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Sample records for faecal incontinence alters

  1. Altered defaecatory behaviour and faecal incontinence in a video-tracked animal model of pudendal neuropathy.

    Science.gov (United States)

    Devane, L A; Lucking, E; Evers, J; Buffini, M; Scott, S M; Knowles, C H; O'Connell, P R; Jones, J F X

    2017-05-01

    The aim was to develop a behavioural animal model of faecal continence and assess the effect of retro-uterine balloon inflation (RBI) injury. RBI in the rat causes pudendal neuropathy, a risk factor for obstetric related faecal incontinence in humans. Video-tracking of healthy rats (n = 12) in a cage containing a latrine box was used to monitor their defaecatory behaviour index (DBI) over 2 weeks. The DBI (range 0-1) was devised by dividing the defaecation rate (pellets per hour) outside the latrine by that of the whole cage. A score of 0 indicates all pellets were deposited in the latrine. Subsequently, the effects of RBI (n = 19), sham surgery (n = 4) and colostomy (n = 2) were determined by monitoring the DBI for 2 weeks preoperatively and 3 weeks postoperatively. The DBI for healthy rats was 0.1 ± 0.03 with no significant change over 2 weeks (P = 0.71). In the RBI group, 13 of 19 rats (68%) showed no significant change in DBI postoperatively (0.08 ±  -0.05 vs 0.11 ±  -0.07) while in six rats the DBI increased from 0.16 ±  -0.09 to 0.46 ± 0.23. The negative control, sham surgery, did not significantly affect the DBI (0.09 ± 0.06 vs 0.08 ± 0.04, P = 0.14). The positive control, colostomy, increased the DBI from 0.26 ± 0.03 to 0.86 ± 0.08. This is the first study showing a quantifiable change in defaecatory behaviour following injury in an animal model. This model of pudendal neuropathy affects continence in 32% of rats and provides a basis for research on interventions for incontinence. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  2. Faecal incontinence following radiotherapy for prostate cancer: A systematic review

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Høyer, Morten; Lundby, Lilli;

    2011-01-01

    for this review. The incidence of faecal incontinence following radiotherapy for prostate cancer varied from 1.6% to 58%. The mechanism of faecal incontinence was not entirely clear but it is most likely due to injury to the nerve plexus of the rectal muscular layer. Correlation between rectal dose...... the spatial distribution of radiation to the rectum may identify a more direct linkage between radiation damage and faecal incontinence....

  3. Managing faecal retention and incontinence in neurodisability.

    Science.gov (United States)

    Pierce, E; Cowan, P; Stokes, M

    The large number of patients with faecal retention and/or incontinence in continuing care wards and rehabilitation units presents a considerable challenge. In order to maintain dignity and minimize the unpleasant odour so commonly associated with these wards and units, effective bowel management should be planned for individual patients. For an effective bowel management regime a team approach should be adopted, involving, where possible, the patient and carer as well as all the health professionals administering the care. Two case studies illustrate the use of assessment and management of bowel problems in patients with severe complex neurodisability. Bowel dysfunction in this patient population, in general, is poorly covered in the literature. The present article, by relating theory to practice, offers information and guidance for nurses working with patients who have bowel-related problems.

  4. [The artificial sphincter: therapy for faecal incontinence].

    Science.gov (United States)

    Baumgartner, U

    2012-08-01

    Faecal incontinence (FI) challenges a patient's professional, social and sexual life. Often the patient becomes depressive and socially isolated. If able to break open for therapy the patient should receive as first line a conservative treatment (like dietary measures, pelvic re-education, biofeedback, bulking agents, irrigation). When is the time to implant an artificial anal sphincter? If conservative therapy fails as well as surgical options (like a sphincteroplasty - if indicated a reconstruction of the pelvic floor if insufficient, or a sacral nerve stimulation) an ultimo surgical procedure should be offered to appropriate and compliant patients: an artificial anal sphincter. Worldwide, there are two established devices on the market: the artificial bowel sphincter® (ABS) from A. M. S. (Minnetonka, MN, USA) and the soft anal band® from A. M. I. (Feldkirch, Austria). How to implant the artificial anal sphincter? Both devices consist of a silicon cuff which can be filled with fluid. Under absolute aseptic conditions this cuff is placed in the lithotomy position by perianal incisions around the anal canal below the pelvic floor. A silicon tube connects the anal cuff with a reservoir (containing fluid) which is placed either behind the pubis bone in front of the bladder (ABS) or below the costal arch (anal band). With a pump placed in the scrotum/labia (ABS) or by pressing the balloon (anal band) in both types operated by the patient the fluid is shifted forth and back between the anal cuff and the reservoir closing or opening the anal canal. Both systems are placed completely subcutaneously. Both devices improve significantly the anal continence. Both systems have a high rate of reoperations. However, the causes for the redos are different. The ABS is associated with high infection and anal penetration rates of the cuff leading to an explantation rate to up to 60 % of the implants. This kind of complication seems to be much lower with the anal band. The major

  5. Perianal injectable bulking agents as treatment for faecal incontinence in adults. (Update)

    DEFF Research Database (Denmark)

    Maeda, Yasuko; Laurberg, Søren; Norton, Christine

    2013-01-01

    BACKGROUND: Faecal incontinence is a complex and distressing condition with significant medical and social implications. Injection of perianal bulking agents has been used to treat the symptoms of passive faecal incontinence. However, various agents have been used without a standardised technique...

  6. Validation of a new scoring system: Rapid assessment faecal incontinence score

    Institute of Scientific and Technical Information of China (English)

    Fernando; de; la; Portilla; Arantxa; Calero-Lillo; Rosa; M; Jiménez-Rodríguez; Maria; L; Reyes; Manuela; Segovia-González; María; Victoria; Maestre; Ana; M; García-Cabrera

    2015-01-01

    AIM: To implement a quick and simple test- rapid assessment faecal incontinence score(RAFIS) and show its reliability and validity.METHODS: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale(FIQL) questionnaire. The patient withoutinfluence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach’s alpha(internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% power.RESULTS: We analysed the results obtained by 53 consecutive patients with faecal incontinence(median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers(median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson’s correlation coefficient between "state" and "leaks" was excellent(r = 0.92, P < 0.005). Internal consistency in the comparison of "state" and "leaks" yielded also excellent correlation(Cronbach’s α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of "r " for the different subscales of the questionnaire were: "lifestyle" r

  7. Being involved in an everlasting fight - a life with postnatal faecal incontinence. A qualitative study

    DEFF Research Database (Denmark)

    Lind, Johanne; Ringsberg, Karin C.

    2010-01-01

    The prevalence of women suffering from faecal incontinence as a complication to childbirth has been estimated to 0.6–6%. The aim of this study was to elucidate the life situation and the psychosocial processes of women suffering from this injury and to find out how they cope with being in that si......The prevalence of women suffering from faecal incontinence as a complication to childbirth has been estimated to 0.6–6%. The aim of this study was to elucidate the life situation and the psychosocial processes of women suffering from this injury and to find out how they cope with being...... in that situation. Nine women were strategically and consecutively selected from a surgery outpatient department at a hospital, to be the participants of this study. Data collection and analysis were made according to the grounded theory approach. In the analysis a core category Being involved in an everlasting...

  8. Flatus and faecal incontinence: prevalence and risk factors at 16 weeks of gestation.

    Science.gov (United States)

    Højberg, K E; Salvig, J D; Winsløw, N A; Bek, K M; Laurberg, S; Secher, N J

    2000-09-01

    To evaluate the prevalence of anal incontinence at 16 weeks of gestation and to identify possible maternal and obstetrical risk factors. Cross sectional study and cohort study. Department of Obstetrics and Gynaecology, Aarhus University Hospital, Denmark. Cross sectional study: 7,557 women attending antenatal care. Cohort study: a subgroup of 1,726 pregnant women with one previous delivery at our department. The prevalence of anal incontinence within the preceding year was 8.6%. Incontinence of liquid and solid stools was reported in 2.3% and 0.6%, respectively. Isolated flatus incontinence at least once a week was reported in 4.2%. The risk of flatus incontinence at least once a week was increased with age > 35 years (OR 1.6; 95% CI 1.1-2.4) and with previous lower abdominal or urological surgery (OR 1.5, 95% CI 1-1-2.1) in a logistic regression model controlling for maternal factors. Increasing parity did not increase the risk. The risk of flatus incontinence was increased after anal sphincter tear and birthweight > 4,000 g in a logistic regression model controlling for maternal and obstetric variables. Episiotomy was insignificantly associated, while spontaneous perineal tear > 3 cm and a number of other intrapartum factors were not associated. CONCLUSION True faecal incontinence is rare among younger women. However, an age > 35 years and previous lower abdominal or urological surgery increased the risk of flatus incontinence in contrast to increasing parity. This suggests that childbirth plays a minor role compared with age. However, when analysing obstetric variables separately, a birthweight > 4,000 g, and anal sphincter tears were significant risk factors for flatus incontinence.

  9. Pelvic floor muscle lesions at endoanal MR imaging in female patients with faecal incontinence

    Energy Technology Data Exchange (ETDEWEB)

    Terra, Maaike P.; Vervoorn, Inge; Dobben, Annette C.; Stoker, Jaap [Academic Medical Center, University of Amsterdam, Department of Radiology, Amsterdam (Netherlands); Beets-Tan, Regina G.H. [University Hospital Maastricht, Department of Radiology, Maastricht (Netherlands); Deutekom, Marije; Bossuyt, Patrick M.M. [Academic Medical Center, University of Amsterdam, Department of Clinical Epidemiology and Biostatistics, Amsterdam (Netherlands); Wasser, Martin N.J.M. [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Witkamp, Theo D. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Baeten, Cor G.M.I. [University Hospital Maastricht, Department of Surgery, Maastricht (Netherlands)

    2008-09-15

    To evaluate the frequency and spectrum of lesions of different pelvic floor muscles at endoanal MRI in women with severe faecal incontinence and to study their relation with incontinence severity and manometric findings. In 105 women MRI examinations were evaluated for internal anal sphincter (IAS), external anal sphincter (EAS), puborectal muscle (PM) and levator ani (LA) lesions. The relative contribution of lesions to differences in incontinence severity and manometric findings was studied. IAS (n=59) and EAS (n=61) defects were more common than PM (n=23) and LA (n=26) defects. PM and LA defects presented mainly with IAS and/or EAS defects (isolated n=2 and n=3). EAS atrophy (n=73) was more common than IAS (n=19), PM (n=16) and LA (n=9) atrophy and presented mainly isolated. PM and LA atrophy presented primarily with EAS atrophy (isolated n=3 and n=1). Patients with IAS and EAS lesions had a lower resting and squeeze pressure, respectively; no other associations were found. PM and LA lesions are relatively common in patients with severe faecal incontinence, but the majority of lesions are found in women who also have IAS and/or EAS lesions. Only an association between anal sphincter lesions and manometry was observed. (orig.)

  10. The design and initial patient evaluation of an integrated care pathway for faecal incontinence: a qualitative study.

    Science.gov (United States)

    Rimmer, Craig John; Gill, Kathryn Ann; Greenfield, Sheila; Dowswell, George

    2015-10-01

    Faecal incontinence is a common, distressing and debilitating condition which remains largely hidden, leading to social isolation and loss of confidence. Patients with faecal incontinence experience delays in accessing appropriate treatment services due to embarrassment and lack of enquiry from primary care health professionals. Despite the publication of three government documents related to continence services in the last decade, these services are still fragmented with asynchronous delivery and poor inter-professional integration. The aim of the study was to describe a novel integrated care pathway for the management of faecal incontinence and examine the experiences of patients with faecal incontinence in relation to this pathway. A focus group (eight participants) and narrative, qualitative individual interviews (five participants) were used to explore the views of patients with faecal incontinence, relating to access and quality of incontinence services and the new integrated care pathway. Emerging themes were identified from the transcribed focus group and interviews via the thematic analysis method. The concept of an integrated care pathway is attractive for increasing accessibility, streamlining of the patient pathway and providing a dedicated service for the management of faecal incontinence. Patients' initial experiences of the pathway are positive. A new ICP was developed and the initial patient evaluation of it was positive. Service users made various suggestions how the FI pathway could have been improved. The issues that patients were most concerned about were access to continence services, GP awareness of continence services and prompt, effective management of their condition. This service was set up within the pelvic floor dysfunction unit with BFNS and an integrated community continence team. The authors are aware that this is not a standard service setup across the country. The fact that it may be uncomfortable for patients to talk about their

  11. Effect of injury on S1 dorsal root ganglia in an experimental model of neuropathic faecal incontinence.

    LENUS (Irish Health Repository)

    Peirce, C

    2011-08-01

    An experimental model of neuropathic faecal incontinence has recently been established. This study aimed to quantify and compare the effect of crush and compression injury on first-order sensory neurones of the inferior rectal nerve (IRN) using a nuclear marker of axonal injury, activating transcription factor (ATF) 3.

  12. Role of internal anal sphincter damage in the causation of idiopathic faecal incontinence: a prospective study.

    Science.gov (United States)

    Petros, Peter; Anderson, Jim

    2005-02-01

    This prospective study aimed to examine the relationship between internal anal sphincter (IAS) damage and 'idiopathic' faecal incontinence (FI) in 50 consecutive patients, using endoanal ultrasound examination. The external anal sphincter (EAS) was intact on direct and ultrasonic assessment in all patients. IAS damage was defined as complete rupture or attenuation, less than 2 mm thickness in some part of the sphincter. Complete rupture was found in one patient and damage in a further 17 (total 36%). All three nulliparous patients had normal IAS and EAS. IAS damage was only minimally associated with 'idiopathic' FI, suggesting IAS per se is unlikely to be a direct cause of FI in the 'idiopathic' group of FI patients. Its role might be analogous to the periurethral striated horse-shoe shape muscle in the urethra, which is thought to act as a mucosal sealant.

  13. Role of clinical pathway in improving the quality of care for patients with faecal incontinence: A randomised trial

    Science.gov (United States)

    Hussain, Zeiad I; Lim, Michael; Stojkovic, Stevan

    2017-01-01

    AIM To assess the development and implementation of the Integrated Rapid Assessment and Treatment (IRAT) pathway for the management of patients with fecal incontinence and measure its impact on patients’ care. METHODS Patients referred to the colorectal unit in our hospital for the management of faecal incontinence were randomised to either the Standard Care pathway or the newly developed IRAT pathway in this feasibility study. The IRAT pathway is designed to provide a seamless multidisciplinary care to patients with faecal incontinence in a timely fashion. On the other hand, patients in the Standard Pathway were managed in the general colorectal clinic. Percentage improvements in St. Marks Incontinence Score, Cleveland Clinic Incontinence Score and Rockwood Faecal Incontinence Quality of Life Scale after completion of treatment in both groups were the primary outcome measures. Secondary endpoints were the time required to complete the management and patients’ satisfaction score. χ2, Mann-Whitney-U and Kendall tau-c correlation coefficient tests were used for comparison of outcomes of the two study groups. A P value of 0.05 or less was considered significant. RESULTS Thirty-nine patients, 34 females, consented to participate. Thirty-one (79.5%) patients completed the final assessment and were included in the outcome analysis. There was no significant difference in the quality of life scales and incontinence scores. Patients in the IRAT pathway were more satisfied with the time required to complete management (P = 0.033) and had stronger agreement that all aspects of their problem were covered (P = 0.006). CONCLUSION Despite of the lack of significant difference in outcome measures, the new pathway has positively influenced patient’s mindset, which was reflected in a higher satisfaction score. PMID:28217378

  14. What’s new in the toolbox for constipation and faecal incontinence?

    Directory of Open Access Journals (Sweden)

    Yeong Yeh eLee

    2014-03-01

    Full Text Available Constipation and faecal incontinence are common complaints predominantly affecting the elderly and women. They are associated with significant morbidity and high healthcare costs. The causes are often multifactorial and overlapping. With the advent of new technologies, we have a better understanding of their underlying pathophysiology which may involve disruption at any levels along the gut-brain-microbiota axis. Initial approach to management should always be the exclusion of secondary causes. Mild symptoms can be approached with conservative measures that may include dietary modifications, exercise and medications. New prokinetics (e.g. prucalopride and secretagogues (e.g. lubiprostone and linaclotide are effective and safe in constipation. Biofeedback is the treatment of choice for dyssynergic defecation. Refractory constipation may respond to neuromodulation therapy with colectomy as the last resort especially for slow-transit constipation of neuropathic origin. Likewise, in refractory FI, less invasive approach can be tried first before progressing to more invasive surgical approach. Injectable bulking agents, sacral nerve stimulation and SECCA procedure have modest efficacy but safe and less invasive. Surgery has equivocal efficacy but there are promising new techniques including dynamic graciloplasty, artificial bowel sphincter and magnetic anal sphincter. Despite being challenging, there are no short of alternatives in our toolbox for the management of constipation and FI.

  15. High-resolution circuit for the diagnosis of faecal incontinence. Patient satisfaction.

    Science.gov (United States)

    Muñoz-Duyos, Arantxa; Lagares-Tena, Laura; Vargas-Pierolas, Harold; Rodón, Anna; Navarro-Luna, Albert

    2017-05-01

    Despite its high prevalence, faecal incontinence (FI) is still underrated and underdiagnosed. Moreover, diagnosis and subsequent treatment can be a challenge for the colorectal surgeon because of its associated social taboo and embarrassment, and the wide range of symptoms. The aim of the present study is to describe a new high-resolution circuit (HRC) for FI diagnosis, that was implemented at our center and to evaluate patient satisfaction. The structure and organization of the HRC are described. Demographic and clinical data of the patients included in the HRC between February 2014 and June 2016 were collected. Moreover, patients' satisfaction was measured through a structured survey. A total of 321 patients were evaluated in our pelvic floor outpatients clinic during the study period: 65% (210) of them had FI (81% women, median age 66 years). The mean time since FI onset was 24 (range 4-540) months. A total of 79% (165) of the patients were included in the HRC. 62% of them responded to the survey. Of these, only 32% (33) had consulted for FI before coming to our centre. The majority, 88% (90) considered that performing the 2diagnostic tests the same day of the visit was a very good option. And 94% (96) were satisfied with the information received on their FI, with a median satisfaction value of 10 (5-10). With the HRC, the patient spends about 2h in the outpatient clinic of the hospital, but leaves with the complete diagnostic process performed. The satisfaction survey confirms that most patients prefer this system. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Managing Faecal INcontinence in people with advanced dementia resident in Care Homes (FINCH) study: a realist synthesis of the evidence.

    Science.gov (United States)

    Goodman, Claire; Norton, Christine; Buswell, Marina; Russell, Bridget; Harari, Danielle; Harwood, Rowan; Roe, Brenda; Rycroft-Malone, Jo; Drennan, Vari M; Fader, Mandy; Maden, Michelle; Cummings, Karen; Bunn, Frances

    2017-08-01

    Eighty per cent of care home residents in the UK are living with dementia. The prevalence of faecal incontinence (FI) in care homes is estimated to range from 30% to 50%. There is limited evidence of what is effective in the reduction and management of FI in care homes. To provide a theory-driven explanation of the effectiveness of programmes that aim to improve FI in people with advanced dementia in care homes. A realist synthesis. This was an iterative approach that involved scoping of the literature and consultation with five stakeholder groups, a systematic search and analysis of published and unpublished evidence, and a validation of programme theories with relevant stakeholders. The databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Scopus, SocAbs, Applied Social Sciences Index and Abstracts, BiblioMap, Sirius, OpenGrey, Social Care Online and the National Research Register. The scoping identified six programme theories with related context-mechanism-outcome configurations for testing. These addressed (1) clinician-led support, assessment and review, (2) the contribution of teaching and support for care home staff on how to reduce and manage FI, (3) the causes and prevention of constipation, (4) how the cognitive and physical capacity of the resident affect outcomes, (5) how the potential for recovery, reduction and management of FI is understood by those involved and (6) how the care of people living with dementia and FI is integral to the work patterns of the care home and its staff. Data extraction was completed on 62 core papers with iterative searches of linked literature. Dementia was a known risk factor for FI, but its affect on the uptake of different interventions and the dementia-specific continence and toileting skills staff required was not addressed. Most care home residents with FI will be doubly incontinent and, therefore, there is limited value in focusing solely on FI or on

  17. Managing passive incontinence and incomplete evacuation.

    Science.gov (United States)

    Collins, Brigitte; Norton, Christine

    Both passive faecal incontinence and evacuation difficulty are distressing and demoralising conditions, resulting in physical and psychological problems including social restrictions, loss of self-esteem, altered body image and loss of skin integrity. Conservative management and biofeedback therapy has been shown to help most patients with faecal incontinence and evacuation difficulty by creating a manageable situation that can significantly improve quality of life. However, some patients may not improve their symptoms and require alternative measures. This article reports an audit of the use of the Qufora mini irrigation system in 50 patients (48 female, 2 male) with passive faecal incontinence and/or evacuation difficulty who had failed to respond to conventional biofeedback. Seventy percent found the irrigation comfortable and 74% rated the system as good or acceptable. Two-thirds believed symptoms were improved and would wish to continue using the system. Prospective studies are needed to confirm which patients are most suitable and respond well to the irrigation.

  18. Faecal incontinence and health related quality of life in inflammatory bowel disease patients: Findings from a tertiary care center in South Asia

    Science.gov (United States)

    Subasinghe, Duminda; Navarathna, Navarathna Mudiyanselage Meththananda; Samarasekera, Dharmabandhu Nandadeva

    2016-01-01

    AIM: To analyze the frequency and severity of faecal incontinence (FI) and its effect on the quality of life (QOL) in inflammatory bowel disease (IBD) patients. METHODS: All patients who attended surgical and medical gastroenterology outpatient clinics in a tertiary care center with an established diagnosis of either ulcerative colitis (UC) or Crohn’s disease (CD) over a period of 10 mo were included in this study. Before enrollment into the study, the patients were explained about the study and informed consent was obtained. The patients with unidentified colitis were excluded. The data on demographics, disease characteristics, FI (Vaizey score), and quality of life (IBD-Q) were collected. Data were analyzed using SPSS version 21. RESULTS: There were 184 patients (women = 101, 54.9%; UC = 153, 83.2%) with a female preponderance for UC (male/female ratio = 1:1.5) and a male preponderance for CD (male/female = 2:1). Forty-eight (26%) patients reported symptoms of FI. Among the patients with FI, 70.8% were women (n = 34) and 29.2% were men (n = 14) with an average age of 52.7 years (range, 20-78 years). Average age of onset of FI was 48.6 (range, 22-74) years. Ten percent (n = 5) reported regular FI. Incontinence to flatus was seen in 33.3% (n = 16), to liquid faeces in 56.2% (n = 27), to solid faeces in 6.2% (n = 3) and to all three in 4.1% (n = 2). Twenty-one percent (n = 10) complained of disruption of their physical and social activity. There was no association between FI and type of IBD. Significant associations were found between FI and age (P = 0.005) and gender (P < 0.001). QOL in our cohort of patients was significantly affected by FI. CONCLUSION: In our study, nearly a quarter of patients reported FI. There was a significant correlation between FI and QOL. Therefore, enquiring about FI in IBD patients can lead to identification of this debilitating condition. This will enable early referral for continence care in this group of patients. PMID:27602247

  19. Reducing and managing faecal incontinence in people with advanced dementia who are resident in care homes: protocol for a realist synthesis.

    Science.gov (United States)

    Goodman, Claire; Rycroft Malone, Jo; Norton, Christine; Harari, Danielle; Harwood, Rowan; Roe, Brenda; Russell, Bridget; Fader, Mandy; Buswell, Marina; Drennan, Vari M; Bunn, Frances

    2015-07-10

    Faecal incontinence (FI) is the involuntary loss of liquid or solid stool that is a social or hygienic problem. The prevalence of FI in residents of care homes is high, but it is not an inevitable consequence of old age or dementia. There is good evidence on risk factors, but few studies provide evidence about effective interventions. There is a need to understand how, why, and in what circumstances particular programmes to reduce and manage FI are effective (or not) for people with dementia. The purpose of this review is to identify which (elements of the) interventions could potentially be effective, and examine the barriers and facilitators to the acceptability, uptake and implementation of interventions designed to address FI in people with dementia who are resident in care homes. A realist synthesis approach to review the evidence will be used which will include studies on continence, person-centred care, implementation research in care homes, workforce and research on care home culture. An iterative four-stage approach is planned. Phase 1: development of an initial programme theory or theories that will be 'tested' through a first scoping of the literature and consultation with five stakeholder groups (care home providers, user representatives, academics and practice educators, clinicians with a special interest in FI and continence specialists). Phase 2: a systematic search and analysis of published and unpublished evidence to test and develop the programme theories identified in phase 1. Phase 3: validation of programme theory/ies with a purposive sample of participants from phase 1. The overall protocol does not require ethical review. The University research ethics committee will review interviews conducted as part of phase 1 and 3. The final fourth phase will synthesise and develop recommendations for practice and develop testable hypotheses for further research. Published by the BMJ Publishing Group Limited. For permission to use (where not already

  20. Stress Incontinence

    Science.gov (United States)

    Stress incontinence Overview Urinary incontinence is the unintentional loss of urine. Stress incontinence happens when physical movement or activity — such ... coughing, sneezing, running or heavy lifting — puts pressure (stress) on your bladder. Stress incontinence is not related ...

  1. Five-week dietary exposure to dry diets alters the faecal bacterial populations in the domestic cat (Felis catus).

    Science.gov (United States)

    Bermingham, Emma N; Kittelmann, Sandra; Henderson, Gemma; Young, Wayne; Roy, Nicole C; Thomas, David G

    2011-10-01

    The effects of wet (canned) or dry (kibbled) diets on faecal bacterial populations in the cat were investigated in eight domestic short-haired cats (four males and four females; averaging 6 years of age and 3.4 kg) in a nested design. The cats were fed ad libitum a commercially available wet diet (moisture 82.0 %, crude protein 51.7 %, fat 28.9 %, carbohydrate (CHO) 8.9 % and ash 10.6 % DM) for 5 weeks. On the fifth week, individual feed intakes and faecal outputs were determined. Fresh faecal samples were collected twice daily, mixed for homogeneity, subsampled and stored at - 85 °C until analysis. The cats were then switched to a commercially available dry diet (moisture 8.5 %, crude protein 33.0 %, fat 11.0 %, CHO 49.4 % and ash 6.6 % DM) for 5 weeks, and fresh faeces were sampled as described previously. Energy intake tended to be higher in cats fed dry diets (P 0.05). Denaturing gradient gel electrophoresis (DGGE) of bacterial 16S rRNA genes amplified from DNA extracted from faeces was performed. The unweighted pair group method with arithmetic mean cluster analysis of bacterial community profiles using Pearson's correlation revealed diet-specific clustering when the same cats were fed on either a dry or a wet diet (dissimilarity between the groups, 88.6 %; P Pelomonas and Fusobacteriaceae were influenced by a short-term change in diet format. This suggests that 5-week dietary exposure is sufficient to alter gastrointestinal microflora.

  2. A vegan or vegetarian diet substantially alters the human colonic faecal microbiota.

    Science.gov (United States)

    Zimmer, J; Lange, B; Frick, J-S; Sauer, H; Zimmermann, K; Schwiertz, A; Rusch, K; Klosterhalfen, S; Enck, P

    2012-01-01

    Consisting of ≈10(14) microbial cells, the intestinal microbiota represents the largest and the most complex microbial community inhabiting the human body. However, the influence of regular diets on the microbiota is widely unknown. We examined faecal samples of vegetarians (n=144), vegans (n=105) and an equal number of control subjects consuming ordinary omnivorous diet who were matched for age and gender. We used classical bacteriological isolation, identification and enumeration of the main anaerobic and aerobic bacterial genera and computed absolute and relative numbers that were compared between groups. Total counts of Bacteroides spp., Bifidobacterium spp., Escherichia coli and Enterobacteriaceae spp. were significantly lower (P=0.001, P=0.002, P=0.006 and P=0.008, respectively) in vegan samples than in controls, whereas others (E. coli biovars, Klebsiella spp., Enterobacter spp., other Enterobacteriaceae, Enterococcus spp., Lactobacillus spp., Citrobacter spp. and Clostridium spp.) were not. Subjects on a vegetarian diet ranked between vegans and controls. The total microbial count did not differ between the groups. In addition, subjects on a vegan or vegetarian diet showed significantly (P=0.0001) lower stool pH than did controls, and stool pH and counts of E. coli and Enterobacteriaceae were significantly correlated across all subgroups. Maintaining a strict vegan or vegetarian diet results in a significant shift in the microbiota while total cell numbers remain unaltered.

  3. Urinary Incontinence

    Science.gov (United States)

    ... It may begin around the time of menopause. Urgency urinary incontinence happens when people have a sudden need ... urinary incontinence is a mix of stress and urgency urinary incontinence. You may leak urine with a laugh ...

  4. Urinary incontinence

    OpenAIRE

    2014-01-01

    Incontinence has about a 15 percent prevalence among elderly women. Some of the factors associated with incontinence are psychosocial implications of stigmatization, the decreased quality of life, and the economic considerations of nursing home costs. There are numerous, often misdiagnosed, reversible causes of incontinence, and many of the problems associated with aging may be alleviated if incontinence is treated symptomatically and controlled.

  5. Urinary Incontinence

    Science.gov (United States)

    ... you to restrict your activities and limit your social interactions Increase the risk of falls in older adults ... increase your risk of developing urinary incontinence include: Gender. Women are more likely to have stress incontinence. ...

  6. [Fecal incontinence--a treatable problem!].

    Science.gov (United States)

    Remmen, Friederike; Dindo, Daniel

    2013-07-01

    Faecal incontinence has an enormous negative impact on patients' quality of life. Although the causes for faecal incontinence may vary (idiopatic, neurogenic, due to pregnancy, birth trauma or anorectal surgery), nowadays different therapies are available to cure or support patients after failure of conservative treatment. During the past decade, sacral nerve stimulation has shown to provide major improvement to patients with faecal incontinence. Regardless of the underlying disease (sphincter defect, diabetes mellitus, multiple sclerosis or idiopathic) the success rate of SNS lies over 80 %. The operation is performed under local anaesthesia and has a low morbidity rate. Not only its good long time results but also its cost effectiveness is based on scientific evidence.

  7. Variable alterations of the microbiota, without metabolic or immunological change, following faecal microbiota transplantation in patients with chronic pouchitis.

    Science.gov (United States)

    Landy, J; Walker, A W; Li, J V; Al-Hassi, H O; Ronde, E; English, N R; Mann, E R; Bernardo, D; McLaughlin, S D; Parkhill, J; Ciclitira, P J; Clark, S K; Knight, S C; Hart, A L

    2015-08-12

    Faecal microbiota transplantation (FMT) is effective in the treatment of Clostridium difficile infection, where efficacy correlates with changes in microbiota diversity and composition. The effects of FMT on recipient microbiota in inflammatory bowel diseases (IBD) remain unclear. We assessed the effects of FMT on microbiota composition and function, mucosal immune response, and clinical outcome in patients with chronic pouchitis. Eight patients with chronic pouchitis (current PDAI ≥7) were treated with FMT via nasogastric administration. Clinical activity was assessed before and four weeks following FMT. Faecal coliform antibiotic sensitivities were analysed, and changes in pouch faecal and mucosal microbiota assessed by 16S rRNA gene pyrosequencing and (1)H NMR spectroscopy. Lamina propria dendritic cell phenotype and cytokine profiles were assessed by flow cytometric analysis and multiplex assay. Following FMT, there were variable shifts in faecal and mucosal microbiota composition and, in some patients, changes in proportional abundance of species suggestive of a "healthier" pouch microbiota. However, there were no significant FMT-induced metabolic or immunological changes, or beneficial clinical response. Given the lack of clinical response following FMT via a single nasogastric administration our results suggest that FMT/bacteriotherapy for pouchitis patients requires further optimisation.

  8. Wheat bran extract alters colonic fermentation and microbial composition, but does not affect faecal water toxicity: a randomised controlled trial in healthy subjects.

    Science.gov (United States)

    Windey, Karen; De Preter, Vicky; Huys, Geert; Broekaert, Willem F; Delcour, Jan A; Louat, Thierry; Herman, Jean; Verbeke, Kristin

    2015-01-28

    Wheat bran extract (WBE), containing arabinoxylan-oligosaccharides that are potential prebiotic substrates, has been shown to modify bacterial colonic fermentation in human subjects and to beneficially affect the development of colorectal cancer (CRC) in rats. However, it is unclear whether these changes in fermentation are able to reduce the risk of developing CRC in humans. The aim of the present study was to evaluate the effects of WBE on the markers of CRC risk in healthy volunteers, and to correlate these effects with colonic fermentation. A total of twenty healthy subjects were enrolled in a double-blind, cross-over, randomised, controlled trial in which the subjects ingested WBE (10 g/d) or placebo (maltodextrin, 10 g/d) for 3 weeks, separated by a 3-week washout period. At the end of each study period, colonic handling of NH3 was evaluated using the biomarker lactose[15N, 15N']ureide, colonic fermentation was characterised through a metabolomics approach, and the predominant microbial composition was analysed using denaturing gradient gel electrophoresis. As markers of CRC risk, faecal water genotoxicity was determined using the comet assay and faecal water cytotoxicity using a colorimetric cell viability assay. Intake of WBE induced a shift from urinary to faecal 15N excretion, indicating a stimulation of colonic bacterial activity and/or growth. Microbial analysis revealed a selective stimulation of Bifidobacterium adolescentis. In addition, WBE altered the colonic fermentation pattern and significantly reduced colonic protein fermentation compared with the run-in period. However, faecal water cytotoxicity and genotoxicity were not affected. Although intake of WBE clearly affected colonic fermentation and changed the composition of the microbiota, these changes were not associated with the changes in the markers of CRC risk.

  9. Stress incontinence

    Science.gov (United States)

    ... incontinence URL of this page: //medlineplus.gov/ency/article/000891.htm Stress urinary incontinence To use the ... irritation. Smoking also increases your risk for bladder cancer. Avoid alcohol ... keep the muscle around your urethra strong and working well. This may help keep ...

  10. [Fecal incontinence in community-dwelling elderly: findings from a study of prevalence, consultation of physicians, psychosocial aspects and treatment

    NARCIS (Netherlands)

    Verhagen, T.E.M.; Lagro-Janssen, A.L.M.

    2001-01-01

    OBJECTIVE: To gain insight into the prevalence of faecal incontinence, looking for medical attention, treatment and the impact of faecal incontinence on the quality of life in community-residing men and women of 60 years and over. DESIGN: Enquiry and interview. METHOD: A questionnaire about the inci

  11. [Fecal incontinence in community-dwelling elderly: findings from a study of prevalence, consultation of physicians, psychosocial aspects and treatment

    NARCIS (Netherlands)

    Verhagen, T.E.M.; Lagro-Janssen, A.L.M.

    2001-01-01

    OBJECTIVE: To gain insight into the prevalence of faecal incontinence, looking for medical attention, treatment and the impact of faecal incontinence on the quality of life in community-residing men and women of 60 years and over. DESIGN: Enquiry and interview. METHOD: A questionnaire about the

  12. Altered faecal and mucosal microbial composition in post-infectious irritable bowel syndrome patients correlates with mucosal lymphocyte phenotypes and psychological distress.

    Science.gov (United States)

    Sundin, J; Rangel, I; Fuentes, S; Heikamp-de Jong, I; Hultgren-Hörnquist, E; de Vos, W M; Brummer, R J

    2015-02-01

    A subset of irritable bowel syndrome (IBS) patients, denoted post-infectious IBS (PI-IBS), develop symptoms after an enteric infection. Bacterial dysbiosis and mucosal inflammation have been proposed to be involved in the pathophysiology of this entity. To characterise the mucosal and faecal microbiota in PI-IBS, general IBS and healthy controls, and to investigate associations between the microbiota and the mucosal immune system. Mucosal biopsies and faeces were collected from 13 PI-IBS patients, 19 general IBS patients and 16 healthy controls. Global bacterial composition was determined by generating 16S rRNA amplicons that were examined by phylogenetic microarray hybridisation, principal component and redundancy analysis. We correlated previously reported lymphocyte proportions with the microbiota. Faecal microbiota composition of PI-IBS patients differed significantly from both general IBS patients and healthy controls (P intestinal microbiota of PI-IBS patients from that of both general IBS patients and HC. The microbial composition is significantly associated with the HADs score and alterations in lymphocyte subsets proportions. © 2014 John Wiley & Sons Ltd.

  13. [Urinary incontinence].

    Science.gov (United States)

    Kuhn, Annette

    2010-01-01

    Incontinence is a common age-dependent and increasing problem in women that may mainly present as stress incontinence, overactive bladder, mixed incontinence or other forms. A thorough history, gynaecological and neurological examination and urinalysis as initial step will lead to the diagnosis and treatment. If midstream urine is difficult to receive, a catheter urine will be easy to obtain. Further investigations as urodynamics, cystoscopy and ultrasound may be required. As initial step, stress incontinence should be treated with physiotherapy and pelvic floor exercises, if not successful with operations as suburethral slings. Slings have good long-term success rates of approximately 85 % with a low morbidity and can even be inserted under local anaesthetic. The treatment of idiopathic overactive bladder consists of bladder training, a behavioural therapy, and mainly anticholinergics. Anticholinergics may cause side effects particularly in the elderly who are under several medications that may add anticholinergic effects as antidepressants, antibiotics or antihistaminics.

  14. [Male urinary incontinence

    NARCIS (Netherlands)

    Boer, TA de; Heesakkers, J.P.F.A.

    2008-01-01

    *Urinary incontinence in males is gaining increasingly more attention. *Male urinary incontinence can be classified as storage incontinence due to overactive bladder syndrome or stress incontinence due to urethral sphincter dysfunction. *Most patients benefit from the currently available treatment o

  15. High prevalence of incontinence among young adults with spina bifida : description, prediction and problem perception

    NARCIS (Netherlands)

    Verhoef, M; Lurvink, M; Barf, HA; Post, MWM; van Asbeck, FWA; Gooskens, RHJM; Prevo, AJH

    2005-01-01

    design: Cross-sectional study. Objectives: To study the prevalence of incontinence, problem perception and determinants of urinary and faecal incontinence in young adults with spina bifida. Setting: Nation-wide study in the Netherlands. Participants: A total of 179 of 350 invited patients participat

  16. Dairy and plant based food intakes are associated with altered faecal microbiota in 2 to 3 year old Australian children

    Science.gov (United States)

    Smith-Brown, P.; Morrison, M.; Krause, L.; Davies, P. S. W.

    2016-01-01

    The first 1000 days (conception to 24 months) is when gut microbiota composition and eating patterns are established, and a critical period influencing lifelong health. The aim of this study is to examine the associations between food intakes and microbiota composition at the end of this period. Diet was quantified for 37 well-nourished Australian children aged between 2 to 3 years by using a food frequency questionnaire and 24 hr recalls. Both dairy and plant-based (fruit, vegetables, soy, pulses and nuts) food intakes were associated with distinct microbiota profiles. Dairy intake was positively associated with the Firmicutes:Bacteroidetes ratio, and in particular Erysipelatoclostridium spp., but negatively associated with species richness and diversity. Vegetable intake was positively associated with the relative abundance of the Lachnospira genus, while soy, pulse and nut intake was positively associated with the relative abundance of bacteria related to Bacteroides xylanisolvens. Fruit intake, especially apples and pears, were negatively associated with the relative abundance of bacteria related to Ruminococcus gnavus. In this cohort of young children dairy and plant based food intakes were found to be associated with altered microbiota composition. Further exploration is needed to elucidate the effect of these dietary and microbial differences on host phenotype. PMID:27694811

  17. Prevalence of Bowel Incontinence

    Science.gov (United States)

    ... Rectum Vol. 44, No. 1 January 2001. FAQs Prevalence Causes of Incontinence Childbirth and Delivery Neurologic Disease or Injury Colorectal Cancer Other Contributing Factors Fecal Incontinence in Children Reporter's ...

  18. Fecal Incontinence in Children

    Science.gov (United States)

    ... children and teens in our Learning Center . FAQs Prevalence Causes of Incontinence Childbirth and Delivery Neurologic Disease or Injury Colorectal Cancer Other Contributing Factors Fecal Incontinence in Children Reporter's ...

  19. Symptoms of Incontinence

    Science.gov (United States)

    ... changes in your bowel control, don’t let embarrassment and your lack of knowledge about treatment options ... Aging Managing Incontinence Managing Incontinence: A Survey The Patient's Perspective Barriers on Diagnosis and Treatment Personal Stories ...

  20. The effect of Yucca schidigera extract on canine and feline faecal volatiles occurring concurrently with faecal aroma amelioration.

    Science.gov (United States)

    Lowe, J A; Kershaw, S J; Taylor, A J; Linforth, R S

    1997-01-01

    Addition of Yucca schidigera extract (YSE) products to canine or feline diets improved faecal aroma as monitored by a human panel. Odour port-gas chromatography (GC) indicated different odour component types in dog faecal volatiles and, in particular, 'faecal'-type odours due to methyl sulfides. GC-mass spectrometry demonstrated several chemical compound classes present in faecal volatiles and quantitation in the cat indicated apparently significant changes in the concentrations of several compounds on YSE treatment, although these were not necessarily aroma components. The potential for direct YSE alteration of aroma perception in a mixture of volatiles, possibly by binding, was demonstrated.

  1. Urinary incontinence in women.

    Science.gov (United States)

    Norton, Peggy; Brubaker, Linda

    2006-01-07

    Urinary incontinence is common in women, but is under-reported and under-treated. Urine storage and emptying is a complex coordination between the bladder and urethra, and disturbances in the system due to childbirth, aging, or other medical conditions can lead to urinary incontinence. The two main types of incontinence in women, stress urinary incontinence and urge urinary incontinence, can be evaluated by history and simple clinical assessment available to most primary care physicians. There is a wide range of therapeutic options, but the recent proliferation of new drug treatments and surgical devices for urinary incontinence have had mixed results; direct-to-consumer advertising has increased public awareness of the problem of urinary incontinence, but many new products are being introduced without long-term assessment of their safety and efficacy.

  2. Faecal microbiota transplantation

    DEFF Research Database (Denmark)

    Jørgensen, Simon M D; Hansen, Mette Mejlby; Erikstrup, Christian

    2017-01-01

    BACKGROUND: Faecal microbiota transplantation (FMT) is currently being established as a second-line treatment for recurrent Clostridium difficile infection. FMT is further being considered for other infectious and inflammatory conditions. Safe and reproducible methods for donor screening, laborat......BACKGROUND: Faecal microbiota transplantation (FMT) is currently being established as a second-line treatment for recurrent Clostridium difficile infection. FMT is further being considered for other infectious and inflammatory conditions. Safe and reproducible methods for donor screening...

  3. Urinary Incontinence in Elderly

    Directory of Open Access Journals (Sweden)

    N. S. Neki

    2016-01-01

    Full Text Available Urinary Incontinence (UI is dened any involuntary leakage of urine. It is twice as common in women as in men and affects at least 1 in 3 older women. It is not a normal result of aging. Rather it is a medical problem that is often curable and should be treated. Urine is stored in the bladder and emptied via the urethra. During urination, muscles of the bladder wall contract, forcing urine from the bladder into the urethra. Sphincter muscles surrounding the urethra relax thus releasing urine from the body. Incontinence occurs if bladder muscles suddenly contract or sphincter muscles are not strong enough to contain urine. The diagnosis of geriatric urinary incontinence includes evaluation for overow incontinence, functional incontinence and stress incontinence. The treatment goal should be realistic and aim to improve the patient's functional status and quality of life. Best treatment outcomes can only be achieved by a holistic treatment approach.

  4. Surgery for Stress Urinary Incontinence

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Surgery for Stress Urinary Incontinence Home For Patients Search ... Stress Urinary Incontinence FAQ166, July 2014 PDF Format Surgery for Stress Urinary Incontinence Special Procedures What is ...

  5. Incontinence Treatment: Newer Treatment Options

    Science.gov (United States)

    ... Bowel Incontinence Signs & Symptoms Symptoms of Incontinence Diarrhea Treatment Lifestyle Changes Dietary Tips Medication Bowel Management Biofeedback Surgical Treatments Newer Treatment Options Tips on Finding a Doctor ...

  6. [Guideline 'Incontinence urine and feces' of the Dutch Preventive Youth Health Care].

