in the Salihli geothermal area are described in this study. This geothermal area is geographically divided into five main groups; Kurşunlu, Caferbey, Greenhouse, üfürük and Sart geothermal fields. In the study area, the outlet temperatures of the thermal waters are between 30 and 90°C, their discharges are between 2 and 80l/s in springs and the depths of wells vary between 200 and 1189m. Hydrochemical analysis results suggest four different water types of Na-HCO 3, Ca-Mg-HCO 3, Ca-Na-HCO 3 and Ca-Mg-SO 4 in Kurşunlu, Caferbey-Greenhouse, Sart, and üfürük, respectively. Cold waters are mainly dominated by the HCO 3 and SO 4 anions and Na, Ca, and Mg cations.Results of environmental isotope and chemical analysis show that the thermal waters are of meteoric origin and the major hydrogeochemical processes show that the thermal waters may be mixing of their end members and/or water-rock interaction at high temperature conditions. The mixed thermal waters are replenished by rainwater and/or groundwater at various depths. EC-tritium and EC-chloride plots indicated shallow and deep circulating groundwater types in the study area. Assessment of the various empirical chemical geothermometers and geochemical modelling suggests that the aquifer temperature in the study area is about 160. °C.The thermal waters are mostly supersaturated with respect to carbonate minerals (calcite, aragonite, and dolomite) at all temperatures. These are likely to cause scaling problems during production and utilization of thermal water. © 2012 Elsevier Ltd

field (Manisa, Turkey)

The town of Salihli is situated in Gediz Graben in the western Anatolia. This region is important in terms of industry, mining, geothermal energy, water sources, and agricultural production. Geothermal flow and anthropogenic activities in Salihli threaten the surrounding environment due to the contamination of cold groundwater, surface water, and soil. The goal of the present study is to determine the environmental effects of the geothermal and anthropogenic activities in Salihli on soil, stream sediments, and water. Stream sediments and farm soil have been contaminated by substances derived from geothermal and industrial effluents. To this end, the quality review of the water was completed and the heavy metal levels in stream sediment samples were measured to determine the extent of contamination. The elements As, B, Br, Fe, and Ni are the major contaminants present in surface water and groundwater in the study area. The concentrations of these elements excess tolerance limits of international water standards. Gibbsite, K-mica, kaolinite, sepiolite, halite, sulfur, willemite, and Pb(OH)(2) might be precipitated as scales at low temperatures on the soil; this could be interpreted as a resultant from soil contamination. The concentrations of 17 elements (As, Ba, B, Cd, Co, Cr, Cu, Fe, Hg, Li, Mo, Mn, Ni, Pb, Sb, Sr, and Zn) were measured in samples from stream sediments and surface soils. In the study area, especially geothermal and anthropogenic activities give rise to environmental pollution