    Science.gov (United States)

    Beltman, Maaike; Deurloo, Jacqueline A; van Leerdam, Frank J M; Wierenga-van der Hoeven, Catelijne J; Bulk-Bunschoten, Anneke M W; Kamphuis, Mascha

    2012-01-01

    Continence problems can occur during childhood. This guideline is for the Dutch Youth Health Care (JGZ) and gives recommendations for the prevention, early detection and treatment of these problems. As a preventative measure advices for potty training should be started in children aged 18-24 months. If incontinence is present, it is important to take a history and carry out physical examination. In children over the age of 5 who are incontinent of urine the following are recommended: taking child out of bed, calendar with reward system, bedwetting alarm or voiding diary; children over the age of 8 can follow dry bed training. Faecal incontinence is often associated with constipation. Incontinent children with constipation are given advice about normal eating and exercise patterns. If this is not successful then laxatives are prescribed. The JGZ should refer further if there are indications of an underlying condition; if children over the age of 5 are wet during the day; if children are incontinent of faeces at night; if children are incontinent of faeces but not constipated; if children persistently wet the bed; if there is faecal incontinence despite counselling, and if medication needs to be prescribed.

  7. Pre- and post-weaning diet alters the faecal metagenome in the cat with differences vitamin and carbohydrate metabolism gene abundances

    Science.gov (United States)

    Young, Wayne; Moon, Christina D.; Thomas, David G.; Cave, Nick J.; Bermingham, Emma N.

    2016-01-01

    Dietary format, and its role in pet nutrition, is of interest to pet food manufacturers and pet owners alike. The aim of the present study was to investigate the effects of pre- and post-weaning diets (kibbled or canned) on the composition and function of faecal microbiota in the domestic cat by shotgun metagenomic sequencing and gene taxonomic and functional assignment using MG-RAST. Post-weaning diet had a dramatic effect on community composition; 147 of the 195 bacterial species identified had significantly different mean relative abundances between kittens fed kibbled and canned diets. The kittens fed kibbled diets had relatively higher abundances of Lactobacillus (>100-fold), Bifidobacterium (>100-fold), and Collinsella (>9-fold) than kittens fed canned diets. There were relatively few differences in the predicted microbiome functions associated with the pre-weaning diet. Post-weaning diet affected the abundance of functional gene groups. Genes involved in vitamin biosynthesis, metabolism, and transport, were significantly enriched in the metagenomes of kittens fed the canned diet. The impact of post-weaning diet on the metagenome in terms of vitamin biosynthesis functions suggests that modulation of the microbiome function through diet may be an important avenue for improving the nutrition of companion animals. PMID:27876765

  8. [The treatment of fecal incontinence].

    Science.gov (United States)

    Romano, G; Bianco, F; Espodito, P

    2003-12-01

    The treatment of faecal incontinence includes: the education of the patient, medical therapy, biofeedback and sphincteric exercises, surgical therapy. Conservative, non-surgical treatment is almost always the initial therapeutic approach, except in those cases in which an evident defect of the sphincter muscle is present. Surgical treatment has seen a noteworthy increase in the last fifteen years as a consequence of the development of new surgical techniques. These techniques include: external anal sphincter plasty, pelvic floor plasties, sacral neuromodulation, muscular transpositions with or without electrostimulation, artificial anal sphincter. These procedures may be employed as first or second level treatment depending on the type of pathology considered and its aetiology. The 1st results achieved by surgical treatment authorise us to believe that reconversion with artificial sphincter is a valid alternative to graciloplasty, notwithstanding the fact that its costs are higher. Attentive pre- operative assessment of patients is important. Patients must be strongly motivated and able to manage the new condition. Although further studies are necessary, the degree of satisfactory of the 1st patients operated is the best stimulus for pursuing the development of this technique.

  9. Urinary incontinence - collagen implants

    Science.gov (United States)

    ... gov/ency/article/007373.htm Urinary incontinence - injectable implant To use the sharing features on this page, please enable JavaScript. Injectable implants are injections of material into the urethra to ...

  10. What is Urinary Incontinence?

    Science.gov (United States)

    ... will go away when the problem is treated. Kegel exercises and bladder training help some types of ... Medicine and surgery are other options.What are Kegel exercises?Stress incontinence can be treated with special ...

  11. The Pertinence of Incontinence

    Directory of Open Access Journals (Sweden)

    António Zilhão

    2005-12-01

    Full Text Available In this paper I suggest a reconstruction of the traditional concepts of con-tinent and incontinent action. This reconstruction proceeds along the lines of a standpoint of bounded rationality. My suggestion agrees with some relevant aspects of Davidson’s treatment of this topic. One of these aspects is that incontinent action is typically signalled by the following two subjective experiences: a feeling of surprise towards one’s own action and a difficulty in understanding oneself; another is that incontinence cannot simply be disposed of in terms of some inability of the agent to avoid “succumbing to temptation”; still another is the view that inconti-nent action is common in real human affairs. But my suggestion dis-agrees with other relevant aspects of Davidson’s treatment of inconti-nence too. In particular, it avoids what I take to be its two major draw-backs. These are a view of continent action that falls prey to a com-pletely unrealistic concept of psychological rationality and the idea that incontinence necessarily involves a dimension of essential irrationality

  12. Female urinary incontinence and sexuality.

    Science.gov (United States)

    Mota, Renato Lains

    2017-01-01

    Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence.

  13. Female urinary incontinence and sexuality

    Science.gov (United States)

    Mota, Renato Lains

    2017-01-01

    ABSTRACT Urinary incontinence is a common problem among women and it is estimated that between 15 and 55% of them complain of lower urinary symptoms. The most prevalent form of urinary incontinence is associated with stress, followed by mixed urinary incontinence and urge urinary incontinence. It is a symptom with several effects on quality of life of women mainly in their social, familiar and sexual domains. Female reproductive and urinary systems share anatomical structures, which promotes that urinary problems interfere with sexual function in females. This article is a review of both the concepts of female urinary incontinence and its impact on global and sexual quality of life. Nowadays, it is assumed that urinary incontinence, especially urge urinary incontinence, promotes anxiety and several self-esteem damages in women. The odour and the fear of incontinence during sexual intercourse affect female sexual function and this is related with the unpredictability and the chronicity of incontinence, namely urge urinary incontinence. Female urinary incontinence management involves conservative (pelvic floor muscle training), surgical and pharmacological treatment. Both conservative and surgical treatments have been studied about its benefit in urinary incontinence and also the impact among female sexual function. Unfortunately, there are sparse articles that evaluate the benefits of female sexual function with drug management of incontinence. PMID:28124522

  14. Gaining Control Over Fecal Incontinence.

    Science.gov (United States)

    Gump, Kendra; Schmelzer, Marilee

    2016-01-01

    Strategies that improve the regularity and efficiency of defecation can eliminate or minimize episodes of fecal incontinence. The medical-surgical nurse's role in identifying patients with fecal incontinence is discussed, along with various treatments to control bowel elimination.

  15. Stem cells for stress urinary incontinence: the adipose promise

    OpenAIRE

    Roche, Régis; Festy, Franck; Fritel, Xavier

    2009-01-01

    Abstract Stress urinary incontinence (SUI), the most common type of incontinence in women, is a frequent and costly ailment responsible for an alteration in the quality of life. Although medical treatment gives some rather deceiving results, surgical techniques that include colposuspension or tension-free vaginal tape, employed in cases of urethral support defect, give a 5-year cure rate of more than 80%. However, these techniques could lead to complications or recurrence of symptoms. Recentl...

  16. [Conservative treatment of urinary incontinence].

    Science.gov (United States)

    Soljanik, I; Schorsch, I; Stanislaus, P; Bauer, R; Mayer, M; Hocaoglu, Y; Becker, A; May, F

    2007-09-20

    Urinary incontinence can be treated with medicinal products in addition to active pelvic floor muscle training and electrostimulation. A local hormone therapy should be first discussed with the gynaecologist. The active substance duloxetine has been used for a few years for treating stress incontinence. Several older and newer active substances are available for treating irritable bladder and stress incontinence.

  17. [Postpartum incontinence. Narrative review].

    Science.gov (United States)

    Rodríguez, Rodolfo; Alós, Rafael; Carceller, M Soledad; Solana, Amparo; Frangi, Andrés; Ruiz, M Dolores; Lozoya, Roberto

    2015-01-01

    The development of fecal incontinence after childbirth is a common event. This incontinence responds to a multifactorial etiology in which the most common element is external anal sphincter injury. There are several risk factors, and it is very important to know and avoid them. Sphincter injury may result from perineal tear or sometimes by incorrectly performing an episiotomy. It is very important to recognize the injury when it occurs and repair it properly. Pudendal nerve trauma may contribute to the effect of direct sphincter injury. Persistence of incontinence is common, even after sphincter repair. Surgical sphincteroplasty is the standard treatment of obstetric sphincter injuries, however, sacral or tibial electric stimulation therapies are being applied in patients with sphincter injuries not repaired with promising results. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Imaging fecal incontinence

    Energy Technology Data Exchange (ETDEWEB)

    Fuchsjaeger, Michael H. E-mail: michael.fuchsjaeger@univie.ac.at; Maier, Andrea G

    2003-08-01

    Fecal incontinence is the inability to defer release of gas or stool from the anus and rectum by mechanisms of voluntary control. It is an important medical disorder affecting the quality of life of up to 20% of the population above 65 years. The most common contributing factors include previous vaginal deliveries, pelvic or perineal trauma, previous anorectal surgery, and rectal prolapse. Many physicians lack experience and knowledge related to pelvic floor incontinence disorders, but advancing technology has improved this knowledge. Increased experience with endoanal ultrasound and endoanal magnetic resonance imaging have given us a better understanding not only of the anatomy of the anal canal but also of the underlying morphological defects in fecal incontinence. Current imaging methods are emphasized and recent literature is reviewed.

  19. Faecal incontinence: Current knowledges and perspectives

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Faecal incontinence (FI) is a disabling and frequentsymptom since its prevalence can vary between 5%and 15% of the general population. It has a particularnegative impact on quality of life. Many tools arecurrently available for the treatment of FI, from conservativemeasures to invasive surgical treatments. Theconservative treatment may be dietetic measures,various pharmacological agents, anorectal rehabilitation,posterior tibial nerve stimulation, and transanal irrigation.If needed, patients may have miniinvasive approachessuch as sacral nerve modulation or antegrade irrigation.In some cases, a surgical treatment is proposed, mainlyexternal anal sphincter repair. Although these differenttherapeutic options are available, new techniques arearriving allowing new hopes for the patients. Moreover,most of them are non-invasive such as local applicationof an α1-adrenoceptor agonist, stem cell injections,rectal injection of botulinum toxin, acupuncture. Newmore invasive techniques with promising results arealso coming such as anal magnetic sphincter andantropylorus transposition. This review reports the maincurrent available treatments of FI and the developingtherapeutics tools.

  20. Reoperation for urinary incontinence

    DEFF Research Database (Denmark)

    Foss Hansen, Margrethe; Lose, Gunnar; Kesmodel, Ulrik Schiøler

    2016-01-01

    on a nationwide population. STUDY DESIGN: We used the Danish National Patient Registry to identify women who had surgery for urinary incontinence from 1998 through 2007 and the outcome was a reoperation within 5 years. Kaplan-Meier curves were used to estimate the rate of reoperation for 6 types of surgery...

  1. Clinical Observation on Electroacupuncture Against Urinary Incontinence

    Institute of Scientific and Technical Information of China (English)

    赵文洁; 胡昌东; 王洁茹; 洪珏

    2009-01-01

    @@ Urinary incontinence is a common problem, usually classified as stress incontinence or urge incontinence[1]. With the development of medical science, people have got more and more profound knowledge towards urinary incontinence. We treated urinary incontinence with electroacupuncture since 2006, and now reported it as follows.

  2. A Content Incontinent: Report of Liposomal Bupivacaine Induced Fecal Incontinence

    Directory of Open Access Journals (Sweden)

    Emanuel A. Shapera

    2016-01-01

    Full Text Available Proper surgical management of anal fistula demands sound clinical judgment and extraordinary care to prevent incontinence and adequate postoperative pain control and provide satisfactory resolution to optimize quality of life. Fecal incontinence can be a devastating complication of procedures performed for fistula in ano. We report a unique case in which temporary incontinence (for less than 4 days followed injection of liposomal bupivacaine for postoperative pain control after draining seton placement for fistula in ano. Patients and physicians should be aware as it may be mistaken for a more serious anatomical and permanent cause of fecal incontinence.

  3. Economic cost of fecal incontinence.

    Science.gov (United States)

    Xu, Xiao; Menees, Stacy B; Zochowski, Melissa K; Fenner, Dee E

    2012-05-01

    Despite its prevalence and deleterious impact on patients and families, fecal incontinence remains an understudied condition. Few data are available on its economic burden in the United States. The aim of this study was to quantify per patient annual economic costs associated with fecal incontinence. A mail survey of patients with fecal incontinence was conducted in 2010 to collect information on their sociodemographic characteristics, fecal incontinence symptoms, and utilization of medical and nonmedical resources for fecal incontinence. The analysis was conducted from a societal perspective and included both direct and indirect (ie, productivity loss) costs. Unit costs were determined based on standard Medicare reimbursement rates, national average wholesale prices of medications, and estimates from other relevant sources. All cost estimates were reported in 2010 US dollars. This study was conducted at a single tertiary care institution. The analysis included 332 adult patients who had fecal incontinence for more than a year with at least monthly leakage of solid, liquid, or mucous stool. The primary outcome measured was the per patient annual economic costs associated with fecal incontinence. The average annual total cost for fecal incontinence was $4110 per person (median = $1594; interquartile range, $517-$5164). Of these costs, direct medical and nonmedical costs averaged $2353 (median, $1176; interquartile range, $294-$2438) and $209 (median, $75; interquartile range, $17-$262), whereas the indirect cost associated with productivity loss averaged $1549 per patient annually (median, $0; interquartile range, $0-$813). Multivariate regression analyses suggested that greater fecal incontinence symptom severity was significantly associated with higher annual direct costs. This study was based on patient self-reported data, and the sample was derived from a single institution. Fecal incontinence is associated with substantial economic cost, calling for more

  4. Urinary incontinence: the basics.

    Science.gov (United States)

    Kennedy, K L; Steidle, C P; Letizia, T M

    1995-08-01

    Urinary incontinence (UI) is a widely prevalent problem that affects people of all ages and levels of physical health, both in healthcare settings and in the community. Contributing to the problem are that many practitioners remain uneducated about this condition, individuals are often too ashamed or embarrassed to seek professional help, and there are significant variations in diagnostic and treatment practices. Five types of UI are stress, urge, overflow, functional and manufactured incontinence. Stress, urge and overflow are caused by factors within the urinary tract and will be concentrated on in this article. To diagnose UI a three-part assessment should be conducted, including the patient history, physical examination, and urinalysis. A behavioral program should be designed which incorporates identification and education for both patient and clinician. Treatment options include pelvic floor exercises (Kegel), vaginal cones, bladder training (retraining), habit training (timed voiding), electrostimulation and biofeedback, clean intermittent catheterization, indwelling catheters, medications, collagen injections, surgery, and absorption products. Most patients can be helped dramatically or cured with the appropriate treatment.

  5. Faecal microbiota of cats with insulin-treated diabetes mellitus.

    Science.gov (United States)

    Bell, Erin T; Suchodolski, Jan S; Isaiah, Anitha; Fleeman, Linda M; Cook, Audrey K; Steiner, Jörg M; Mansfield, Caroline S

    2014-01-01

    Microorganisms within the gastrointestinal tract significantly influence metabolic processes within their mammalian host, and recently several groups have sought to characterise the gastrointestinal microbiota of individuals affected by metabolic disease. Differences in the composition of the gastrointestinal microbiota have been reported in mouse models of type 2 diabetes mellitus, as well as in human patients. Diabetes mellitus in cats has many similarities to type 2 diabetes in humans. No studies of the gastrointestinal microbiota of diabetic cats have been previously published. The objectives of this study were to compare the composition of the faecal microbiota of diabetic and non-diabetic cats, and secondarily to determine if host signalment and dietary factors influence the composition of the faecal microbiota in cats. Faecal samples were collected from insulin-treated diabetic and non-diabetic cats, and Illumina sequencing of the 16S rRNA gene and quantitative PCR were performed on each sample. ANOSIM based on the unweighted UniFrac distance metric identified no difference in the composition of the faecal microbiota between diabetic and non-diabetic cats, and no significant differences in the proportions of dominant bacteria by phylum, class, order, family or genus as determined by 16S rRNA gene sequencing were identified between diabetic and non-diabetic cats. qPCR identified a decrease in Faecalibacterium spp. in cats aged over ten years. Cat breed or gender, dietary carbohydrate, protein or fat content, and dietary formulation (wet versus dry food) did not affect the composition of the faecal microbiota. In conclusion, the composition of the faecal microbiota was not altered by the presence of diabetes mellitus in cats. Additional studies that compare the functional products of the microbiota in diabetic and non-diabetic cats are warranted to further investigate the potential impact of the gastrointestinal microbiota on metabolic diseases such as

  6. Magnetic resonance imaging for stress incontinence: evaluation of patients before and after surgical correction

    Energy Technology Data Exchange (ETDEWEB)

    Perk, Hakki E-mail: hakkiperk@yahoo.com; Oral, Baha; Yesildag, Ahmet; Serel, T. Ahmet; Oezsoy, Mesut; Turgut, Tayfun

    2002-10-01

    Objective: The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in the pre and postoperative assessment of stress urinary incontinence. Methods: Fifteen female patients with clinical evidence of stress urinary incontinence were included in this prospective study. All the patients underwent MRI in the supine position both preoperatively and postoperatively. For imaging, we used a 1.0 T magnet, T2-weighted images were obtained in the midline sagittal plane with patients at rest. Images were evaluated for anatomical stress urinary incontinence alterations, such as the increased distance between the pubococcygeal line and the bladder base and the posterior urethro-vesical angle and the urethral inclination angle changes. Wilcoxon signed rank test allowed comparisons of pre and postoperative results. Results: Compared with postoperative measurements, the bladder base was lowered significantly by an average of 9.4{+-}4.0 mm (P<0.01), posterior urethro-vesical angle was significantly increased by an average of 127.8{+-}11.4 deg. (P<0.01), and the urethral inclination angle was significantly increased by an average of 54.9{+-}10.1 deg. (P<0.01) preoperatively. Conclusion: Our results suggest that MRI can play a major role in the preoperative and postoperative assessment of stress urinary incontinence. It can reliably detect anatomical urinary incontinence alterations. MRI should be considered in failed surgery, complex prolapse, and in differentiating genuine stress incontinence resulting from malposition of the bladder neck from stress incontinence due to intrinsic urethral damage.

  7. La incontinencia urinaria Urinary incontinence

    Directory of Open Access Journals (Sweden)

    J. E. Robles

    2006-08-01

    Full Text Available La incontinencia urinaria, entendida como cualquier pérdida involuntaria de orina, constituye un problema médico y social importante. Puede clasificarse en incontinencia urinaria de esfuerzo, incontinencia urinaria de urgencia e incontinencia urinaria mixta, principalmente. Las proporciones de estos tres tipos principales de incontinencia urinaria son difíciles de establecer y varían notablemente según las fuentes, pero, podrían estar en torno a 40, 33 y 20%, respectivamente. Su diagnóstico requiere una correcta historia clínica y exploración física, junto con algunas exploraciones complementarias. El primer escalón terapéutico lo constituyen las medidas higiénico-dietéticas y las técnicas de modificación de la conducta. El tratamiento farmacológico es específico para cada tipo de incontinencia urinaria, utilizándose anticolinérgicos e inhibidores de la recaptación de serotonina. Por último, las diferentes técnicas quirúrgicas tienen su papel ante el fracaso de los tratamientos conservadores o frente a incontinencia urinaria severa.Urinary incontinence, understood as any involuntary loss of urine, constitutes an important medical and social problem. It can be classified as stress urinary incontinence, urgent urinary incontinence or mixed urinary incontinence. The proportions of these three types of urinary incontinence are difficult to establish and vary notably between sources, but they might be about 40, 33 and 20% respectively. Its diagnosis requires a correct clinical history and physical exploration, together with some complementary explorations. The first therapeutic step consists of hygienic-dietary measures and behaviour modification techniques. Pharmacological treatment is specific for each type of urinary incontinence, using anticholinergics and inhibitors of serotonin reuptake. Finally, different surgical techniques have a role in cases where conservative treatments fail or when dealing with severe urinary

  8. [Urinary incontinence and obesity].

    Science.gov (United States)

    Legendre, G; Fritel, X; Capmas, P; Pourcelot, A-G; Fernandez, H

    2012-06-01

    Obesity, defined as a body mass index (BMI) more than or equal to 30kg/m(2), promotes pelvic floor disorders such as urinary incontinence (UI) and genital prolapse. Datas from cohort studies found an association between high BMI and the onset of UI. This association seems to be predominant with for mixed UI and stress UI. For the urge UI and overactive bladder syndrome, the analysis of the literature found a weaker association. The weight is therefore the only modifiable risk factor. Thus, the weight loss by a hypocaloric diet associated with pelvic floor muscle training should be the front line treatment in the obese patient suffering from UI. Bariatric surgery can be discussed in the most obese patient, even if the risk/benefit balance should be weighed because of significant morbidity of this surgery. The results of sub urethral sling (by retropubic tension-free vaginal tape or transobturator sling) in obese patients appear to be equivalent to those obtained in patients of normal weight. Datas on per- and postoperative complications for suburethral slings are reassuring.

  9. [Conservative treatment in male urinary incontinence].

    Science.gov (United States)

    Kirschner-Hermanns, R; Anding, R

    2014-03-01

    Prevalence, pathophysiology, diagnostic and therapeutic approaches of urinary incontinence are well studied in women; however, studies on male urinary incontinence focus on incontinence following surgery of the bladder or prostate, predominantly incontinence after radical prostatectomy. Aging men suffer from incontinence, most frequently urge incontinence (overactive bladder, OAB), nearly as often as women do.The domain of conservative therapy of urinary stress incontinence in men is pelvic floor training. It remains unclear whether biofeedback procedures, electrostimulation therapy, or magnetic stimulation therapy can enhance pelvic floor training. There are data suggesting that an off-label therapy with Duloxetin®, a selective serotonin-noradrenaline reuptake inhibitor (SSNRI), improves urinary incontinence following radical prostatectomy. Antimuscarinic agents in combination with bladder training have been proven as safe and effective treatment in men with OAB. Data, however, suggest that men with OAB are far less frequently treated than women.

  10. Urinary incontinence - what to ask your doctor

    Science.gov (United States)

    ... to help with my urinary incontinence? What are Kegel exercises? What can I do when I want ... tape Urinary incontinence - vaginal sling procedures Patient Instructions Kegel exercises - self-care Self catheterization - female Self catheterization - ...

  11. Achieving sustainable quality in maternity services – using audit of incontinence and dyspareunia to identify shortfalls in meeting standards

    Directory of Open Access Journals (Sweden)

    Newburn Mary

    2001-10-01

    Full Text Available Abstract Background Some complications of childbirth (for example, faecal incontinence are a source of social embarrassment for women, and are often under reported. Therefore, it was felt important to determine levels of complications (against established standards and to consider obstetric measures aimed at reducing them. Methods Clinical information was collected on 1036 primiparous women delivering at North and South Staffordshire Acute and Community Trusts over a 5-month period in 1997. A questionnaire was sent to 970 women which included self-assessment of levels of incontinence and dyspareunia prior to pregnancy, at 6 weeks post delivery and 9 to 14 months post delivery. Results The response rate was 48%(470/970. Relatively high levels of obstetric interventions were found. In addition, the rates of instrumental deliveries differed between the two hospitals. The highest rates of postnatal symptoms had occurred at 6 weeks, but for many women problems were still present at the time of the survey. At 9–14 months high rates of dyspareunia (29%(102/347 and urinary incontinence (35%(133/382 were reported. Seventeen women (4% complained of faecal incontinence at this time. Similar rates of urinary incontinence and dyspareunia were seen regardless of mode of delivery. Conclusion Further work should be undertaken to reduce the obstetric interventions, especially instrumental deliveries. Improvements in a number of areas of care should be undertaken, including improved patient information, improved professional communication and improved professional recognition and management of third degree tears. It is likely that these measures would lead to a reduction in incontinence and dyspareunia after childbirth.

  12. Urinary Incontinence: Management and Treatment Options

    Science.gov (United States)

    Griebling, Tomas L.

    2009-01-01

    Urinary incontinence, defined as the involuntary leakage of urine, is a common health problem in both women and men. Children may also suffer from this condition. Management and treatment of urinary incontinence depends primarily on the specific type of incontinence and the underlying problem causing the leakage for a given patient. Because…

  13. Undertreatment of urinary incontinence in general practice.

    NARCIS (Netherlands)

    Penning-van Beest, F.J.A.; Sturkenboom, M.C.; Bemelmans, B.L.H.; Herings, R.M.C.

    2005-01-01

    BACKGROUND: In the urinary incontinence guidelines that are issued by the Dutch College of General Practitioners, treatment guidelines are related to the type of incontinence. It is unknown whether treatment of urinary incontinence in general practice complies with these guidelines. OBJECTIVE: To de

  14. [Stress incontinence in elderly women].

    Science.gov (United States)

    Loertzer, H; Schneider, P

    2013-06-01

    Stress incontinence is one of the major challenges in geriatric medicine. This is becoming more apparent in routine urology practice with the demographic changes in the population. A thorough diagnosis for a correct treatment of stress incontinence is as important in elderly women as it is in younger patients. This includes assessing the risk factors of incontinence and obesity, parturition, pelvic surgery and changes in hormone levels are risk factors usually found in elderly women. These are the main reasons why this patient group is most frequently affected. Treatment options do not differ significantly from these of younger women. Lifestyle modification, weight loss and supervised pelvic floor training are the mainstays of conservative therapy and surgical treatment should only be considered after these options have been exhausted. In these cases minimally invasive surgical techniques offer clear advantages especially for elderly often multimorbid women.

  15. Changes in incontinence after hysterectomy

    DEFF Research Database (Denmark)

    Kruse, Anne Raabjerg; Jensen, Trine Dalsgaard; Lauszus, Finn Friis

    2017-01-01

    . Sample size calculation indicated that 102 women had to be included. The incontinence status was estimated by a Danish version of the ICIG questionnaire; further, visual analogue scale, dynamometer for hand grip, knee extension strength and balance were applied. Work capacity was measured ergometer cycle...... together with lean body mass by impedance. Quality of life was assessed using the SF-36 questionnaire. Patients were examined preoperatively and twice postoperatively. Results: In total 41 women improved their incontinence after hysterectomy and 10 women reported deterioration. Preoperative stress...... patients undergoing planned hysterectomy were compared pre- and postoperatively. In a sub-study of the prospective follow-up study the changes in incontinence, postoperative fatigue, quality of life, physical function, and body composition were evaluated preoperatively, 13 and 30 days postoperatively...

  16. [Diagnostics and conservative treatment of anal incontinence].

    Science.gov (United States)

    Geile, Dorothea; Osterholzer, Georg; Rosenberg, Robert

    2004-01-01

    Anal incontinence is diagnosed primarily by clinical and proctologic examination. Etiological factors of the disease are found in 85% of the patients by additional examinations. Motility dysfunction of colon and rectum has to be excluded (stenosis, dyschezia, internal hernias). Because anal incontinence is a multifactorial disease as a rule, the single compounds have to be diagnosed and have to undergo therapy. Accordingly, useful investigations are: endorectal ultrasound (defect of muscle, inflammatory or tumour infiltration), manometry (alteration of either anal resting pressure and/or anal squeezing pressure) and surface electromyography (ability of contraction, duration of contraction, strength). Neurophysiological examinations are: needle electromyography, pudendal nerve latency time measurement (PNLT). The occurrence of nerve damage determines the outcome of operative intervention! Conservative treatment is indicated in 80 to 90% of all patients, even higher when one includes all patients in the perioperative period. Possible therapy modalities are: nutrition consultation, physiotherapy, pelvic floor training, biofeedback training of pelvic floor and sphincter muscles, electrostimulation and the combination of both (EMG-triggered electrostimulation). Short-term results are satisfying in up to 85% of patients, but later, successful results depend on the patient's willingness or ability to continue training, and on his/her age.

  17. Incontinence: prevalence, management, staff knowledge and professional practice environment in rehabilitation units.

    Science.gov (United States)

    McCarthy, Geraldine; McCormack, Brendan; Coffey, Alice; Wright, Jayne; Slater, Paul

    2009-03-01

    Background.  Bladder and bowel incontinence is a major health care problem, which adversely affects the lives of many individuals living at home or in health service facilities. Current approaches to continence care emphasize comfort, safety and reduction of risk, rather than detailed individualized assessment and management. The literature illustrates a gap between evidence and actual practice and emphasizes the context of care as being a key element for successful implementation of evidence based practice. Aims.  To identify prevalence of bowel and bladder incontinence and its management, investigate continence knowledge and describe the professional practice environment within a rehabilitation unit for older people. Method.  An integrated evaluation of continence prevalence, staff knowledge and the work environment was adopted. Results.  Findings revealed a high incidence of incontinence (60% urinary, 3% faecal, 37% mixed) a lack of specific continence assessment and specific rationale for treatment decisions or continuation of care. The focus was on continence containment rather than on proactive management. Staff demonstrated a reasonable knowledge of incontinence causation and treatment as measured by the staff knowledge audit. The evaluation of the work environment indicated a low to moderate perception of control over practice (2.39), autonomy in practice (2.87), nurse doctor relationship (2.67) and organizational support (2.67).

  18. Managing incontinence due to detrusor instability.

    Science.gov (United States)

    2001-08-01

    Urinary incontinence affects around 3.5 million people of all ages in the UK. For many, incontinence severely restricts their routine activities and damages their quality of life and self-esteem. In about one-third of women sufferers, and around a half of all men with incontinence, the cause is detrusor instability. This condition is characterised by involuntary bladder contractions or pressure rises during bladder filling, which result in a strong or uncontrollable urge to pass urine and, often, incontinence. Here, we consider a primary care-based approach to managing urinary incontinence in adults, concentrating on the medical management of detrusor instability.

  19. Anal incontinence after two vaginal deliveries without obstetric anal sphincter rupture.

    Science.gov (United States)

    Persson, Lisa K G; Sakse, Abelone; Langhoff-Roos, Jens; Jangö, Hanna

    2017-06-01

    To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. This is a nation-wide cross-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry. Women with more than two deliveries in total till 2012 were excluded at this stage. Of the 1000 women randomly identified, 763 were eligible and received a questionnaire. Maternal and obstetric data were retrieved from the national registry. The response rate was 58.3%. In total, 394 women were included for analysis after reviewing responses according to previously defined exclusion criteria. Median follow-up time was 9.8 years after the first delivery and 6.4 years after the second. The prevalence of flatal incontinence, fecal incontinence and fecal urgency were 11.7, 4.1, and 12.3%, respectively. Overall, 20.1% had any degree of anal incontinence and/or fecal urgency. In 6.3% these symptoms affected their quality of life. No maternal or obstetric factors including episiotomy and vacuum extraction were consistently associated with altered risk of anal incontinence in the multivariable analyses. Anal incontinence and fecal urgency is reported by one fifth of women with two vaginal deliveries without OASIS at long-term follow-up. Episiotomy or vacuum extraction did not alter the risk of long-term anal incontinence.

  20. Effect of room temperature transport vials on DNA quality and phylogenetic composition of faecal microbiota of elderly adults and infants.

    LENUS (Irish Health Repository)

    Hill, Cian J

    2016-05-01

    Alterations in intestinal microbiota have been correlated with a growing number of diseases. Investigating the faecal microbiota is widely used as a non-invasive and ethically simple proxy for intestinal biopsies. There is an urgent need for collection and transport media that would allow faecal sampling at distance from the processing laboratory, obviating the need for same-day DNA extraction recommended by previous studies of freezing and processing methods for stool. We compared the faecal bacterial DNA quality and apparent phylogenetic composition derived using a commercial kit for stool storage and transport (DNA Genotek OMNIgene GUT) with that of freshly extracted samples, 22 from infants and 20 from older adults.

  1. Urinary incontinence and its functional anatomy in frontotemporal lobar degenerations

    Energy Technology Data Exchange (ETDEWEB)

    Perneczky, Robert [Technical University Munich Medical School, Department of Psychiatry and Psychotherapy, Munich (Germany); Technische Universitaet Muenchen, Klinik und Poliklinik fuer Psychiatrie und Psychotherapie, Muenchen (Germany); Diehl-Schmid, Janine; Foerstl, Hans; Kurz, Alexander [Technical University Munich Medical School, Department of Psychiatry and Psychotherapy, Munich (Germany); Drzezga, Alexander [Technical University Munich Medical School, Department of Nuclear Medicine, Munich (Germany); May, Florian [Technical University Munich Medical School, Department of Urology, Munich (Germany)

    2008-03-15

    The frontal lobes play a crucial role in micturition control. However, no reports exist on the functional role of distinct frontal brain regions in urinary incontinence (UIC) in patients with a neurodegenerative damage of the frontal lobe. The aim of the present study was therefore to explore if functional brain lesions were associated with UIC in patients suffering from frontotemporal lobar degenerations (FTLD). Forty-four patients, including eight incontinent subjects, underwent cranial positron emission tomography scanning with {sup 18}F-fluoro-2-deoxy-glucose ({sup 18}F-FDG PET) to assess the relative metabolic rate of glucose (rCMRglc). Group comparisons of rCMRglc were conducted in SPM2 to identify brain regions where the group of incontinent patients (FTLD+UIC) had significant alterations compared with the group without UIC (FTLD-UIC). At the stringent statistical threshold of p < 0.05, corrected for multiple comparisons according to the family-wise error rate, the statistical analysis revealed two significant right-hemispheric hypometabolic clusters located in the premotor/anterior cingulate cortex and the putamen/claustrum/insula. No hypermetabolic regions were found. The present study is the first to provide evidence for brain functional alterations involved in the occurrence of UIC in FTLD. These results provide an important piece of evidence to the understanding of a particularly distressing autonomic nervous system symptom of dementia. (orig.)

  2. Biofeedback therapy for fecal incontinence.

    Science.gov (United States)

    Goldenberg, D A; Hodges, K; Hershe, T; Jinich, H

    1980-10-01

    Operant conditioning offers a new therapeutic modality for fecal incontinence. Our experience with biofeedback therapy in six male and six female patients (ages 12-78 years) is presented. Incontinence was associated with a surgical procedure in six patients and with a medical condition in six patients. Rectosphincteric manometry was performed using a three balloon technic, with one balloon positioned in the rectum as a distending stimulus and the others at the internal and external sphinchters. Pressure responses to measured volumes of rectal distention were displayed on a polygraph. Rectosphincteric reflexes and sensory thresholds for rectal distention were determined. Patients were then encouraged to elevate sphinchter pressures while observing their manometric responses. Follow-up of 10-96 weeks showed ten patients had good responses, with complete continence in six patients. Nine of 10 responders required only one treatment session. Operant conditioning is a valuable technic in properly selected patients with an 80% probability of success.

  3. The menopause and urinary incontinence

    DEFF Research Database (Denmark)

    Foldspang, Anders; Mommsen, Søren

    1994-01-01

    The objective was to study the possible role of the menopause in adult female urinary incontinence (UI) etiology, using a cross-sectional population study comprising a random sample of adult females and self-reported data based on postal questionnaires. The study group comprised 915 women who...... prevalence in 1987 of episodes of stress and urge urinary incontinence; prevalence of menopause and exposure to childbirth, gynecologic surgery, cystitis and obesity as indicated by body mass index more than 29; prevalence relative risks, as indicated by odds ratio of UI conditional on menopause and other...... the year of final menstruation. The findings suggest perimenopausal processes rather than the menopause in general to be responsible for an increased risk of developing UI. The elevation of UI prevalence in the perimenopause may reflect the adjustment of the female continence mechanism to function...

  4. EAU guidelines on urinary incontinence.

    Science.gov (United States)

    Thüroff, Joachim W; Abrams, Paul; Andersson, Karl-Erik; Artibani, Walter; Chapple, Christopher R; Drake, Marcus J; Hampel, Christian; Neisius, Andreas; Schröder, Annette; Tubaro, Andrea

    2011-03-01

    The first European Association of Urology (EAU) guidelines on incontinence were published in 2001. These guidelines were periodically updated in past years. The aim of this paper is to present a summary of the 2009 update of the EAU guidelines on urinary incontinence (UI). The EAU working panel was part of the 4th International Consultation on Incontinence (ICI) and, with permission of the ICI, extracted the relevant data. The methodology of the 4th ICI was a comprehensive literature review by international experts and consensus formation. In addition, level of evidence was rated according to a modified Oxford system and grades of recommendation were given accordingly. A full version of the EAU guidelines on urinary incontinence is available as a printed document (extended and short form) and as a CD-ROM from the EAU office or online from the EAU Web site (http://www.uroweb.org/guidelines/online-guidelines/). The extent and invasiveness of assessment of UI depends on severity and/or complexity of symptoms and clinical signs and is different for men, women, frail older persons, children, and patients with neuropathy. At the level of initial management, basic diagnostic tests are applied to exclude an underlying disease or condition such as urinary tract infection. Treatment is mostly conservative (lifestyle interventions, physiotherapy, physical therapy, pharmacotherapy) and is of an empirical nature. At the level of specialised management (when primary therapy failed, diagnosis is unclear, or symptoms and/or signs are complex/severe), more elaborate assessment is generally required, including imaging, endoscopy, and urodynamics. Treatment options include invasive interventions and surgery. Treatment options for UI are rapidly expanding. These EAU guidelines provide ratings of the evidence (guided by evidence-based medicine) and graded recommendations for the appropriate assessment and according treatment options and put them into clinical perspective. Copyright

  5. [EAU Guidelines on Urinary Incontinence].

    Science.gov (United States)

    Thüroff, J W; Abrams, P; Andersson, K-E; Artibani, W; Chapple, C R; Drake, M J; Hampel, C; Neisius, A; Schröder, A; Tubaro, A

    2011-01-01

    The first European Association of Urology (EAU) guidelines on incontinence were published in 2001. These guidelines were periodically updated in past years. The aim of this paper is to present a summary of the 2009 update of the EAU guidelines on urinary incontinence (UI). The EAU working panel was part of the 4th International Consultation on Incontinence (ICI) and, with permission of the ICI, extracted the relevant data. The methodology of the 4th ICI was a comprehensive literature review by international experts and consensus formation. In addition, level of evidence was rated according to a modified Oxford system and grades of recommendation were given accordingly. A full version of the EAU guidelines on urinary incontinence is available as a printed document (extended and short form) and as a CD-ROM from the EAU office or online from the EAU Web site (http://www.uroweb.org/guidelines/online-guidelines/). The extent and invasiveness of assessment of UI depends on severity and/or complexity of symptoms and clinical signs and is different for men, women, frail older persons, children, and patients with neuropathy. At the level of initial management, basic diagnostic tests are applied to exclude an underlying disease or condition such as urinary tract infection. Treatment is mostly conservative (lifestyle interventions, physiotherapy, physical therapy, pharmacotherapy) and is of an empirical nature. At the level of specialised management (when primary therapy failed, diagnosis is unclear, or symptoms and/or signs are complex/severe),more elaborate assessment is generally required, including imaging, endoscopy, and urodynamics. Treatment options include invasive interventions and surgery. Treatment options for UI are rapidly expanding. These EAU guidelines provide ratings of the evidence (guided by evidence-based medicine) and graded recommendations for the appropriate assessment and according treatment options and put them into clinical perspective. Copyright

  6. Incontinência urinária no idoso Urinary incontinence in the elderly

    Directory of Open Access Journals (Sweden)

    Rodolfo Borges dos Reis

    2003-01-01

    Full Text Available A prevalência da incontinência urinária no idoso varia de 8 a 34% segundo o critério ou método de avaliação. A principais causas são: alterações teciduais da senilidade que comprometem o trato urinário inferior e o assoalho pélvico, do sistema nervoso central e periférico, alterações hormonais como a menopausa, poliúria noturna, alterações psicológicas, hiperplasia prostática benigna, doenças concomitantes e efeitos colaterais de medicamentos. A incontinência pode ser transitória ou permanente. Além da anamnese cuidadosa para caracterização das perdas urinárias, a busca de causas associadas ou concomitantes e o diário miccional, recorre-se com freqüência a exames especializados como a urodinâmica. O diagnóstico preciso é importante para o manejo adequado que pode requerer apenas medidas conservadoras baseadas em orientações e mudanças de hábitos, como o uso de medicamentos, ou então métodos invasivos que incluem procedimentos cirúrgicos específicos.The prevalence of urinary incontinence in the elderly varies from 8 to 34% according to the criteria or method of investigation. The etiology or main associated factors are: aging tissular degeneration that compromise the lower urinary tract and pelvic floor, changes of peripheric and central nervous system, hormonal alterations such as menopause, nocturnal polyuria, benign prostate hyperplasia, concomitant diseases and side effects of medical drugs. The incontinence may be transitory or permanent. Besides a criterious medical history for a better characterization of the urinary loss, a search for associated or concomitant causes and the miccional diary, one oftenly may rely on specialized exams such as urodynamics. A specific diagnosis is of utmost value for correct management that may require only conservative measures based on changes of behaviour or counceiling, drugs prescription, or invasive methods including surgical procedures.

  7. Urethral sensitivity in incontinent women.

    Science.gov (United States)

    Kinn, A-C; Nilsson, B Y

    2005-07-01

    The aim of this study was to ascertain whether frequent voiding and urge incontinence are associated with supersensitivity to electrical stimulation in the posterior urethra. Current perception thresholds (CPT) were tested at four stimulus frequencies (1, 3, 20, and 100 Hz; duration 0.5 ms) using a square-wave constant current electrical stimulator connected to ring electrodes on a urethral catheter. The strength of the current at the first tingling sensation was regarded as the CPT. CPT analysis and cystometry were performed on 61 women (ages 28-89 years). CPTs were significantly higher at lower than at elevated stimulus frequencies, and they were also generally higher in old than in younger patients. Seven women repeated the CPT test after two months, and the thresholds were unchanged. There were no significant differences in sensitivity between patient groups with stress incontinence, urge, or mixed symptoms. Moreover, CPT was not significantly related to bladder volume at first sensation of filling. Measuring CPT is an easy and reproducible method of testing urethral sensibility, but our results do not support the suspicion that urethral hypersensitivity is involved in increased voiding frequency and urge incontinence.

  8. Comparative study of anal acoustic reflectometry and anal manometry in the assessment of faecal incontinence

    DEFF Research Database (Denmark)

    Hornung, B R; Mitchell, P J; Carlson, G L;

    2012-01-01

    Anal acoustic reflectometry (AAR) is a reproducible technique providing a novel physiological assessment of anal sphincter function. It may have advantages over conventional anal manometry. The aims of this study were to determine the ability of AAR and anal manometry to identify changes in anal...

  9. First diagnosis and management of incontinence in older people with and without dementia in primary care: a cohort study using The Health Improvement Network primary care database.

    Directory of Open Access Journals (Sweden)

    Robert L Grant

    2013-08-01

    Full Text Available BACKGROUND: Dementia is one of the most disabling and burdensome diseases. Incontinence in people with dementia is distressing, adds to carer burden, and influences decisions to relocate people to care homes. Successful and safe management of incontinence in people with dementia presents additional challenges. The aim of this study was to investigate the rates of first diagnosis in primary care of urinary and faecal incontinence among people aged 60-89 with dementia, and the use of medication or indwelling catheters for urinary incontinence. METHODS AND FINDINGS: We extracted data on 54,816 people aged 60-89 with dementia and an age-gender stratified sample of 205,795 people without dementia from 2001 to 2010 from The Health Improvement Network (THIN, a United Kingdom primary care database. THIN includes data on patients and primary care consultations but does not identify care home residents. Rate ratios were adjusted for age, sex, and co-morbidity using multilevel Poisson regression. The rates of first diagnosis per 1,000 person-years at risk (95% confidence interval for urinary incontinence in the dementia cohort, among men and women, respectively, were 42.3 (40.9-43.8 and 33.5 (32.6-34.5. In the non-dementia cohort, the rates were 19.8 (19.4-20.3 and 18.6 (18.2-18.9. The rates of first diagnosis for faecal incontinence in the dementia cohort were 11.1 (10.4-11.9 and 10.1 (9.6-10.6. In the non-dementia cohort, the rates were 3.1 (2.9-3.3 and 3.6 (3.5-3.8. The adjusted rate ratio for first diagnosis of urinary incontinence was 3.2 (2.7-3.7 in men and 2.7 (2.3-3.2 in women, and for faecal incontinence was 6.0 (5.1-7.0 in men and 4.5 (3.8-5.2 in women. The adjusted rate ratio for pharmacological treatment of urinary incontinence was 2.2 (1.4-3.7 for both genders, and for indwelling urinary catheters was 1.6 (1.3-1.9 in men and 2.3 (1.9-2.8 in women. CONCLUSIONS: Compared with those without a dementia diagnosis, those with a dementia diagnosis

  10. Incontinence in persons with Down Syndrome.

    Science.gov (United States)

    Niemczyk, Justine; von Gontard, Alexander; Equit, Monika; Medoff, David; Wagner, Catharina; Curfs, Leopold

    2017-08-01

    To assess the rates of incontinence and associated psychological problems in children, adolescents and adults with Down Syndrome, a genetic syndrome caused by partial or complete triplication (trisomy) of chromosome 21 and characterized by typical facial features, a physical growth delay and mild or moderate intellectual disability. Three hundred and seventeen persons with Down Syndrome (4-51 years) were recruited through a German parent support group (59.6% male, mean age 19.2 years). The Parental Questionnaire: Enuresis/Urinary Incontinence, the Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms, as well as the Developmental Behavior Checklist (DBC) for parents or for adults were filled out by parents or care-givers. 17.2% of the sample had nocturnal enuresis, 15.9% had daytime urinary incontinence, and 14.2% had fecal incontinence. Incontinence was present in 64.0% of young children (4-12 years), 10.3% of teens (13-17 years), 12.8% of young adults (18-30 years) and in 22.4% of older adults (>30 years). 13.6% of children and 8.4% of adults had a DBC score in the clinical range. 19.5% of children and 27.8% of adults with incontinence had behavioral problems. There was a significant association between nocturnal enuresis, daytime urinary incontinence and clinical DBC scores in adults. Incontinence in Down Syndrome is mainly present in young children and increases in older adults. Behavioral comorbidity is associated with incontinence only in adults with Down Syndrome. Screening and treatment of incontinence in individuals with Down Syndrome is recommended. © 2016 Wiley Periodicals, Inc.

  11. Urinary Incontinence: Causes and Methods of Evaluation

    Science.gov (United States)

    Griebling, Tomas L.

    2008-01-01

    This article presents the third of a multi-part series offering the most timely educational information, innovative approaches, products and technology solutions as well as coping and stigma-fighting approaches available on the subject of incontinence. Here, the author introduces the types and physiology of urinary incontinence. The author also…

  12. Endoluminal magnetic resonance imaging in fecal incontinence

    NARCIS (Netherlands)

    E. Rociu (Elena)

    2000-01-01

    textabstractFecal incontinence is a chronic disability, has serious emotional impact and increased risk for social isolation. Imaging has become important in the diagnostic work-up of fecal incontinence. The research described in this thesis continues the line of efforts to improve the quality and t

  13. Urinary incontinence: the role of menopause.

    Science.gov (United States)

    Trutnovsky, Gerda; Rojas, Rodrigo Guzman; Mann, Kristy Pamela; Dietz, Hans P

    2014-04-01

    This study aims to explore the effects of menopause and hormone therapy on the symptoms and signs of stress urinary incontinence and urge urinary incontinence. Records of women who attended a tertiary urogynecological unit were reviewed retrospectively. A standardized interview included evaluations of symptoms, menopause age (ie, time since last menstrual period or onset of menopausal symptoms), current or previous hormone use, and visual analogue scales for bother. Multichannel urodynamics, including urethral pressure profilometry and determination of abdominal leak point pressure, was performed. Of 382 women seen during the inclusion period, 62% were postmenopausal. Current systemic or local hormone use was reported by 7% and 6%, respectively. Two hundred eighty-eight women (76%) reported symptoms of stress urinary incontinence, with a mean bother of 5.7, and 273 women (72%) reported symptoms of urge urinary incontinence, with a mean bother of 6.4. On univariate analysis, symptoms and bother of urge incontinence were significantly related to menopause age, whereas this relationship was not found for stress incontinence. After calendar age was controlled for, length of menopause showed no significant relationship with any symptom or sign of urinary incontinence. Hormone deficiency after menopause is unlikely to play a major role in urinary incontinence.

  14. Impacts of infection with different toxigenic Clostridium difficile strains on faecal microbiota in children

    Science.gov (United States)

    Ling, Zongxin; Liu, Xia; Jia, Xiaoyun; Cheng, Yiwen; Luo, Yueqiu; Yuan, Li; Wang, Yuezhu; Zhao, Chunna; Guo, Shu; Li, Lanjuan; Xu, Xiwei; Xiang, Charlie

    2014-12-01

    Increasing evidence suggests that altered intestinal microbial composition and function result in an increased risk of Clostridium difficile-associated diarrhoea (CDAD); however, the specific changes of intestinal microbiota in children suffering from CDAD and their associations with C. difficile strain toxigenicity are poorly understood. High-throughput pyrosequencing showed that reduced faecal bacterial diversity and dramatic shifts of microbial composition were found in children with CDAD. The Firmicutes/Bacteroidetes ratio was increased significantly in patients with CDAD, which indicated that dysbiosis of faecal microbiota was closely associated with CDAD. C. difficile infection resulted in an increase in lactate-producing phylotypes, with a corresponding decrease in butyrate-producing bacteria. The decrease in butyrate and lactate buildup impaired intestinal colonisation resistance, which increased the susceptibility to C. difficile colonisation. Strains of C. difficile which were positive for both toxin A and toxin B reduced faecal bacterial diversity to a greater degree than strains that were only toxin B-positive, and were associated with unusually abundant Enterococcus, which implies that the C. difficile toxins have different impacts on the faecal microbiota of children. Greater understanding of the relationships between disruption of the normal faecal microbiota and colonisation with C. difficile that produces different toxins might lead to improved treatment.

  15. [Conservative treatment of female urinary incontinence].

    Science.gov (United States)

    Kerdraon, Jacques; Denys, Pierre; Amarenco, Gérard

    2011-09-01

    Female urinary incontinence can be improved by nonsurgical pharmacologic as well as non-pharmacologic treatments. Hygiene and dietary rules apply to all forms of incontinence. If overweight, weight loss improves stress urinary incontinence. There are levels of evidence to show that pelvic floor muscle training and behavioral therapy improve incontinence. Duloxetine is better than placebo for improvement of quality of life and for the impression of an improvement, but its place is still not determined in the algorithm of conservative treatments. The effects of vaginal electrostimulation and oestrogen are inconsistent or inhomogeneous. In case of urgency incontinence, anticholinergics remain the first line treatment and the place of stimulation of posterieur tibial nerve is still to be defined.

  16. Adult female urinary incontinence and childhood bedwetting

    DEFF Research Database (Denmark)

    Foldspang, Anders; Mommsen, S.

    1994-01-01

    A cross-sectional random population sample of women 30 to 59 years old was sent a questionnaire on urinary incontinence and, among other things, childhood bedwetting. Among 2,613 responders 17.0% reported prevalent urinary incontinence (14.7% stress provoked, 8.3% associated with urge, 6.8% stress...... and urge overlap, 2.2% occurring especially during sleep and 3.9% occurring especially when anxious), and 6.5% reported childhood bedwetting after age 5 years and 3.3% after age 10 years. Childhood bedwetting was associated with prevalent urge urinary incontinence (p incontinence occurring...... during sleep (p urinary incontinence occurring in situations of anxiety (p

  17. Baseline concentrations of faecal sterols and assessment of sewage input into different inlets of Admiralty Bay, King George Island, Antarctica.

    Science.gov (United States)

    Martins, César C; Aguiar, Sabrina N; Wisnieski, Edna; Ceschim, Liziane M M; Figueira, Rubens C L; Montone, Rosalinda C

    2014-01-15

    The Antarctic region is one of the best preserved environments in the world. However, human activities such as the input of sewage result in the alteration of this pristine site. We report baseline values of faecal sterols in Admiralty Bay, Antarctica. Four sediment cores were collected during the 2006/2007 austral summer at the Ezcurra (THP and BAR), Mackelar (REF) and Martel (BTP) inlets. Concentrations of faecal sterols (coprostanol+epicoprostanol) were sterols in core layers for THP, BAR, REF and BTP, were 0.04 ± 0.02, 0.03 ± 0.01, 0.07 ± 0.01 and 0.04 ± 0.02 μg g(-1), respectively. These results established as natural contributions of faecal sterols, suggesting that these markers can be useful indicators of human-derived faecal input and contributing to monitoring programs to prevent anthropogenic impacts. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Social networks lack useful content for incontinence.

    Science.gov (United States)

    Sajadi, Kamran P; Goldman, Howard B

    2011-10-01

    To assess the incontinence resources readily available for patients among social networks. Social networks allow users to connect with each other and share content and are a widely popular resource on the Internet. These sites attract millions of users; however, social media are underused in the healthcare industry. A search for "incontinence" was performed on Facebook, Twitter, and YouTube in September 2010. The first 30 results were reviewed for each. The results were evaluated as useful or not useful and additionally catalogued as healthcare professionals, commercial products, or complementary and alternative medicine resources. On Facebook, 4 results (13%) were informative, 12 (40%) advertised commercial incontinence products, and 14 (47%) had no usable information. Of the live "tweets" reviewed on Twitter, 18 (60%) linked to incontinence-related healthcare information (none were from, or referred one to, healthcare professionals), 9 (30%) advertised for commercial incontinence products, 1 (3%) advertised complementary and alternative medicine resources, and 2 (7%) were humorous. Of 4 Twitter user results, 1 was comic, 1 provided incontinence-related health information, and 2 were incontinence medical supply companies. There were 14 (47%) informational YouTube videos, of which 9 came from healthcare professionals or professional organizations. Of the remainder, 12 (40%) were commercial, 1 (3%) advertised complementary and alternative medicine resources, and the remaining 3 (10%) were not useful. The results of our study show that social networks have insufficient useful incontinence content, especially from healthcare professionals and incontinence organizations. Medical professionals and societies should target these avenues to reach and educate patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. Obesity and female stress urinary incontinence.

    Science.gov (United States)

    Osborn, David James; Strain, Matthew; Gomelsky, Alex; Rothschild, Jennifer; Dmochowski, Roger

    2013-10-01

    The purpose of this article was to review the epidemiology, pathophysiology, and treatment options for stress urinary incontinence in the obese female patient and draw conclusions regarding the optimal treatment of this condition in this unique patient population. Obesity results in increased intra-abdominal pressure and this leads to weakening of the pelvic floor innervation and musculature. Weight loss through lifestyle modification and bariatric surgery improves stress urinary incontinence. Success of stress urinary incontinence surgery in obese women is similar to nonobese patients. Obese women should not be excluded from potentially curative surgery based on their body mass index (BMI) alone.

  20. Nocturnal faecal soiling and anal masturbation.

    OpenAIRE

    Clark, A. F.; Tayler, P J; Bhate, S R

    1990-01-01

    Two cases of late onset faecal soiling as a result of anal masturbation in children who were neither mentally handicapped nor psychotic were studied. The role of soiling in aiding the young person and his family to avoid separating and maturing is highlighted. We suggest that the association of anal masturbation and resistant nocturnal soiling may be unrecognised.

  1. Conservative management for urinary incontinence.

    Science.gov (United States)

    Moore, K H

    2000-04-01

    Gynaecologists have become increasingly aware of the need to offer conservative therapy for genuine stress incontinence. There is good objective evidence from randomized controlled trials to support the use of supervised pelvic floor exercises. The efficacy of biofeedback therapy, vaginal cone weights and electrostimulation therapy is variable and requires further study to identify those women who will benefit the most. The mainstay of therapy for detrusor instability/sensory urgency remains bladder training, which has proven objective efficacy, but new treatments such as transcutaneous electrical nerve stimulation (TENS) offer promise. Finally, for certain groups of women with mixed stress and urge leak, a new range of vaginal and urethral devices provide useful additional options. The specific requirements for future research are discussed.

  2. Treatment of stress urinary incontinence

    DEFF Research Database (Denmark)

    Fischer-Rasmussen, W

    1990-01-01

    is unlikely to offer more than a placebo effect. Studies of a single surgical procedure usually report high cure rates. In making the appropriate choice of operation the best guidelines are the cure rates from comparative or prospective randomized reports. From such studies an abdominal retropubic suspension......This review presents reported cure and improvement rates of stress urinary incontinence in women obtained by different treatment modalities. Apart from the urodynamic findings, histological and histochemical changes of the pelvic floor may be clinically relevant to treatment in the future. Long......-term cure and improvement rates achieved by non-surgical treatment (physiotherapy, biofeedback, bladder training, electrostimulation) are commented on. These rates range from 40-60% for physiotherapy and electrostimulation but are considerably less after biofeedback and bladder training. Pharmacotherapy...

  3. [Urinary urgency and reflex incontinence].

    Science.gov (United States)

    Madersbacher, H

    1991-07-01

    Urge and reflex incontinence are caused by detrusor dysfunction:urgency may be due to hyperactivity or hypersensitivity of the bladder. Neurogenic hyperactivity of the detrusor is called detrusor hyperreflexia: the neurogenic uninhibited bladder is caused by incomplete, and the so-called reflex bladder by complete, suprasacral lesions. The pathophysiology of symptomatic and idiopathic detrusor hyperactivity and the therapeutic armentarium are described. Bladder drill together with biofeedback and pharmacotherapy with spasmolytic drugs - several potent spasmolytic drugs with different modes of action are available - are the basis of treatment for hyperactivity and hypersensitivity of the detrusor. An alternative is electrostimulation: stimulation of the afferents of the pudendal nerve, via the pelvic floor (anal, vaginal), percutaneously (dorsal nerve of the penis, clitoric nerve) or by the implantation of electrodes results in inhibition of the detrusor. Most (80-90%) patients can be treated successfully by conservative means. Operative measurements comprise bladder denervation and bladder augmentation. The results of bladder denervation by transtrigonal phenolization of the pelvic plexus are highly controversial. In patients with uncontrollable hyperactivity of the detrusor, augmentation of the bladder (e.g. clam ileocystoplasty) is the method of choice, while for those with uncontrollable hypersensitivity of the detrusor, cystectomy followed by bladder substitution should be performed as a last resort. Treatment for urinary incontinence due to detrusor hyperreflexia must be selected bearing in mind that bladder emptying is inadequate, in most cases because of dyssynergia between detrusor and external sphincter. Therapy is basically aimed at transforming hyperreflexia of the detrusor into hyporeflexia, primarily by potent spasmolytic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Blinded comparison of faecal loading on plain radiography versus radio-opaque marker transit studies in the assessment of constipation

    Energy Technology Data Exchange (ETDEWEB)

    Cowlam, S. [Sunderland Royal Hospital, Sunderland (United Kingdom); Vinayagam, R.; Khan, U.; Marsden, S.; Minty, I.; Moncur, P.; Bain, I. [University Hospital of North Durham, Durham (United Kingdom); Yiannakou, Y.J. [University Hospital of North Durham, Durham (United Kingdom)], E-mail: yan.yiannakou@cddft.nhs.uk

    2008-12-15

    Aim: To compare faecal loading on plain radiography versus radio-opaque marker transit studies in the assessment of constipation. Methods: The study group was a convenience sample of patients attending the Durham Constipation Clinic. All patients underwent transit studies according to an established protocol, and severity of constipation was assessed contemporaneously using a validated questionnaire (PAC-SYM). Transit studies were performed using radio-opaque markers that were ingested over 3 consecutive days, with a radiograph taken on the fourth day. Digital images of the radiograph were digitally altered to remove all traces of the transit markers without affecting the underlying pattern of faecal loading. Four observers assessed faecal loading independently; two clinicians (C1 and C2) and two radiologists (R1 and R2). C1 and R1 used a previously described formal scoring method of assessing faecal loading, whereas C2 and R2 assessed the images as if they were in a clinic or reporting session, grading the faecal loading as mild, moderate, or severe. Results: One hundred patients were recruited out of 186 presenting in a 2-year period. All patients completed assessments. The correlation between observers was only fair to moderate (r ranging from 0.34-0.51). There were some surprisingly marked disagreements in 10-18% of assessments. The correlation between faecal loading and transit was weak for all observers (r ranging from 0.261-0.311). Symptom severity did not correlate with faecal loading. Conclusion: These results suggest that there is considerable inter-observer variation in the radiological assessment of faecal loading, irrespective of the training or method used by the observer, and that there is very poor correlation with colonic transit. The diagnosis of constipation, and the assessment of severity, is best performed clinically.

  5. New drug treatments for urinary incontinence.

    Science.gov (United States)

    Robinson, Dudley; Cardozo, Linda

    2010-04-01

    Urinary incontinence remains a common and distressing condition affecting many women and is known to have a significant effect on quality of life (QoL). Whilst conservative and behavioural therapy are important in the management of women with both stress incontinence and overactive bladder (OAB) ultimately many may benefit from pharmacological therapy. Antimuscarinic drugs are the commonly used agents in the treatment of OAB although often compliance and persistence are affected by adverse effects. Consequently many newer agents remain under investigation. In addition duloxetine has recently been introduced for the management of women with stress incontinence and may offer an alternative to surgery in selected cases. The aim of this review is to provide an overview of the current and new developments in the management of women with urinary incontinence as well as reviewing the role of oestrogen therapy in relation to lower urinary tract dysfunction.

  6. Selecting appropriate absorbent products to treat urinary incontinence.

    Science.gov (United States)

    Payne, Drew

    2015-11-01

    Urinary incontinence can have a significant negative effect on a person's life, especially if left unmanaged and untreated. Continence assessment, often carried out by community nurses, is an important element in the management of a person's urinary incontinence, and so is the selection of appropriate absorbent incontinence pads. This article reviews: the causes and effects of urinary incontinence; how to derive the most appropriate information from a continence assessment; strategies for selecting incontinence pads for a person, on the basis of the results of the continence assessment; and some of the problems and risks associated with the use of incontinence pads.

  7. Comparison of faecal microbiota in Blastocystis-positive and Blastocystis-negative irritable bowel syndrome patients.

    Science.gov (United States)

    Nagel, Robyn; Traub, Rebecca J; Allcock, Richard J N; Kwan, Marcella M S; Bielefeldt-Ohmann, Helle

    2016-08-31

    We investigated whether the carriage of Blastocystis in IBS patients was associated with differences in the faecal microbiota. Forty patients with diarrhoea-predominant IBS (26 Blastocystis-positive and 14 Blastocystis-negative) and 57 healthy controls (HC) (42 Blastocystis-positive and 15 Blastocystis-negative) submitted faecal samples for metataxonomic analysis of the 16S ribosomal RNA gene. Differences in the relative abundance of bacteria in these IBS and HC groups were evaluated from phylum to genus level. Significant changes were observed in two dominant phyla in IBS patients, regardless of Blastocystis infection status, namely a rise in Firmicutes and a statistically significant reduction in relative abundance of Bacteroidetes (with a threefold increase in the Firmicutes to Bacteoridetes ratio). Significant differences at genus level in IBS subjects compared to HC were also observed for many bacterial species. However, further clinical subgroup analysis of Blastocystis-positive and Blastocystis-negative subjects, regardless of symptoms, showed no significant differences at the phylum or genus level in IBS-P compared to IBS-N. Significant differences in the faecal microbiota between diarrhoea-predominant IBS patients and healthy controls were confirmed, but the carriage of Blastocystis did not significantly alter the faecal microbiota. If Blastocystis-positive patients represent a separate clinical subtype of IBS, this group is not identified by changes in the microbiota.

  8. Urgency urinary incontinence and the interoceptive network: a functional magnetic resonance imaging study.

    Science.gov (United States)

    Ketai, Loren H; Komesu, Yuko M; Dodd, Andrew B; Rogers, Rebecca G; Ling, Josef M; Mayer, Andrew R

    2016-10-01

    Treatment of urgency urinary incontinence has focused on pharmacologically treating detrusor overactivity. Recent recognition that altered perception of internal stimuli (interoception) plays a role in urgency urinary incontinence suggests that exploration of abnormalities of brain function in this disorder could lead to better understanding of urgency incontinence and its treatment. We sought to: (1) evaluate the relationship between bladder filling, perceived urgency, and activation at brain sites within the interoceptive network in urgency urinary incontinence; (2) identify coactivation of other brain networks that could affect interoception during bladder filling in urgency incontinence; and (3) demonstrate interaction between these sites prior to bladder filling by evaluating their resting-state connectivity. We performed an observational cohort study using functional magnetic resonance imaging to compare brain function in 53 women with urgency urinary incontinence and 20 controls. Whole-brain voxelwise analyses of covariance were performed to examine differences in functional brain activation between groups during a task consisting of bladder filling, hold (static volume), and withdrawal phases. The task was performed at 3 previously established levels of baseline bladder volume, the highest exceeding strong desire to void volume. All women continuously rated their urge on a 0- to 10-point Likert scale throughout the task and a mixed measures analysis of variance was used to test for differences in urge ratings. Empirically derived regions of interest from analysis of activation during the task were used as seeds for examining group differences in resting-state functional connectivity. In both urgency urinary incontinent participants and controls, changes in urge ratings were greatest during bladder filling initiated from a high baseline bladder volume and urgency incontinent participants' rating changes were greater than controls. During this bladder

  9. Effect of weight loss on urinary incontinence in women

    Directory of Open Access Journals (Sweden)

    Whitcomb EL

    2011-08-01

    Full Text Available Emily L Whitcomb1, Leslee L Subak21Southern California Permanente Medical Group, Female Pelvic Medicine and Reconstructive Surgery, Orange County-Irvine Medical Center, Irvine, CA, USA; 2University of California San Francisco, UCSF Departments of Obstetrics, Gynecology and Reproductive Sciences, and Urology, and Epidemiology and Biostatistics, SF Veterans Affairs Medical Center, San Francisco, CA, USABackground: The purpose of this research was review the epidemiology of the association of obesity and urinary incontinence, and to summarize the published data on the effect of weight loss on urinary incontinence.Methods: A literature review of the association between urinary incontinence and overweight/obesity in women was performed. Case series and clinical trials reporting the effect of surgical, behavioral, and/or pharmacological weight loss on urinary incontinence are summarized.Results: Epidemiological studies demonstrate that obesity is a strong and independent risk factor for prevalent and incident urinary incontinence. There is a clear dose-response effect of weight on urinary incontinence, with each 5-unit increase in body mass index associated with a 20%–70% increase in risk of urinary incontinence. The maximum effect of weight on urinary incontinence has an odds ratio of 4–5. The odds of incident urinary incontinence over 5–10 years increase by approximately 30%–60% for each 5-unit increase in body mass index. There appears to be a stronger association between increasing weight and prevalent and incident stress incontinence (including mixed incontinence than for urge incontinence. Weight loss studies indicate that both surgical and nonsurgical weight loss leads to significant improvements in prevalence, frequency, and/or symptoms of urinary incontinence.Conclusion: Epidemiological studies document overweight and obesity as important risk factors for urinary incontinence. Weight loss by both surgical and more conservative

  10. [Validation of questionnaires to assess quality of life related to fecal incontinence in children with anorectal malformations and Hirschsprung's disease].

    Science.gov (United States)

    Mathias, Arthur Loguetti; Tannuri, Ana Cristina Aoun; Ferreira, Mariana Aparecida Elisei; Santos, Maria Mercês; Tannuri, Uenis

    2016-01-01

    Surgical treatment of anorectal malformations (ARMs) and Hirschsprung's disease (HD) leads to alterations in bowel habits and fecal incontinence, with consequent quality of life impairment. The objectives were to create and validate a Questionnaire for the Fecal Incontinence Index (FII) based on the Holschneider score, as well as a Questionnaire for the Assessment of Quality of Life Related to Fecal Incontinence in Children and Adolescents (QQVCFCA), based on the Fecal Incontinence Quality of Life. The questionnaires were applied to 71 children submitted to surgical procedure, in two stages. Validity was tested by comparing the QQVCFCA and a generic quality of life questionnaire (SF-36), and between QQVCFCA and the FII. A group of 59 normal children was used as control. At two stages, 45.0% (32/71) and 42.8% (21/49) of the patients had fecal incontinence. It was observed that the QQVCFCA showed a significant correlation with the SF-36 and FII (Pearson's correlation 0.57), showing that the quality of life is directly proportional to improvement in fecal incontinence. Quality of life in patients with fecal incontinence is still globally impaired, when compared with control subjects (p<0.05, Student's t test). There were also significant differences between the results of children with ARMs and children with HD. QQVCFCA and FII are useful tools to assess the quality of life and fecal incontinence in these groups of children. Children with ARMs submitted to surgical procedure and HD have similar quality of life impairment. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. Validation of questionnaires to assess quality of life related to fecal incontinence in children with anorectal malformations and Hirschsprung's disease

    Directory of Open Access Journals (Sweden)

    Arthur Loguetti Mathias

    2016-03-01

    Full Text Available Abstract Objective: Surgical treatment of anorectal malformations (ARMs and Hirschsprung's disease (HD leads to alterations in bowel habits and fecal incontinence, with consequent quality of life impairment. The objectives were to create and validate a Questionnaire for the Fecal Incontinence Index (FII based on the Holschneider score, as well as a Questionnaire for the Assessment of Quality of Life Related to Fecal Incontinence in Children and Adolescents (QQVCFCA, based on the Fecal Incontinence Quality of Life. Methods: The questionnaires were applied to 71 children submitted to surgical procedure, in two stages. Validity was tested by comparing the QQVCFCA and a generic quality of life questionnaire (SF-36, and between QQVCFCA and the FII. A group of 59 normal children was used as control. Results: At two stages, 45.0% (32/71 and 42.8% (21/49 of the patients had fecal incontinence. It was observed that the QQVCFCA showed a significant correlation with the SF-36 and FII (Pearson's correlation 0.57, showing that the quality of life is directly proportional to improvement in fecal incontinence. Quality of life in patients with fecal incontinence is still globally impaired, when compared with control subjects (p<0.05, Student's t-test. There were also significant differences between the results of children with ARMs and children with HD. Conclusions: QQVCFCA and FII are useful tools to assess the quality of life and fecal incontinence in these groups of children. Children with ARMs submitted to surgical procedure and HD have similar quality of life impairment.

  12. Faecal microbiota composition and host-microbe cross-talk following gastroenteritis and in postinfectious irritable bowel syndrome

    NARCIS (Netherlands)

    Jalanka-Tuovinen, J.; Salojärvi, J.; Salonen, A.; Immonen, O.; Garsed, K.; Kelly, F.M.; Zaitoun, A.; Palva, A.; Spiller, R.C.; Vos, de W.M.

    2014-01-01

    Background - About 10% of patients with IBS report the start of the syndrome after infectious enteritis. The clinical features of postinfectious IBS (PI-IBS) resemble those of diarrhoea-predominant IBS (IBS-D). While altered faecal microbiota has been identified in other IBS subtypes, composition of

  13. Treatment of stress urinary incontinence.

    Science.gov (United States)

    Fischer-Rasmussen, W

    1990-12-01

    This review presents reported cure and improvement rates of stress urinary incontinence in women obtained by different treatment modalities. Apart from the urodynamic findings, histological and histochemical changes of the pelvic floor may be clinically relevant to treatment in the future. Long-term cure and improvement rates achieved by non-surgical treatment (physiotherapy, biofeedback, bladder training, electrostimulation) are commented on. These rates range from 40-60% for physiotherapy and electrostimulation but are considerably less after biofeedback and bladder training. Pharmacotherapy is unlikely to offer more than a placebo effect. Studies of a single surgical procedure usually report high cure rates. In making the appropriate choice of operation the best guidelines are the cure rates from comparative or prospective randomized reports. From such studies an abdominal retropubic suspension operation (cure rates after five years 57-78 %) is more likely to help the patient than an anterior colporrhaphy (cure rates 31-70 %) or a transvaginal needle bladder neck suspension (cure rates 39-61 %). In selected patients sling procedures or the use of artificial sphincters may produce excellent results (70-80 %). To estimate the results of different treatments urine loss should be assessed objectively and physical restrictions and hygienic and social implications taken into account. A method of pre- and post-treatment "performance scores" should be developed.

  14. Staying Trim, Strong May Cut Risk of Urinary Incontinence

    Science.gov (United States)

    ... frequency over time, but not with changes in urgency urinary incontinence frequency over time," said the study's lead ... pressure (i.e., coughing, laughing, sneezing)," she explained. "Urgency urinary incontinence is involuntary leakage of urine accompanied or ...

  15. Guidelines for the Treatment of Urinary Incontineence and ...

    African Journals Online (AJOL)

    Guidelines for the Treatment of Urinary Incontineence and Overactive Bladder. ... more than 60% of persons with UI never mention their problem to a doctor or nurse. ... Keywords: urinary incontinence, overactive bladder, treatment, Muscarinic ...

  16. Botox Beats Implant for Urinary Incontinence in Women

    Science.gov (United States)

    ... html Botox Beats Implant for Urinary Incontinence in Women But both have side effects that may affect ... 2016 TUESDAY, Oct. 4, 2016 (HealthDay News) -- For women with bladder incontinence who haven't been helped ...

  17. Factors Associated with Urinary Stress Incontinence in Primiparas

    Directory of Open Access Journals (Sweden)

    Pei-Ling Chou

    2005-03-01

    Conclusion: For primiparas who underwent vaginal delivery, an increase in age was associated with increased risk of development of stress incontinence. Increased vulnerability of the pelvic floor with age might explain this finding. Pelvic floor exercise had a protective effect against postpartum stress incontinence in primiparas who underwent cesarean section. This reflects the fact that pregnancy per se carries a risk of stress incontinence. We recommend that primiparas perform pelvic floor exercises to prevent the development of postpartum stress incontinence.

  18. 21 CFR 876.5920 - Protective garment for incontinence.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Protective garment for incontinence. 876.5920... garment for incontinence. (a) Identification. A protective garment for incontinence is a device that... garment from the patient's excreta. This generic type of device does not include diapers for infants....

  19. Urinary incontinence after surgery for pelvic organ prolapse

    NARCIS (Netherlands)

    Lensen, E.J.M.; Withagen, M.I.J.; Kluivers, K.B.; Milani, A.L.; Vierhout, M.E.

    2013-01-01

    AIMS: This study focused on the changes in urinary incontinence (UI) rates pre- and postoperatively and identified risk factors which predict the presence of symptoms of urgency urinary incontinence (UUI) or stress urinary incontinence (SUI) after surgery for pelvic organ prolapse (POP) without conc

  20. A 4-year-old boy presenting with persistent urinary incontinence: Questions.

    Science.gov (United States)

    Keenswijk, Werner; Walle, Johan Vande

    2017-05-01

    A 4-year-old boy was referred to the nephrologist with daytime urinary incontinence and suspicion of an overactive bladder. At the age of 17 months he had been referred to the pediatric endocrinologist because of polyuria and polydipsia in order to exclude diabetes insipidus. Repeated water deprivation tests and a magnetic resonance imaging scan of the brain were normal. Diabetes insipidus was excluded, and primary polydipsia was thought to be most likely since diabetes mellitus also had been excluded. At the current presentation, he drank up to 3 L a day and quite often had wet diapers. He also seemed to pass stools infrequently and with difficulty. Curiously his grandmother had similar symptoms of polyuria and polydipsia since childhood and had been diagnosed with primary polydipsia. The physical examination of our pediatric patient was normal. In the differential diagnosis we included diabetes insipidus but also contemplated other possibilities, such as nephronophthisis, tubulopathies and hypercalciuria. Laboratory results including urinalysis and an ultrasound of the kidney did not show any abnormalities, making a tubulopathy or hypercalciuria unlikely. A desmopressin test by the intravenous route came back completely normal, pointing to another cause than diabetes insipidus. Genetic testing for the nephronophthisis came back negative but was positive for a missense mutation in the AVPR2 gene (p.Arg104Cys) associated with partial nephrogenic diabetes insipidus. He was started on daily desmopressin. Within 3 days the urinary incontinence resolved as did the polyuria and faecal incontinence. His grandmother was referred to the geneticist and eventually the adult nephrologist. This case highlights the importance of being thorough when confronted with a difficult diagnosis. It also emphasizes that a test result does not necessarily equate to the presence or absence of a condition since the test with 100 % sensitivity and specificity has yet to be discovered.

  1. Teflon injections in post-prostatectomy incontinence

    DEFF Research Database (Denmark)

    Osther, P J; Røhl, H F

    1988-01-01

    Twenty-five males with post-prostatectomy incontinence due to sphincter damage underwent transperineal or transurethral Teflon injections. The results were classified into three grades: good, moderate, and poor. Good or moderate results were obtained in 24%. No major immediate complications...... or longterm side-effects were observed. This intervention is associated with a minimum of discomfort for the patient and hospitalization can be limited to 48-72 hours. The results are not so good as those obtained in female incontinence, and the procedure cannot be recommended as first choice treatment...... in patients with post-prostatectomy incontinence, but because of the simplicity of the procedure, it is considered to be a valuable alternative in patients not suitable for prosthetic surgery....

  2. The relationships between preoperative urodynamic parameters and clinical outcomes in urinary stress incontinence

    Directory of Open Access Journals (Sweden)

    Yaşar Bozkurt

    2008-12-01

    Full Text Available The aim of present study was to evaluate the influence of urodynamic parameters on preoperative and postoperative clinical pictures in stress incontinence.Charts of patients, who were operated for stress incontinence using autologous rectus fascia sling between March 1999 and January 2005 in Tepecik Training and Research Hospital Urology Clinic, were evaluated retrospectively.A total of 41 patients were divided into two subgroups as, pure (10 patients and mixed stress incontinence (31 patients groups. Mean age of patients was 50.4 (33-70 years. Fifteen patients had intrinsic sphincter insufficiency (ISI. Mixed incontinence group had lower volume for first sensation and more detrusor overactivity than pure group. ISI did not alter the success of operation. Urodynamically no relationship was found between detrusor pressure and postoperative postvoiding residual urine (P>0.05.In conclusion, urodynamic evaluation before surgery was not related to preoperative and postoperative clinical picture of patients, but first sensation of bladder is only predictive for the success in fascial sling surgery.

  3. Understanding the mechanisms of faecal microbiota transplantation.

    Science.gov (United States)

    Khoruts, Alexander; Sadowsky, Michael J

    2016-09-01

    This Review summarizes mechanistic investigations in faecal microbiota transplantation (FMT), which has increasingly been adapted into clinical practice as treatment for Clostridium difficile infection (CDI) that cannot be eliminated with antibiotics alone. Administration of healthy donor faecal microbiota in this clinical situation results in its engraftment and restoration of normal gut microbial community structure and functionality. In this Review, we consider several main mechanisms for FMT effectiveness in treatment of CDI, including direct competition of C. difficile with commensal microbiota delivered by FMT, restoration of secondary bile acid metabolism in the colon and repair of the gut barrier by stimulation of the mucosal immune system. Some of these mechanistic insights suggest possibilities for developing novel, next-generation CDI therapeutics. FMT might also have potential applications for non-CDI indications. The gut can become a reservoir of other potential antibiotic-resistant pathogens under pressure of antibiotic treatments, and restoration of normal microbial community structure by FMT might be a promising approach to protect against infections with these pathogens as well. Finally, FMT could be considered for multiple chronic diseases that are associated with some form of dysbiosis. However, considerable research is needed to optimize the FMT protocols for such applications before their therapeutic promise can be evaluated.

  4. Metabolic and inflammatory faecal markers in collagenous colitis

    DEFF Research Database (Denmark)

    Wildt, Signe; Lassen, Inge Nordgaard; Bendtsen, Flemming

    2007-01-01

    To evaluate the excretion of the inflammatory and metabolic faecal markers calprotectin, lactoferrin, and short-chain fatty acids in symptomatic and quiescent collagenous colitis.......To evaluate the excretion of the inflammatory and metabolic faecal markers calprotectin, lactoferrin, and short-chain fatty acids in symptomatic and quiescent collagenous colitis....

  5. [Biofeedback effectiveness in patients with fecal incontinence].

    Science.gov (United States)

    Guerra-Mora, José Raúl; Buenrostro-Acebes, José María; Erciga-Vergara, Nancy; Zubieta-O'Farrill, Gregorio; Castillo-Calcáneo, Juan de Dios; Mosqueda, Maria Elena; Monroy-Argumedo, Montserrat; González-Alvarado, Carlos; Villanueva-Saenz, Eduardo

    2015-01-01

    Fecal incontinence is defined as an involuntary bowel movement through the anal canal in inadequate time and place. There are different types of therapies for the management of fecal incontinence, being biofeedback therapy one of the most effective techniques. The aim of this study was to evaluate the necessary number of sessions of biofeedback electromyographyc therapy to achieve the maximum sphincteric complex contraction. Descriptive, retrospective and longitudinal study. 65 patients with fecal incontinence were included. Weekly electromyographyc biofeedback therapies were applied, with a maximum of 6, in which the sphincteric complex contraction was measured. A two ways Friedman analysis was made to determine the significant differences between the sessions. A total of 65 patients were evaluated for fecal incontinence. The values for pelvic floor contraction were significantly higher in the third session, and did not show any significant difference in posterior sessions. The maximum contraction of the sphicnteric complex was achieved in the third weekly biofeedback session, without any significant differences in the posterior sessions.

  6. Cough-induced electrostimulation in incontinence.

    Science.gov (United States)

    Vereecken, R L; Sansen, W; VanNuland, T; Dhaene, P

    1994-01-01

    A new method for treatment of urinary stress incontinence is described. Through a vaginal plug the pelvic floor muscles receive a series of electric stimulations which are triggered by an increase of abdominal pressure, detected by an inbuilt pressure sensor. In this study the best parameters for the stimuli are determined during three successive coughs, which are the most common course of urine loss.

  7. Prolene (mesh bulbourethral sling in male incontinence

    Directory of Open Access Journals (Sweden)

    Rakesh Kapoor

    2007-01-01

    Full Text Available Objective : We present our preliminary results of bulbar urethral sling (single bolster in treatment of postprostatectomy urinary incontinence (PPUI. Materials and Methods: From May 2003 to June 2005, six patients with postprostatectomy urinary incontinence (transurethral resection of prostate in five patients and after open prostatectomy in one patient underwent prolene mesh bulbar urethral sling surgery. Preoperative evaluation included physical examination, neurological assessment, stress cystogram and urethrocystoscopy. Urodynamic evaluation was done in all patients for abdominal leak point pressure and ruling out bladder pathology. Results : Urodynamic studies did not demonstrate bladder instability in any patient. Mean abdominal leak point pressure was 43cm of water (range 26-80 cm of water. Mean duration of hospital stay was 3.2 days. Follow-up ranged from 6-22 months. Four patients out of six patients were completely dry till their last follow-up. One patient developed mild stress incontinence after one year of the surgery and required use of one to two pads per day. Mean pad use after surgery was 0.6 pads per day in comparison to mean pad usage of 6.4 pads per day preoperatively. One patient was over-continent after the procedure and required clean intermittent catheterization till last follow-up (six months. Mean cost of the procedure was $ 350+15. Conclusion: Prolene bulbar urethral sling (single bolster is an economically effective option in patients with postprostatectomy urinary incontinence.

  8. Electrokinetic properties of incontinence nonwoven devices

    Science.gov (United States)

    An understanding of the water transport properties of nonwoven incontinence devices is a prerequisite to the design of cotton-based nonwovens. A complete understanding of the interfacial moisture movement which occurs between the layers of coverstock, acquisition layer, distribution layer, absorbent...

  9. Sexual Experiences of Men with Incontinent Partners

    NARCIS (Netherlands)

    Bekker, Milou D.; Beck, Jacky J. H.; Putter, Hein; van Driel, Mels F.; Pelger, Rob C. M.; Weijmar Schultz, Willibrordus; Nijeholt, Guus A. B. Lycklama A.; Elzevier, Henk W.

    2010-01-01

    Introduction. Several studies show that urinary incontinence (UI) impairs women's sexual functioning and sexual satisfaction. However, there is no scientific knowledge about the effects of UI on sexual functioning of the male partners. Aim. To analyze sexual functioning of the male partners of femal

  10. Introital ultrasonography in female urinary incontinence

    Energy Technology Data Exchange (ETDEWEB)

    Weon, Young Cheol; Cho, Kyoung Sik; Lee, Jin Seong; Choi, Sang Hee; Kim, Keon Seok; Choo, Myung Soo [Ulsan Univ. Asan Medical Center, Seoul (Korea, Republic of)

    1996-06-01

    To evaluate the usefulness of introital ultrasonography in the assessment of female urinary incontinence. Introital ultrasonography was performed in fifteen with stress urinary incontinence(mean age 50) and six patients without symptoms of incontinence(mean age 37). Using a sagittal section of the anterior pelvis in the plane of the symphysis pubis the posterior urethrovesical angle, the pubourethral distance and the pubo-yregrak abgle were measured at rest and during stress(Valsalva's maneuver state). The student T-test and the ANOVA test were used in statistical analysis. The posterior urethrovesical angles of the controls were 125.3 deg ({+-}10.9) at rest and 125.7 deg ({+-}7.6) during stress. In the patients, the corresponding angles were 135.3 deg ({+-}11.3) and 139.6 deg({+-}10.8). The posterior urethrovesical angles increased 0.3 deg ({+-}4.7) in the controls and 5.6 deg ({+-}4.0) in the patients(p=0.018). In the controls, the pubo-urethral distances were 21.8 mm({+-}5.8) at rest and 18.2 mm({+-}7.1) during stress, while in the patients these distances were 18.4 mm({+-}3.9) and 12.6 mm({+-}4.4). The pubo-urethral distance decreased 3.5 mm ({+-}1.5) in the controls and 5.8 mm ({+-}2.3) in the patients(p=0.039). In the patients with mild incontinence(Grade I), the posterior urethrovesical angles increased 3.4 deg ({+-}2.8) : 132.3 deg ({+-}12.5) at rest and 135.6 deg (12.8) during stress. In the patients with moderate incontinence(Grade II), the angles increased 8.1 deg({+-}3.8) : 136.0 deg({+-}6.5) at rest and 144.1 deg({+-}5.9) during stress. The change of the posterior urethrovesical angle was related to the grade of urinary incontinence in the patients(p<0.05). There was no statistical significancy in the pubo-urethral angle (p=0.315). Introital ultrasonography may be useful for assessment of stress urinary incontinence.

  11. Faecal microbiota transplantation: Key points to consider.

    Science.gov (United States)

    Bourlioux, P

    2015-05-01

    Faecal microbiota transplantation (FMT) from a healthy donor has become the gold standard treatment for patients suffering from recurrent Clostridium difficile infection where antibiotic treatment (with vancomycin, metronidazole or fidaxomicin) has failed. FMT eradicates C. difficile and helps restore the recipient's intestinal flora, but its mechanism of action remains unclear. Since FMT's complex and highly variable composition cannot be easily characterized - nor its quality routinely assessed - FMT as a sui generis biologic drug cannot conform to existing standards for preparation. Clearly, donors must be carefully selected and the raw material prepared under close microbiological control, but FMT should also conform to manufacturing and laboratory practice standards for which international consensus can only be achieved with further experience. The objective should be to engage biomedical research to develop protocols that help elucidate the mechanism of action of FMT and support the production of safe and efficacious products. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  12. Predictors of female urinary incontinence at midlife and beyond.

    Science.gov (United States)

    Menezes, M; Pereira, M; Hextall, A

    2010-02-01

    Urinary incontinence (UI) is an important middle age health issue and approximately 20% of women over 40 years of age have problems with continence. Urinary incontinence poses a significant negative impact on social functioning and quality of life to many individuals. It is estimated that around three million people are regularly incontinent in the UK with a prevalence of about 40 per 1000 adults. There are various factors which can cause incontinence such as pregnancy, childbirth, obesity, menopause, or just inherent connective-tissue weakness. All of these factors can cause pathophysiology changes in the muscular and fascial structures of the pelvic floor and lead to pelvic support defects and possibly pelvic floor dysfunction. We aim with this review article to highlight predictors or predisposing factors of incontinence; in order to help clinicians during their decisions and put in place a policy of a preventive strategy to decrease the incontinence rate in the general population.

  13. Urinary incontinence nursing diagnoses in patients with stroke

    Directory of Open Access Journals (Sweden)

    Telma Alteniza Leandro

    2015-12-01

    Full Text Available Abstract OBJECTIVE Identifying the prevalence of Stress urinary incontinence (SUI, Urge urinary incontinence (UUI, Functional urinary incontinence (FUI, Overflow urinary incontinence (OUI and Reflex urinary incontinence (RUI nursing diagnoses and their defining characteristics in stroke patients. METHOD A cross-sectional study with 156 patients treated in a neurological clinic. Data were collected through interviews and forwarded to nurses for diagnostic inference. RESULTS 92.3% of the patients had at least one of the studied diagnoses; OUI showed the highest prevalence (72.4%, followed by FUI (53.2%, RUI (50.0%, UUI (41.0% and SUI (37.8%. Overdistended bladder and reports of inability to reach the toilet in time to avoid urine loss were the most prevalent defining characteristics. A statistically significant association of the defining characteristics with the studied diagnosis was verified. CONCLUSION The five incontinence diagnoses were identified in the evaluated patients, with different prevalence.

  14. Taking Control: Non-Surgical Treatment Options for Urinary Incontinence in Women

    Science.gov (United States)

    ... Home > Decision Aids > Urinary Incontinence > What is UI? Taking Control: Non-surgical Treatment Options for Urinary Incontinence in ... 0 Page 2 What is urinary incontinence (UI)? Taking Control (5-minute video) Click on the video above ...

  15. Mixed Incontinence: How Best to Manage It?

    Science.gov (United States)

    Porena, Massimo; Costantini, Elisabetta; Lazzeri, Massimo

    2013-03-01

    Although common in women, mixed urinary incontinence (MUI) is under-reported and under-treated. It is linked to concomitant disturbances, which may be due to childbirth, ageing, or other medical conditions, in the complex bladder-urethra coordinated system of urine storage and emptying. Primary care physicians can evaluate MUI through history and simple clinical assessment or they can avail of more complex device and tools, such as urodynamic assessment. There is a wide range of therapeutic options. The recent proliferation of new drug treatments and surgical devices for urinary incontinence offers innovative strategies for therapy but products risk being introduced without long-term safety and efficacy assessment. Direct-to-consumer advertising has increased public awareness of MUI.

  16. [Causes and diagnosis of female urinary incontinence].

    Science.gov (United States)

    Schorsch, I; Soljanik, I; Stanislaus, P; Bauer, R; Mayer, M; Hocaoglu, Y; Becker, A; May, F

    2007-09-20

    The primary cause of stress incontinence is birth traumata. However, obesity, asthma, chronic constipation or hard physical work can also overtax the pelvic floor and lead to injury of the connective tissue and a slackening of the ligamentous apparatus. Pelvic floor defects are initially diagnosed simply through a thorough urogynaecological examination. To predict the success of a surgical treatment, the functions can be tested by performing simulated operations.

  17. [risk Factors For Urinary Incontinence In Women].

    OpenAIRE

    Higa,Rosângela; Lopes, Maria Helena Baena de Moraes; dos Reis, Maria José

    2015-01-01

    The goal of this study was to conduct a review of the main papers published between 1983 and 2003 on the main risk factors for urinary incontinence (UI) in women. Thirty-eight publications in English and Portuguese were analyzed using the MEDLINE and LILACS databases as well as through research in libraries. There is evidence that the main risk factors are age, pelvic floor trauma, hereditary factors, race, menopausal status, obesity, chronic diseases, use of some sympathomimetics and parasym...

  18. [Sport and urinary incontinence in women].

    Science.gov (United States)

    Lousquy, R; Jean-Baptiste, J; Barranger, E; Hermieux, J-F

    2014-09-01

    Women are more attentive to their physical appearance and a quarter of French women use to practice a regular physical activity. Benefits of sport on general health are recognized. However, sport may be the cause of various diseases when it is poorly chosen or improperly performed. In literature, intensive exercise is a risk factor for urinary incontinence, defined as "the complaint of any involuntary leakage of urine". It is essentially stress urinary incontinence, occurring because of the phenomenon of intrabdominal hyperpressure, inherent with certain activities, and excess capacity of sphincters. Some sports are more risky than others, and high-level sportswomen are the most exposed. Health professionals must invest in information, screening, prevention, counseling and treatment track athletes So, the general practitioner and the doctor of sports play a vital role in informing, screening, prevention, therapeutic and monitoring of sportswomen. Better information is needed because according to the severity of incontinence and its impact, there are simple, effective, more or less invasive treatment options. The aim of this study was to establish an inventory of scientific knowledge and to improve the management of these patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  19. Neurological aspects of urinary incontinence in the elderly

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2013-01-01

    Full Text Available The paper gives data on the prevalence, pathogenesis, and treatment of urinary incontinence in the elderly. There is a high rate of urinary incontinence among the patients who have experienced stroke or suffer from dementia or other neurological diseases. The ideas on the pathogenesis and manifestations of overactive bladder, stress urinary incontinence are outlined. Currently available drugs (anticholinergics, antidepressants, botulinum toxin preparations, methods for behavioral therapy and physiotherapy, and skin care in urinary incontinence are discussed. The current treatment options can improve quality of life in the elderly and their milieu.

  20. [Urinary stress incontinence: rehabilitation treatment of the pelvic floor].

    Science.gov (United States)

    Braccini, S; Toniazzi, P

    1995-11-01

    The authors inspected 112 patients with diagnostic urogynecologic and urodynamic criteria. They suffered from urinary stress incontinence. Forty patients effected rehabilitative therapy of the pelvic floor with visits twice weekly with a method which included: pelvic muscle exercises, biofeedback and functional electrostimulation. The patients were divided into two groups in accordance with the kind of urinary stress incontinence: in the first group there were patients with genuine urinary stress incontinence, in the second group patients with mixed urinary stress incontinence. The results at the end of treatment reported a proportion of success of 66% in the first group and of 54% in the second group.

  1. [Treatment of stress and urge incontinence in women].

    Science.gov (United States)

    Glavind, K; Mouritsen, A L; Lose, G

    1998-01-01

    Urinary incontinence has a great impact on the quality of life in many patients. This article gives simple regulations and advice which can improve the situation. The treatment of stress- and urge incontinence is discussed. In stress incontinence conservative treatment in the form of pelvic floor muscle exercise should always be the first choice of treatment. This treatment can be aided by biofeedback, cones or electrostimulation. Mechanical devices and pharmacological treatment is another option. Different surgical methods are discussed. Urge incontinence can be treated with bladder drill, biofeedback, hypnosis, acupuncture, pharmacological treatment electrostimulation or rarely surgery. Any treatment should consider the expectations and motivation of the patient and the need for treatment.

  2. Bacteriuria is associated with urge urinary incontinence in older women

    Science.gov (United States)

    Rodhe, Nils; Englund, Lars; Mölstad, Sigvard; Samuelsson, Eva

    2008-01-01

    Objective To investigate the association between bacteriuria and frequency and type of urinary incontinence in elderly people living in the community. Bacteriuria and urinary incontinence are common conditions and often coexisting in this population; the authors have previously reported the prevalence of bacteriuria to be 22.4% in women and 9.4% in men. Design Cross-sectional study. Setting The catchment area of a primary healthcare centre in a Swedish middle-sized town. Subjects Residents, except for those in nursing homes, aged 80 and over. Participation rate: 80.3% (431/537). Main outcome measures Urinary cultures and questionnaire data on urinary incontinence. Results In women the OR for having bacteriuria increased with increasing frequency of urinary incontinence; the OR was 2.83 (95% CI 1.35–5.94) for women who were incontinent daily as compared with continent women. Reporting urge urinary incontinence increased the risk of having bacteriuria: 3.36 (95% CI 1.49–7.58) in comparison with continent women while there was no significant association between stress urinary incontinence and bacteriuria. The prevalence of bacteriuria among men was too low to make any meaningful calculations about the association between bacteriuria and frequency and type of incontinence. Conclusion Bacteriuria is associated with more frequent leakage and predominantly with urge urinary incontinence. The causes of this association and their clinical implications remain unclear. There might be some individuals who would benefit from antibiotic treatment, but further studies are warranted. PMID:18297561

  3. The sensitivity of direct faecal examination, direct faecal flotation, modified centrifugal faecal flotation and centrifugal sedimentation/flotation in the diagnosis of canine spirocercosis

    Directory of Open Access Journals (Sweden)

    J. Christie

    2011-04-01

    Full Text Available Several faecal examination techniques have shown variable sensitivity in demonstrating Spirocerca lupi (S. lupi eggs. The objective of this study was to determine which faecal examination technique, including a novel modified centrifugal flotation technique, was most sensitive to diagnose spirocercosis. Ten coproscopic examinations were performed on faeces collected from 33 dogs confirmed endoscopically to have spirocercosis. The tests included a direct faecal examination, a faecal sedimentation/flotation test, 4 direct faecal flotations and 4 modified faecal centrifugal flotations. These latter 2 flotation tests utilised 4 different faecal flotation solutions:NaNO3 (SG 1.22,MgSO4 (SG 1.29,ZnSO4 (SG 1.30 and sugar (SG 1.27. The sensitivity of the tests ranged between 42 %and 67 %, with theNaNO3 solution showing the highest sensitivity in both the direct and modified-centrifugal flotations. The modified NaNO3 centrifugal method ranked 1st with the highest mean egg count (45.24±83, and was superior (i.e. higher egg count and significantly different (P< 0.05 compared with the routine saturated sugar,ZnSO4 andMgSO4 flotation methods. The routine NaNO3 flotation method was also superior and significantly different (P < 0.05 compared with the routine ZnSO4 andMgSO4 flotation methods. Fifteen per cent (n=5 of dogs had neoplastic oesophageal nodules and a further 18 % (n = 6 had both neoplastic and non-neoplastic nodules. S. lupi eggs were demonstrated in 40%of dogs with neoplastic nodules only and 72.9 % of the dogs with non-neoplastic nodules. The mean egg count in the non-neoplastic group (61 was statistically greater (P = 0.02 than that of the neoplastic group (1. The results show that faecal examination using a NaNO3 solution is the most sensitive in the diagnosis of spirocercosis. The modified centrifugal flotation faecal method using this solution has the highest egg count. The study also found that dogs with neoplastic nodules shed

  4. The sensitivity of direct faecal examination, direct faecal flotation, modified centrifugal faecal flotation and centrifugal sedimentation/flotation in the diagnosis of canine spirocercosis.

    Science.gov (United States)

    Christie, J; Schwan, E V; Bodenstein, L L; Sommerville, J E M; van der Merwe, L L

    2011-06-01

    Several faecal examination techniques have shown variable sensitivity in demonstrating Spirocerca lupi (S. lupi) eggs. The objective of this study was to determine which faecal examination technique, including a novel modified centrifugal flotation technique, was most sensitive to diagnose spirocercosis. Ten coproscopic examinations were performed on faeces collected from 33 dogs confirmed endoscopically to have spirocercosis. The tests included a direct faecal examination, a faecal sedimentation/flotation test, 4 direct faecal flotations and 4 modified faecal centrifugal flotations. These latter 2 flotation tests utilised 4 different faecal flotation solutions: NaNO3 (SG 1.22), MgSO4 (SG 1.29), ZnSO4 (SG 1.30) and sugar (SG 1.27). The sensitivity of the tests ranged between 42% and 67%, with the NaNO3 solution showing the highest sensitivity in both the direct and modified-centrifugal flotations. The modified NaNO3 centrifugal method ranked 1st with the highest mean egg count (45.24 +/- 83), and was superior (i.e. higher egg count) and significantly different (P < 0.05) compared with the routine saturated sugar, ZnSO4 and MgSO4 flotation methods. The routine NaNO3 flotation method was also superior and significantly different (P < 0.05) compared with the routine ZnSO4 and MgSO4 flotation methods. Fifteen per cent (n = 5) of dogs had neoplastic oesophageal nodules and a further 18% (n = 6) had both neoplastic and non-neoplastic nodules. S. lupi eggs were demonstrated in 40% of dogs with neoplastic nodules only and 72.9% of the dogs with non-neoplastic nodules. The mean egg count in the non-neoplastic group (61) was statistically greater (P = 0.02) than that of the neoplastic group (1). The results show that faecal examination using a NaNO3 solution is the most sensitive in the diagnosis of spirocercosis. The modified centrifugal flotation faecal method using this solution has the highest egg count. The study also found that dogs with neoplastic nodules shed

  5. Incontinence Symptom Index-Pediatric: development and initial validation of a urinary incontinence instrument for the older pediatric population.

    Science.gov (United States)

    Nelson, Caleb P; Park, John M; Bloom, David A; Wan, Julian; Dunn, Rodney L; Wei, John T

    2007-10-01

    Although urinary incontinence is common in children, no validated pediatric instruments exist for measuring urinary incontinence symptoms and bother. We developed and validated a patient reported pediatric survey for urinary incontinence measurement. The Incontinence Symptom Index-Pediatric is an 11-item instrument comprising 2 domains, that is 1) impairment and 2) symptom severity, including subdomains for stress urinary incontinence, urge urinary incontinence, insensate urinary incontinence, nocturnal urinary incontinence and pad use. The survey was self-administered twice, 2 weeks apart, to boys and girls ages 11 to 17 years. Children completed the survey independently. Cases consisted of patients presenting to pediatric urology clinic with the chief complaint of urinary incontinence. Controls consisted of healthy children presenting for evaluation up at a general pediatric practice. Formal validation analysis was performed. A total of 19 subjects per arm completed at least 1 survey. Internal consistency was good with a Cronbach's alpha of 0.84 for the complete instrument. Item-scale correlations were greater than 0.60 for all except 1 item. Test-retest reliability was also good (r = 0.97, p <0.0001). Discriminative validity was good with a total severity scale score of 9.3 in wet children and 0.7 in controls (p <0.0001). Impairment scale scores differed by 2.2 points (p <0.0001). Mean scores differed significantly between subscales for all domains except pad use. The most dramatic difference was in the urge urinary incontinence domain, which differed by a mean of 3.6 points (p = 0.0002). This pilot study provides initial validation of a survey instrument for urinary incontinence in children and adolescents. This instrument can be used in children ages 11 to 17 years to objectively and reproducibly measure patient reported urinary incontinence.

  6. Faecal mucus degrading glycosidases in ulcerative colitis and Crohn's disease.

    Science.gov (United States)

    Rhodes, J M; Gallimore, R; Elias, E; Allan, R N; Kennedy, J F

    1985-08-01

    Because the normal faecal flora includes bacteria which can produce mucus-digesting glycosidases, it follows that increased digestion of colonic mucus by these bacterial enzymes could be important in the pathogenesis of ulcerative colitis. Faecal activities of potential mucus-degrading glycosidases have therefore been assayed in samples from patients with inflammatory bowel disease and normal controls. The enzymes alpha-D-galactosidase, beta-D-galactosidase, beta-NAc-D-glucosaminidase alpha-L-fucosidase and neuraminidase were assayed. Considerable glycosidase activity was present in most faecal samples. Similar activities of all the enzymes assayed were found in faeces from patients with ulcerative colitis, Crohn's disease and normal controls and there was no significant correlation with disease activity. These results imply that relapse of ulcerative colitis is not initiated by increased degradation of colonic mucus by faecal glycosidases but do not exclude a role for bacterial mucus degradation in the pathogenesis of ulcerative colitis.

  7. Utility of faecal calprotectin analysis in adult inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Lyn A Smith; Daniel R Gaya

    2012-01-01

    The inflammatory bowel diseases (IBD),Crohn's disease and ulcerative colitis,are chronic relapsing,remitting disorders.Diagnosis,along with assessment of disease activity and prognosis present challenges to managing clinicians.Faecal biomarkers,such as faecal calprotectin,are a non-invasive method which can be used to aid these decisions.Calprotectin is a calcium and zinc binding protein found in the cytosol of human neutrophils and macrophages.It is released extracellularly in times of cell stress or damage and can be detected within faeces and thus can be used as a sensitive marker of intestinal inflammation.Faecal calprotectin has been shown to be useful in the diagnosis of IBD,correlates with mucosal disease activity and can help to predict response to treatment or relapse.With growing evidence supporting its use,over the last decade this faecal biomarker has significantly changed the way IBD is managed.

  8. Effects of dietary bran and the colon carcinogen 1,2-dimethylhydrazine on faecal. beta. -glucuronidase activity in mice

    Energy Technology Data Exchange (ETDEWEB)

    London, J.F.; Clapp, N.K.; Henke, M.A.

    1981-01-01

    To evaluate the physiological changes that might provide either mechanistic or prognostic information in colon carcinogenesis, we treated 8-wk-old male BALB/c mice with semisynthetic bran diets containing 20% by weight of either soya bean, winter wheat, or corn bran and gave ten weekly injections (from age 11 to 21 wk) of 20 mg 1,2-dimethylhydrazine (DMH)/kg body weight. Appropriate controls were included. Faecal samples were collected 11 to 13 wk after completion of DMH treatment and after 24 to 26 wk of continuous bran diet feeding. Daily faecal ..beta..-glucuronidase activity fluctuations were observed, but these were not statistically significant. Faecal enzyme activity varied depending upon the type of bran diet (control > wheat > soya bean > corn). DMH generally depressed faecal enzyme activity to a statistically significant degree (P < 0.03). These results demonstrate the persistent enzyme alterations produced by DMH and the assay's sensitivity for detecting such change. Further, the effects of diet suggest that dietary brans cause physiological changes that have the potential to modify colon carcinogenesis.

  9. Integrated community profiling indicates long-term temporal stability of the predominant faecal microbiota in captive cheetahs.

    Science.gov (United States)

    Becker, Anne A M J; Janssens, Geert P J; Snauwaert, Cindy; Hesta, Myriam; Huys, Geert

    2015-01-01

    Understanding the symbiotic relationship between gut microbes and their animal host requires characterization of the core microbiota across populations and in time. Especially in captive populations of endangered wildlife species such as the cheetah (Acinonyx jubatus), this knowledge is a key element to enhance feeding strategies and reduce gastrointestinal disorders. In order to investigate the temporal stability of the intestinal microbiota in cheetahs under human care, we conducted a longitudinal study over a 3-year period with bimonthly faecal sampling of 5 cheetahs housed in two European zoos. For this purpose, an integrated 16S rRNA DGGE-clone library approach was used in combination with a series of real-time PCR assays. Our findings disclosed a stable faecal microbiota, beyond intestinal community variations that were detected between zoo sample sets or between animals. The core of this microbiota was dominated by members of Clostridium clusters I, XI and XIVa, with mean concentrations ranging from 7.5-9.2 log10 CFU/g faeces and with significant positive correlations between these clusters (Pcombination thereof, which temporarily altered the relative proportions of Clostridium clusters I and XIVa. In conclusion, this first long-term monitoring study of the faecal microbiota in feline strict carnivores not only reveals a remarkable compositional stability of this ecosystem, but also shows a qualitative and quantitative similarity in a defined set of faecal bacterial lineages across the five animals under study that may typify the core phylogenetic microbiome of cheetahs.

  10. REDUCTION OF FAECAL MICROBIOLOGICAL INDICATORS IN DIFFERENT COMPOST TOILETS

    OpenAIRE

    Møller, J.; Forslund, A.; Dalsgaard, A.

    2003-01-01

    Large variations in numbers of faecal indicator bacteria were found irrespective of the storage time of collected human faeces. Little heat seemed generated from composting processes when bin units were stored locally in households. The low reduction in microbiological parameters and very limited temperature increase were generally corroborated by the results obtained in experiment 2 when pathogen indicators were added to thoroughly mixed faecal matter. Even though Salmonella died of rapidly ...

  11. [CT-guided electrode placement for sacral nerve stimulation in the treatment of faecal incontinence (cSNS)].

    Science.gov (United States)

    Goos, M; Ruf, G; Jargon, D; Trummer, C; Thomusch, O; Grüneberger, J; Bulla, S; Kotter, E; Ruthmann, O

    2014-12-01

    The sacral nerve stimulation (SNS) can be performed in the screening phase under local anaesthesia. Implantation of the tined-lead electrodes is usually performed in an inpatient setting under general anaesthesia. An outpatient procedure for both PNE and implantation of the electrodes offers decisive advantages with respect to the accuracy of electrode placement. From 2006 to 2011 a total of 51 patients was treated with SNS in an outpatient setting. Of 51 patients having the PNE, in four patients the procedure could not successfully be completed. In 39 of the 47 patients screened, the testing was positive. Eight times the screening was negative. The functional results show a significant decline in the Cleveland scores from 14.9 to 6.4. The manometric resting pressure improved from 23.4 mmHg to 43.81 mmHg, the squeezing pressure improved from 42.2 mmHg to 76.12 mmHg. Due to patients' perception and according to the response on the stimulus, the electrodes were placed on the left in S4 11 times, 23 times in the left S3, 3 times in the right S3, once in the left S2 and once in the right S2. CT-guided electrode placement is safe for temporary (subchronic) and permanent (chronic) sacral nerve stimulation and provides a valuable means for placement of the stimulating material. Georg Thieme Verlag KG Stuttgart · New York.

  12. Conventional treatment of functional constipation has a positive impact on the behavioural difficulties in children with and without faecal incontinence

    DEFF Research Database (Denmark)

    Modin, Line; Jakobsen, Ida Skytte; Jakobsen, Marianne Skytte

    2016-01-01

    aged five to 16 years who fulfilled the Rome III criteria for FC received conventional treatment. The Strength and Difficulties Questionnaire was completed at inclusion and at the 12-month follow-up. RESULTS: We included 116 children. The behaviour scores decreased in successfully treated boys (10...

  13. Incontinence in individuals with Angelman syndrome: a comparative study.

    Science.gov (United States)

    Radstaake, Maartje; Didden, Robert; Giesbers, Sanne; Korzilius, Hubert; Peters-Scheffer, Nienke; Lang, Russell; von Gontard, Alexander; Curfs, Leopold M G

    2013-11-01

    Frequency and type of incontinence and variables associated with incontinence were assessed in individuals with Angelman syndrome (AS; n=71) and in a matched control group (n=69) consisting of individuals with non-specific intellectual disability (ID). A Dutch version of the "Parental Questionnaire: Enuresis/Urinary Incontinence" (Beetz, von Gontard, & Lettgen, 1994) was administered and information on primary caretakers' perspectives regarding each individual's incontinence was gathered. Results show that diurnal incontinence and fecal incontinence during the day more frequently occurred in the control group than in the AS group. In both groups, nocturnal enuresis was the most common form of incontinence. More incontinence was seen in individuals with AS who were younger, had a lower level of adaptive functioning and/or had epilepsy. Individuals with AS were able to stay dry for longer periods of time than the controls and often showed both in-toilet urination and urinary accidents during the day, whereas accidents and correct voids during the day were more set apart in the control group. Also, persons with AS had a lower micturition frequency implying possible voiding postponement. Both groups showed high rates of LUTS (lower urinary tract symptoms) possibly indicative of functional bladder disorders such as voiding postponement, dysfunctional voiding, or even an underactive bladder. In general, most primary caretakers reported severe intellectual disability as the main cause for urinary incontinence. Based on these results incontinence does not appear to be part of the behavioral phenotype of Angelman syndrome. Therefore, pediatric or urologic diagnostics and treatment are recommended for all persons with incontinence and intellectual disability. Further implications for practice and research are given. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Effective Factors on Urinary Incontinence in Natural Menopausal Women

    Directory of Open Access Journals (Sweden)

    Shohani

    2015-10-01

    Full Text Available Background Urinary tract infections and urinary incontinence are common urogenital problems affecting 7 - 10% of menopausal women. Objectives The primary objective of this study was to quantify effective factors on urinary incontinence in a cohort of menopausal women. Patients and Methods A sample of 150 menopausal women (natural menopause for at least 12 months were recruited from 13 healthcare centers in Ilam, Iran. Data regarding diagnosis, medical history and clinical symptoms were collected using a structured questionnaire and screening patient medical records. Logistic regression models were used to examine associations between urinary incontinence and other variables. Results Multiple atrophic urogenital changes were identified including vaginal dryness (42%, decreased libido (41.3%, dyspareunia (16%, vaginal itching (11.3% and vaginal discharge and burning (10.7%. The prevalence of urinary frequency, stress urinary incontinence, nocturia and urge urinary incontinence were 33.3%, 28.7%, 22.7% and 17.3%, respectively. A multivariate logistic model found that urinary infection (OR 5.6; 95% CI: 2.6 - 11.58, cystocele (OR 1.73; 95% CI: 1.29 - 2.33 and rectocele (OR 1.47; 95% CI: 1.20 - 1.80 were potential risk factors for incontinence. A significant association was observed between marital status and vaginal atrophy, body mass index and urinary incontinence and parity type and urinary incontinence (P < 0.05 for all. Conclusions Multiple associations existed between atrophic urogenital changes and urinary incontinence. The most significant interaction was between urinary tract infections and urinary incontinence in menopausal women, with urinary tract infections increasing the risk of incontinence by 5.6 fold. We recommend health professionals to focus on early screening of these issues and implement educational programs for women as part of standard practice.

  15. Faecal calprotectin: Management in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    José; Manuel; Benítez; Valle; García-Sánchez

    2015-01-01

    Inflammatory bowel disease(IBD) is a chronic and relapsing disorder which leads to an inflammation of the gastrointestinal tract. A tailored therapy to achieve mucosal healing with the less adverse events has become a key issue in the management of IBD. In the past, the clinical remission was the most important factor to consider for adapting diagnostic procedures and therapeutic strategies. However, there is no a good correlation between symptoms and intestinal lesions, so currently the goals of treatment are to achieve not only the control of symptoms, but deep remission, which is related with a favourable prognosis. Thus, the determination of biological markers or biomarkers of intestinal inflammation play a crucial role. Many biomarkers have been extensively evaluated in IBD showing significant correlation with endoscopic lesions, risk of recurrence and response to treatment. One of the most important markers is faecal calprotectin(FC). Despite calprotectin limitations, this biomarker represents a reliable and noninvasive alternative to reduce the need for endoscopic procedures. FC has demonstrated its performance for regular monitoring of IBD patients, not only to the diagnosis for discriminating IBD from non-IBD diagnosis, but for assessing disease activity, relapse prediction and response to therapy. Although, FC provides better results than other biomarkers such as C-reactive protein and erythrocyte sedimentation rate, these surrogate markers of intestinal inflammation should not be used isolation but in combination with other clinical, endoscopic, radiological or/and histological parameters enabling a comprehensive assessment of IBD patients.

  16. Enhancing faecal sludge management in peri-urban areas of Lusaka through faecal sludge valorisation: challenges and opportunities

    Science.gov (United States)

    Tembo, J. M.; Nyirenda, E.; Nyambe, I.

    2017-03-01

    Lusaka, the capital city of Zambia, has two million inhabitants with 70% residing in peri-urban areas. Ninety (90) % of this population employ pit latrines for excretion generating approximately 22,680 tons of faecal sludge per annum. This sludge is inadequately managed hence of the generated amount, over 60% remains within the residential environment thereby compromising both the environment and public health. To foster a solution to this problem, a study was commissioned to assess faecal sludge valorisation potential and how it would impact on Faecal Sludge Management. The study evaluated policy, institutional and regulatory frameworks, sanitation practices including latrine construction and usage aspects and also characterised the faecal sludge for selected parameters relevant to valorisation. Four peri-urban areas were adopted as study sites. Policy issues together with existing institutional and regulatory frameworks were assessed through literature review. Sanitation practices were evaluated through physical observations, focus group discussions, interviews and questionnaire administration. Faecal sludge characterisation was through sampling and analysis. It was observed that there are policy gaps in fostering faecal sludge valorisation. Sanitation practices and latrines construction also do not favour valorisation. The quality of the raw sludge has potential for valorisation though again, some parameters like solid waste content require drastic changes in sanitation practices in order not to compromise the reuse potential of the sludge. It was concluded that if faecal sludge management is to be enhanced through valorisation, there is need to have policies promoting pit latrine faecal sludge reuse and strengthened regulatory and institutional frameworks in this respect.

  17. Incontinence in Individuals with Rett Syndrome: A Comparative Study

    NARCIS (Netherlands)

    Giesbers, S.A.H.; Didden, H.C.M.; Radstaake, M.; Korzilius, H.P.L.M.; Gontard, A. von; Lang, R.; Smeets, E.E.J.; Curfs, L.M.G

    2012-01-01

    Frequency and type of incontinence and its association with other variables were assessed in females with Rett Syndrome (RS) (n = 63), using an adapted Dutch version of the ‘Parental Questionnaire: Enuresis/Urinary Incontinence’ (Beetz et al. 1994). Also, incontinence in RS was compared to a control

  18. Incontinence in individuals with Angelman syndrome: A comparative study

    NARCIS (Netherlands)

    Radstaake, M.; Didden, H.C.M.; Giesbers, S.A.H.; Korzilius, H.P.L.M.; Peters-Scheffer, N.C.; Lang, R.; Gontard, A. von; Curfs, L.M.G.

    2013-01-01

    Frequency and type of incontinence and variables associated with incontinence were assessed in individuals with Angelman syndrome (AS; n=71) and in a matched control group (n=69) consisting of individuals with non-specific intellectual disability (ID). A Dutch version of the "Parental Questionnaire:

  19. Prevention and treatment of incontinence-associated dermatitis: literature review.

    NARCIS (Netherlands)

    Beeckman, D.; Schoonhoven, L.J.; Verhaeghe, S.; Heyneman, A.; Defloor, T.

    2009-01-01

    AIM: This paper is a report of a review conducted to describe the current evidence about the prevention and treatment of incontinence-associated dermatitis and to formulate recommendations for clinical practice and research. BACKGROUND: Incontinence-associated dermatitis is a common problem in

  20. Female urinary stress incontinence treated with Teflon injections

    DEFF Research Database (Denmark)

    Osther, P J; Røhl, H

    1987-01-01

    Twenty-six women with urinary stress incontinence underwent transperineal or transurethral Teflon injections. The results were classified into three grades (good, moderate, and poor). Good or moderate results were obtained in 50%. No major immediate complications or long-term side-effects were...... for urinary incontinence should this prove necessary....

  1. The Management of Urinary Incontinence by Community-Living Elderly.

    Science.gov (United States)

    Mitteness, Linda S.

    1987-01-01

    Explored ways elderly people (N=30) manage urinary incontinence. Subjects tended to dismiss their urinary incontinence as a normal part of aging and used various behavioral and psychological strategies to maintain their independence, usually without any assistance from the health professions. Management strategies commonly involved some degree of…

  2. Towards patient centered care in female stress urinary incontinence

    NARCIS (Netherlands)

    Labrie, J.

    2015-01-01

    This thesis focussed on the treatment of stress urinary incontinence in women. It comprises the results of the PORTRET study (Physiotherapy OR Tvt Effectiveness Trial). Currently, pelvic floor muscle training is advised as initial treatment for all women with stress urinary incontinence. We question

  3. The risk of anal incontinence in obese women.

    Science.gov (United States)

    Altman, Daniel; Falconer, Christian; Rossner, Stephan; Melin, Ingela

    2007-11-01

    The objectives of this study was to estimate the risk of anal incontinence in morbidly obese women and to identify risk factors associated with anal incontinence in an obese population sample. A case-control study based on the registry of a university hospital obesity unit. A consecutive sample of women with body mass index > or = 35 (obesity class II) was randomly matched by age, gender and residential county to control subjects using the computerised Register of the Total Population. Data were collected by a self-reported postal survey including detailed questions on medical and obstetrical history, obesity history, socioeconomic indices, life style factors and the validated Cleveland Clinic Incontinence Score. The questionnaire was returned by 131/179 (73%) of the cases and 453/892 (51%) of the control subjects. Compared to the control group, obese women reported a significantly increased defecation frequency (p flatus and faeces (p flatus incontinence (p flatus incontinence in morbidly obese women was 1.5 [95% confidence interval (CI) 1.1-4.1]. A history of obstetric sphincter injury was independently associated with an increased risk of flatus incontinence (OR, 4.3; 95% CI, 2.0-9.2) and incontinence of loose stools (OR, 6.6; 95% CI, 1.4-31.4). Other medical and life style interactions did not remain at significant levels in an adjusted multivariable analysis. Obese women are at increased risk for mild to moderate flatus incontinence.

  4. [Conservative therapy of female urinary incontinence--potential and effect].

    Science.gov (United States)

    Horcicka, L; Chmel, R; Novácková, M

    2005-01-01

    Non-surgical treatment of female stress urinary incontinence is not as effective as surgical methods but it is very successful in indicated cases. Rehabilitation of the pelvic floor muscles (Kegel exercises, vaginal cones, and electrostimulation of the pelvic floor muscles), drug treatment (alfa-mimetics, tricyclic antidepressives, estrogens, duloxetin), pessarotherapy and uretral obturator devices represent possibilities of conservative therapy of the stress incontinence. Conservative therapy is the method of choice in the treatment of urge incontinence. The most successful are anticholinergic drugs but they have very frequent serious side effects (dryness of the mucous membranes, accommodation disorders, constipation). Spasmolytics, estrogens and tricyclic antidepressives are the other popular used drugs. Life style modification, bladder training and electrostimulation represent very important parts of the conservative treatment. Effectiveness of the non-surgical treatment of both urge and stress urinary incontinence can not reach 100 percent but it helps very much in the quality of life improvement of incontinent women.

  5. Evaluation of a simple, non-surgical concept for management of urinary incontinence (minimal care) in an open-access, interdisciplinary incontinence clinic

    DEFF Research Database (Denmark)

    Sander, P; Mouritsen, L; Andersen, J T

    2000-01-01

    Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non-surgical tr......Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non....... The minimal care program and interdisciplinary structure in the incontinence clinic offer effective and low cost treatment for urinary incontinence. The open-access, interdisciplinary incontinence clinic model is recommended. Neurourol. Urodynam. 18:9-17, 2000....

  6. Evaluation of a simple, non-surgical concept for management of urinary incontinence (minimal care) in an open-access, interdisciplinary incontinence clinic

    DEFF Research Database (Denmark)

    Sander, P; Mouritsen, L; Andersen, J T

    2000-01-01

    Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non-surgical tr......Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non....... The minimal care program and interdisciplinary structure in the incontinence clinic offer effective and low cost treatment for urinary incontinence. The open-access, interdisciplinary incontinence clinic model is recommended. Neurourol. Urodynam. 18:9-17, 2000....

  7. Role of antimuscarinics in the treatment of nonneurogenic daytime urinary incontinence in children

    NARCIS (Netherlands)

    Nijman, RJM

    Idiopathic or "functional" urinary incontinence in children-incontinence with no known neurologic or anatomic cause-may take the form of urge incontinence, the most common type of incontinence, which is characterized by detrusor overactivity during the filling phase, or dysfunctional voiding. The

  8. Patient Reported Outcomes Tools in an Observational Study of Female Stress Urinary Incontinence

    NARCIS (Netherlands)

    van de Vaart, Huub; Falconer, Christian; Quail, Deborah; Timlin, Louise; Manning, Martina; Tincello, Douglas; Tunn, Ralf

    2010-01-01

    Aims: To determine which patient characteristics, incontinence and non-incontinence related, are associated with the symptom severity scores of the Urogenital Distress Inventory (UDI) and the International Consultation on Incontinence Questionnaire Urinary Incontinence (ICIQ-UI); and to determine th

  9. Role of antimuscarinics in the treatment of nonneurogenic daytime urinary incontinence in children

    NARCIS (Netherlands)

    Nijman, RJM

    2004-01-01

    Idiopathic or "functional" urinary incontinence in children-incontinence with no known neurologic or anatomic cause-may take the form of urge incontinence, the most common type of incontinence, which is characterized by detrusor overactivity during the filling phase, or dysfunctional voiding. The la

  10. Surgical Management of Post-Prostatectomy Incontinence

    Directory of Open Access Journals (Sweden)

    Arthi Satyanarayan

    2016-04-01

    Full Text Available Post-prostatectomy incontinence (PPI is a common and significant issue that can affect the quality of life in men who are undergoing treatment for prostate cancer. While some patients opt for conservative management of their incontinence, many elect to undergo surgical treatment as a result of the significant impact to quality of life. The most commonly employed surgical techniques to address PPI are placement of a male sling or artificial urinary sphincter (AUS. Currently, the AUS continues to serve as the gold standard for management, with robust data concerning longitudinal outcomes available. However, in recent years, the various methods to place the male sling have emerged as viable, less complex alternatives that avoid the need for pump manipulation. In the present review, we discuss these main surgical treatment modalities for PPI, and focus on the selection criteria that may influence appropriate operative stratification of PPI patients. Indeed, an individualised, comprehensive assessment of baseline urinary function, age, radiation, prior surgeries, functional status, and other comorbidities must be considered in the context of shared decision-making between the treatment provider and the patient in determining the optimal approach to managing PPI.

  11. [Urine incontinence referral criteria for primary care].

    Science.gov (United States)

    Brenes Bermúdez, F J; Cozar Olmo, J M; Esteban Fuertes, M; Fernández-Pro Ledesma, A; Molero García, J M

    2013-05-01

    Despite the high incidence of urinary incontinence (UI), health professional awareness of this disease is low, which in itself is not serious but significantly limits the lives of the patients. The Primary Care associations, Sociedad Española de Médicos de Atención Primaria [SEMERGEN], Sociedad Española de Médicos Generales y de Familia [SEMG], Sociedad Española de Medicina de Familia y Comunitaria [semFYC]) along with the Asociación Española de Urología (EAU) have developed this consensus with the proposal of making GPs aware, and to help them in the diagnosis, treatment and referral to Urologists. The first goal in primary care must be the detection of UI, thus an opportunistic screening at least once in the lifetime of asymptomatic women > 40 years old and asymptomatic men > 55 years old. The diagnosis, based on medical history and physical examination, must determine the type and severity of the UI in order to refer severe cases to the Urologist. Except for overactive bladder (OAB), non-pharmacological conservative treatment is the first approach to uncomplicated UI in females and males. Antimuscarinics are the only drugs that have demonstrated efficacy and safety in urge urinary incontinence (UUI) and OAB. In men with mixed symptoms, excluding severe obstruction cases, a combination therapy of alpha-blockers and antimuscarinics should be chosen.

  12. Rescue of Fructose-Induced Metabolic Syndrome by Antibiotics or Faecal Transplantation in a Rat Model of Obesity.

    Science.gov (United States)

    Di Luccia, Blanda; Crescenzo, Raffaella; Mazzoli, Arianna; Cigliano, Luisa; Venditti, Paola; Walser, Jean-Claude; Widmer, Alex; Baccigalupi, Loredana; Ricca, Ezio; Iossa, Susanna

    2015-01-01

    A fructose-rich diet can induce metabolic syndrome, a combination of health disorders that increases the risk of diabetes and cardiovascular diseases. Diet is also known to alter the microbial composition of the gut, although it is not clear whether such alteration contributes to the development of metabolic syndrome. The aim of this work was to assess the possible link between the gut microbiota and the development of diet-induced metabolic syndrome in a rat model of obesity. Rats were fed either a standard or high-fructose diet. Groups of fructose-fed rats were treated with either antibiotics or faecal samples from control rats by oral gavage. Body composition, plasma metabolic parameters and markers of tissue oxidative stress were measured in all groups. A 16S DNA-sequencing approach was used to evaluate the bacterial composition of the gut of animals under different diets. The fructose-rich diet induced markers of metabolic syndrome, inflammation and oxidative stress, that were all significantly reduced when the animals were treated with antibiotic or faecal samples. The number of members of two bacterial genera, Coprococcus and Ruminococcus, was increased by the fructose-rich diet and reduced by both antibiotic and faecal treatments, pointing to a correlation between their abundance and the development of the metabolic syndrome. Our data indicate that in rats fed a fructose-rich diet the development of metabolic syndrome is directly correlated with variations of the gut content of specific bacterial taxa.

  13. Rescue of Fructose-Induced Metabolic Syndrome by Antibiotics or Faecal Transplantation in a Rat Model of Obesity.

    Directory of Open Access Journals (Sweden)

    Blanda Di Luccia

    Full Text Available A fructose-rich diet can induce metabolic syndrome, a combination of health disorders that increases the risk of diabetes and cardiovascular diseases. Diet is also known to alter the microbial composition of the gut, although it is not clear whether such alteration contributes to the development of metabolic syndrome. The aim of this work was to assess the possible link between the gut microbiota and the development of diet-induced metabolic syndrome in a rat model of obesity. Rats were fed either a standard or high-fructose diet. Groups of fructose-fed rats were treated with either antibiotics or faecal samples from control rats by oral gavage. Body composition, plasma metabolic parameters and markers of tissue oxidative stress were measured in all groups. A 16S DNA-sequencing approach was used to evaluate the bacterial composition of the gut of animals under different diets. The fructose-rich diet induced markers of metabolic syndrome, inflammation and oxidative stress, that were all significantly reduced when the animals were treated with antibiotic or faecal samples. The number of members of two bacterial genera, Coprococcus and Ruminococcus, was increased by the fructose-rich diet and reduced by both antibiotic and faecal treatments, pointing to a correlation between their abundance and the development of the metabolic syndrome. Our data indicate that in rats fed a fructose-rich diet the development of metabolic syndrome is directly correlated with variations of the gut content of specific bacterial taxa.

  14. Effect of a vaginal device on quality of life with urinary stress incontinence

    DEFF Research Database (Denmark)

    Sander, P; Thyssen, H; Lose, G;

    1999-01-01

    OBJECTIVE: To assess the effect of a vaginal device (Continence Guard) on urine leakage and quality of life. METHODS: Fifty-five women with stress incontinence participated in a 3-month study. They were assessed by the Incontinence Impact Questionnaire, two incontinence-related quality-of-life qu...... of urinary stress incontinence. An incontinence-specific, rather than a generic, quality-of-life questionnaire was important in assessing treatment outcomes.......OBJECTIVE: To assess the effect of a vaginal device (Continence Guard) on urine leakage and quality of life. METHODS: Fifty-five women with stress incontinence participated in a 3-month study. They were assessed by the Incontinence Impact Questionnaire, two incontinence-related quality...... months. The quality of life measured by the Incontinence Impact Questionnaire showed highly significant improvement, and the results of the two incontinence-related quality of life questions also showed significant improvement. Responses to the Short Form-36 general health questionnaire showed...

  15. [Transobturator slings for female stress urinary incontinence].

    Science.gov (United States)

    Sousa, Ana; Jesus, André; Carvalho, Maria; Carvalho, Giselda; Marques, João; Falcão, Francisco; Torgal, Isabel

    2014-01-01

    Introdução: A incontinência urinária de esforço afeta 20 a 40% das mulheres. Os slings colocados sob a uretra média, aplicados por via transobturadora, são a terapêutica consensualmente aceite na atualidade. O objetivo do estudo foi avaliar a eficácia e possíveis complicações associadas à aplicação dos slings colocados por via transobturadora no tratamento da incontinência urinária de esforço. Material e Métodos: Avaliaram-se retrospetivamente 363 doentes submetidas a cirurgia de incontinência urinária de esforço por via transobturadora, nos Hospitais da Universidade de Coimbra do Centro Hospitalar e Universitário de Coimbra, no período de 1 Janeiro de 2008 a 1 Julho de 2010. Resultados: A média das idades das doentes foi de 56 anos [28-86]. Além da correção da incontinência urinária de esforço, em 13,5% das mulheres foi associada outra cirurgia vaginal. A maioria (95,3%) das mulheres apresentou hipermobilidade da uretra. Ocorreram complicações per-operatórias em 0,8%, complicações pós-operatórias imediatas em 5,2% e complicações pós-operatórias tardias em 15,7%. A taxa de sucesso global foi de 93,7%. A taxa de sucesso nas doentes com uretra fixa foi 77,8%, verificando-se melhores resultados (94,5%) naquelas com hipermobilidade da uretra (p = 0,02). A taxa de sucesso foi comparável nas doentes com e sem cirurgias vaginais associadas. Discussão: As técnicas transobturadoras têm taxas de sucesso elevadas, tendo-se tornado o tratamento de primeira linha para as doentes com IUE, independentemente se tratadas pela técnica outside-in (TOT®) ou pela inside-out (TVT-O®). Ambas as técnicas foram concebidas com o intuito de evitar a passagem no espaço retropúbico, reduzindo assim o número de complicações. Conclusão: As taxas de cura para as abordagens transobturadoras oscilam entre 80 e 95%. A taxa de cura aumenta quando o mecanismo responsável pela incontinência urinária de esforço é a hipermobilidade da uretra

  16. Skin care in the frail, elderly, dependent, incontinent patient.

    Science.gov (United States)

    Jeter, K F; Lutz, J B

    1996-01-01

    Despite a plethora of recommendations, protocols and dictums in the nursing literature, no research studies have defined the basic elements of preventive skin care for incontinent patients, and the prevalence of skin problems associated with incontinence is unknown. Yet the importance of skin care for incontinent elderly or immobilized patients has long been acknowledged. This literature review sought to determine current practices and principles for skin care of frail, elderly, dependent, incontinent patients. Protocols vary widely. And although there is mounting evidence that incontinence, particularly fecal incontinence, is a primary risk factor for pressure ulcer development, most preventive efforts focus on pressure relief, repositioning, and nutrition, rather than incontinence care. More clinical trials are needed in this area. The design and analysis of these trials should take into account the frequency and manner in which skin is cleansed, products used for skin care, risks and benefits of absorbent products and devices, the presence of infection, and patients' concomitant medical conditions and degree of immobility.

  17. Prevention and treatment of incontinence-associated dermatitis: literature review.

    Science.gov (United States)

    Beeckman, Dimitri; Schoonhoven, Lisette; Verhaeghe, Sofie; Heyneman, Alexander; Defloor, Tom

    2009-06-01

    This paper is a report of a review conducted to describe the current evidence about the prevention and treatment of incontinence-associated dermatitis and to formulate recommendations for clinical practice and research. Incontinence-associated dermatitis is a common problem in patients with incontinence. It is a daily challenge for healthcare professionals to maintain a healthy skin in patients with incontinence. PubMed, Cochrane, Embase, the Cumulative Index to Nursing and Allied Health Literature, reference lists and conference proceedings were explored up to September 2008. Publications were included if they reported research on the prevention and treatment of incontinence-associated dermatitis. As little consensus about terminology was found, a very sensitive filter was developed. Study design was not used as a selection criterion due to the explorative character of the review and the scarce literature. Thirty-six publications, dealing with 25 different studies, were included. The implementation of a structured perineal skin care programme including skin cleansing and the use of a moisturizer is suggested. A skin protectant is recommended for patients considered at risk of incontinence-associated dermatitis development. Perineal skin cleansers are preferable to using water and soap. Skin care is suggested after each incontinence episode, particularly if faeces are present. The quality of methods in the included studies was low. Incontinence-associated dermatitis can be prevented and healed with timely and appropriate skin cleansing and skin protection. Prevention and treatment should also focus on a proper use of incontinence containment materials. Further research is required to evaluate the efficacy and effectiveness of various interventions.

  18. Urodynamic study in women with pure stress urinary incontinence.

    Science.gov (United States)

    Valdevenito, J P; Águila, F; Naser, M; Manríquez, V; Wenzel, C; Díaz, J P

    2015-03-01

    To describe the results of urodynamic study in women with pure stress urinary incontinence symptoms, including the characteristics of the overactive detrusor. No other clinical assessments were taken into account. A retrospective study in women with urinary incontinence consecutively evaluated by urodynamic study. From a total of 710 women, only 108 (15%) with pure stress urinary incontinence symptoms were selected. Women with prior urinary incontinence surgery, pelvic organ prolapse (stage ≥iii), pelvic radiotherapy, using medication active on the lower urinary tract and neurological diseases were excluded. Infusion rate was 70 ml/min. Detrusor overactivity was induced only by cough. A standardized cough stress test with progressive cough intensity was carried out. Reference urodynamic values for stress incontinent women are described. Urodynamic stress incontinence was observed in 79 women (73.1%), detrusor overactivity in 4 (3.7%) and mixed urodynamic diagnosis in 15 (13.8%). Test was inconclusive in 10 patients (9.2%). Two women had detrusor overactivity incontinence (1.9%). One patient had detrusor overactivity induced by cough without urodynamic stress incontinence (0.9%). There was an association between detrusor overactivity and nocturia ≥2 (P=.002; odds ratio: 3.74; 95% confidence interval: 1.22-11.39). One woman had a bladder outlet obstruction (0.9%). In women with pure stress urinary incontinence, without knowing the outcome of other clinical assessments, urodynamic study can provide useful information to define the proper therapy. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Identifying avian sources of faecal contamination using sterol analysis.

    Science.gov (United States)

    Devane, Megan L; Wood, David; Chappell, Andrew; Robson, Beth; Webster-Brown, Jenny; Gilpin, Brent J

    2015-10-01

    Discrimination of the source of faecal pollution in water bodies is an important step in the assessment and mitigation of public health risk. One tool for faecal source tracking is the analysis of faecal sterols which are present in faeces of animals in a range of distinctive ratios. Published ratios are able to discriminate between human and herbivore mammal faecal inputs but are of less value for identifying pollution from wildfowl, which can be a common cause of elevated bacterial indicators in rivers and streams. In this study, the sterol profiles of 50 avian-derived faecal specimens (seagulls, ducks and chickens) were examined alongside those of 57 ruminant faeces and previously published sterol profiles of human wastewater, chicken effluent and animal meatwork effluent. Two novel sterol ratios were identified as specific to avian faecal scats, which, when incorporated into a decision tree with human and herbivore mammal indicative ratios, were able to identify sterols from avian-polluted waterways. For samples where the sterol profile was not consistent with herbivore mammal or human pollution, avian pollution is indicated when the ratio of 24-ethylcholestanol/(24-ethylcholestanol + 24-ethylcoprostanol + 24-ethylepicoprostanol) is ≥0.4 (avian ratio 1) and the ratio of cholestanol/(cholestanol + coprostanol + epicoprostanol) is ≥0.5 (avian ratio 2). When avian pollution is indicated, further confirmation by targeted PCR specific markers can be employed if greater confidence in the pollution source is required. A 66% concordance between sterol ratios and current avian PCR markers was achieved when 56 water samples from polluted waterways were analysed.

  20. Steinert's syndrome presenting as anal incontinence: a case report

    Directory of Open Access Journals (Sweden)

    Uzum Ayse

    2011-08-01

    Full Text Available Abstract Introduction Myotonic dystrophy (MD or Steinert's syndrome is a rare cause of chronic diarrhea and anal incontinence. In the presence of chronic diarrhea and fecal incontinence with muscle weakness, neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis. Case Presentation We present the case of a 45-year-old Turkish man with Steinert's syndrome, who was not diagnosed until the age of 45. Conclusions In clinical practice, the persistence of diarrhea and fecal incontinence with muscle weakness should suggest that the physician perform an anal manometric study and electromyography. Neuromuscular disorders such as myotonic dystrophy should be considered in the differential diagnosis.

  1. Urinary incontinence: hospital-based prevalence and risk factors

    Directory of Open Access Journals (Sweden)

    Marzieh Nojomi

    2008-02-01

    Full Text Available

    • BACKGROUND: This study was carried out to determine the prevalence and risk factors of urinary incontinence in women aged 30 to 70 years, who were attending to a gynecologic hospital.
    • METHODS: During 2006, married women (aged 30-70 years attending to a teaching gynecological hospital were assessed during their visits for any gynecologic diseases. We used a questionnaire with interview for collecting data. The potential risk factors were measured; i.e., the demographics, menopausal status, urinary symptoms (frequency, nocturia and urgency, urinary incontinence, (urgency, stress and mixed, body mass index, medical history (type of delivery, parity, gravidity, chronic illnesses, medication use, pelvic surgery and seeking medical care for their problem.
    • RESULTS: The mean age was 46.5 (± 8.4 years. The mean parity was 5.1 ± 1.5. 27% of the participants reported urinary incontinence. Out of 111 women with urinary incontinence, 77 (18.7%, CI: 14.7-22.7%, 17 (4.1%, CI: 2.2-5.8% and 17 (4.1%, CI: 2.2-5.8% were classified as having stress, urge and mixed urinary incontinence, respectively. The overall prevalence of urinary incontinence was 18.9% (34 subjects in women aged 30-44 years, 30.9% (46 subjects in those aged 45-54 years and 37.8% (31 subjects in those aged 55 years and older. Out of 117 menopause women, 39 (33.3% were incontinent. On average, women reported 4.4 (± 1.06 diurnal and 0.55 (± 0.66 nocturnal voidings in 24 hours. Diurnal and nocturnal frequencies were different between continent and incontinent women. The high parity, excessive birth weight, pelvic trauma, constipation, chronic illnesses (specially diabetes and gynecologic and other pelvic surgeries were known as risk factors for urinary incontinence.>
    • CONCLUSIONS: There was a significant association between urinary incontinence and high parity, excessive birth weight, pelvic

    • Expert system for management of urinary incontinence in women.

      Science.gov (United States)

      Gorman, R.

      1995-01-01

      The purpose of this nursing informatics and outcomes research study was to determine the effectiveness of an expert system for disseminating knowledge to ambulatory women health care consumers with urinary incontinence. Clinical knowledge from the Agency for Health Care Policy and Research (AHCPR) patient guideline for urinary incontinence and research literature for behavioral treatments provided the knowledge base for the expert system. Two experimental groups (booklet and expert system) and one control group were utilized. Study results suggest the use of an expert system as one effective communication means for disseminating clinical information in an advisory capacity to ambulatory women with urinary incontinence. PMID:8563340

    • Update on duloxetine for the management of stress urinary incontinence

      Directory of Open Access Journals (Sweden)

      Maya Basu

      2008-11-01

      Full Text Available Maya Basu, Jonathan RA DuckettDepartment of Obstetrics and Gynaecology, Medway Maritime Hospital, Gillingham, Kent, UKAbstract: Duloxetine is a relatively balanced serotonin and noradrenaline reuptake inhibitor (SNRI, which is the first drug with widely proven efficacy to have been licensed for the medical treatment of women with stress urinary incontinence (SUI. Despite favorable results from randomized controlled trials, surgical management continues to be the mainstay of treatment for SUI. In this review we explore the pharmacology of duloxetine in the nervous system and lower urinary tract, and the evidence for its use in the management of women with urinary incontinence.Keywords: duloxetine, stress urinary incontinence, overactive bladder

    • [Electrostimulation of the pelvic floor muscles in urinary incontinence].

      Science.gov (United States)

      Tjelum, K B; Lose, G; Abel, I; Pedersen, L M

      1994-04-11

      External electrical stimulation is a simple, noninvasive and inexpensive treatment modality, which is useful in the treatment of stress- and/or idiopathic urge incontinence. The mode of action arises from excitation of the pudendal nerves leading to direct and reflex contraction of pelvic floor muscles and a reflex inhibition of the detrusor. Treatment can be applied either as a weak long-term stimulation at home, as a short-term maximal stimulation in clinic, hospital or home treatment. Approximately 50%-75% of incontinent patients are either cured or improved and the adverse effects are sparse. Electrostimulation seems to be valuable in the treatment of incontinence.

    • Obesity, overweight, and eating problems in children with incontinence.

      Science.gov (United States)

      Wagner, Catharina; Equit, Monika; Niemczyk, Justine; von Gontard, Alexander

      2015-08-01

      The aim was to analyze the prevalence of eating problems and specific associations between overweight, obesity, and eating behavior in children with incontinence. Forty-three consecutively presented children with incontinence, diagnosed to International Children's Continence Society standards, and 44 matched continent controls were examined prospectively. All children received a physical examination, sonography, and a one-dimensional intelligence test. Child psychopathology was measured with the Child Behavior Checklist (CBCL/4-18). Eating problems were assessed with the German version of the Dutch Eating Behaviour Questionnaire for Children (DEBQ-C) and a 40-item-parental questionnaire referring to atypical eating problems. Of the 43 children with incontinence, 23.3% had nocturnal enuresis (NE) only, 37.2% had any form of daytime urinary incontinence (DUI) (isolated or combined with NE) and 39.5% had fecal incontinence (FI) (isolated or combined with NE and/or DUI). Incontinent children showed significantly more CBCL externalizing symptoms (35.7% vs. 6.8%) and total problems (46.3% vs. 6.8%) in the clinical range (>90th percentile), as well as significantly lower mean IQ (105.5 vs. 120.6) than continent controls. Of the children with incontinence, 16.9% were affected by obesity (≥95th body mass index [BMI] percentile) compared with none of the continent controls. Especially in children with FI, the rate of obesity was significantly increased (23.5%). In addition, 46.5% of incontinent children, but none of the controls, had constipation. Again, children with FI (82.4%) had the highest rate of constipation (>DUI: 25% > NE only: 20%). "Food refusal" (FR) and "intense fear of gaining weight" (GW), but not other eating problems, were significantly more common among incontinent children (FR mean score 7.3; GW mean score 1.4) than in controls (FR mean score 5.6; GW mean score 0.7). After controlling for BMI percentiles, FR still was significantly higher in

    • Survival and transport of faecal bacteria in agricultural soils

      DEFF Research Database (Denmark)

      Bech, Tina Bundgaard

      Today, there is yearly applied 34 million tonnes of animal waste to arable land in Denmark. This waste may contain pathogenic zoonotic bacteria and/or antibiotic resistant bacteria, and when applied to arable land there is a risk of contaminating groundwater, surface water, feeding animals or fresh...... produce. Prediction of faecal bacterial survival and transport in the soil environment will help minimize the risk of contamination, as best management practices can be adapted to this knowledge. The aim of this Ph.D. is to study factors influencing faecal bacteria survival and transport in soil...

    • Survival and transport of faecal bacteria in agricultural soils

      DEFF Research Database (Denmark)

      Bech, Tina Bundgaard

      Today, there is yearly applied 34 million tonnes of animal waste to arable land in Denmark. This waste may contain pathogenic zoonotic bacteria and/or antibiotic resistant bacteria, and when applied to arable land there is a risk of contaminating groundwater, surface water, feeding animals or fresh...... produce. Prediction of faecal bacterial survival and transport in the soil environment will help minimize the risk of contamination, as best management practices can be adapted to this knowledge. The aim of this Ph.D. is to study factors influencing faecal bacteria survival and transport in soil...

    • The sexual function and influence of urinary incontinence questionnaire (SF-IUIQ) - assessing sexual function of urinary incontinent women in south Africa

      NARCIS (Netherlands)

      Lambrechtsen, F. A. C. P.; van Rensburg, J. A.; Steyn, P. S.; Grove, D.

      2007-01-01

      Objective. To develop and psychometrically validate a questionnaire that assesses sexual function of urinary incontinent women in South Africa and the influence of incontinence on their sexual function. Design. A prospective descriptive study. Setting. Urogynaecology and gynaecology outpatient clini

    • Impact of faecal DM excretion on faecal calcium losses in dogs eating complete moist and dry pet foods - food digestibility is a major determinant of calcium requirements.

      Science.gov (United States)

      Kienzle, Ellen; Brenten, Thomas; Dobenecker, Britta

      2017-01-01

      The recommendations for the Ca supply for maintenance of dogs have been reduced by about 75 % in the last decades. An important factor for Ca requirements is faecal Ca losses. In previous studies with experimental diets faecal Ca losses depended on Ca intake and on faecal DM excretion. A predictive equation for faecal Ca losses in mg/kg body weight (BW) developed in a fibre model is: faecal losses = -33·8 + (13·6 faecal DM excretion (g/kg BW)) + (0·78 Ca intake (mg/kg BW)). The present study aimed at testing this equation in pet food with material from trials carried out for other purposes. Digestion trials with twenty-five dry and fifteen moist foods (326 observations in total) were evaluated retrospectively. Faecal DM excretion and faecal Ca losses were significantly correlated (r(2) 0·86; P food. Faecal DM excretion has a considerable impact on faecal Ca losses in a practical feeding situation. In conclusion, Ca requirements for maintenance may vary with food DM intake and digestibility.

    • The Effect of Pelvic Muscle Exercises on Urinary Incontinency and Self-Esteem of Elderly Females With Stress Urinary Incontinency, 2013

      OpenAIRE

      Jahromi, Marzieh Kargar; Talebizadeh, Malihe; Mirzaei, Maryam

      2014-01-01

      Introduction: Millions of women are afflicted with stress urinary incontinence. Urinary incontinence is mentioned as one of the geriatric syndromes, together with pressure ulcers, functional decline, falls, and low self-esteem. The aim of the present study was to determine the effect of pelvic muscle exercises on urinary incontinency and self- esteem of elderly females with stress urinary incontinency in Shiraz, Iran, 2013. Material and Method: In this interventional study, 50 old females age...

    • Bladder Pain Syndrome International Consultation on Incontinence

      DEFF Research Database (Denmark)

      Hanno, P.; Lin, A.; Nordling, J.

      2010-01-01

      possible, existing evidence was assessed and a level of recommendation was developed according to the Oxford system of classification. Results: The consultation decided to refer to the condition as "bladder pain syndrome" (BPS) because the designation is more descriptive of the clinical condition......Aims of Study: The Bladder Pain Syndrome Committee of the International Consultation on Incontinence was assigned the task by the consultation of reviewing the syndrome, formerly known as interstitial cystitis, in a comprehensive fashion. This included the topics of definition, nomenclature......, taxonomy, epidemiology, etiology, pathology, diagnosis, symptom scales, outcome assessment, principles of management, specific therapies, and future directions in research. Study Design, Materials, Methods: The emphasis was on new information developed since the last consultation 4 years previously. Where...

    • Correlates of urinary incontinence in pregnancy

      DEFF Research Database (Denmark)

      Hvidman, Lone; Foldspang, Anders; Mommsen, S.

      2002-01-01

      for the nulliparous and the primiparous, respectively. The present data suggest pregnancy UI not to be provoked by the mere onset of pregnancy, but by increasing hormonal concentrations or local tissue changes caused by hormones, whereas there was no support for a theory based on increasing pressure on the bladder......In a population sample, the period prevalence of urinary incontinence (UI) during pregnancy was found to be 19.9% and 24.1% among 352 nulliparous and 290 primiparous women, respectively. The first UI episode ever was experienced by 16.7% and 7.0% during the two last trimesters of the first...... and second pregnancies, respectively. None of the pregnancy-specific risk factors, such as emesis and birthweight, was significantly associated with UI during pregnancy. Previous UI was a significant risk factor for period prevalent UI during pregnancy, explaining 34% and 83% of pregnancy UI...

    • Preventing urinary incontinence during pregnancy and postpartum

      DEFF Research Database (Denmark)

      Wesnes, Stian Langeland; Lose, Gunnar

      2013-01-01

      : women should be advised not to smoke before or during pregnancy (grade B), aim at normal weight before pregnancy (grade B), and aim at regaining prepregnancy weight postpartum (grade B). Occasional low-intensity training should be advocated (grade B), and constipation should be avoided during pregnancy......Urinary incontinence (UI) is a common condition in association with pregnancy. Incident UI in pregnancy or postpartum are significant risk factors for UI later in life. Epidemiological studies on UI during pregnancy and postpartum list numerous variables associated with UI. For women, the main...... (grade B) and postpartum (grade C). Women should be advised to perform pelvic floor muscle training during pregnancy and postpartum (grade A) and to use perineal warm packs during delivery (grade B). Cesarean section to prevent UI cannot be recommended (grade D). If lifestyle recommendations...

    • [Neurogenic urinary incontinence. Value of surgical management].

      Science.gov (United States)

      Kutzenberger, J

      2008-06-01

      Damage to the CNS, the cauda equina, and the pelvic nerval structures causes neurogenic bladder dysfunction with neurogenic urinary incontinence (NUI). The definitive diagnosis of NUI is made with urodynamic examination methods. The most frequent cause of NUI is neurogenic detrusor overactivity (NDO). The treatment concept must take into account the physical and emotional restrictions. The treatment of NUI due to NDO is a domain of conservative therapy, i.e., mostly antimuscarinics and intermittent catheterization (IC). In about 30%, there is a good chance for therapy failures. An advancement in therapy is the injection of BTX-A into the detrusor. The missing drug approval is a disadvantage.Operative treatments are considered if conservative and minimally invasive therapies are unsuccessful. Sacral deafferentation (SDAF) and sacral anterior root stimulator implantation (SARSI) are available as organ-preserving techniques only for paraplegics with NDO and reflex urinary incontinence and neuromodulation for the other forms of NDO provided that a successful percutaneous nerve evaluation (PNE) test has previously taken place. Augmentation cystoplasty is indicated if SDAF and neuromodulation cannot be used and the bladder wall is damaged irreversibly by fibrosis. Kidney function of at least 25% and acceptance of IC are prerequisites. Myectomy (autoaugmentation) has an indication similar to augmentation cystoplasty but there must not be any fibrosis. Bladder neck insufficiency (BNI) caused by paralysis or iatrogenically can be treated by the implantation of an alloplastic sphincter high at the bladder neck. A stable reservoir function is required. If not all methods are possible, the ileum conduit or the suprapubic bladder fistula can be the last resort.

    • Risk factors for postpartum urinary incontinence

      Directory of Open Access Journals (Sweden)

      Lígia da Silva Leroy

      2016-04-01

      Full Text Available Abstract OBJECTIVE: To investigate the risk factors for postpartum urinary incontinence (UI and its characteristics. METHOD: This was a case-control study with 344 puerperal women (77 cases and 267 controls with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. RESULTS: Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, p<0.0001, multiparity (OR 2.26, CI 95% 1.22 - 4.19, p=0.009, gestational age at birth greater or equal to 37 weeks (OR 2.52, CI 95% 1.16 - 5.46, p=0.02 and constipation (OR 1.94, CI 95% 1.05 - 5.46, p=0.035. CONCLUSION: Most often, UI first appeared during pregnancy and remained through the postpartum period. Urinary incontinence during pregnancy, multiparity, gestational age at birth greater or equal to 37 weeks, and constipation were presented as risk factors. In the studied group, stress UI was more frequent.

    • Faecal carriage of Pseudomonas aeruginosa in healthy humans: antimicrobial susceptibility and global genetic lineages.

      Science.gov (United States)

      Estepa, Vanesa; Rojo-Bezares, Beatriz; Torres, Carmen; Sáenz, Yolanda

      2014-07-01

      The aim of this study was to analyse the Pseudomonas aeruginosa faecal carriage rate in 98 healthy humans and to perform the phenotypic and genotypic characterization of recovered isolates. The genetic relatedness among the isolates was analysed by pulsed-field gel electrophoresis and multilocus sequence typing that was compared with worldwide epidemic clones. Pseudomonas aeruginosa was isolated from eight healthy individuals (8.2%), and two of them remained colonized after 5 months (in one case by the same clone). All 10 isolates (one/sample) were susceptible to 14 tested antipseudomonal agents and lacked integron structures. Six pulsed-field gel electrophoresis patterns and six sequence types (ST245, ST253, ST254, ST274, ST663 and the new one, ST1059) were identified among them. Four groups of OprD alterations were detected based on mutations and deletions related to PAO1 reference strain in our carbapenem-susceptible strains. This is the first study focused on P. aeruginosa from faecal samples of healthy humans that provides additional insights into the antimicrobial resistance and genetic diversity of P. aeruginosa. Although the isolates were antimicrobial susceptible, most of the sequence types detected were genetically related to Spanish epidemic clones or globally spread sequence types, such as ST274 and ST253.

    • Advanced Procedures in Male Incontinence: The Male Sling

      Medline Plus

      Full Text Available Advanced Procedures in Male Incontinence: The Virtue® Male Sling Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. All rights reserved.

    • Consider Acupuncture for Incontinence, Not Certain Infertility Cases

      Science.gov (United States)

      ... https://medlineplus.gov/news/fullstory_166898.html Consider Acupuncture for Incontinence, Not Certain Infertility Cases Research yields ... 27, 2017 TUESDAY, June 27, 2017 (HealthDay News) -- Acupuncture, a 3,000-year-old healing technique, received ...

    • High prevalence of urinary incontinence and poor knowledge of ...

      African Journals Online (AJOL)

      2010-12-02

      Dec 2, 2010 ... In 1998, the World Health Organization's first International. Consultation on Incontinence classified UI as a disease, made recommendations on its assessment and treatment, and advocated ... S Knight, MB BCh, FCPHM (SA).

    • Urinary incontinence in the prediction of falls in hospitalized elderly

      Directory of Open Access Journals (Sweden)

      Hellen Cristina de Almeida Abreu

      2014-10-01

      Full Text Available Objective Analyzing the effect of urinary incontinence as a predictor of the incidence of falls among hospitalized elderly. Method Concurrent cohort study where 221 elderly inpatients were followed from the date of admission until discharge, death or fall. The Kaplan-Meier methods, the incidence density and the Cox regression model were used for the survival analysis and the assessment of the association between the exposure variable and the other variables. Results Urinary incontinence was a strong predictor of falls in the surveyed elderly, and was associated with shorter time until the occurrence of event. Urinary incontinence, concomitant with gait and balance dysfunction and use of antipsychotics was associated with falls. Conclusion Measures to prevent the risk of falls specific to hospitalized elderly patients who have urinary incontinence are necessary.

  1. Urinary incontinence in the prediction of falls in hospitalized elderly

    Directory of Open Access Journals (Sweden)

    Hellen Cristina de Almeida Abreu

    Full Text Available Objective Analyzing the effect of urinary incontinence as a predictor of the incidence of falls among hospitalized elderly. Method Concurrent cohort study where 221 elderly inpatients were followed from the date of admission until discharge, death or fall. The Kaplan-Meier methods, the incidence density and the Cox regression model were used for the survival analysis and the assessment of the association between the exposure variable and the other variables. Results Urinary incontinence was a strong predictor of falls in the surveyed elderly, and was associated with shorter time until the occurrence of event. Urinary incontinence, concomitant with gait and balance dysfunction and use of antipsychotics was associated with falls. Conclusion Measures to prevent the risk of falls specific to hospitalized elderly patients who have urinary incontinence are necessary.

  2. Advanced Procedures in Male Incontinence: The Male Sling

    Medline Plus

    Full Text Available Advanced Procedures in Male Incontinence: The Virtue® Male Sling Click Here to view the BroadcastMed, Inc. Privacy Policy and Legal Notice © 2017 BroadcastMed, Inc. All rights reserved.

  3. Pyrosequencing the canine faecal microbiota: breadth and depth of biodiversity.

    Directory of Open Access Journals (Sweden)

    Daniel Hand

    Full Text Available Mammalian intestinal microbiota remain poorly understood despite decades of interest and investigation by culture-based and other long-established methodologies. Using high-throughput sequencing technology we now report a detailed analysis of canine faecal microbiota. The study group of animals comprised eleven healthy adult miniature Schnauzer dogs of mixed sex and age, some closely related and all housed in kennel and pen accommodation on the same premises with similar feeding and exercise regimes. DNA was extracted from faecal specimens and subjected to PCR amplification of 16S rDNA, followed by sequencing of the 5' region that included variable regions V1 and V2. Barcoded amplicons were sequenced by Roche-454 FLX high-throughput pyrosequencing. Sequences were assigned to taxa using the Ribosomal Database Project Bayesian classifier and revealed dominance of Fusobacterium and Bacteroidetes phyla. Differences between animals in the proportions of different taxa, among 10,000 reads per animal, were clear and not supportive of the concept of a "core microbiota". Despite this variability in prominent genera, littermates were shown to have a more similar faecal microbial composition than unrelated dogs. Diversity of the microbiota was also assessed by assignment of sequence reads into operational taxonomic units (OTUs at the level of 97% sequence identity. The OTU data were then subjected to rarefaction analysis and determination of Chao1 richness estimates. The data indicated that faecal microbiota comprised possibly as many as 500 to 1500 OTUs.

  4. Immunoglobulin coating of faecal bacteria in inflammatory bowel disease

    NARCIS (Netherlands)

    van der Waaij, LA; Kroese, FGM; Visser, A; Nelis, FG; Westerveld, BD; Jansen, PLM; Hunter, JO

    2004-01-01

    Objective An inappropriate mucosal immune response to the commensal bacterial flora may play a role in the pathogenesis of inflammatory bowel disease (IBD). In this study we determined the percentage of immunoglobulin-coated bacteria in the stools of patients and controls. Methods Faecal samples wer

  5. Preliminary monitoring of faecal indicator organisms of surface water ...

    African Journals Online (AJOL)

    Preliminary monitoring of faecal indicator organisms of surface water: A case study ... in Mvudi River used as a source of domestic water for people who live around it. ... of Water Affairs and Forestry of South Africa (DWAF) and the World Health ...

  6. Faecal Parasitology: Concentration Methodology Needs to be Better Standardised

    Science.gov (United States)

    Manser, Monika M.; Saez, Agatha Christie Santos; Chiodini, Peter L.

    2016-01-01

    Aim To determine whether variation in the preservative, pore size of the sieve, solvent, centrifugal force and centrifugation time used in the Ridley-Allen Concentration method for examining faecal specimens for parasite stages had any effect on their recovery in faecal specimens. Methods A questionnaire was sent to all participants in the UK NEQAS Faecal Parasitology Scheme. The recovery of parasite stages was compared using formalin diluted in water or formalin diluted in saline as the fixative, 3 different pore sizes of sieve, ether or ethyl acetate as a solvent, 7 different centrifugal forces and 6 different centrifugation times according to the methods described by participants completing the questionnaire. Results The number of parasite stages recovered was higher when formalin diluted in water was used as fixative, a smaller pore size of sieve was used, ethyl acetate along with Triton X 100 was used as a solvent and a centrifugal force of 3,000 rpm for 3 minutes were employed. Conclusions This study showed that differences in methodology at various stages of the concentration process affect the recovery of parasites from a faecal specimen and parasites present in small numbers could be missed if the recommended methodology is not followed. PMID:27073836

  7. Faecal Parasitology: Concentration Methodology Needs to be Better Standardised.

    Directory of Open Access Journals (Sweden)

    Monika M Manser

    2016-04-01

    Full Text Available To determine whether variation in the preservative, pore size of the sieve, solvent, centrifugal force and centrifugation time used in the Ridley-Allen Concentration method for examining faecal specimens for parasite stages had any effect on their recovery in faecal specimens.A questionnaire was sent to all participants in the UK NEQAS Faecal Parasitology Scheme. The recovery of parasite stages was compared using formalin diluted in water or formalin diluted in saline as the fixative, 3 different pore sizes of sieve, ether or ethyl acetate as a solvent, 7 different centrifugal forces and 6 different centrifugation times according to the methods described by participants completing the questionnaire.The number of parasite stages recovered was higher when formalin diluted in water was used as fixative, a smaller pore size of sieve was used, ethyl acetate along with Triton X 100 was used as a solvent and a centrifugal force of 3,000 rpm for 3 minutes were employed.This study showed that differences in methodology at various stages of the concentration process affect the recovery of parasites from a faecal specimen and parasites present in small numbers could be missed if the recommended methodology is not followed.

  8. Molecular Detection of Strongyloides ratti in Faecal Samples from ...

    African Journals Online (AJOL)

    the detection of DNA from Strongyloides ratti (an animal model of S. stercoralis) in faecal samples of wild Brown rats ... Human parasite S. stercoralis, which was discovered for ... species on the agar plate surface [4]. The ... based technique have been developed. PCR has .... Reproductive system without seminal receptacle.

  9. Streptococcus caviae sp. nov., isolated from Guinea pig faecal samples

    NARCIS (Netherlands)

    Palakawong Na Ayudthaya, Susakul; Hilderink, Loes J.; Oost, van der John; Vos, de Willem M.; Plugge, Caroline M.

    2017-01-01

    A novel cellobiose-degrading and lactate-producing bacterium, strain Cavy grass 6T, was isolated from faecal samples of guinea pigs (Cavia porcellus). Cells of the strain were ovalshaped, non-motile, non-spore-forming, Gram-stain-positive and facultatively anaerobic. The strain gr at 2

  10. Longitudinal prevalence and faecal shedding of Chlamydia pecorum in sheep.

    Science.gov (United States)

    Yang, Rongchang; Jacobson, Caroline; Gardner, Graham; Carmichael, Ian; Campbell, Angus J D; Ryan, Una

    2014-09-01

    The prevalence and faecal shedding of Chlamydia spp. in sheep in Australia has not been well described. Two species-specific quantitative PCRs (qPCRs) targeting the chlamydial outer membrane protein cell surface antigen gene (ompA) were validated and used to determine the prevalence and faecal shedding of C. abortus and C. pecorum from faecal samples of lambs at three sampling times (weaning, post-weaning and pre-slaughter) from eight farms in South Australia, New South Wales, Victoria and Western Australia. A total of 3412 faecal samples were collected and screened from approximately 1189 lambs across the four states. C. abortus was not detected in any of the samples screened. The overall prevalence of C. pecorum was 1027/3412 (30.1%) and median bacterial concentrations at weaning, post-weaning and pre-slaughter were 1.8 × 10(7), 1.2 × 10(7) and 9.6 × 10(5)/g faeces, respectively. A subset of C. pecorum positive samples from each farm, (n = 48) was sequenced to confirm their identity. The present study demonstrates that C. pecorum is prevalent in Australian sheep, highlighting a need for further research on the impact of this bacterium on production.

  11. The psychosocial impact of urinary incontinence on women aged 25 to 45 years.

    Science.gov (United States)

    Valerius, A J

    1997-09-01

    The purpose of this research was to describe the relationship between symptoms of urinary incontinence and their impact on daily activities, and the degree of incontinence-related distress perceived by 25- to 45-year-old women. A second purpose was to identify differences, if any, in impact on daily life and degree of incontinence-related distress perceived among women with stress, urge, and mixed incontinence. Guided by Lazarus and Folkman's (1984) Stress, Appraisal and Coping Theory, a descriptive correlational prospective study (N = 35) was conducted using the Urogenital Distress Inventory and the Incontinence Impact Questionnaire. A significant moderate (r = 0.5701, p = 0.000) correlation was found between urinary incontinence symptoms and their impact on travel, social, physical, and emotional activities. No significant differences were found among women with stress, urge, and mixed urinary incontinence and the impact of incontinence symptoms on their daily activities or with their perceived degree of incontinence-related distress.

  12. Pathophysiology of pelvic organ prolapse and stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Payal D Patel

    2006-01-01

    Full Text Available Although they may present with significant morbidity, pelvic organ prolapse and stress urinary incontinence are mainly afflicitions that affect quality of life. To appropiately treat these entities, comprehension of the various theories of pathophysiology is paramount. Utilizing a Medline search, this article reviews recent data concerning intrinsic (i.e., genetics, postmenopausal status and extrinsic factors (i.e., previous hysterectomy, childbirth leading to organ prolapse or stress incontinence

  13. [Sleep and nocturnal incontinence in hospital or institutional care].

    Science.gov (United States)

    Walk, Eliane; Schwartz, Chantal; Hidot, Nathalie; Mazin, Véronique; Pochon, Sandrine; Renaux-Bouttier, Valérie; Guyon, Anne; Greusard, Claire; Wenger, Isabelle

    A survey carried out in 2004 studied the link between quality of sleep and the nocturnal management of incontinence. This same survey was repeated 10 years later. The results reveal the impact on quality of sleep, the deteriorating management of incontinence with the lenghtening of waiting time and the causes of waking. This discussion process on the quality of sleep must continue. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  14. Improving diaper design to address incontinence associated dermatitis

    OpenAIRE

    Zöllner Petra; Homann Vanessa; Souchon Sandrine; Hallet-Lezy Anne-Marie; Guihaire Claudine; Malaquin-Pavan Evelyne; Beguin Anne-Marie; Swerev Maximilian; Kesselmeier Rüdiger; Hornung Fridmann; Smola Hans

    2010-01-01

    Abstract Background Incontinence associated dermatitis (IAD) is an inflammatory skin disease mainly triggered by prolonged skin contact with urine, feces but also liberal detergent use when cleansing the skin. To minimize the epidermal barrier challenge we optimized the design of adult incontinence briefs. In the fluid absorption area we interposed a special type of acidic, curled-type of cellulose between the top sheet in contact with the skin and the absorption core beneath containing the p...

  15. Complete Pelvic Floor Repair in Treating Fecal Incontinence

    OpenAIRE

    Lee, Patrick Y. H.; Steele, Scott R

    2005-01-01

    Fecal incontinence is associated with 20 to 40% of the patients with pelvic floor prolapse. Successful management of fecal incontinence requires not only an understanding of anorectal function but also a thorough understanding of pelvic floor anatomy and how pelvic floor prolapse affects fecal continence. Imaging techniques have been instrumental in visualizing pelvic floor prolapse and have helped correlate surgical findings. Stabilization of the perineal body appears to be a key component t...

  16. Efficacy of Physiotherapy for Urinary Incontinence following Prostate Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Elżbieta Rajkowska-Labon

    2014-01-01

    Full Text Available The study enrolled 81 with urinary incontinence following radical prostate-only prostatectomy for prostatic carcinoma. The patients were divided into two groups. The patients in Group I were additionally subdivided into two subgroups with respect to the physiotherapeutic method used. The patients of subgroup IA received a rehabilitation program consisting of three parts. The patients of subgroup IB rehabilitation program consist of two parts. Group II, a control group, had reported for therapy for persistent urinary incontinence following radical prostatectomy but had not entered therapy for personal reasons. For estimating the level of incontinence, a 1-hour and 24-hour urinary pad tests, the miction diary, and incontinence questionnaire were used, and for recording the measurements of pelvic floor muscles tension, the sEMG (surface electromyography was applied. The therapy duration depended on the level of incontinence and it continued for not longer than 12 months. Superior continence outcomes were obtained in Group I versus Group II and the difference was statistically significant. The odds ratio for regaining continence was greater in the rehabilitated Group I and smaller in the group II without the rehabilitation. A comparison of continence outcomes revealed a statistically significant difference between Subgroups IA versus IB. The physiotherapeutic procedures applied on patients with urine incontinence after prostatectomy, for most of them, proved to be an effective way of acting, which is supported by the obtained results.

  17. Incontinence and Erectile Dysfunction Following Radical Prostatectomy: A Review

    Directory of Open Access Journals (Sweden)

    Gerasimos Alivizatos

    2005-01-01

    Full Text Available Radical prostatectomy remains the treatment of choice for localized prostate cancer in age-appropriate and health-appropriate men. Although cancer control is the most important aspect of a radical prostatectomy, minimization of postoperative morbidity, especially urinary incontinence and erectile dysfunction, is becoming a greater concern. We reviewed recent data available on Medline regarding the incidence, pathophysiology, evaluation, and treatment of incontinence and sexual dysfunction after radical prostatectomy. Health-related quality of life issues have been specifically addressed. Although low incidences of incontinence and erectile dysfunction after radical prostatectomy have been reported in the hands of experienced surgeons, the literature review revealed a great variety, with incontinence rates ranging from 0.3–65.6% and potency rates ranging from 11–87%. Several factors contribute to this wide difference, the most important being the application of a meticulous surgical technique. General and cancer-specific health-related quality of life is not being affected after radical prostatectomy. The incidence of incontinence and erectile dysfunction is higher after radical prostatectomy when compared to the incidence observed when other therapies for localized prostate cancer are applied. However, the majority of the patients undergoing radical prostatectomy would vote for the operation again. Today, avoidance of major complications after radical prostatectomy depends mostly on a high-quality surgical technique. When incontinence or erectile dysfunction persists after radical prostatectomy, the majority of the treated patients can be managed effectively by various methods.

  18. The TNF-α antagonist etanercept reverses age-related decreases in colonic SERT expression and faecal output in mice

    Science.gov (United States)

    Patel, Bhavik Anil; Fidalgo, Sara; Wang, Chunfang; Parmar, Leena; Mandona, Kasonde; Panossian, Annabelle; Flint, Melanie S.; Ranson, Richard N.; Saffrey, M. Jill; Yeoman, Mark S.

    2017-01-01

    Treatment for chronic constipation in older people is challenging and the condition has a major impact on quality of life. A lack of understanding about the causes of this condition has hampered the development of effective treatments. 5-HT is an important pro-kinetic agent in the colon. We examined whether alterations in colonic 5-HT signalling underlie age–related changes in faecal output in mice and whether these changes were due to an increase in TNF-α. Components of the 5-HT signalling system (5-HT, 5-HIAA, SERT) and TNF-α expression were examined in the distal colon of 3, 12, 18 and 24-month old mice and faecal output and water content monitored under control conditions and following the administration of etanercept (TNF-α inhibitor; 1 mg Kg−1). Faecal output and water content were reduced in aged animals. Age increased mucosal 5-HT availability and TNF-α expression and decreased mucosal SERT expression and 5-HIAA. Etanercept treatment of old mice reversed these changes, suggesting that age-related changes in TNFα expression are an important regulator of mucosal 5-HT signalling and pellet output and water content in old mice. These data point to “anti-TNFα” drugs as potential treatments for age-related chronic constipation. PMID:28198447

  19. Effect of dental correction on voluntary hay intake, apparent digestibility of feed and faecal particle size in horse.

    Science.gov (United States)

    Zwirglmaier, S; Remler, H-P; Senckenberg, E; Fritz, J; Stelzer, P; Kienzle, E

    2013-02-01

    In nine adult Warmblood horses with mild to moderate dental findings (no signs of discomfort during chewing), voluntary hay intake before and after dental correction was examined. In a second experiment, digestibility of feed and faecal particle size were determined (3 days of total faecal collection) before and after dental correction. During both digestion trials including a 3-day adaptation period, the amount of hay and concentrate (mixture of oats, barley and maize) was kept constant in each individual horse before and after dental correction. Voluntary hay intake in individual horses ranged from 11 to 22 g DM/kg BW/day and did not differ before and after dental treatment. Apparent digestibility of DM, energy, crude fibre and Nfe increased significantly after dental correction (energy digestibility before dental correction 46.8 ± 7.4%, after dental correction 51.5 ± 8.5%). Apparent digestibility of feed was higher in horses eating more concentrates than in those eating less concentrates. Improvement of digestibility was more marked in horses eating larger amounts of grain. There was no relationship between severity or type of dental alterations and improvement of apparent feed digestibility. Dental correction had no effect on faecal particle size.

  20. Integrated community profiling indicates long-term temporal stability of the predominant faecal microbiota in captive cheetahs.

    Directory of Open Access Journals (Sweden)

    Anne A M J Becker

    Full Text Available Understanding the symbiotic relationship between gut microbes and their animal host requires characterization of the core microbiota across populations and in time. Especially in captive populations of endangered wildlife species such as the cheetah (Acinonyx jubatus, this knowledge is a key element to enhance feeding strategies and reduce gastrointestinal disorders. In order to investigate the temporal stability of the intestinal microbiota in cheetahs under human care, we conducted a longitudinal study over a 3-year period with bimonthly faecal sampling of 5 cheetahs housed in two European zoos. For this purpose, an integrated 16S rRNA DGGE-clone library approach was used in combination with a series of real-time PCR assays. Our findings disclosed a stable faecal microbiota, beyond intestinal community variations that were detected between zoo sample sets or between animals. The core of this microbiota was dominated by members of Clostridium clusters I, XI and XIVa, with mean concentrations ranging from 7.5-9.2 log10 CFU/g faeces and with significant positive correlations between these clusters (P<0.05, and by Lactobacillaceae. Moving window analysis of DGGE profiles revealed 23.3-25.6% change between consecutive samples for four of the cheetahs. The fifth animal in the study suffered from intermediate episodes of vomiting and diarrhea during the monitoring period and exhibited remarkably more change (39.4%. This observation may reflect the temporary impact of perturbations such as the animal's compromised health, antibiotic administration or a combination thereof, which temporarily altered the relative proportions of Clostridium clusters I and XIVa. In conclusion, this first long-term monitoring study of the faecal microbiota in feline strict carnivores not only reveals a remarkable compositional stability of this ecosystem, but also shows a qualitative and quantitative similarity in a defined set of faecal bacterial lineages across the five

  1. Integrated Community Profiling Indicates Long-Term Temporal Stability of the Predominant Faecal Microbiota in Captive Cheetahs

    Science.gov (United States)

    Becker, Anne A. M. J.; Janssens, Geert P. J.; Snauwaert, Cindy; Hesta, Myriam; Huys, Geert

    2015-01-01

    Understanding the symbiotic relationship between gut microbes and their animal host requires characterization of the core microbiota across populations and in time. Especially in captive populations of endangered wildlife species such as the cheetah (Acinonyx jubatus), this knowledge is a key element to enhance feeding strategies and reduce gastrointestinal disorders. In order to investigate the temporal stability of the intestinal microbiota in cheetahs under human care, we conducted a longitudinal study over a 3-year period with bimonthly faecal sampling of 5 cheetahs housed in two European zoos. For this purpose, an integrated 16S rRNA DGGE-clone library approach was used in combination with a series of real-time PCR assays. Our findings disclosed a stable faecal microbiota, beyond intestinal community variations that were detected between zoo sample sets or between animals. The core of this microbiota was dominated by members of Clostridium clusters I, XI and XIVa, with mean concentrations ranging from 7.5-9.2 log10 CFU/g faeces and with significant positive correlations between these clusters (Pcheetahs. The fifth animal in the study suffered from intermediate episodes of vomiting and diarrhea during the monitoring period and exhibited remarkably more change (39.4%). This observation may reflect the temporary impact of perturbations such as the animal’s compromised health, antibiotic administration or a combination thereof, which temporarily altered the relative proportions of Clostridium clusters I and XIVa. In conclusion, this first long-term monitoring study of the faecal microbiota in feline strict carnivores not only reveals a remarkable compositional stability of this ecosystem, but also shows a qualitative and quantitative similarity in a defined set of faecal bacterial lineages across the five animals under study that may typify the core phylogenetic microbiome of cheetahs. PMID:25905625

  2. Clinical course of a cohort of children with non-neurogenic daytime urinary incontinence symptoms followed at a tertiary center

    Directory of Open Access Journals (Sweden)

    Adrienne Lebl

    2016-04-01

    Full Text Available Abstract Objective: To characterize a cohort of children with non-neurogenic daytime urinary incontinence followed-up in a tertiary center. Methods: Retrospective analysis of 50 medical records of children who had attained bladder control or minimum age of 5 years, using a structured protocol that included lower urinary tract dysfunction symptoms, comorbidities, associated manifestations, physical examination, voiding diary, complementary tests, therapeutic options, and clinical outcome, in accordance with the 2006 and 2014 International Children's Continence Society standardizations. Results: Female patients represented 86.0% of this sample. Mean age was 7.9 years and mean follow-up was 4.7 years. Urgency (56.0%, urgency incontinence (56.0%, urinary retention (8.0%, nocturnal enuresis (70.0%, urinary tract infections (62.0%, constipation (62.0%, and fecal incontinence (16.0% were the most prevalent symptoms and comorbidities. Ultrasound examinations showed alterations in 53.0% of the cases; the urodynamic study showed alterations in 94.7%. At the last follow-up, 32.0% of patients persisted with urinary incontinence. When assessing the diagnostic methods, 85% concordance was observed between the predictive diagnosis of overactive bladder attained through medical history plus non-invasive exams and the diagnosis of detrusor overactivity achieved through the invasive urodynamic study. Conclusions: This subgroup of patients with clinical characteristics of an overactive bladder, with no history of urinary tract infection, and normal urinary tract ultrasound and uroflowmetry, could start treatment without invasive studies even at a tertiary center. Approximately one-third of the patients treated at the tertiary level remained refractory to treatment.

  3. Intestinal microbiota and faecal transplantation as treatment modality for insulin resistance and type 2 diabetes mellitus.

    Science.gov (United States)

    Udayappan, S D; Hartstra, A V; Dallinga-Thie, G M; Nieuwdorp, M

    2014-07-01

    The prevalence of obesity and diabetes mellitus type 2 is increasing rapidly around the globe. Recent insights have generated an entirely new perspective that the intestinal microbiota may play a significant role in the development of these metabolic disorders. Alterations in the intestinal microbiota composition promote systemic inflammation that is a hallmark of obesity and subsequent insulin resistance. Thus, it is important to understand the reciprocal relationship between intestinal microbiota composition and metabolic health in order to eventually prevent disease progression. In this respect, faecal transplantation studies have implicated that butyrate-producing intestinal bacteria are crucial in this process and be considered as key players in regulating diverse signalling cascades associated with human glucose and lipid metabolism.

  4. Incontinence, bladder neck mobility, and sphincter ruptures in primiparous women

    Directory of Open Access Journals (Sweden)

    Jundt K

    2010-06-01

    Full Text Available Abstract Objective To compare the function of the pelvic floor in primiparae before and during pregnancy with the status post partum concerning symptoms of incontinence, sphincter ruptures, bladder-neck mobility and the influence of the different modes of deliveries. Methods Questionnaire evaluating symptoms of urinary and anal incontinence in nulliparous women before and after delivery and correlating these symptoms with functional changes of the pelvic floor based on a careful gynaecologic examination as well as perineal and endoanal ultrasound. Results 112 women were included in our study and came for the first visit, 99 women returned for follow-up 6 months after childbirth. Stress and flatus incontinence significantly increased from before pregnancy (3 and 12% to after childbirth (21 and 28% in women with spontaneous delivery or vacuum extraction. No new symptoms occurred after c-section. There was no significant difference between the bladder neck position before and after delivery. The mobility of the bladder neck was significantly higher after vaginal delivery using a vacuum extraction compared to spontaneous delivery or c-section. The bladder neck in women with post partum urinary stress incontinence was significantly more mobile than in continent controls. The endoanal ultrasound detected seven occult sphincter defects without any correlation to symptoms of anal incontinence. Conclusion Several statistically significant changes of the pelvic floor after delivery were demonstrated. Spontaneous vaginal delivery or vacuum extraction increases the risk for stress or anal incontinence, delivery with vacuum extraction leads to higher bladder neck mobility and stress incontinent women have more mobile bladder necks than continent women.

  5. Usage results of a mobile app for managing urinary incontinence.

    Science.gov (United States)

    Pepper, Jeff; Zhang, Amy; Li, Rui; Wang, Xiao Hui

    2015-04-01

    Slight changes in urinary incontinence severity may be difficult to notice, so that even high functioning patients are unable to detect if urinary incontinence is improving or worsening. We describe a recently released free software app, iDry®, that enables individuals with urinary incontinence to document incontinence symptoms, view progress, evaluate effectiveness of interventions and report status to their health care provider. After 2 field trials, iDry was published as a free download from the Apple® App Store and was downloaded 1,231 times in the first 19 months. iDry also collects large quantities of anonymized usage data for research purposes. Data analysis shows that long-term users had significantly more severe urinary incontinence symptoms (p ≤ 0.01) than short-term users. Short-term users reduced pad use by 20% but long-term users' pad use remaining unchanged. Average leakage was reduced 14.6 mg per day for short-term vs 4.5 mg per day for long-term users, but this difference was not statistically significant (p=0.93) due to high data variability (SD 611). There was no significant difference between long-term and short-term users in severity of self-reported stress and urge incontinence. Bladder training positively correlated with a reduction in pad use (p=0.03) and leakage amount (p=0.02). Overall our findings suggest that iDry is a useful, accessible and convenient tool to document urinary incontinence symptoms and improvement, but controlled studies are needed to assess its effectiveness. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  6. Risk factors for postpartum urinary incontinence.

    Science.gov (United States)

    Leroy, Lígia da Silva; Lúcio, Adélia; Lopes, Maria Helena Baena de Moraes

    2016-04-01

    To investigate the risk factors for postpartum urinary incontinence (UI) and its characteristics. This was a case-control study with 344 puerperal women (77 cases and 267 controls) with up to 90 days postpartum. In a single session, participants were given a questionnaire with sociodemographic and clinical data and two others that assessed urine leakage, leakage situations, and type of UI. Stress UI was present in 45.5% of the women, incidents of urine leakage several times a day in 44.2%, of which 71.4% were in small amounts and 57.1% when coughing or sneezing. In 70.1% of cases, UI began during pregnancy and remained through the postpartum period. After running a binary logistic regression model, the following factors remained in the final model: UI during pregnancy (OR 12.82, CI 95% 6.94 - 23.81, pmodelo de regressão logística binária, apenas IU na gestação (OR 12,82, IC 95% 6,94 - 23,81, pmodelo final. A IU iniciou-se frequentemente na gestação e permaneceu no puerpério. A presença de IU na gestação, multiparidade, idade gestacional no parto maior ou igual a 37 semanas e constipação foram fatores de risco. No grupo estudado a IU de esforço foi a mais frequente.

  7. Antimicrobial resistance in commensal faecal Escherichia coli of hospitalised horses

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    Bryan Jill

    2010-06-01

    Full Text Available Abstract The objective of this study was to examine the impact of hospitalisation and antimicrobial drug administration on the prevalence of resistance in commensal faecal E. coli of horses. Faecal samples were collected from ten hospitalised horses treated with antimicrobials, ten hospitalised horses not treated with antimicrobials and nine non-hospitalised horses over a consecutive five day period and susceptibility testing was performed on isolated E. coli. Results revealed that hospitalisation alone was associated with increased prevalence of antimicrobial resistance and multidrug resistance in commensal E. coli of horses. Due to the risk of transfer of resistance between commensal and pathogenic bacteria, veterinarians need to be aware of possible resistance in commensal bacteria when treating hospitalised horses.

  8. Implementation of immunochemical faecal occult blood test in general practice

    DEFF Research Database (Denmark)

    Juul, Jakob Søgaard; Bro, Flemming; Hornung, Nete

    2016-01-01

    anvendelsen af immunochemical faecal occult blood test (iFOBT) i almen praksis. iFOBT detekterer humant globin i fæces og indikerer gastrointestinal blødning. Studiet udgør en del af et ph.d.-studie, der bidrager med ny viden til at optimere udredningen af patienter med tarmkræft. Der er et stort behov...

  9. MR imaging of pelvic floor in stress urinary incontinence=20

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Rae; Park, Heung Jae; Kook, Shin Ho; Chung, Eun Chul [Kangbuk Samsung Hospital, College of Medicine, Sungkyunkwan University, Seoul (Korea, Republic of)

    2000-04-01

    To demonstrate the anatomy of the female pelvic floor and to determine the anatomic differences between normal controls and women with stress urinary incontinence, using MRI. Five healthy, young, nulliparous women and 12 with stress urinary incontinence underwent MR imaging. We obtained FSE T2-weighted axial images, 3mm thick, of the region extending from the urethroversical junction to the perineal membrane. The following parameters were determined : angle, asymmetry and signal intensity of the levator ani muscles, the distance between the urethra and symphysis, and the presence, shape and angulation of urethropelvic ligament. In contrast to normal controls, frequent findings in women with stress incontinence were as follows : increased angle (43%), asymmetry (43%) and higher signal intensity (67%) of the levator ani muscles; increased distance between the urethra and symphysis; loss (43%), discontinuity (60%) and dorsal angulation (43%) of the urethropelvic ligament. In women with stress urinary incontinence, MRI clearly demonstrates the anatomy of the female pelvic floor, changes in the levator ani muscles, the distance between the urethra and symphysis, and the urethropelvic ligament. The modality can therefore be used to evaluate the anatomical changes occurring in cases of stress urinary incontinence. (author)

  10. Studies on risk factors for urinary incontinence in Swedish female twins

    OpenAIRE

    Tettamanti, Giorgio

    2013-01-01

    Approximately half of all women in industrialized countries will experience urinary incontinence during their lifetime. Even though urinary incontinence is not a life threatening disease, it often has severe implications for daily function, social interactions, sexuality and psychological well-being. Moreover, urinary incontinence has a major impact on health economy and is increasingly recognized as a global health burden. Hence, identifying risk factors for urinary incontinence is of import...

  11. Faecal biomarkers of intestinal health and disease in children

    Directory of Open Access Journals (Sweden)

    Tamara ePang

    2014-01-01

    Full Text Available The identification of various faecal biomarkers has provided insight into the intestinal milieu. Most of these markers are associated with the innate immune system of the gut, apart from the more novel M2-pyruvate kinase (M2-PK. The innate immunity of the gut plays a role in maintaining a fine balance between tolerance to commensal bacteria and immune response to potential pathogens. It is a complex system, which comprises of multiple elements, including antimicrobial peptides (e.g. defensins, cathelicidins, lactoferrin and osteoprotegerin, inflammatory proteins (e.g. calprotectin and S100A12, and microbial products (e.g. short-chain fatty acids. Dysfunction of any component can lead to the development of intestinal disease, and different diseases have been associated with different faecal levels of these biomarkers. Stool quantification of these biomarkers therefore provides a non- invasive method that can assist in the assessment and diagnosis of various gastrointestinal conditions. This can potentially reduce the need for invasive procedures such as endoscopy. The abovementioned faecal biomarkers and their role in intestinal health and disease will be reviewed in this paper with a paediatric focus.

  12. Faecal calprotectin in the diagnosis of inflammatory bowel disease.

    Science.gov (United States)

    Burri, Emanuel; Beglinger, Christoph

    2011-01-01

    Suspicion of inflammatory bowel disease should be raised in any patient with chronic or recurrent abdominal pain and diarrhoea. However, symptoms of inflammatory bowel disease (IBD) overlap with functional gastrointestinal disorders and those patients may not need endoscopy. Currently, colonoscopy with multiple biopsies is considered the gold standard to establish the diagnosis of IBD. Unfortunately, patient selection for endoscopy based on symptoms is not reliable. The use of guidelines of appropriateness for endoscopy yields significantly more significant findings but the selection criteria suffer from low specificity. Calprotectin is a calcium binding protein of neutrophil granulocytes that correlates well with neutrophil infiltration of the intestinal mucosa when measured in faeces. In the last decade, a large body of evidence on the diagnostic value of faecal calprotectin has accumulated and measurement of calprotectin in faeces has been suggested as a surrogate marker of intestinal inflammation. Testing of faecal calprotectin has been highly useful to distinguish organic from functional intestinal disorders in patients with abdominal complaints. Additionally, faecal calprotectin has reliably identified colonic inflammation in patients with suspected IBD. The use of this inexpensive and widely available test in the evaluation and risk stratification in patients with abdominal complaints is likely to increase in the future.

  13. Application of tissue engineering in the treatment of stress urinary incontinence

    Institute of Scientific and Technical Information of China (English)

    SONG Xiao-fei; FU Qiang; XU Yue-min

    2009-01-01

    @@ Stress urinary incontinence is one of the most common diseases in urology. The main treatments for stress urinary incontinence are pharmacotherapy, physico-behavioral therapy and surgery.1 However, the results of present methods are not satisfactory. Tissue engineering is a newly emerging technology that may provide a novel method for the treatment of stress urinary incontinence.2

  14. Prevalence of double incontinence, risks and influence on quality of life in a general female population.

    NARCIS (Netherlands)

    Slieker-ten Hove, M.C.; Pool-Goudzwaard, A.L.; Eijkemans, M.J.; Steegers-Theunissen, R.P.M.; Burger, C.W.; Vierhout, M.E.

    2010-01-01

    BACKGROUND: Urinary incontinence (UI) and anal incontinence (AI) are complaints with impact on quality of life (QOL). Few data are available on prevalence of double incontinence (DI) in the general female population. OBJECTIVE: To determine prevalence of UI, AI, and DI, their associations with age,

  15. Post-weaning diet affects faecal microbial composition but not selected adipose gene expression in the cat (Felis catus.

    Directory of Open Access Journals (Sweden)

    Emma N Bermingham

    Full Text Available The effects of pre- (i.e., gestation and during lactation and post-weaning diet on the composition of faecal bacterial communities and adipose expression of key genes in the glucose and insulin pathways were investigated in the cat. Queens were maintained on a moderate protein:fat:carbohydrate kibbled ("Diet A"; 35:20:28% DM; n  =  4 or high protein:fat:carbohydrate canned ("Diet B"; 45:37:2% DM; n = 3 diet throughout pregnancy and lactation. Offspring were weaned onto these diets in a nested design (n  =  5 per treatment. Faecal samples were collected at wk 8 and 17 of age. DNA was isolated from faeces and bacterial 16S rRNA gene amplicons were analysed by pyrosequencing. RNA was extracted from blood (wk 18 and adipose tissue and ovarian/testicular tissues (wk 24 and gene expression levels determined using RT-qPCR. Differences (P<0.05 in composition of faecal bacteria were observed between pregnant queens fed Diet A or B. However, pre-weaning diet had little effect on faecal bacterial composition in weaned kittens. In contrast, post-weaning diet altered bacterial population profiles in the kittens. Increased (P<0.05 abundance of Firmicutes (77% vs 52% of total reads and Actinobacteria (0.8% vs 0.2% of total reads, and decreased (P<0.05 abundance of Fusobacteria (1.6% vs 18.4% of total reads were observed for kittens fed the Diet A compared to those fed Diet B post-weaning. Feeding Diet B pre-weaning increased (P<0.05 the expression levels of INRS, LEPT, PAI-1 and tended to increase GLUT1, while the expression levels of IRS-1 in blood increased in kittens fed Diet A pre-weaning. Post-weaning diet had no effect on expression levels of target genes. Correlations between the expression levels of genes involved in glucose and insulin pathways and faecal Bacteriodetes and Firmicutes phyla were identified. The reasons for why post-weaning diet affects microbial populations and not gene expression levels are of interest.

  16. Climate and land-use change impact on faecal indicator bacteria in a temperate maritime catchment (the River Conwy, Wales)

    Science.gov (United States)

    Bussi, Gianbattista; Whitehead, Paul G.; Thomas, Amy R. C.; Masante, Dario; Jones, Laurence; Jack Cosby, B.; Emmett, Bridget A.; Malham, Shelagh K.; Prudhomme, Christel; Prosser, Havard

    2017-10-01

    Water-borne pathogen contamination from untreated sewage effluent and runoff from farms is a serious threat to the use of river water for drinking and commercial purposes, such as downstream estuarine shellfish industries. In this study, the impact of climate change and land-use change on the presence of faecal indicator bacteria in freshwater was evaluated, through the use of a recently-developed catchment-scale pathogen model. The River Conwy in Wales has been used as a case-study, because of the large presence of livestock in the catchment and the importance of the shellfish harvesting activities in its estuary. The INCA-Pathogens catchment model has been calibrated through the use of a Monte-Carlo-based technique, based on faecal indicator bacteria measurements, and then driven by an ensemble of climate projections obtained from the HadRM3-PPE model (Future Flow Climate) plus four land-use scenarios (current land use, managed ecosystem, abandonment and agricultural intensification). The results show that climate change is not expected to have a very large impact on average river flow, although it might alter its seasonality. The abundance of faecal indicator bacteria is expected to decrease in response to climate change, especially during the summer months, due to reduced precipitation, causing reduced runoff, and increased temperature, which enhances the bacterial die-off processes. Land-use change can also have a potentially large impact on pathogens. The "managed ecosystems" scenario proposed in this study can cause a reduction of 15% in average water faecal indicator bacteria and up to 30% in the 90th percentile of water faecal indicator bacteria, mainly due to the conversion of pasture land into grassland and the expansion of forest land. This study provides an example of how to assess the impacts of human interventions on the landscape, and what may be the extent of their effects, for other catchments where the human use of the natural resources in the

  17. PHYSICAL TREATMENT OF THE STRESS URINARY INCONTINENCE IN WOMEN

    Directory of Open Access Journals (Sweden)

    Jugoslav Stojiljković

    2003-01-01

    Full Text Available The paper presents various methods of the physical treatment used in healing women with the stress urinary incontinence. It is emphasized that the exercises for strengthening the pelvic floor are effective in curing the stress incontinence but the most efficient exercise program has not been determined yet. Likewise, it is pointed out that the biofeedback application, along with the exercise, is no more efficient than the application of the exercises only but, still, much better results are achieved by applying the biofeedback at the beginning of the treatment. In order to evaluate the effects of the vaginal coni, electric and magnetic simulations in treating women with the stress urinary incontinence further explorations are necessary.

  18. Psychocultural meanings of urinary incontinence in women: a review.

    Science.gov (United States)

    Higa, Rosângela; Lopes, Maria Helena Baena de Mores; Turato, Egberto Ribeiro

    2008-01-01

    The purpose of the present study was to identify and analyze studies in health literature about the psychocultural meanings reported by women who experience urinary incontinence (UI). A bibliographical search was executed in the following databases: Lilacs, Medline, Pubmed and Medscape. The present review showed that studies note several meanings. The articles were grouped in three categories defined as significant: according to age experiences, cultural-religious experiences and experiences in self-care. The studies revealed that the degree of anguish and the range of the difficulties experienced are related both with age, ethnic group or religion and with the perception each individual has of her incontinence, which will lead to different levels of emotional disorders and to seeking (or not seeking) treatment. Besides, barriers regarding self-care are perceived. It is concluded that the UI may cause suffering and incontinent women have difficulties to deal with this problem.

  19. The UCLA surgical approach to sphincteric incontinence in women.

    Science.gov (United States)

    Rovner, E S; Ginsberg, D A; Raz, S

    1997-01-01

    Stress urinary incontinence (SUI) in the female may be treated by a variety of non-surgical and surgical therapies. However, once the patient has chosen to undergo operative repair the ideal procedure is based on three considerations: the degree of anterior vaginal wall prolapse, the degree of incontinence and associated anatomic abnormalities requiring surgical repair. In the vast majority of cases vaginal wall sling is our procedure of choice for the surgical treatment of SUI in the female. Vaginal wall sling is based on sound anatomic principles, may be performed as an outpatient procedure and is equally efficacious for the treatment of SUI due to anatomic incontinence (urethral hypermobility) and intrinsic sphincter deficiency. Since vaginal wall sling is performed through a transvaginal approach, other associated manifestations of pelvic floor prolapse such as rectocele can be addressed and repaired simultaneously. When necessary the vaginal wall sling can be easily modified to repair large grade cystoceles.

  20. An integral theory of female urinary incontinence. Experimental and clinical considerations.

    Science.gov (United States)

    Petros, P E; Ulmsten, U I

    1990-01-01

    In this Theory paper, the complex interplay of the specific structures involved in female urinary continence are analyzed. In addition the effects of age, hormones, and iatrogenically induced scar tissue on these structures, are discussed specifically with regard to understanding the proper basis for treatment of urinary incontinence. According to the Theory stress and urge symptoms may both derive, for different reasons from the same anatomical defect, a lax vagina. This laxity may be caused by defects within the vaginal wall itself, or its supporting structures i.e. ligaments, muscles, and their connective tissue insertions. The vagina has a dual function. It mediates (transmits) the various muscle movements involved in bladder neck opening and closure through three separate closure mechanisms. It also has a structural function, and prevents urgency by supporting the hypothesized stretch receptors at the proximal urethra and bladder neck. Altered collagen/elastin in the vaginal connective tissue and/or its ligamentous supports may cause laxity. This dissipates the muscle contraction, causing stress incontinence, and/or activation of an inappropriate micturition reflex, ("bladder instability") by stimulation of bladder base stretch receptors. The latter is manifested by symptoms of frequency, urgency, nocturia with or without urine loss.

  1. Sacral nerve stimulation for urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence: an evidence-based analysis.

    Science.gov (United States)

    2005-01-01

    The aim of this review was to assess the effectiveness, safety, and cost of sacral nerve stimulation (SNS) to treat urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence. CONDITION AND TARGET POPULATION Urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence are prevalent, yet rarely discussed, conditions. They are rarely discussed because patients may be uncomfortable disclosing their symptoms to a health professional or may be unaware that there are treatment options for these conditions. Briefly, urge incontinence is an involuntary loss of urine upon a sudden urge. Urgency-frequency is an uncontrollable urge to void, which results in frequent, small-volume voids. People with urgency-frequency may or may not also experience chronic pelvic pain. Urinary retention refers to the inability to void despite having the urge to void. It can be caused by a hypocontractile detrusor (weak or no bladder muscle contraction) or obstruction due to urethral overactivity. Fecal incontinence is a loss of voluntary bowel control. The prevalence of urge incontinence, urgency-frequency, and urinary retention in the general population is 3.3% to 8.2%, and the prevalence of fecal incontinence is 1.4% to 1.9%. About three-quarters of these people will be successfully treated by behaviour and/or drug therapy. For those who do not respond to these therapies, the options for treatment are management with diapers or pads, or surgery. The surgical procedures are generally quite invasive, permanent, and are associated with complications. Pads and/or diapers are used throughout the course of treatment as different therapies are tried. Patients who respond successfully to treatment may still require pads or diapers, but to a lesser extent. SACRAL NERVE STIMULATION Sacral nerve stimulation is a procedure where a small device attached to an electrode is implanted in the abdomen or buttock to stimulate the sacral nerves in an

  2. Pelvic-Floor Properties in Women Reporting Urinary Incontinence After Surgery and Radiotherapy for Endometrial Cancer.

    Science.gov (United States)

    Bernard, Stéphanie; Moffet, Hélène; Plante, Marie; Ouellet, Marie-Pier; Leblond, Jean; Dumoulin, Chantale

    2017-04-01

    Endometrial cancer is the fourth most prevalent cancer in Canadian women. Radiotherapy (RT) is frequently recommended as an adjuvant treatment. There is a high prevalence (>80%) of urinary incontinence (UI) after RT. It is plausible that UI is associated, at least in part, with alterations of the pelvic-floor muscles (PFM). The aim of this exploratory study was to compare the PFM functional properties of women reporting UI after hysterectomy and RT for endometrial cancer with those of women with a history of hysterectomy but without UI. A descriptive cross-sectional study was conducted. Eleven women were recruited for the affected group, and 18 were recruited for the comparison group. Urogenital and bowel functions were assessed using International Consultation on Incontinence Questionnaires, and PFM properties were evaluated using a Montreal dynamometer. Nonparametric tests were used for comparison of personal characteristics, functional status, and muscle properties. A correspondence analysis detailed the association between UI severity and PFM properties. Maximal opening of dynamometer branches, maximal vaginal length, PFM maximum force and rate of force development in a strength test, and number of rapid contractions during a speed test were reduced in the affected group. No significant difference was found for the endurance test. The severity of UI was found to correspond to the rate of force development and the number of rapid contractions in a speed test, endurance, age, and vaginal length. The results are limited to the population studied. The small sample size limited the strength of the conclusions. Some evidence of alterations in PFM properties were found in women with UI after hysterectomy and RT for endometrial cancer. These alterations appeared to be associated with UI, suggesting a possible role for rehabilitation.

  3. [Update on current care guidelines: urinary incontinence (female)].

    Science.gov (United States)

    2012-01-01

    Female urinary incontinence (UI) is divided into stress (SUI), urgency (UUI), mixed (MUI) and overflow incontinence (chronic retention). Advanced age, obesity and pregnancy are the most important risk factors. Standardised questionnaires are used in diagnosis. The pad test, cough stress test and bladder diary are objective tools. A gynaecological examination includes pelvic floor muscle palpation and residual urine measurement. Urodynamics, cystoscopy and ultrasonography are complementary tools. Guided pelvic floor-muscle training is the first-line therapy. UUI can be treated with anticholinergic medicines. If conservative treatments are ineffective, SUI and MUI can be treated surgically with mid-urethral slings (TVT TOT and TVT-0).

  4. Reusables get high marks in adult incontinence care market.

    Science.gov (United States)

    Tison-Rossman, J

    1992-11-01

    The adult incontinence care market is coming of age. As environmental concerns gradually erode the popularity of disposables, nursing homes and hospitals are looking at reusables in a new light. In addition, the aging of the U.S. population is expected to increase the demand for incontinence care products. A recent study found that the sales of reusable cloth diapers and pads accounted for $385 million annually. All of these factors add up to a lucrative market for textile rental companies that can supply these products.

  5. Complete pelvic floor repair in treating fecal incontinence.

    Science.gov (United States)

    Lee, Patrick Y H; Steele, Scott R

    2005-02-01

    Fecal incontinence is associated with 20 to 40% of the patients with pelvic floor prolapse. Successful management of fecal incontinence requires not only an understanding of anorectal function but also a thorough understanding of pelvic floor anatomy and how pelvic floor prolapse affects fecal continence. Imaging techniques have been instrumental in visualizing pelvic floor prolapse and have helped correlate surgical findings. Stabilization of the perineal body appears to be a key component to the success of pelvic floor repair and fecal continence, but the optimal repair is far from being established.

  6. Biogas potential from anaerobic co-digestion of faecal sludge with food waste and garden waste

    Science.gov (United States)

    Afifah, Ukhtiy; Priadi, Cindy Rianti

    2017-03-01

    The limited faecal sludge management can be optimized by converting the sludge into biogas. This study purposed to optimize the biogas potential of faecal sludge with food waste and garden waste. The system using Anaerobic Co-digestion on the variation 25% and 50% concentration of faecal sludge based on Volatile Solids (VS). Inoculum used was cow's rumen. The study was operated using lab-scale batch reactor 51 L for 42 days. Biogas produced at 25% concentration of faecal sludge is 0,30 m3CH4/kg with 71,93% VS and 72,42% COD destruction. Meanwhile, at 50% concentration of faecal sludge produce 0,56 m3CH4/kg VS biogas with 92,43% VS and 87,55% COD destruction. This study concludes that biogas potential of 50% concentration greater than 25% concentration of faecal sludge.

  7. Incontinência do choro e infarto protuberancial unilateral Incontinence of crying and unilateral pontine infarct

    Directory of Open Access Journals (Sweden)

    Ricardo de Oliveira-Souza

    1995-09-01

    Full Text Available O presente estudo trata do caso de um paciente que apresentou incontinência do choro e hemiplegia direita por infarto ventroprotuberancial paramediano detectado pela RNM. O caráter circunscrito da lesão foi endossado pela normalidade dos potenciais evocados sômato-sensitivos e auditivos de curta-latência. Os episódios de choro desapareceram poucos dias depois do início do tratamento com doses baixas de imipramina. Discutimos o choro e riso patológicos como forma de incontinência da mímica resultante de desconexão límbico-motora, enfatizando a impropriedade de incluí-los na síndrome pseudobulbar, uma vez que dependem de correlatos anatômicos e funcionais distintos.A 64-year-old man presented with pathologic crying and right hemiplegia due to a unilateral pontine infarct from probable branch disease of the basilar artery. The circumscribed nature of the lesion was supported by MRI and short-latency evoked potentials. The weeping spells ceased after a few days of imipramine in low doses. Pathologic laughing and crying can be viewed as a limbic-motor disconnection syndrome, in which the faciovocal motor system is released from forebrain afferents carrying information of emotional content. The inclusion of pathologic laughing and crying in the syndrome pseudobulbar palsy is inaccurate and misleading, since each is related to distinct functional and anatomic systems intrinsic to the human brainstem.

  8. Restrições causadas pela incontinência urinária à vida da mulher Restricciones ocasionadas por la incontinencia urinaria en la vida de la mujer Urinary incontinence restrictions in women's life

    Directory of Open Access Journals (Sweden)

    Maria Helena Baena de Moraes Lopes

    2006-03-01

    negativas en el cotidiano de esas mujeres.Our purpose with this study was to verify the restriction of the urinary incontinence (UI in a woman's daily life, considering the type of incontinence, and find out how women deal with that. It is a secondary analysis of data taken from a previous study that were obtained using open and closed questions. Interviews were held with 164 incontinent inpatients of gynecological and urological clinics of two hospital schools in the city of Campinas, in the State of São Paulo, with ages ranging from 25 to 85 years. Of this universe, 104 (64% indicated one or more restrictions regarding their daily life activities, such as altered sexual (40.9%, social (33.5%, domestic (18.9% and occupational activities (15.2%. Mixed urinary incon-tinence and urge incontinence were mentioned as that affected the most women's daily life. The disposable pad system was the most utilized strategy in dealing with UI. It was concluded that UI has a negative impact on the daily life of these women.

  9. Prevalence and risk factors for urinary and fecal incontinence four months after vaginal delivery.

    Science.gov (United States)

    Baydock, Sandra A; Flood, Catherine; Schulz, Jane A; MacDonald, Dianna; Esau, Deborah; Jones, Sandra; Hiltz, Craig B

    2009-01-01

    To determine the prevalence of and risk factors for urinary and fecal incontinence four months after vaginal delivery. All patients who had vaginal deliveries at a tertiary care hospital over a three-month period were approached during their postpartum hospital stay regarding participation in the study. Participants underwent a telephone interview at four months after their delivery to determine the presence and type of any incontinence. Of 632 patients, 145 (23%) had stress incontinence, 77 (12%) had urge incontinence, 181 (29%) had any urinary incontinence and 23 (4%) had fecal incontinence. In univariate analysis, stress incontinence was found to be increased in patients>or=30 years of age (26.2%) compared with patientsor=30 years (34.1%) compared to or=30 years (P<0.01) and forceps delivery (P<0.01). There were no identified risk factors for fecal incontinence. Urinary incontinence is common in women at four months post partum. Fecal incontinence is less common. Maternal age and forceps assisted delivery were risk factors for urinary incontinence.

  10. The prevalence of stress urinary incontinence in women studying nursing and related quality of life.

    Science.gov (United States)

    Opara, Józef; Czerwińska-Opara, Wioletta Ewa

    2014-03-01

    Urinary incontinence is a growing problem that affects millions of people worldwide. The purpose of this study was to assess the prevalence of stress urinary incontinence (SUI) in women studying nursing. Respondents completed a questionnaire assessing urinary incontinence, severity of symptoms and quality of life. Short forms to assess symptoms of distress for urinary incontinence and quality of life: UDI-6 and IIQ-7 have been used. The study's conclusions are as follows: 1) among the 113 interviewed women, stress urinary incontinence (SUI) was observed in 25% of respondents; this prevalence is similar to the age-matched population; 2) among the triggering factors mentioned in stress urinary incontinence the most frequent were: coughing, laughing and sneezing; 3) moderate impact of incontinence on quality of life has been shown, but this effect was not statistically significant.

  11. [Urinary incontinence: neither men nor women should be forgotten

    NARCIS (Netherlands)

    Jaunin-Stalder, N.; Lagro-Janssen, A.L.M.

    2013-01-01

    The prevalence of urinary incontinence is higher in women, but up to 40% of elderly men suffer from it. It is very important for care givers to search actively for this problem, because only half of the patients, mostly men, will seek help specifically for this symptom. The patients, who do not ask

  12. Urinary incontinence in persons with Prader-Willi Syndrome

    NARCIS (Netherlands)

    Gontard, A. von; Didden, H.C.M.; Sinnema, M.; Curfs, L.M.G

    2010-01-01

    OBJECTIVE To assess and identify the frequency and type of urinary incontinence (UI), as well as associated symptoms in persons with Prader-Willi syndrome (PWS). PWS is characterized by mental retardation, short stature, obesity and hypogonadism. The behavioural phenotype includes eating problems,

  13. Transanal irrigation is effective in functional fecal incontinence

    DEFF Research Database (Denmark)

    Jørgensen, Cecilie Siggaard; Kamperis, Konstantinos; Modin, Line

    2017-01-01

    and 35% (n = 25) were titrated to daily sessions. Of the 63 children who fulfilled the Rome III criteria of constipation, 46 (73%) showed full response with complete remission of incontinence episodes. Eleven (17%) showed partial response (≥50% reduction). Of nine children with FNRFI, four (44%) showed...

  14. The meanings of silence in Brazilian women with urinary incontinence.

    Science.gov (United States)

    Higa, Rosângela; Chvatal, Vera Lucia Soares; de Moraes Lopes, Maria Helena Baena; Turato, Egberto Ribeiro

    2011-01-01

    We explored the meanings of silence for Brazilian women with urinary incontinence (UI). The sample consisted of 8 women, aged 30 to 45 years. Respondents worked as housekeepers or cleaning staff and were from lower social, economic, and educational strata. Their years of formal education varied from 0 to 8 years and they earned up to 4.5 times the Brazilian minimum wage, which is equivalent to US$900. A qualitative method using semistructured interviews was employed to gather data. Individual semistructured interviews were recorded and subsequently transcribed, including researchers' observations of subjects' nonverbal behaviors. The interviews began with the question: "Can you tell me about your experience with urinary incontinence?" Data were analyzed using a content analysis technique. Respondents avoided discussing UI and initially resisted labeling themselves as incontinent, but their nonverbal behaviors provided clues to the psychosocial distress caused by urinary leakage. Results suggest that respondents' underprivileged social, economic, and cultural situation may aggravate their limitations when expressing their feelings. We found that the women employed silence as a means to contain the psychosocial distress created by their UI, and that the silence itself should be interpreted as an expression of distress associated with UI. The silence of Brazilian women with UI is an essential element of communication about incontinence. We believe that the silence used by these women expresses the pain and anxiety they experienced, and it acts as an adaptive psychosocial mechanism.

  15. [Therapy of urine incontinence by electro-stimulation (author's transl)].

    Science.gov (United States)

    Tischer, W; Schwock, G; Festge, O A; Estel, S

    1982-01-01

    The most common cause of urine incontinence in childhood is a neurogenic disturbed micturition in cases of myelo-dysplasia. Of decisive significance for the diagnosis and choice of therapy are urodynamic examinations. A report is given on the effectiveness of the author's own examinations using transurethral electro-stimulation.

  16. Cystitis as a correlate of female urinary incontinence

    DEFF Research Database (Denmark)

    Mommsen, S.; Foldspang, Anders; Elving, Lisbeth Bach

    1994-01-01

    The objectives of the research were to study the association between prevalent urge and stress urinary incontinence (UI) and a history of cystitis in adult females. A cross-section of the adult female population, aged 30–59 years, in the Municipality of Aarhus, Denmark, was studied, using self-re...

  17. High-resolution endovaginal MR imaging in stress urinary incontinence

    Energy Technology Data Exchange (ETDEWEB)

    Stoker, Jaap; Lameris, Johan S. [Department of Radiology, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam (Netherlands); Rociu, Elena [Department of Radiology, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam (Netherlands); Department of Radiology, Erasmus Medical Center, 3015 GD, Rotterdam (Netherlands); Bosch, J.L.H. Ruud [Department of Urology, Erasmus Medical Center, 3015 GD, Rotterdam (Netherlands); Messelink, Embert J. [Department of Urology, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE, Amsterdam (Netherlands); Department of Urology, Onze Lieve Vrouwe Gasthuis, 1091 HA, Amsterdam (Netherlands); Hulst, Victor P.M. van der [Department of Radiology, Onze Lieve Vrouwe Gasthuis, 1091 HA, Amsterdam (Netherlands); Groenendijk, Annette G. [Department of Gynecology, Onze Lieve Vrouwe Gasthuis, 1091 HA, Amsterdam (Netherlands); Eijkemans, Marinus J.C. [Department of Public Health, Erasmus Medical Center, 3015 GD, Rotterdam (Netherlands)

    2003-08-01

    The causes of stress urinary incontinence are not completely known. Recent papers have stressed the importance of more anatomical information, which may help to elucidate the mechanism of stress urinary incontinence. The purpose of this study was to evaluate the prevalence of lesions of the urethral support mechanism and lesions (defects and scars, thinning) of levator ani muscle with endovaginal MRI in a case-control study. Forty women (median age 52 years, age range 40-65 years) - 20 patients with stress urinary incontinence (cases) and 20 age-matched healthy volunteers (controls) - underwent endovaginal MRI: axial, coronal, and sagittal T2-weighted turbo spin echo. The examinations were evaluated for the presence of lesions of urethral supporting structures and levator ani and scar tissue of the levator ani. The thickness of the levator ani muscle was measured. Lesions of the urethral support system and levator ani were significantly more prevalent in cases than in controls (p<0.01). Median levator ani thickness in patients was significantly lower than in healthy controls [2.5 mm (range 0.9-4.1 mm) vs 3.9 mm (range 1.4-7 mm)] (p<0.01). This study indicates a relationship between stress urine incontinence and the presence of lesions of the urethral support and levator ani and levator ani thinning. (orig.)

  18. ProACT for stress urinary incontinence after radical prostatectomy.

    NARCIS (Netherlands)

    Martens, F.M.J.; Lampe, M.; Heesakkers, J.P.F.A.

    2009-01-01

    INTRODUCTION: Stress urinary incontinence is a bothersome complication of radical prostatectomy. Surgical treatment consists of the artificial urinary sphincter (AUS), the male sling and bulk injections. This study presents the results of the first series of implantations of ProACT in the Netherland

  19. [Urinary incontinence: neither men nor women should be forgotten

    NARCIS (Netherlands)

    Jaunin-Stalder, N.; Lagro-Janssen, A.L.M.

    2013-01-01

    The prevalence of urinary incontinence is higher in women, but up to 40% of elderly men suffer from it. It is very important for care givers to search actively for this problem, because only half of the patients, mostly men, will seek help specifically for this symptom. The patients, who do not ask

  20. Treatment seeking behavior for urinary incontinence among north Indian women

    Directory of Open Access Journals (Sweden)

    Kumari Santosh

    2008-09-01

    Full Text Available Background: Urinary incontinence is a common but neglected problem of women. Aims: To ascertain the treatment seeking behavior of north Indian women having urinary incontinence (UI. Setting: Two residential colonies of Chandigarh. DESIGN: Cross-sectional face-to-face interview based study. Materials and Methods: This study was conducted by a trained nurse during April 2005-July 2005 among women aged 18 years and above. Women with UI were identified in a screening survey. They were interviewed individually regarding their treatment seeking behavior and socio-demographic data. Statistical Analysis Used: Percentage, mean, standard deviation, chi-square test. Results: Of the 220 enlisted incontinent women 20% (44 women consulted some health agency. Only 8.6% (19 women had heard about pelvic floor muscle exercises. Seventy-two percent (158 cases had UI for more than one year. The most common reason quoted for not seeking treatment was, ′UI was considered as ′normal′, ′did not take it seriously′ and ′shyness.′ Many (153;70% women reported that UI affected their daily routine as well as social activities like shopping and visiting friends. Conclusion: Urinary incontinence seriously affected the quality of life of women. Still, consultation rate for UI was low in the north Indian women.

  1. Electrokinetic profiles of nonowoven cotton for absorbent incontinence material

    Science.gov (United States)

    This paper discusses recent work on cotton/synthetic nonwovens, their electrokinetic analysis, and their potential use in incontinence materials. Electrokinetic analysis is useful in exploring fiber surface polarity properties, and it is a useful tool to render a snap shot of the role of fiber char...

  2. Urinary incontinence in persons with Prader-Willi Syndrome

    NARCIS (Netherlands)

    Gontard, A. von; Didden, H.C.M.; Sinnema, M.; Curfs, L.M.G

    2010-01-01

    OBJECTIVE To assess and identify the frequency and type of urinary incontinence (UI), as well as associated symptoms in persons with Prader-Willi syndrome (PWS). PWS is characterized by mental retardation, short stature, obesity and hypogonadism. The behavioural phenotype includes eating problems, t

  3. ProACT for stress urinary incontinence after radical prostatectomy.

    NARCIS (Netherlands)

    Martens, F.M.J.; Lampe, M.; Heesakkers, J.P.F.A.

    2009-01-01

    INTRODUCTION: Stress urinary incontinence is a bothersome complication of radical prostatectomy. Surgical treatment consists of the artificial urinary sphincter (AUS), the male sling and bulk injections. This study presents the results of the first series of implantations of ProACT in the Netherland

  4. Investigator Bias in Urodynamic Studies for Functional Urinary Incontinence

    NARCIS (Netherlands)

    Bael, An; Verhulst, John; Lax, Hildegard; Hirche, Herbert; van Gool, Jan D.

    2009-01-01

    Purpose: In the setting of the European Bladder Dysfunction Study, a multi-center, randomized, controlled trial of treatment options for functional incontinence in children, we assessed the concordance between reported and reviewed urodynamic scores. Materials and Methods: A total of 97 children wit

  5. Detection of porcine rotavirus from tissue and faecal specimens

    Directory of Open Access Journals (Sweden)

    Prabha Suji

    2009-01-01

    Full Text Available Porcine small intestinal sub-mucosa is a cell-free collagen matrix that has demonstrated its ability as a scaffold material. Transplantation poses special hazards because grafted tissues and organs transmit pathogens efficiently, especially viruses. Rotavirus is thought to be confined to the intestine, causing acute diarrhoea. The purpose of this study was to evaluate the porcine intestinal tissue scaffold for Rotavirus and to study the incidence of this virus among pig herds. Only one isolate was successfully adapted to grow in cell line MA 104 from faecal samples. This isolate was further confirmed by reverse transcriptase polymerase chain reaction and sequence analysis.

  6. Effects of obesity, energy restriction and neutering on the faecal microbiota of cats.

    Science.gov (United States)

    Fischer, Manuela M; Kessler, Alexandre M; Kieffer, Dorothy A; Knotts, Trina A; Kim, Kyoungmi; Wei, Alfreda; Ramsey, Jon J; Fascetti, Andrea J

    2017-09-29

    Surveys report that 25-57 % of cats are overweight or obese. The most evinced cause is neutering. Weight loss often fails; thus, new strategies are needed. Obesity has been associated with altered gut bacterial populations and increases in microbial dietary energy extraction, body weight and adiposity. This study aimed to determine whether alterations in intestinal bacteria were associated with obesity, energy restriction and neutering by characterising faecal microbiota using 16S rRNA gene sequencing in eight lean intact, eight lean neutered and eight obese neutered cats before and after 6 weeks of energy restriction. Lean neutered cats had a bacterial profile similar to obese rodents and humans, with a greater abundance (Penergy restriction (PEnergy reduction was concurrent with significant shifts in two low-abundance bacterial genera and trends in four additional genera. The greatest change was a reduction in the Firmicutes genus, Sarcina, from 4·54 to 0·65 % abundance after energy restriction. The short duration of energy restriction may explain why few bacterial changes were observed in the obese cats. Additional work is needed to understand how neutering, obesity and weight loss are related to changes in feline microbiota and how these microbial shifts affect host physiology.

  7. Trans-obturator Tape in surgical treatment of urinary incontinence

    Directory of Open Access Journals (Sweden)

    Ashrafi M

    2008-06-01

    Full Text Available Background: The aim of this study was to assess the efficacy and safety of a new minimally-invasive surgical procedure using trans-obturator Tape (TOT to treat female stress urinary incontinence.Methods: This clinical trial study was performed from 2003 to 2004 in the Gynecology Department of Imam Hospital, Vali-e-Asr, Tehran, Iran. A total of 35 women with stress urinary incontinence underwent the TOT procedure. All patients underwent pre-operative clinical examination, cough-stress test (full bladder, uroflowmetry and post-voiding residual volume assessment. Results: The mean age of patients was 50 years, ranging from 26 to 74 years, with an average urinary stress incontinence duration of six years. The mean time of follow-up was 14 months (at 1, 6, 12 and 24 months and the average duration of surgery was about 20 minutes. The perioperative complication rate was 9% with no vascular, nerve or bowel injuries. The rate of hemorrhagic side effects (spontaneously-absorbed hematoma and blood loss not requiring blood transfusion was 2.9%. Post-operative urinary retention and vaginal erosion occurred in one case each; the former was treated by intermittent self-catheterization. In total, 91.4% of patients were completely cured and 8.6% were improved without failure of treatment. Conclusions: The present study confirms the results obtained by Delorme and coworkers, and allows us to consider TOT as a safe, minimally invasive and efficient short-term surgical technique for the treatment of female stress urinary incontinence, alone or in combination with prolapse repair. Following this study, a randomized control trial is recommended to compare TOT with the gold standard surgery for women with urinary incontinence.

  8. Coital incontinence: what can we learn from urodynamic assessment?

    Science.gov (United States)

    Madhu, Chendrimada; Hashim, Hashim; Enki, Doyo; Yaasin, Musaab; Drake, Marcus

    2015-05-01

    To evaluate the association of coital incontinence (CI) with lower urinary tract symptoms (LUTS) and to understand the pathophysiology of CI. A database of all women who underwent urodynamic testing in a tertiary referral center in the United Kingdom, from January 1991 to December 2009, was retrospectively analyzed. All women reporting CI were included in the study. Urodynamic testing and interpretation of results were performed in accordance with the recommendations of the International Continence Society. The prevalence of CI in women with LUTS undergoing urodynamics was 11.8%, and they were significantly younger (mean age = 45.3 years; P 30 kg/m(2)) and parity were significantly associated with CI (P <.001). Women reporting CI significantly smoked cigarettes and used antidepressants (P <.001). There were fewer postmenopausal women (P <.001) with CI, and previous hysterectomy had a negative association with CI (P = .005). The majority of women had overactive bladder symptoms and stress urinary incontinence (P <.001). CI was significantly associated with urodynamic stress incontinence (UDSI; odds ratio = 2.35) and detrusor overactivity (DO; odds ratio = 1.22) but not DO incontinence (P <.001). Parity, overactive bladder symptoms, and UDSI reached statistical significance when analysis was performed for age-matched controls. CI is not uncommon in women with LUTS, and they present earlier than women with LUTS and no CI. CI is significantly associated with risk factors like parity, obesity, cigarette smoking, and antidepressant usage. CI is multifactorial and associated with UDSI and DO but not DO incontinence. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  9. All Incontinence is Not Created Equal: Impact of Urinary and Fecal Incontinence on Quality of Life in Adults with Spina Bifida.

    Science.gov (United States)

    Szymanski, Konrad M; Cain, Mark P; Whittam, Benjamin; Kaefer, Martin; Rink, Richard C; Misseri, Rosalia

    2017-03-01

    We previously reported that the self-reported amount of urinary incontinence is the main predictor of lower health related quality of life in adults with spina bifida. In this study we sought to determine the impact of fecal incontinence on health related quality of life after correcting for urinary incontinence. An international sample of adults with spina bifida was surveyed online in 2013 to 2014. We evaluated fecal incontinence in the last 4 weeks using clean intervals (less than 1 day, 1 to 6 days, 1 week or longer, or no fecal incontinence), amount (a lot, medium, a little or none), number of protective undergarments worn daily and similar variables for urinary incontinence. Validated instruments were used, including QUALAS-A (Quality of Life Assessment in Spina bifida for Adults) for spina bifida specific health related quality of life and the generic WHOQOL-BREF (WHO Quality of Life, short form). Linear regression was used (all outcomes 0 to 100). Mean age of the 518 participants was 32 years and 33.0% were male. Overall, 55.4% of participants had fecal incontinence, 76.3% had urinary incontinence and 46.9% had both types. On multivariate analysis fecal incontinence was associated with lower bowel and bladder health related quality of life across all amounts (-16.2 for a lot, -20.9 for medium and -18.5 for little vs none, p spina bifida. Health related quality of life is lower with an increasing amount of urinary incontinence. Fecal incontinence has a more uniform impact on health related quality of life regardless of frequency or amount. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Effect of room temperature transport vials on DNA quality and phylogenetic composition of faecal microbiota of elderly adults and infants.

    Science.gov (United States)

    Hill, Cian J; Brown, Jillian R M; Lynch, Denise B; Jeffery, Ian B; Ryan, C Anthony; Ross, R Paul; Stanton, Catherine; O'Toole, Paul W

    2016-05-10

    Alterations in intestinal microbiota have been correlated with a growing number of diseases. Investigating the faecal microbiota is widely used as a non-invasive and ethically simple proxy for intestinal biopsies. There is an urgent need for collection and transport media that would allow faecal sampling at distance from the processing laboratory, obviating the need for same-day DNA extraction recommended by previous studies of freezing and processing methods for stool. We compared the faecal bacterial DNA quality and apparent phylogenetic composition derived using a commercial kit for stool storage and transport (DNA Genotek OMNIgene GUT) with that of freshly extracted samples, 22 from infants and 20 from older adults. Use of the storage vials increased the quality of extracted bacterial DNA by reduction of DNA shearing. When infant and elderly datasets were examined separately, no differences in microbiota composition were observed due to storage. When the two datasets were combined, there was a difference according to a Wilcoxon test in the relative proportions of Faecalibacterium, Sporobacter, Clostridium XVIII, and Clostridium XlVa after 1 week's storage compared to immediately extracted samples. After 2 weeks' storage, Bacteroides abundance was also significantly different, showing an apparent increase from week 1 to week 2. The microbiota composition of infant samples was more affected than that of elderly samples by storage, with significantly higher Spearman distances between paired freshly extracted and stored samples (p microbiota profiles were analysed at the operational taxonomic unit (OTU) level, three infant datasets in the study did not cluster together, while only one elderly dataset did not. The lower microbiota diversity of the infant gut microbiota compared to the elderly gut microbiota (p microbiota samples, but may be less appropriate for lower diversity samples. Differences between fresh and stored samples mean that where storage is

  11. The Neanderthal meal: a new perspective using faecal biomarkers.

    Science.gov (United States)

    Sistiaga, Ainara; Mallol, Carolina; Galván, Bertila; Summons, Roger Everett

    2014-01-01

    Neanderthal dietary reconstructions have, to date, been based on indirect evidence and may underestimate the significance of plants as a food source. While zooarchaeological and stable isotope data have conveyed an image of Neanderthals as largely carnivorous, studies on dental calculus and scattered palaeobotanical evidence suggest some degree of contribution of plants to their diet. However, both views remain plausible and there is no categorical indication of an omnivorous diet. Here we present direct evidence of Neanderthal diet using faecal biomarkers, a valuable analytical tool for identifying dietary provenance. Our gas chromatography-mass spectrometry results from El Salt (Spain), a Middle Palaeolithic site dating to ca. 50,000 yr. BP, represents the oldest positive identification of human faecal matter. We show that Neanderthals, like anatomically modern humans, have a high rate of conversion of cholesterol to coprostanol related to the presence of required bacteria in their guts. Analysis of five sediment samples from different occupation floors suggests that Neanderthals predominantly consumed meat, as indicated by high coprostanol proportions, but also had significant plant intake, as shown by the presence of 5β-stigmastanol. This study highlights the applicability of the biomarker approach in Pleistocene contexts as a provider of direct palaeodietary information and supports the opportunity for further research into cholesterol metabolism throughout human evolution.

  12. The Neanderthal meal: a new perspective using faecal biomarkers.

    Directory of Open Access Journals (Sweden)

    Ainara Sistiaga

    Full Text Available Neanderthal dietary reconstructions have, to date, been based on indirect evidence and may underestimate the significance of plants as a food source. While zooarchaeological and stable isotope data have conveyed an image of Neanderthals as largely carnivorous, studies on dental calculus and scattered palaeobotanical evidence suggest some degree of contribution of plants to their diet. However, both views remain plausible and there is no categorical indication of an omnivorous diet. Here we present direct evidence of Neanderthal diet using faecal biomarkers, a valuable analytical tool for identifying dietary provenance. Our gas chromatography-mass spectrometry results from El Salt (Spain, a Middle Palaeolithic site dating to ca. 50,000 yr. BP, represents the oldest positive identification of human faecal matter. We show that Neanderthals, like anatomically modern humans, have a high rate of conversion of cholesterol to coprostanol related to the presence of required bacteria in their guts. Analysis of five sediment samples from different occupation floors suggests that Neanderthals predominantly consumed meat, as indicated by high coprostanol proportions, but also had significant plant intake, as shown by the presence of 5β-stigmastanol. This study highlights the applicability of the biomarker approach in Pleistocene contexts as a provider of direct palaeodietary information and supports the opportunity for further research into cholesterol metabolism throughout human evolution.

  13. Generic Modelling of Faecal Indicator Organism Concentrations in the UK

    Directory of Open Access Journals (Sweden)

    Carl M. Stapleton

    2011-06-01

    Full Text Available To meet European Water Framework Directive requirements, data are needed on faecal indicator organism (FIO concentrations in rivers to enable the more heavily polluted to be targeted for remedial action. Due to the paucity of FIO data for the UK, especially under high-flow hydrograph event conditions, there is an urgent need by the policy community for generic models that can accurately predict FIO concentrations, thus informing integrated catchment management programmes. This paper reports the development of regression models to predict base- and high-flow faecal coliform (FC and enterococci (EN concentrations for 153 monitoring points across 14 UK catchments, using land cover, population (human and livestock density and other variables that may affect FIO source strength, transport and die-off. Statistically significant models were developed for both FC and EN, with greater explained variance achieved in the high-flow models. Both land cover and, in particular, population variables are significant predictors of FIO concentrations, with r2 maxima for EN of 0.571 and 0.624, respectively. It is argued that the resulting models can be applied, with confidence, to other UK catchments, both to predict FIO concentrations in unmonitored watercourses and evaluate the likely impact of different land use/stocking level and human population change scenarios.

  14. Virulence factors and bacteriocins in faecal enterococci of wild boars.

    Science.gov (United States)

    Poeta, Patricia; Igrejas, Gilberto; Costa, Daniela; Sargo, Roberto; Rodrigues, Jorge; Torres, Carmen

    2008-10-01

    The production of antimicrobial, haemolytic and gelatinase activities was tested in 67 enterococci (39 E. faecium, 24 E. hirae, 2 E. faecalis, and 2 Enterococcus spp.), recovered from faecal samples of wild boars. In addition, the presence of genes encoding bacteriocin and virulence factors was also analysed by PCR and sequencing. Production of antimicrobial activity was checked in all enterococci against 9 indicator bacteria and it was detected in 11 E. faecium isolates (16.5%); eight and two of them harboured the genes encoding enterocin A + enterocin B and enterocin L50A/B, respectively. Sixty-seven per cent of our enterococci harboured different combinations of genes of the cyl operon, but none of them contained the complete cyl L(L)L(S)ABM operon, necessary for cytolysin expression. The presence of gel E gene, associated with the fsr ABC locus, was identified in 4 E. faecium and two E. faecalis isolates, exhibiting all of them gelatinase activity. beta -hemolytic activity was not found in our isolates. Both cpd and ace genes, encoding respectively the accessory colonisation factor and pheromone, were detected in two E. faecalis isolates, and the hyl gene, encoding hyalorunidase, in two E. faecium isolates, one of them gelatinase-positive. Genes encoding bacteriocins and virulence factors are widely disseminated among faecal enterococci of wild boars and more studies should be carried out to know the global distribution of these determinants in enterococci of different ecosystems.

  15. Effect of special Hungarian probiotic kefir on faecal microflora

    Institute of Scientific and Technical Information of China (English)

    Mária Figler; Gyula Mózsik; Béla Schaffer; Beáta Gasztonyi; Pongrác (A)cs; Béla Szili; Regina Rab; Sándor Szakály

    2006-01-01

    AIM: To investigate the effect of a four-week consumption of a special Hungarian probiotic agent (Biofir(R)) on the faecal microflora in human healthy subjects.METHODS: The effect of Biofir(R) with 106/cm3 initial germs on the faecal microflora was studied in 120healthy volunteers (71 females, 49 males). The traditional Russian type kefir was used as control. The various germ groups and pH values were determined in wk 2, 4and 6.RESULTS: The number of all microbes increased during the 4-week probiotic treatment. The number of microbes increased 4.3-fold in the control group and 6.8-fold in Biofir-treated group. The probiotic kefir caused multiplication of the probiotic flora, meanwhile the undesired bacteria multiplied in the control group. No significant change of pH values of the faeces was found in both groups.CONCLUSION: The Hungarian probiotic kefir (Biofir(R)) is capable of promoting multiplication of probiotic bacterial flora in the large bowel.

  16. Flatography: Detection of gastrointestinal diseases by faecal gas analysis

    Institute of Scientific and Technical Information of China (English)

    Evelien; F; de; Groot; Tim; G; de; Meij; Daniel; J; Berkhout; Marc; P; van; der; Schee; Nanne; K; de; Boer

    2015-01-01

    Patients presenting with gastro-intestinal symptoms might suffer from a range of possible underlying diseases. An unmet need exists for novel cost-effective,reproducible, easy-to-perform and non-invasive tests. Hippocrates used body odours to diagnose diseases circa 460 before Christ. The art of diagnostic smelling is making a promising high-tech come-back with portable "electronic diagnostic noses". Analysis of faecal volatile organic compounds is a novel field in metabolomics with considerable potential to improve the diagnosis, phenotyping and monitoring of gastro-intestinal disease. Challenges will be to mature over the coming years by development of a standardized methodology for stool sample collection, storage, handling and analysis. Furthermore, key volatiles need to be identified to improve test accuracy and sensitivity by development of sensors tailored toward the accurate identification of disease specific volatiles. If these challenges are adequately faced, analysis of faecal volatiles has realistic potential to considerably improve screening, diagnosis and disease monitoring for gastro-intestinal diseases.

  17. A new rapid home test for faecal calprotectin in ulcerative colitis

    DEFF Research Database (Denmark)

    Elkjaer, M; Burisch, Johan; Hansen, V Voxen

    2010-01-01

    Enzyme-linked immunosorbent assay (ELISA) is a time-consuming method for the measurement of faecal calprotectin. Two new quantitative rapid tests have been developed.......Enzyme-linked immunosorbent assay (ELISA) is a time-consuming method for the measurement of faecal calprotectin. Two new quantitative rapid tests have been developed....

  18. A new rapid home test for faecal calprotectin in ulcerative colitis

    DEFF Research Database (Denmark)

    Elkjaer, M; Burisch, Johan; Hansen, V Voxen

    2010-01-01

    Enzyme-linked immunosorbent assay (ELISA) is a time-consuming method for the measurement of faecal calprotectin. Two new quantitative rapid tests have been developed.......Enzyme-linked immunosorbent assay (ELISA) is a time-consuming method for the measurement of faecal calprotectin. Two new quantitative rapid tests have been developed....

  19. Prevalence of urinary incontinence and its relation with sedentarism in Spain.

    Science.gov (United States)

    Leirós-Rodríguez, R; Romo-Pérez, V; García-Soidán, J L

    2017-06-03

    To determine the prevalence of urinary incontinence in the elderly Spanish population of both sexes and identify a possible relationship between physical activity habits and the presence of urinary incontinence in the elderly. We used data from 8146 individuals older than 60 years (age range, 60-94 years), from which data from a 15-year cohort were obtained. Of these, 4745 (58.2%) were women and 3401 (41.8%) were men. We analysed the presence of urinary incontinence, physical activity habits and the influence of other variables such as sex, age, weight and body mass index. We detected a prevalence of urinary incontinence of 15% for the women and 11.6% for the men. Those with urinary incontinence had a greater average age, weight and body mass index than the healthy participants. At the same time, the patient group with incontinence showed more sedentary habits compared with the healthy participants. A strong relationship was observed between the body mass index and prevalence of urinary incontinence. Urinary incontinence was also related to attitudinal aspects such as physical inactivity, a behaviour that predisposes the elderly to developing incontinence. For the first time, we observed a reduction in the prevalence of incontinence compared with previous studies. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Prevalence and incidence of urinary incontinence in the elderly: a longitudinal study in South Australia

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective To identify the prevalence, incidence and trend of urinary incontinence in the elderly over a two-year period. Methods We randomly selected 4187 elderly people using the State Electoral Data Base in South Australia. Questionnaire surveys were conducted in 1992 with a response rate of 53.4%. The following two surveys were conducted 12 and 24 months later. A total of 2087 elderly people completed all three surveys. Results Urge incontinence had a higher prevalence rate, with 36.6% to 41.6% of the elderly having at least an occasional problem (with 7.5% to 9.6% having problems often), compared to 23.4% to 28.8% having at least an occasional problem with stress incontinence (with 3.3% to 5.0% having problems often). Combined incontinence and urge incontinence were more common than stress incontinence alone. The incidence rates of urge incontinence and stress incontinence were 19.8% (with 3.1% often) and 14.5% (with 1.9% often), respectively. The trends toward incontinence during the two-year period indicated increasing trends in the elderly. Conclusion Urinary incontinence is an important health problem in the elderly and our data show that it has an increasing trend for future.

  1. Anal incontinence and fecal urgency following vaginal delivery with episiotomy among primiparous patients.

    Science.gov (United States)

    Rusavy, Zdenek; Karbanova, Jaroslava; Jansova, Magdalena; Kalis, Vladimir

    2016-12-01

    To investigate anal incontinence following mediolateral or lateral episiotomy during a first vaginal delivery. The present prospective follow-up study enrolled primiparous patients who underwent vaginal delivery including mediolateral or lateral episiotomy between April 1, 2010 and March 31, 2012. Participants completed interviews before delivery, and were given anal-incontinence questionnaires to be returned for analysis at 3 months and 6 months postpartum. Anal incontinence was defined as a St Mark's incontinence score above four and individual anal-incontinence components were analyzed separately; results were compared between the two episiotomy techniques. Questionnaires were returned by 300 and 366 patients who underwent mediolateral and lateral episiotomies, respectively; baseline characteristics were similar. Anal incontinence at 3 months and 6 months was recorded among 21 (7.0%) and 9 (3.0%) patients who underwent mediolateral and 27 (7.4%) and 20 (5.5%) who underwent lateral episiotomy, respectively. The study was underpowered to confirm equivalence between the groups; however, no statistically significant differences were observed in the rates of anal incontinence, flatus, solid or liquid incontinence, and de novo incontinence. Fecal urgency (P=0.017) and de novo fecal urgency (P=0.008) were more prevalent among patients who underwent lateral episiotomies at 6 months. Anal incontinence was comparable between primiparous patients who underwent mediolateral or lateral episiotomy. The association between lateral episiotomy and fecal urgency merits further scientific interest. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  2. Modelling the fate and transport of faecal bacteria in estuarine and coastal waters.

    Science.gov (United States)

    Gao, Guanghai; Falconer, Roger A; Lin, Binliang

    2015-11-15

    This paper details a numerical model developed to predict the fate and transport of faecal bacteria in receiving surface waters. The model was first validated by comparing model predicted faecal bacteria concentrations with available field measurements. The model simulations agreed well with the observation data. After calibration, the model was applied to investigate the effects of different parameters, including: tidal processes, river discharges from the upstream boundaries and bacteria inputs from the upstream boundaries, wastewater treatment works (WwTWs), rivers and combined sewer overflows (CSO), on the concentrations of faecal bacteria in the Ribble Estuary. The results revealed that the tide and upstream boundary bacteria inputs were the primary factors controlling the distribution of faecal bacteria. The bacteria inputs from the WwTWs in the model domain were generally found not to have a significant impact on distribution of faecal bacteria in the estuary.

  3. Early diagnosis and treatment of genuine stress urinary incontinence in women after pregnancy: midwives as detectives.

    Science.gov (United States)

    Peeker, Iréne; Peeker, Ralph

    2003-01-01

    Genuine stress incontinence is often a hidden problem in that many women suffering from genuine stress incontinence after delivery do not seek medical advice. This article reviews signs and symptoms of genuine stress incontinence that, when identified, may enable midwives to initiate or suggest treatment as needed. A comprehensive literature search was performed in relevant medical databases. The following adverse risk factors for the development of genuine stress incontinence are vaginal delivery, multiparity, and obesity, with an increased risk for women who did not actively exert pelvic floor training. Prolonged second stage of labor and heavier babies were two factors associated with an increase in the risk of damage to the pelvic floor innervation as well as genuine stress incontinence. Several conservative treatment options, such as special instructions for pelvic floor training, the use of weight cones, and electrical stimulation, are reported to alleviate genuine stress incontinence symptoms.

  4. [Prevalence and risk factors of urinary incontinence in female workers of hotels].

    Science.gov (United States)

    Fontana, L; Falconi, G; Di Martino, T; Iavicoli, I

    2007-01-01

    The International Continence Society defines urinary incontinence (UI) as "a condition in which involuntary loss of urine is a social or hygienic problem and is objectively demonstrable". There are three different jorms of UI. stress urinary incontinence, urge urinary incontinence and mixed incontinence. The aim of this study was to investigate the prevalence of UI in a group of female workers in the hotel sector. The International Consultation on Incontinence Questionnaire Urinary Incontinence short form (ICIQ-UI Short Form) was administered to all female workers and data were collected about age, body mass index, number of vaginal and Caesarean delivery. Results showed a prevalence of UI widely bigger in the plans waitress than in video display terminal workers and suggest the hypothesis that manual handling of loads representing a possible occupational risk for UI.

  5. Faecal gas analysis by electronic nose as novel, non-invasive method for assessment of active and quiescent paediatric inflammatory bowel disease: Proof of principle study.

    Science.gov (United States)

    de Meij, Tim G J; de Boer, Nanne K H; Benninga, Marc A; Lentferink, Yvette E; de Groot, Evelien F J; van de Velde, Mirjam E; van Bodegraven, Adriaan A; van der Schee, Marc P

    2014-09-22

    Inflammatory bowel disease (IBD) and its two phenotypes ulcerative colitis (UC) and Crohn's disease (CD) are essentially assessed by endoscopy, both in initial diagnostic work-up and during follow-up. This carries a high burden, especially on paediatric patients. Faecal volatile organic compounds (VOCs) are considered potential non-invasive biomarkers for intestinal diseases linked to gut microbiota alterations. We hypothesized that faecal VOC analysis by electronic nose allows discrimination of children with CD, UC and controls during active disease and remission. Faecal VOC patterns of children with newly diagnosed IBD and controls were studied by an electronic nose (Cyranose 320®), at baseline and upon achieving remission at 6-weeks of follow-up. Disease activity was assessed by global physician's assessment, substantiated by serum C-reactive protein and faecal calprotectin. Internally cross-validated receiver-operator-characteristic curves and corresponding sensitivity and specificity for detection of IBD were calculated RESULTS: Faecal VOC profiles of patients with UC (26) and CD (29) differed from controls (28); in active disease (AUC±95% CI, p-value, sensitivity, specificity: 1.00±0.00; p<0.001, 100%, 100%) and (0.85±0.05, p<0.001, 86%, 67%) and in clinical remission (0.94±0.06, p<0.001, 94%, 94%) and (0.94±0.06, p<0.001, 94%, 94%), respectively. Furthermore, CD-patients differed from UC-patients during active disease (0.96±0.03; p<0.001, 97%, 92%), and upon achieving clinical remission (0.81±0.08, p=0.002, 88%, 72%). Faecal VOC analysis allowed discrimination of paediatric patients with IBD from controls, both during active disease and remission. It therefore has potential as non-invasive test, in both diagnostic work-up and assessment of disease activity in IBD. Copyright © 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  6. Mayer-Rokitansky-Kuster-Hauser syndrome and stress urinary incontinence.

    Science.gov (United States)

    Aniuliene, R; Aniulis, P

    2015-11-01

    Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a disorder of development of the female genital tract, characterized by the absence of the upper portion of the vagina, an absent or hypoplastic uterus, and normal or hypoplastic fallopian tubes. Affected women may have associated urological or skeletal abnormalities. Case report. A 19-year-old female with MRKH syndrome, female genotype and phenotype, primary amenorrhoea and stress urinary incontinence was admitted to the outpatient department of the university hospital. The patient underwent tension free vaginal obturator tape (TVT-O) surgery for stress urinary incontinence. The patient's objective self-evaluation of the efficacy of treatment after 6 months was 60%. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. The management of stress urinary incontinence: A case report

    Directory of Open Access Journals (Sweden)

    Preshani Reddy

    2015-04-01

    Full Text Available Introduction: Conservative management is the first option for patients with stress urinary incontinence (SUI. However, successful management of women diagnosed with SUI is dependent on a proper assessment and a tailored treatment plan. This case report aims to show the effectiveness of physiotherapy management in a 42-year-old patient diagnosed with SUI.Patient presentation: The patient’s main complaints were involuntary loss of urine on coughing, sneezing and lifting of heavy objects, which started following the birth of her third child.Management and outcome: The patient was taught the ‘Knack’ manoeuvre and provided with a tailored pelvic floor exercise programme. Improvement was noted at the third visit and the patient no longer had involuntary episodes.Conclusion: This case report shows the successful outcome of conservative management in a patient with stress urinary incontinence.

  8. Treatment strategies in obstructed defecation and fecal incontinence

    Institute of Scientific and Technical Information of China (English)

    Marat Khaikin; Steven D Wexner

    2006-01-01

    Obstructed defecation (OD) and fecal incontinence(FI) are challenging clinical problems, which are commonly encountered in the practice of colorectal surgeons and gastroenterologists. These disorders socially and psychologically distress patients and greatly impair their quality of life. The underlying anatomical and pathophysiological changes are complex, often incompletely understood and cannot always be determined. As a consequence, many medical, surgical,and behavioral approaches have been described, with no panacea. Over the past decade, advances in an understanding of these disorders together with rational and similar methods of evaluation in anorectal physiology laboratories (ARP), radiology studies, and new surgical techniques have led to promising results. In this brief review, we discuss treatment strategies and recent updates on clinical and therapeutic aspects of obstructed defecation and fecal incontinence.

  9. Occurrence of pathogenic and faecal Escherichia coli in layer hens

    Directory of Open Access Journals (Sweden)

    Silvia Tagliabue

    2010-01-01

    Full Text Available A total of 117 Escherichia coli from colibacillosis affected (APEC and clinically healthy birds (AFEC were serotyped and tested for the presence of virulence genes: iss, tsh, cva. A total of 54.5% E. Coli were typeable and 15 different serogroups were identified. The most common serogroups among APEC strains were O78, O2 and O128, whereas O139 was predominant in faecal strains from healthy birds. Iss, tsh e cva were more frequently detected among the septicaemic E. coli strains. The association of virulence genes was observed. Particularly, the pathotype iss-tsh-cva was present in 46.5% of APEC strains. Referring to serogroups, E. coli O78 and O2 originating from colibacillosis affected birds were always isstsh- cva positive but did not share virulence genes when they came from healthy birds.

  10. Near infrared reflectance measurement of nitrogen faecal losses.

    Science.gov (United States)

    Benini, L; Caliari, S; Bonfante, F; Guidi, G C; Brentegani, M T; Castellani, G; Sembenini, C; Bardelli, E; Vantini, I

    1992-06-01

    Chemical methods of measuring nitrogen in stools are complex, unpleasant, and therefore rarely performed. Recently, near infrared reflectance (NIRA) has been suggested for stool analysis. The aim of this study was to evaluate the possible application of this method in routine faecal nitrogen measurement. Nitrogen concentration and daily output were measured in the stools of 83 patients using NIRA and, for comparison, the Kjeldahl method. Nitrogen concentration and output ranged between 0.4-2.72 g% and 0.45-8.96 g/day respectively. Correlation coefficients (r), of 0.89 and 0.97 were found between the two methods for concentration and output respectively, and similar values were found in patients on enteral nutrition. Repeated measurements from the same stool collection, requiring only a few minutes, allowed homogenisation to be avoided. NIRA seems to be an easy, fast, and reliable alternative to chemical assays of nitrogen measurement in the management of patients with digestive disorders.

  11. Identifying the quality of life effects of urinary incontinence with depression in an Australian population

    Directory of Open Access Journals (Sweden)

    Avery Jodie C

    2013-02-01

    Full Text Available Abstract Background To explore the additive effect of urinary incontinence, in people with comorbid depression, on health related quality of life. Methods Males and females, 15 to 95 years (n = 3010, response rate 70.2% were interviewed face to face in the 1998 Autumn South Australian Health Omnibus Survey. Results Self-reported urinary incontinence was found in 20.3% (n=610, and depression as defined by the PRIME-MD in 15.2% (n=459 of the survey population. Urinary incontinence with comorbid depression was found in 4.3% of the overall population. Univariate analysis showed that respondents with urinary incontinence and comorbid depression were more likely to be aged between 15 and 34 years and never married when compared to those with incontinence only. Multivariate analysis demonstrated that in people with incontinence, the risk of having comorbid depression was increased by an overall health status of Fair or Poor, or the perception that their incontinence was moderately or very serious. Respondents reporting that they experienced incontinence with comorbid depression scored significantly lower than those experiencing incontinence without depression on all dimensions of the SF-36. The interaction of the presence of incontinence and the presence of depression was significantly associated with the dimensions of physical functioning. Conclusions Depression and incontinence both reduce QOL. When they occur together there appears to be an additive effect which affects both physical and mental health, perhaps by increasing a person’s negative perceptions of their illness. Clinicians should identify and manage comorbid depression when treating patients who have incontinence to improve their overall QOL.

  12. Measurement of urethral closure function in women with stress urinary incontinence

    DEFF Research Database (Denmark)

    Klarskov, N; Scholfield, D; Soma, K;

    2009-01-01

    , double-blind, placebo controlled, crossover study 17 women with stress urinary incontinence or mixed urinary incontinence received 4 mg esreboxetine or placebo for 7 to 9 days followed by a washout period before crossing over treatments. Urethral pressure reflectometry and urethral pressure profilometry...... esreboxetine patients had significantly fewer incontinence episodes and reported a treatment benefit (global impression of change) compared to placebo. CONCLUSIONS: The opening pressure measured with urethral pressure reflectometry was less variable compared to the parameters measured with urethral pressure...

  13. Teaching strategies for assessing and managing urinary incontinence in older adults.

    Science.gov (United States)

    Bradway, Christine; Cacchione, Pamela

    2010-07-01

    Urinary incontinence is common and affects many aspects of older adults' lives; therefore, it is essential that nursing faculty include this content in classroom and clinical teaching situations. This article describes innovative strategies for teaching upper-level nursing students (e.g., junior and senior undergraduates) about urinary incontinence in older adults, specifically, the relevant anatomy and physiology of continence and associated pathophysiology of urinary incontinence, risk factors and consequences, definitions and types, and effective nursing assessment and management strategies.

  14. Association between urinary incontinence in women and a previous history of surgery

    DEFF Research Database (Denmark)

    Mommsen, S.; Foldspang, Anders; Elving, L.;

    1993-01-01

    In a cross-sectional study, 85% of 3114 women responded to a questionnaire on urinary incontinence and a history of abdominal, gynaecological and urological surgery. In 1987 the prevalence of urinary incontinence was 17%; 63% had undergone surgery, mainly gynaecological, and almost one......-third of the respondents had had more than one operation. Bivariate and multivariate analysis showed stress urinary incontinence to be associated with previous exposure to surgery....

  15. Analysis of computed X-ray tomography of the brain in incontinence patients with senile dementia

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Yasuyuki; Machida, Toyohei; Oishi, Yukihiko (Jikei Univ., Tokyo (Japan). School of Medicine); Kamachi, Chikahumi; Okabe, Tsutomu; Akazawa, Kouhei; Takasaka, Satoshi

    1994-02-01

    To evaluate the condition of incontinence in patients with senile dementia, we performed computed tomography X-rays to the brain and analyzed the relationship among the circulatory defect of the brain, the brain atrophy and the degree of incontinence. There were 92 patients subjected to this study who were hospitalised due to senile dementia; 74 patients had vascular dementia, 10 patients had senile dementia of Alzheimer type, and 8 patients had the mixed type. (age range: 54-95 years; mean: 80.3 years). The degree of incontinence in these patients varied as follows: 18 patients with continence, 16 patients with moderate incontinence, 58 patients with total incontinence. The diagnosis of circulatory defect of the brain was based on computed tomography observation of periventricular lucency (P.V.L.), and the degree of brain atrophy was evaluated based on 4 criteria: the Lateral body ratio, the Huckman number, the Evans ratio, and the enlargement of the subarachnoid space. Among the 92 patients, P.V.L. was present in 31 patients, among them 27 patients suffered from incontinence. There was a significant correlation between P.V.L. and incontinence (p<0.001). As the incontinence progressively worsened (Continence, Moderate incontinence, Total incontinence), the lateral body ratio increased to 24.8, 27.8, 28.6, (p<0.05). The Huckman number also increased to 18.3, 19.3, 21.3, (p<0.01), and the evans ratio likewise 29.9, 32.3, 33.7 (p<0.01). The enlargement of the subarachnoid space was also correlated with the severity of incontinence. We conclude that urinary incontinence originating from senile dememtia is connected to brain atrophy and is strongly influenced by the circulatory disorders of the brain. (author).

  16. Diagnosis and office-based treatment of urinary incontinence in adults. Part two: treatment

    OpenAIRE

    Cameron, Anne P.; Jimbo, Masahito; Heidelbaugh, Joel J.

    2013-01-01

    Urinary incontinence is a common problem in both men and women. In this review article we address treatment of the various forms of incontinence with conservative treatments, medical therapy, devices and surgery. The US Preventive Services Task Force, The Cochrane Database of Systematic Reviews, and PubMed were reviewed for articles focusing on urinary incontinence. Conservative therapy with education, fluid and food management, weight loss, timed voiding and pelvic floor physical therapy are...

  17. Prevalence and factors associated with urinary incontinence in climacteric

    Directory of Open Access Journals (Sweden)

    Máyra Cecilia Dellú

    Full Text Available SUMMARY Objective: To estimate the prevalence and identify associated factors to urinary incontinence (UI in climacteric women. Method: In a cross-sectional study with a stratified random sample, 1,200 women aged between 35 and 72 years were studied, enrolled in the Family Health Strategy in the city of Pindamonhangaba, São Paulo. Urinary incontinence was investigated using the International Consultation of Incontinence Questionnaire - Short Form, while associated factors were assessed based on a self-reported questionnaire with socio-demographic, obstetric and gynecological history, morbidities and drug use. The prevalence of urinary incontinence was estimated with a 95% confidence interval (95CI and the associated factors were identified through multiple logistic regression model performed using Stata software, version 11.0. Results: Women had a mean age of 51.9 years, most were in menopause (59.4%, married (87.5%, Catholic (48.9%, and declared themselves black or brown (47.2%. The mean age of menopause of women with UI was 47.3 years. The prevalence of UI was 20.4% (95CI: 17.8-23.1%. The factors associated with UI were urinary loss during pregnancy (p=0.000 and after delivery (p=0.000, genital prolapse (p=0.000, stress (p=0.001, depression (p=0.002, and obesity (p=0.006. Conclusion: The prevalence of UI was lower but similar to that found in most similar studies. Factors associated with the genesis of UI were urinary loss during pregnancy and after delivery, genital prolapse and obesity.

  18. Psychosocial problems of women with stress urinary incontinence

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    Grażyna Stadnicka

    2015-09-01

    Full Text Available Objective. The aim of the study was evaluation of the influence of stress urinary incontinence on women’s quality of life. Material and method. The study covered 275 women between 30–65 years of age. The study was conducted using the following tools: [i]Gaudenz [/i]Questionnaire, [i]King’s Health Questionnaire[/i] (KHQ, [i]Female Sexual Function Index[/i] (FIFI Questionnaire, and a questionnaire devised by the authors of the study. Results. The study shows that the disease has a negative effect on evaluation of the quality of thee women’s lives. The symptoms of stress urinary incontinence had a significant influence on the feeling of emotional comfort, social and professional activity of the surveyed women – respectively p= 0.000; p=0.000; p=0.000. Nearly every third woman (28.7% felt great mental discomfort related to the disease symptoms, 31.7% a considerable discomfort, 33.1% a moderate, and very few women (6.5 % claimed that the disease had a minimal effect on their emotional state. About two-thirds of the surveyed women (68.7% were sexually active, and the remaining 31.3% declared the lack of sexual intercourse. Conclusions. The occurrence of stress urinary incontinence symptoms affects the quality of life of women, especially their mental state and interpersonal contacts. Most women with the symptoms of stress urinary incontinence fulfill their sexual needs; however, many of them do not feel complete satisfaction with their sex life.

  19. Physiotherapy for Women with Stress Urinary Incontinence: A Review Article

    OpenAIRE

    Ghaderi, Fariba; Oskouei, Ali E.

    2014-01-01

    [Purpose] This review article is designed to expose physiotherapists to a physiotherapy assessment of stress urinary incontinence (SUI) and the treatment and possibly preventive roles that they might play for women with SUI. Specifically, the goal of this article is to provide an understanding of pelvic floor muscle function and the implications that this function has for physiotherapy treatment by reviewing articles published in this area. [Methods] A range of databases was searched to ident...

  20. Dietary Fiber Supplementation for Fecal Incontinence: A Randomized Clinical Trial

    OpenAIRE

    2014-01-01

    Dietary fiber supplements are used to manage fecal incontinence (FI), but little is known about the fiber type to recommend or the level of effectiveness of such supplements, which appear related to the fermentability of the fiber. The aim of this single-blind, randomized controlled trial was to compare the effects of three dietary fiber supplements (carboxymethylcellulose [CMC], gum arabic [GA], or psyllium) with differing levels of fermentability to a placebo in community-living individuals...

  1. Influence of clinical and laboratory variables on faecal antigen ELISA results in dogs with canine parvovirus infection.

    Science.gov (United States)

    Proksch, A L; Unterer, S; Speck, S; Truyen, U; Hartmann, K

    2015-06-01

    False negative faecal canine parvovirus (CPV) antigen ELISA results in dogs with CPV infection are common, but the factors that lead to these false negative results are still unknown. The aim of this study was to investigate whether dogs with a false negative faecal CPV antigen ELISA result have milder clinical signs and laboratory changes, a lower faecal virus load, higher faecal and serum CPV antibody titres and a faster recovery than dogs with a positive result. Eighty dogs with CPV infection, confirmed by the presence of clinical signs and a positive faecal CPV polymerase chain reaction (PCR), were assigned to two groups according to their faecal antigen ELISA result. Time until presentation, severity of symptoms, laboratory parameters, faecal virus load, faecal and serum antibody titres, and CPV sequencing data were compared between both groups. In 38/80 dogs that were hospitalised until recovery, the time to recovery, mortality, and the course of the disease were compared between dogs with positive and negative faecal antigen ELISA results. Of the 80 dogs included, 41 (51.3%) had a false negative faecal antigen ELISA result. ELISA-negative dogs had a significantly shorter time until presentation, lower frequency of defaecation, lower faecal virus load, and higher serum antibody concentrations than ELISA-positive dogs. Laboratory changes, CPV shedding, and outcomes were not associated with faecal antigen ELISA results. In conclusion, low faecal CPV load and antibodies binding to CPV antigen in faeces are likely to be important reasons for false negative faecal antigen ELISA results. Dogs with clinical signs of CPV infection should be retested by faecal PCR.

  2. Reducing the leakage of body-worn incontinence pads.

    Science.gov (United States)

    Clancy, B; Malone-Lee, J

    1991-02-01

    The aim of this research was to evaluate the effect of various absorbent materials (fluff pulp and superabsorbent) on the leakage performance of incontinence pads. A shaped pad-and-pant system was used as the basic design and four pad types made to different specifications were compared using a double-blind technique. Forty-five elderly hospital residents who were incontinent of urine used all four pad types in a randomly allocated order. Data were recorded on more than 5000 pads over a 2-month period. Leakage was reduced by adding a second layer of fluff pulp and, whilst the addition of a superabsorbent material tended to reduce leakage further, we found no clear relationship between the amount of superabsorbent and the reduction of leakage. Other data indicated the importance of securing the pad in place with the appropriate net pants and the leakage rates of pads in relation to the amount of urine they contained. This research suggests that superabsorbent materials have great potential for reducing the leakage rate of incontinence pads but that the way in which they are incorporated into the pad, the amount of fluff pulp and the design of the pad also play an important part.

  3. Factors Influencing the Sexual Function of Women with Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    Miok Kim

    2013-06-01

    Full Text Available PurposeSexual function involves a complex interaction of emotions, body image, and intact physical responses. The purpose of this study was to determine the sexual functioning of women who are incontinent and to identify associated factors.MethodsFor this descriptive correlation study, data were collected from 147 women with urinary incontinence. Data were analyzed using t-test, ANOVA, and stepwise multiple regression.ResultsMean scores were 22.39 (sexual dysfunction ≤26.55 for sexual function, 13.38 (of 63 for depression, and 55.47 (range of score 17~85 for body image. Urinary symptoms and daily life symptoms averaged 36.04 (range of score 20~100 and 16.03 (range of score 8~40. Sexual function had a positive correlation with body image and negative correlation with daily life symptoms. Sexual satisfaction, daily life symptoms, marital satisfaction, and frequency of sexual intercourse were factors affecting sexual function.ConclusionStudy results indicate that urinary incontinence has a negative impact on various aspects of sexual function. Nurses should be aware of the wider consideration that needs to be made in relation to general and sexual quality of life when caring for clients suffering from urological diseases.

  4. Overactive bladder in women with stress urinary incontinence

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    A. I. Neymark

    2013-01-01

    Full Text Available The estimation of the role of a functional component in the development of urination disorders in women with stress urination incontinence (SUI concurrent with imperative urge urination incontinence that is a manifestation of overactive bladder (OAB has become particularly relevant in recent years. Urodynamic study reveals the signs of SUI concurrent with detrusor overactivity. The purpose of the investigation was to improve the results of OAB treatment in women with SUI and to study a relationship between the clinical and urodynamic manifestations of the disease. Forty treated women with OAB and SUI were examined. All the patients received combination medical therapy: an Mcholinolytic (solifenacin 10 mg once daily in the morning, picamilonum 5 mg thrice daily, and exercises to strengthen pelvic floor muscles. The treatment lasted 3 months. After the treatment, urinary output and maximal urine flow rate changed, by reaching the normal values in patients with rapid and obstructive urination. Cystometric capacity was increased; involuntary detrusor contractions (spontaneous or provoked became fewer during bladder filling or they were absent at all. Our investigation has determined that the combination medical treatment whose basis is the M-cholinolytic drug solifenacin is effective in treating OAB in women with SUI. Thus, the combination medical treatment considerably reduces the degree of clinical symptoms of OAB in women with SUI and it is the first stage in the treatment of patients with mixed urinary incontinence. According to the results of the performed treatment and examination, the clinical effect was observed in 18 (72 % patients.

  5. Overactive bladder in women with stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    A. I. Neymark

    2014-11-01

    Full Text Available The estimation of the role of a functional component in the development of urination disorders in women with stress urination incontinence (SUI concurrent with imperative urge urination incontinence that is a manifestation of overactive bladder (OAB has become particularly relevant in recent years. Urodynamic study reveals the signs of SUI concurrent with detrusor overactivity. The purpose of the investigation was to improve the results of OAB treatment in women with SUI and to study a relationship between the clinical and urodynamic manifestations of the disease. Forty treated women with OAB and SUI were examined. All the patients received combination medical therapy: an Mcholinolytic (solifenacin 10 mg once daily in the morning, picamilonum 5 mg thrice daily, and exercises to strengthen pelvic floor muscles. The treatment lasted 3 months. After the treatment, urinary output and maximal urine flow rate changed, by reaching the normal values in patients with rapid and obstructive urination. Cystometric capacity was increased; involuntary detrusor contractions (spontaneous or provoked became fewer during bladder filling or they were absent at all. Our investigation has determined that the combination medical treatment whose basis is the M-cholinolytic drug solifenacin is effective in treating OAB in women with SUI. Thus, the combination medical treatment considerably reduces the degree of clinical symptoms of OAB in women with SUI and it is the first stage in the treatment of patients with mixed urinary incontinence. According to the results of the performed treatment and examination, the clinical effect was observed in 18 (72 % patients.

  6. Performance of the Incontinence Impact Questionnaire in Canada.

    Science.gov (United States)

    Beaulieu, Sylvie; Collet, Jean-Paul; Tu, Le Mai; Macrammalla, Effat; Wood-Dauphinee, Sharon; Corcos, Jacques

    1999-02-01

    The Incontinence Impact Questionnaire (IIQ) was developed in the US and has been shown to be a valid and reliable measure of how urinary incontinence (UI) affects a woman's quality of life. This study aimed to test the performance of the IIQ in Canada with English and French-speaking Canadians. The IIQ underwent professional forwards-backwards translation and psychometric testing. Women (36 English and 34 French-speaking) consulting a urologist for stress urinary incontinence underwent routine multichannel urodynamic testing and completed the SF-36 and the IIQ. Test-retest reliability was moderate (ICC =.73) and each IIQ subscale demonstrated good internal consistency (a=.83 to.91). Moderate correlations between IIQ scores and number of pads/day and severity ratings support construct validity in both languages. In English, correlations with Physical and Social Functioning scales of the SF-36 were also moderate. The IIQ has demonstrated strong reliability and adequate validity with English-speaking Canadian women. Moreover, similar psychometric properties in both English and French provide evidence that the IIQ has been successfully translated into Canadian French.

  7. MRI in the diagnosis of female stress incontinence

    Energy Technology Data Exchange (ETDEWEB)

    Furukawa, Akira; Murata, Kiyoshi; Kawaguchi, Nobuyuki (Shiga University of Medical Science, Otsu (Japan)) (and others)

    1992-10-01

    The purpose of this study is to evaluate the utility of MRI in the diagnosis of female stress urinary incontinence. MRI and chain urethrocystography (chain UCG) were performed to measure the posterior urethrovesical angle in 12 patients with female stress urinary incontinence, who had Stamey's operation. Both examinations were performed before and after the operation in every patient. Using a 1.5 T MR system (GE, SIGNA), T[sub 1]-weighted, proton density weighted, T[sub 2]-weighted, and Gd-DTPA enhanced T[sub 1]-weighted images were obtained to evaluate the appropriate pulse sequence for measuring the posterior urethrovesical angle. We also compared the measured values in MRI with those obtained in chain UCG. The measurement of the posterior urethrovesical angle was possible on all MR images except for T[sub 1]-weighted image. The values measured in MR imaging correlated well with those obtained in chain UCG. In addition, MR imaging provided information about the structures that might influence on the values of the posterior urethrovesical angle such as gas in rectum and enlarged uterus. In conclusion, non-invasive MR imaging can provide reliable information in the diagnosis of female stress urinary incontinence. (author).

  8. EAU guidelines on assessment and nonsurgical management of urinary incontinence.

    Science.gov (United States)

    Lucas, Malcolm G; Bosch, Ruud J L; Burkhard, Fiona C; Cruz, Francisco; Madden, Thomas B; Nambiar, Arjun K; Neisius, Andreas; de Ridder, Dirk J M K; Tubaro, Andrea; Turner, William H; Pickard, Robert S

    2012-12-01

    The previous European Association of Urology (EAU) guidelines on urinary incontinence comprised a summary of sections of the 2009 International Consultation on Incontinence. A decision was made in 2010 to rewrite these guidelines based on an independent systematic review carried out by the EAU guidelines panel, using a sustainable methodology. We present a short version of the full guidelines on assessment, diagnosis, and nonsurgical treatment of urinary incontinence, with the aim of increasing their dissemination. Evidence appraisal included a pragmatic review of existing systematic reviews and independent new literature searches, based on Population, Intervention, Comparator, Outcome questions. Appraisal of papers was carried out by an international panel of experts, who also collaborated on a series of consensus discussions, to develop concise structured evidence summaries and action-based recommendations using a modified Oxford system. The full version of the guidelines is available online (http://www.uroweb.org/guidelines/online-guidelines/). The guidelines include algorithms that refer the reader back to the supporting evidence, and they are more immediately useable in daily clinical practice. These new guidelines present an up-to-date summary of the available evidence, together with clear clinical algorithms and action-based recommendations based on the best available evidence. Where such evidence does not exist, they present a consensus of expert opinion. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  9. Urinary Incontinence in Juvenile Female Soft-Coated Wheaten Terriers: Hospital Prevalence and Anatomic Urogenital Anomalies.

    Science.gov (United States)

    Callard, Jason; McLoughlin, Mary A; Byron, Julie K; Chew, Dennis J

    2016-01-01

    Urinary incontinence in juvenile female dogs is often associated with urogenital anatomic anomalies. Study objectives include: (1) determine hospital prevalence of urinary incontinence in juvenile female soft-coated wheaten terriers (SCWTs) compared to other affected dogs; (2) characterize anatomic anomalies affecting urinary incontinent juvenile female SCWTs utilizing uroendoscopy; and (3) compare incidence of ectopic ureters, paramesonephric remnants, and short urethras in juvenile female urinary incontinent SCWTs to other juvenile female dogs with urinary incontinence. We hypothesize juvenile SCWTs have an increased prevalence of urinary incontinence and an increased incidence of ectopic ureters, paramesonephric remnants, and short urethras compared to non-SCWTs with urinary incontinence within our hospital population. Medical records of female dogs 6 mo of age and younger with clinical signs of urinary incontinence and video uroendoscopic evaluation presenting to The Ohio State University Veterinary Medical Center from January 2000 to December 2011 were reviewed. Twelve juvenile SCWTs and 107 juvenile non-SCWTs met the inclusion criteria. Juvenile SCWTs were found to have an increased hospital prevalence of urinary incontinence compared to other affected breeds. Observed anomalies in SCWTs include: ectopic ureters, shortened urethras, paramesonephric remnants, and bifid vaginas. This information will help guide veterinarians in recognizing a breed-related disorder of the lower urogenital tract in SCWTs.

  10. The prevalence of stress urinary incontinence in women studying nursing and related quality of life

    OpenAIRE

    Józef Opara; Wioletta Ewa Czerwińska-Opara

    2014-01-01

    Urinary incontinence is a growing problem that affects millions of people worldwide. The purpose of this study was to assess the prevalence of stress urinary incontinence (SUI) in women studying nursing. Respondents completed a questionnaire assessing urinary incontinence, severity of symptoms and quality of life. Short forms to assess symptoms of distress for urinary incontinence and quality of life: UDI-6 and IIQ-7 have been used. The study’s conclusions are as follows: 1) among the 113 int...

  11. Patients' experience compared with physicians' recommendations for treating fecal incontinence: a qualitative approach.

    Science.gov (United States)

    Cichowski, Sara B; Dunivan, Gena C; Rogers, Rebecca G; Komesu, Yuko M

    2014-07-01

    Using qualitative methods, we compared physician-recommended treatment options for fecal incontinence to patient knowledge of treatment options. Our hypothesis was that physician recommendations were not being communicated well to patients and that this impaired patients' ability to cope with fecal incontinence. Cognitive interviews were conducted with physicians who routinely care for women with fecal incontinence. Physicians were asked to describe their typical nonsurgical treatment recommendations and counseling for fecal incontinence. Women with bothersome fecal incontinence were recruited to participate in focus groups and asked about personal experience with fecal incontinence symptoms and treatment options. For both physician interviews and patient focus groups, qualitative data analysis was performed using grounded-theory methodology. Physicians identified several barriers patients face when seeking treatment: lack of physician interest toward fecal incontinence, and patient embarrassment in discussing fecal incontinence. Physicians universally recommended fiber and pelvic floor exercise; they felt the majority (approximately 70-80 %) of patients will improve with these therapies. Collectively, patients were able to identify all treatment recommendations given by physicians, although many had discovered these treatments through personal experience. Three concepts emerged regarding treatment options that physicians did not identify but that patients felt were important in their treatment: hope for improvement, personal effort to control symptoms, and encouragement to go on living life fully. Whereas physicians had treatment to offer women with fecal incontinence, women had already found the best treatments through personal research and effort. Women want to hear a message of hope and encouragement and perceive personal effort from providers.

  12. Effect of Urinary Incontinence on Quality of Life among Iranian Women.

    Directory of Open Access Journals (Sweden)

    Fatemeh Mallah

    2014-03-01

    Full Text Available Present study aimed to evaluate the effects of stress, urge and mixed urinary incontinence on the quality of life and mental health of Iranian women with urinary incontinence (UI.This was a cross sectional study of quality of life and mental health among women without and with different types of urinary incontinence (n = 140. Quality of life (QOL and mental health were compared and measured using the Urogenital Distress Inventory (UDI-6, the Incontinence Impact Questionnaire (IIQ-7 and the 12-items General Health Questionnaire (GHQ-12.Women with any types of urinary incontinence showed a significant lower degree of mental health. Women with mixed incontinence reported significantly lower QOL and mental health (P < 0.0001 compared to those with stress and urge incontinence, while there was no significant difference between women with stress and urge incontinence (P= 0.95.Patients with UI showed inferior mental health and QOL while these symptoms were more severe among patients with mixed urinary incontinence.

  13. Correlação entre achados manométricos e sintomatologia na incontinência fecal Correlation between manometric findings and symptomatology in fecal incontinence

    Directory of Open Access Journals (Sweden)

    Flávia Balsamo

    2011-03-01

    Full Text Available Foram estudados 92 pacientes com sintomatologia de incontinência fecal, no período de julho de 2005 a fevereiro de 2009. Os sintomas de incontinência foram classificados de acordo com o Cleveland Clinic Incontinence Score e os pacientes foram submetidos à manometria anorretal. Foram avaliados: idade, sexo, cirurgia prévia, sintomatologia e achado manométrico. Observou-se que o aumento da intensidade da sintomatologia de incontinência fecal está relacionado à diminuição progressiva das pressões de repouso. O mesmo não foi constatado com as pressões de contração na amostra estudadaWe have studied 92 patients with fecal incontinence symptoms, from July 2005 to February 2009. They were classified on the Cleveland Clinic Incontinence Score and all of them have undergone on manometric examination. Sex, age, previous surgery, symptomatology, and manometric findings were analyzed. We have concluded that the increase of incontinence symptoms is related to the progressive decrease on resting pressures. The same was not found with squeeze pressures in the studied sample

  14. Faecal excretion of brush border membrane enzymes in patients with clostridium difficile diarrhoea

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    Katyal R

    2002-01-01

    Full Text Available PURPOSE: To look for the presence of intestinal brush border membrane (BBM enzymes in the faecal samples of patients with Clostridium difficile association. METHODS: One hundred faecal samples were investigated for C.difficile toxin (CDT. Simultaneous assays for faecal excretion of intestinal BBM enzymes viz., disaccharidases, alkaline phosphatase (AP and leucine aminopeptidase (LAP were also done. RESULTS: C.difficile toxin was detected in 25 (25% of the samples with a titre ranging from 10 to 160. No significant difference (p>0.05 was seen between the CDT positive and negative groups with any of the disaccharidases studied. However, significant increase (pC.difficile diarrhoea.

  15. Traditional suburethral sling operations for urinary incontinence in women.

    Science.gov (United States)

    Rehman, Haroon; Bezerra, Carlos A; Bruschini, Homero; Cody, June D; Aluko, Patricia

    2017-07-26

    Stress urinary incontinence constitutes a significant health and economic burden to society. Traditional suburethral slings are one of the surgical operations used to treat women with symptoms of stress urinary incontinence. To determine the effects of traditional suburethral slings on stress or mixed incontinence in comparison with other management options. We searched the Cochrane Incontinence Group Specialised Register (searched 3 June 2010) and the reference lists of relevant articles. Randomised or quasi-randomised trials that included traditional suburethral slings for the treatment of stress or mixed urinary incontinence. At least three reviewers independently extracted data from included trials onto a standard form and assessed trial methodological quality. The data abstracted were relevant to predetermined outcome measures. Where appropriate, we calculated a summary statistic: a relative risk for dichotomous data and a weighted mean difference for continuous data. We included 26 trials involving 2284 women. The quality of evidence was moderate for most trials and there was generally short follow-up ranging from 6 to 24 months.One medium-sized trial compared traditional suburethral sling operations with oxybutynin in the treatment of women with mixed urinary incontinence. Surgery appeared to be more effective than drugs in treating participant-reported incontinence (n = 75, risk ratio (RR) 0.18, 95% confidence interval (CI) 0.08 to 0.43).One trial found that traditional slings were more effective than transurethral injectable treatment (RR for clinician-assessed incontinence within a year 0.21, 95% CI 0.09 to 0.21)Seven trials compared slings with open abdominal retropubic colposuspension. Participant-reported incontinence was lower with the slings after one year (RR 0.75, 95% CI 0.62 to 0.90), but not when assessed by clinicians. Colposuspension, however, was associated with fewer peri-operative complications, shorter duration of use of indwelling catheter

  16. Multiparametric monitoring of microbial faecal pollution reveals the dominance of human contamination along the whole Danube River.

    Science.gov (United States)

    Kirschner, A K T; Reischer, G H; Jakwerth, S; Savio, D; Ixenmaier, S; Toth, E; Sommer, R; Mach, R L; Linke, R; Eiler, A; Kolarevic, S; Farnleitner, A H

    2017-11-01

    The microbial faecal pollution of rivers has wide-ranging impacts on a variety of human activities that rely on appropriate river water quality. Thus, detailed knowledge of the extent and origin of microbial faecal pollution is crucial for watershed management activities to maintain safe water use. In this study, the microbial faecal pollution levels were monitored by standard faecal indicator bacteria (SFIB) along a 2580 km stretch of the Danube, the world's most international river, as well as the Danube's most important tributaries. To track the origin of faecal pollution, host-associated Bacteroidetes genetic faecal marker qPCR assays for different host groups were applied in concert with SFIB. The spatial resolution analysis was followed by a time resolution analysis of faecal pollution patterns over 1 year at three selected sites. In this way, a comprehensive faecal pollution map of the total length of the Danube was created, combining substantiated information on both the extent and origin of microbial faecal pollution. Within the environmental data matrix for the river, microbial faecal pollution constituted an independent component and did not cluster with any other measured environmental parameters. Generally, midstream samples representatively depicted the microbial pollution levels at the respective river sites. However, at a few, somewhat unexpected sites, high pollution levels occurred in the lateral zones of the river while the midstream zone had good water quality. Human faecal pollution was demonstrated as the primary pollution source along the whole river, while animal faecal pollution was of minor importance. This study demonstrates that the application of host-associated genetic microbial source tracking markers in concert with the traditional concept of microbial faecal pollution monitoring based on SFIB significantly enhances the knowledge of the extent and origin of microbial faecal pollution patterns in large rivers. It constitutes a

  17. Prevalence and risk factors of urinary incontinence in Fuzhou Chinese women

    Institute of Scientific and Technical Information of China (English)

    SONG Yan-feng; ZHANG Wen-ju; SONG Jian; XU Bo

    2005-01-01

    Background We randomly sampled a healthy community to evaluate the prevalence and associated risk factors of urinary incontinence. Methods The survey was performed in Fuzhou, China. Of women over twenty years of age in the city, 3.0% were randomly selected and 4684 evaluated by Bristol Female Urinary Tract Symptoms Questionnaire. Results Of the women in Fuzhou, 19.0% had urinary incontinence. The prevalence of stress incontinence, urge incontinence and mixed incontinence was 16.6% (n=777), 10.0% (n=468), 7.7% (n=360) respectively. The prevalence of the three types of urinary incontinence increased significantly with age (P2 (2.1, 1.5-2.9), hypertension (2.7, 1.4-5.6), constipation (2.6, 1.8-3.8), alcohol consumption (4.7, 1.1-20.2), episiotomy (1.7, 1.4-2.0), higher body mass index (BMI, 1.8, 1.5-2.2) and unskilled worker (0.7, 0.5-0.8) were potential risk factors for stress incontinence. Urge incontinence was associated with age (OR, 1.3, 95%CI, 0.9-1.3), menopause (1.6, 1.1-2.4), Caesarean delivery (0.2, 0.1-0.5), parity >2 (2.6, 1.8-3.8), constipation (2.3, 1.4-3.7), foetal birthweight (1.7, 1.1-2.4), episiotomy (1.4, 1.1-1.8), higher BMI (1.5, 1.2-2.0) and unskilled worker (0.7, 0.5-0.9). Conclusions The prevalence of urinary incontinence and its subtypes in Chinese women is lower than that of occidental women. In China, age, vaginal delivery, parity, hypertension, constipation, alcohol consumption, episiotomy, higher BMI are potential risk factors for stress incontinence. Urge incontinence is associated with age, menopause, Caesarean delivery, parity, constipation, foetal birthweight, episiotomy, higher body mass index.

  18. Efficacy of antibiotherapy for treating flatus incontinence associated with small intestinal bacterial overgrowth: A pilot randomized trial

    National Research Council Canada - National Science Library

    Chloé Melchior; Guillaume Gourcerol; Valérie Bridoux; Philippe Ducrotté; Jean-François Quinton; Anne-Marie Leroi

    2017-01-01

    ...) is a contributing factor for flatus incontinence. The aims of our study were to assess the efficacy of metronidazole in a select population of patients with flatus incontinence associated with SIBO and to compare its efficacy with that of...

  19. Microbial water quality and sedimentary faecal sterols as markers of sewage contamination in Kuwait.

    Science.gov (United States)

    Lyons, B P; Devlin, M J; Abdul Hamid, S A; Al-Otiabi, A F; Al-Enezi, M; Massoud, M S; Al-Zaidan, A S; Smith, A J; Morris, S; Bersuder, P; Barber, J L; Papachlimitzou, A; Al-Sarawi, H A

    2015-11-30

    Microbial water quality and concentrations of faecal sterols in sediment have been used to assess the degree of sewage contamination in Kuwait's marine environment. A review of microbial (faecal coliform, faecal streptococci and Escherichia coli) water quality data identified temporal and spatial sources of pollution around the coastline. Results indicated that bacterial counts regularly breach regional water quality guidelines. Sediments collected from a total of 29 sites contained detectable levels of coprostanol with values ranging from 29 to 2420 ng g(-1) (dry weight). Hot spots based on faecal sterol sediment contamination were identified in Doha Bay and Sulaibikhat Bay, which are both smaller embayments of Kuwait Bay. The ratio of epicoprostanol/coprostanol indicates that a proportion of the contamination was from raw or partially treated sewage. Sewage pollution in these areas are thought to result from illegal connections and discharges from storm drains, such as that sited at Al-Ghazali.

  20. Heterogeneous distributions of Escherichia coli O157 within naturally infected bovine faecal pats.

    Science.gov (United States)

    Robinson, Susan E; Brown, Patrick E; John Wright, E; Bennett, Malcolm; Hart, C Anthony; French, Nigel P

    2005-03-15

    Escherichia coli O157 is an important human pathogen for which cattle are considered a reservoir. This paper describes and models the variation in counts of E. coli O157 that exists within individual bovine faecal pats. The presence and concentration of E. coli O157 in faecal samples was determined using a combination of direct spiral plating followed by a more sensitive isolation procedure. The data were modelled using multilevel random effect models, in which the random effects were allowed to be correlated to allow for the fact that pooled and individual samples come from the same pat. Up to a two log difference in the concentration of E. coli O157 was demonstrated in samples from different areas within a faecal pat. Pooling of individual samples from throughout the faecal pat and processing it as one composite sample allows this heterogeneity to be overcome.

  1. Reset of a critically disturbed microbial ecosystem: faecal transplant in recurrent Clostridium difficile infection

    NARCIS (Netherlands)

    Fuentes Enriquez de Salamanca, S.; Nood, van E.; Tims, S.; Heikamp-de Jong, I.; Braak, ter C.J.F.; Keller, J.J.; Zoetendal, E.G.; Vos, de W.M.

    2014-01-01

    Recurrent Clostridium difficile infection (CDI) can be effectively treated by infusion of a healthy donor faeces suspension. However, it is unclear what factors determine treatment efficacy. By using a phylogenetic microarray platform, we assessed composition, diversity and dynamics of faecal

  2. The effects of physiotherapy for female urinary incontinence: Individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126

  3. The effects of physiotherapy for female urinary incontinence: individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126

  4. Does pelvic floor muscle training abolish symptoms of urinary incontinence? A randomized controlled trial.

    Science.gov (United States)

    Celiker Tosun, O; Kaya Mutlu, E; Ergenoglu, A M; Yeniel, A O; Tosun, G; Malkoc, M; Askar, N; Itil, I M

    2015-06-01

    To determine whether symptoms of urinary incontinence is reduced by pelvic floor muscle training, to determine whether urinary incontinence can be totally eliminated by strengthening the pelvic floor muscle to grade 5 on the Oxford scale. Prospective randomized controlled clinical trial. Outpatient urogynecology department. One hundred thirty cases with stress and mixed urinary incontinence. All participants were randomly allocated to the pelvic floor muscle training group or control group. A 12-week home based exercise program, prescribed individually, was performed by the pelvic floor muscle training group. Urinary incontinence symptoms (Incontinence Impact Questionnaire-7, Urogenital Distress Inventory-6, bladder diary, stop test and pad test) were assessed, and the pelvic floor muscle strength was measured for (PERFECT testing, perineometric and ultrasound) all participants before and after 12 weeks of treatment. The pelvic floor muscle training group had significant improvement in their symptoms of urinary incontinence (P=0.001) and an increase in pelvic floor muscle strength (P=0.001, by the dependent t test) compared with the control group. All the symptoms of urinary incontinence were significantly decreased in the patients that had reached pelvic floor muscle strength of grade 5 and continued the pelvic floor muscle training (P<0.05). The study demonstrated that pelvic floor muscle training is effective in reducing the symptoms of stress and mixed urinary incontinence and in increasing pelvic floor muscle strength. © The Author(s) 2014.

  5. Interventions for preventing and treating incontinence-associated dermatitis in adults

    NARCIS (Netherlands)

    Beeckman, D.; Damme, N. Van; Schoonhoven, L.; Lancker, A. Van; Kottner, J.; Beele, H.; Gray, M.; Woodward, S.; Fader, M.; Bussche, K. Van den; Hecke, A. Van; Meyer, D.; Verhaeghe, S.

    2016-01-01

    BACKGROUND: Incontinence-associated dermatitis (IAD) is one of the most common skin problems in adults who are incontinent for urine, stool, or both. In practice, products and procedures are the same for both prevention and treatment of IAD. OBJECTIVES: The objective of this review was to assess the

  6. Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

    NARCIS (Netherlands)

    Labrie, J.; Lagro-Janssen, A. L. M.; Fischer, K.; Berghmans, L. C. M.; van der Vaart, C. H.

    2015-01-01

    To predict who will undergo midurethral sling surgery (surgery) after initial pelvic floor muscle training (physiotherapy) for stress urinary incontinence in women. This was a cohort study including women with moderate to severe stress incontinence who were allocated to the physiotherapy arm from a

  7. The effects of physiotherapy for female urinary incontinence: individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126 re

  8. The effects of physiotherapy for female urinary incontinence: Individual compared with group treatment

    NARCIS (Netherlands)

    Janssen, C.C.M.; Lagro-Janssen, A.L.M.; Felling, A.J.A.

    2001-01-01

    OBJECTIVES: To compare, in a randomized trial, the effects of individual and group physiotherapy for urinary incontinence in women referred by their general practitioner (GP). PATIENTS AND METHODS: The study included women of all ages (mean 47.8 years) with stress, urge or mixed incontinence; 126 re

  9. Can the outcome of pelvic-floor rehabilitation in patients with fecal incontinence be predicted?

    NARCIS (Netherlands)

    M.P. Terra; M. Deutekom (Marije); A.C. Dobben (Annette); C.G.M.I. Baeten; L.W.M. Janssen (Lucas); G.E. Boeckxstaens (Guy); A.F. Engel (Alexander); R.J.F. Felt-Bersma; J.F.W. Slors; M.F. Gerhards (Michael); A.B. Bijnen (Bart); E. Everhardt; W.R. Schouten (Ruud); B. Berghmans; P.M.M. Bossuyt (Patrick); J. Stoker (Jacob)

    2008-01-01

    textabstractPurpose: Pelvic-floor rehabilitation does not provide the same degree of relief in all fecal incontinent patients. We aimed at studying prospectively the ability of tests to predict the outcome of pelvic-floor rehabilitation in patients with fecal incontinence. Materials and methods: Two

  10. Urinary incontinence and other pelvic floor disorders after radiation therapy in endometrial cancer survivors.

    Science.gov (United States)

    Segal, Saya; John, Gabriella; Sammel, Mary; Andy, Uduak Umoh; Chu, Christina; Arya, Lily A; Brown, Justin; Schmitz, Kathryn

    2017-03-18

    To investigate radiation therapy as a risk factor for urinary or fecal incontinence, pelvic organ prolapse, and sexual dysfunction in endometrial cancer survivors. We performed a retrospective cohort study of endometrial cancer survivors. Data were collected using a mailed survey and the medical record. Validated questionnaires were used to generate rates of urinary incontinence and other pelvic floor disorders. The incidence rates of pelvic floor disorders were compared across groups with different exposures to radiation. Of the 149 endometrial cancer survivors, 41% received radiation therapy. Fifty-one percent of women reported urine leakage. The rates of urinary incontinence in women exposed and not exposed to vaginal brachytherapy (VBT) or whole-pelvis radiation were 48% and 58%, respectively (p=0.47). The incidence of fecal incontinence did not differ between groups, but the score for overall sexual function was significantly higher in women who did not undergo radiation therapy. On multivariable analysis, significant risk factors for urinary incontinence were age (AOR 1.06 95% CI 1.02, 1.10) and BMI (AOR 1.07 95% CI 1.02, 1.11), but treatment with radiation was not significantly associated with urinary incontinence, or fecal incontinence (p>0.05). Age, BMI, and radiation exposure were independent predictors of decreased sexual function score (p<0.01). Local or regional radiation is not associated with urinary or fecal incontinence, but may contribute to sexual dysfunction in endometrial cancer survivors. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Dutch guidelines for physiotherapy in patients with stress urinary incontinence: an update

    NARCIS (Netherlands)

    Bernards, A.T.; Berghmans, B.C.; Slieker-ten Hove, M.C.; Staal, J.B.; Bie, R.A. de; Hendriks, E.J.

    2014-01-01

    INTRODUCTION AND HYPOTHESIS: Stress urinary incontinence (SUI) is the most common form of incontinence impacting on quality of life (QOL) and is associated with high financial, social, and emotional costs. The purpose of this study was to provide an update existing Dutch evidence-based clinical

  12. A Graduate Nursing Curriculum for the Evaluation and Management of Urinary Incontinence

    Science.gov (United States)

    Rogalski, Nicole

    2005-01-01

    Geriatric nurse practitioners should be educated in the evaluation and treatment of common geriatric syndromes like urinary incontinence. However, many advanced-practice nursing programs do not place an educational emphasis on urinary incontinence management. The purpose of this project is to provide information that supports the need for…

  13. Dutch guidelines for physiotherapy in patients with stress urinary incontinence: An update

    NARCIS (Netherlands)

    A.T.M. Bernards (Arnold); B. Berghmans; M.C.P. Slieker-ten Hove (Marijke); J.B. Staal (Bart); R.A. de Bie (Robert); E.J.M. Hendriks (Erik)

    2014-01-01

    textabstractIntroduction and hypothesis: Stress urinary incontinence (SUI) is the most common form of incontinence impacting on quality of life (QOL) and is associated with high financial, social, and emotional costs. The purpose of this study was to provide an update existing Dutch evidence-based c

  14. Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

    NARCIS (Netherlands)

    Labrie, J.; Lagro-Janssen, A.; Fischer, K.; Berghmans, L.C.; Vaart, C.H. van der

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: To predict who will undergo midurethral sling surgery (surgery) after initial pelvic floor muscle training (physiotherapy) for stress urinary incontinence in women. METHODS: This was a cohort study including women with moderate to severe stress incontinence who were allo

  15. Dutch guidelines for physiotherapy in patients with stress urinary incontinence: an update

    NARCIS (Netherlands)

    Bernards, A.T.; Berghmans, B.C.; Slieker-ten Hove, M.C.; Staal, J.B.; Bie, R.A. de; Hendriks, E.J.

    2014-01-01

    INTRODUCTION AND HYPOTHESIS: Stress urinary incontinence (SUI) is the most common form of incontinence impacting on quality of life (QOL) and is associated with high financial, social, and emotional costs. The purpose of this study was to provide an update existing Dutch evidence-based clinical prac

  16. Surgical management of urinary stress incontinence in women: A historical and clinical overview

    NARCIS (Netherlands)

    P. Hinoul; J.P. Roovers; W. Ombelet; R. Vanspauwen

    2009-01-01

    Urinary incontinence is a highly prevalent condition that has a significant impact on the affected patients' quality of life. Approximately one in three women suffers from some degree of urinary incontinence. Six to ten percent of them are severely affected. Cure or significant improvement can often

  17. Stress urinary incontinence and posterior bladder suspension defects. Results of vaginal repair versus Burch colposuspension

    DEFF Research Database (Denmark)

    Thunedborg, P; Fischer-Rasmussen, W; Jensen, S B

    1990-01-01

    Vaginal repair has been recommended in cases of stress urinary incontinence and posterior bladder suspension defect diagnosed by colpocysto-urethrography. Thirty-eight women with stress urinary incontinence and posterior suspension defect have been treated. First, 19 women underwent a vaginal rep...

  18. Rectal prolapse and anal incontinence treated with a modified Roscoe Graham operation

    DEFF Research Database (Denmark)

    Klaaborg, K E; Qvist, N; Kronborg, O

    1985-01-01

    thirds of the patients with incontinence for solid and/or fluid feces were cured for prolapse as well as incontinence. Seven became constipated, while 14 were fully satisfied. Seven of eight patients with a highly reduced tone of the external sphincter before surgery had a marked improvement after...

  19. Faecal corticosterone levels of dogs relinquished to a shelter in Japan

    OpenAIRE

    2015-01-01

    This study investigated the baseline level of faecal corticosterone in dogs relinquished to a shelter and compared changes in it caused by social events that dogs experienced. Faecal corticosterone was measured to assess the average stress levels of dogs that depend on the actual conditions of the shelter. One category of subject animals was dogs relinquished by their owner or stray dogs who were penned in a group (group RG) or caged individually due to their incompatibility (group RI), and t...

  20. Effect of disturbance of the gastrointestinal microflora on the faecal excretion of Fusobacterium necrophorum biovar A.

    OpenAIRE

    Smith, G. R.; Thornton, E. A.

    1993-01-01

    Oral pretreatment of mice with either a mixture of kanamycin and erythromycin or metronidazole to modify the gut microflora greatly enhanced the faecal excretion of Fusobacterium necrophorum biovar A given by mouth. This lends support to the suggestion that disturbance of the gastrointestinal microflora in animals such as cattle, which often carry the organism in the rumen, may lead to intestinal multiplication and faecal excretion, thereby providing a source of infection that may lead to nec...

  1. Taenia saginata: an unusual cause of post-appendectomy faecal fistula

    Science.gov (United States)

    Najih, Mohammed; Laraqui, Hicham; Njoumi, Nouredine; Mouhafid, Faycel; Moujahid, Mountassir; Ehirchiou, Abdelkader; Zentar, Aziz

    2016-01-01

    Post-appendectomy faecal fistula is a rare surgical complication, associated with significant morbidity. Taenia saginata infestation is one of the most common cestode infestation in the gastrointestinal tract. It makes many complications as obstruction, perforation, anastomotic leakage or appendicular stump dehiscence. The objective of our study is to report a very rare case of post appendectomy faecal fistula caused by taenia saginata infestation and was successfully treated conservatively. PMID:28292157

  2. Faecal short chain fatty acid pattern and allergy in early childhood.

    Science.gov (United States)

    Sandin, Anna; Bråbäck, Lennart; Norin, Elisabeth; Björkstén, Bengt

    2009-05-01

    To investigate whether functional changes of the gut flora over time were related to sensitization and allergic symptoms at four years of age. The levels of short chain fatty acids (SCFAs) in faecal samples at one (n = 139) and four (n = 53) years of age were related to the development of positive skin prick tests (SPT) and allergic symptoms during the first four years of life. Faecal acetic (p diversity.

  3. Faecal phytic acid and its relation to other putative markers of risk for colorectal cancer.

    OpenAIRE

    Owen, R W; Weisgerber, U M; Spiegelhalder, B; Bartsch, H

    1996-01-01

    AIMS--Phytic acid, a major constituent of cereals, pulses, and seeds has been advocated as an important antioxidant component of dietary fibre that affords possible protection against colorectal cancer. This is supported by experimental studies showing it has antineoplastic activity in animal models of both colon and breast cancer. To date the concentration of faecal phytic acid in human clinical groups has not been evaluated. Therefore the faecal phytic acid content of adenoma patients drawn...

  4. Effect of soy on faecal dry matter content and excretion of Brachyspira hyodysenteriae in pigs

    Science.gov (United States)

    Grahofer, Alexander; Overesch, Gudrun; Nathues, Heiko; Zeeh, Friederike

    2016-01-01

    The aim of this study was to investigate the effect of a soy diet on the excretion of Brachyspira hyodysenteriae in five farms with subclinically infected pigs. The effects on general health, faecal consistency and dry matter were analysed. In total, 200 pigs of different ages (group 1 feed ration was replaced by pure soy on two consecutive days. Faecal scores were used to determine faecal consistency and a microwave method to assess faecal dry matter content (FDMC). In age group 1, soy feeding resulted in a statistically significant decrease of the FDMC of 2.5 per cent compared with group C and in age group 2 in a significant increase of 2.2 per cent compared with group C at day 2. Overall seven (T: 5, C: 2) out of 597 faecal samples tested positive for B hyodysenteriae by PCR. In conclusion, a high soy diet applied over two days influenced the faecal consistency and the FDMC in growers, finishers and sows under field conditions. Further investigations with more sensitive diagnostic methods are needed to prove a potential influence of a high soy diet on the detection rate of B hyodysenteriae in subclinically infected herds. PMID:27239320

  5. Abdominal obesity is associated with stress urinary incontinence in Korean women.

    Science.gov (United States)

    Han, Myung Ok; Lee, Nan Young; Park, Hye Soon

    2006-01-01

    This study investigated the relationship between abdominal obesity and stress urinary incontinence in Korean women. Women aged 30 and over, who visited the Department of Family Medicine of Asan Medical Center were recruited to participate in this study. Anthropometric measurements including body mass index (BMI) and waist circumference were taken, and associated factors of stress urinary incontinence was assessed by questionnaire. Stress urinary incontinence was significantly associated with physical work, vaginal delivery, and high waist circumference. In comparison with women in the lowest quartile of waist circumference, the odds ratios (OR) for stress urinary incontinence in women in the second, third, and fourth quartiles were increased significantly (1.79, 95% CI 1.07-2.98; 3.50, 95% CI 2.02-6.07; and 6.07, 95% CI 3.23-11.40, respectively). Our results indicate that high waist circumference may be a risk factor associated with stress urinary incontinence in women.

  6. The Prevalence of Urinary Incontinence among the Elderly in a Rural Community in Selangor

    Science.gov (United States)

    Mohd Sidik, Sherina

    2010-01-01

    Background: Urinary incontinence is a common but poorly understood problem in the elderly population. The aim of this study was to determine the prevalence of urinary incontinence and its associated factors among the elderly in a community setting. Methods: A cross-sectional study design was used. Stratified cluster sampling was used in this study. All elderly residents aged 60 years old and above who fulfilled the selection criteria were included as respondents. The translated Malay version of the Barthel’s Index (BI) was used to identify the presence of urinary incontinence. Results: The prevalence of urinary incontinence was 9.9% among the elderly respondents. Urinary incontinence among the elderly was significantly associated with age, gender, depression, functional dependence, and diabetes mellitus (P < 0.05). PMID:22135533

  7. Female stress and urge incontinence in family practice: insight into the lower urinary tract.

    Science.gov (United States)

    Viktrup, L

    2002-11-01

    As many as 25% of all women are affected by urinary incontinence, but only a few are treated. This frequent, often medically unrecognised, condition occurs in women of all ages. The continence mechanism is based on bladder detrusor control, intact anatomical structures in and around the urethra, correct positioning of the bladder neck and a comprehensive innervation of the lower urinary tract. Age and childbearing are established risk factors for the development of urinary incontinence, but other factors are currently suggested. The evaluation of urinary incontinence should include history, gynaecological examination, urine test, frequency-volume diary and a pad-weighing test. Female urinary incontinence can be treated in general practice by simple means, e.g. pelvic floor muscle training, bladder training, electrostimulation, drug therapy, or a combination of these approaches. This review updates the knowledge of the continence mechanism and summarises the epidemiology, risk factors, assessment and treatment of urinary incontinence in general practice.

  8. In incontinence developing after radical prostatectomy the role of nurses on implementing behavioral therapy

    Directory of Open Access Journals (Sweden)

    Aylin Aydın Sayılan

    2016-11-01

    Full Text Available Developing after radical prostatectomy urinary incontinence (UI is a major health problem affecting the quality of life of men. Urinary incontinence patients in their care and treatment purpose is to provide continence. In the treatment of urinary incontinence surgery, medication and behavioral treatments are used. For the purposes of behavioral therapy; increasing the capacity of the bladder function and is aimed at promoting bladder control. Behavioral treatments for incontinence; diet, exercise bladder training and pelvic floor muscle training (PFMT is located.  Diet is regulated by the bladder diary. PFME is first identified in 1948 by Arnold Kegel, which is aimed pelvic to strengthen the muscles of the base and are expressed in improving the urethral sphincter function. In the literature, in the treatment of incontinence; with drug therapy or surgery, it should be emphasized also behavioral therapy.

  9. Markov chain decision model for urinary incontinence procedures.

    Science.gov (United States)

    Kumar, Sameer; Ghildayal, Nidhi; Ghildayal, Neha

    2017-03-13

    Purpose Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective. Design/methodology/approach This research employs randomized, prospective studies to obtain robust cost and utility data used in the Markov chain decision model for examining which of these surgical interventions is more effective in treating women with stress UI based on two measures: number of quality adjusted life years (QALY) and cost per QALY. Treeage Pro Healthcare software was employed in Markov decision analysis. Findings Results showed the Sling procedure is a more effective surgical intervention than the Burch. However, if a utility greater than certain utility value, for which both procedures are equally effective, is assigned to persistent incontinence, the Burch procedure is more effective than the Sling procedure. Originality/value This paper demonstrates the efficacy of a Markov chain decision modeling approach to study the comparative effectiveness analysis of available treatments for patients with UI, an important public health issue, widely prevalent among elderly women in developed and developing countries. This research also improves upon other analyses using a Markov chain decision modeling process to analyze various strategies for treating UI.

  10. Pelvic floor exercises with biofeedback for stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Maria V. Capelini

    2006-08-01

    Full Text Available OBJECTIVE: Prospective study to objectively evaluate the benefits of pelvic floor strengthening exercises associated to biofeedback for the treatment of stress urinary incontinence. MATERIALS AND METHODS: Fourteen patients diagnosed with stress urinary incontinence (SUI were selected for this study. All patients underwent a pelvic floor training associated to biofeedback for 12 consecutive weeks. Urodynamic tests, pad test and bladder diary were analyzed at the beginning of the study, at the end and after 3 months. The King's Health Questionnaire (KHQ was applied before and after treatment to assess the impact in the quality of life. RESULTS: There was a significant reduction in the pad weight (from 14.21 g to 1 g, number of urinary leakage episodes (from 8.14 per day to 2.57 per day and daytime frequency (from 7.93 per day to 5.85 per day. At urodynamics the authors observed a significant increase in Valsalva leak-point pressure (from 103.93 cm H2O to 139.14 cm H2O, cistometric capacity (from 249.29 mL to 336.43 mL, p = 0.0015 and bladder volume at first desire to void (from 145 mL to 215.71 mL. Those differences were kept during the first 3 months of follow up. The KHQ revealed significant differences except in the case of "general health perception", which covers health in general and not exclusively urinary incontinence. CONCLUSION: Treatment of SUI with pelvic floor exercises associated to biofeedback caused significant changes in the parameters analyzed, with maintenance of good results 3 months after treatment.

  11. Artificial urinary sphincters for male stress urinary incontinence: current perspectives

    Directory of Open Access Journals (Sweden)

    Cordon BH

    2016-07-01

    Full Text Available Billy H Cordon,1 Nirmish Singla,1 Ajay K Singla2 1Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, 2Department of Urology, University of Toledo College of Medicine, Toledo, OH, USA Abstract: The artificial urinary sphincter (AUS, which has evolved over many years, has become a safe and reliable treatment for stress urinary incontinence and is currently the gold standard. After 4 decades of existence, there is substantial experience with the AUS. Today AUS is most commonly placed for postprostatectomy stress urinary incontinence. Only a small proportion of urologists routinely place AUS. In a survey in 2005, only 4% of urologists were considered high-volume AUS implanters, performing >20 per year. Globally, ~11,500 AUSs are placed annually. Over 400 articles have been published regarding the outcomes of AUS, with a wide variance in success rates ranging from 61% to 100%. Generally speaking, the AUS has good long-term outcomes, with social continence rates of ~79% and high patient satisfaction usually between 80% and 90%. Despite good outcomes, a substantial proportion of patients, generally ~25%, will require revision surgery, with the rate of revision increasing with time. Complications requiring revision include infection, urethral atrophy, erosion, and mechanical failure. Most infections are gram-positive skin flora. Urethral atrophy and erosion lie on a spectrum resulting from the same problem, constant urethral compression. However, these two complications are managed differently. Mechanical failure is usually a late complication occurring on average later than infection, atrophy, or erosions. Various techniques may be used during revisions, including cuff relocation, downsizing, transcorporal cuff placement, or tandem cuff placement. Patient satisfaction does not appear to be affected by the need for revision as long as continence is restored. Additionally, AUS following prior sling surgery has comparable

  12. Urinary Incontinence and Urosepsis due to Forgotten Ureteral Stent

    Directory of Open Access Journals (Sweden)

    Diego Martin Barreiro

    2016-09-01

    Full Text Available Case report of a patient who, while being under study due to total urinary incontinence and multiple urinary tract infections, interoccurs with urosepsis due to a forgotten and encrusted double-J stent. An open surgery is performed with two surgical approaches, suprapubic and minimal lumbotomy, in which a nephrectomy of the atrophic kidney, a resection of the urether with a calcified double-J in its interior and a cystolithotomy were conducted with the resulting favorable resolution of the pathology.

  13. Urinary Incontinence and Urosepsis due to Forgotten Ureteral Stent.

    Science.gov (United States)

    Barreiro, Diego Martin; Losada, Johanna Belén; Montiel, Francisco Castro; Lafos, Norberto

    2016-09-01

    Case report of a patient who, while being under study due to total urinary incontinence and multiple urinary tract infections, interoccurs with urosepsis due to a forgotten and encrusted double-J stent. An open surgery is performed with two surgical approaches, suprapubic and minimal lumbotomy, in which a nephrectomy of the atrophic kidney, a resection of the urether with a calcified double-J in its interior and a cystolithotomy were conducted with the resulting favorable resolution of the pathology.

  14. Effects of quebracho tannin extract (Schinopsis balansae Engl.) and activated charcoal on nitrogen balance, rumen microbial protein synthesis and faecal composition of growing Boer goats.

    Science.gov (United States)

    Al-Kindi, Amal; Dickhoefer, Uta; Schlecht, Eva; Sundrum, Albert; Schiborra, Anne

    2016-08-01

    Under irrigated arid conditions, organic fertiliser rich in slowly decomposable nitrogen (N) and carbon (C) is needed for soil fertility maintenance. Feeding ruminants with condensed tannins will lower ruminal protein degradation, reduce urinary N excretion and might increase the faecal fraction of slowly decomposable N. Supplementation with activated charcoal (AC) might enrich manure with slowly degrading C. Therefore, we investigated the effects of feeding quebracho tannin extract (QTE) and AC on the N balance of goats, the efficiency of microbial protein synthesis in the rumen (EMPS) and the composition of faeces. The feeding trial comprised three periods; in each period, 12 male Boer goats (28 ± 3.9 kg live weight) were assigned to six treatments: a Control diet (per kg diet 500 g grass hay and 500 g concentrate) and to further five treatments the Control diet was supplemented with QTE (20 g and 40 g/kg; diets QTE2 and QTE4, respectively), with AC (15 g and 30 g/kg, diets AC1.5 and AC3.0, respectively) and a mixture of QTE (20 g/kg) plus AC (15 g/kg) (diet QTEAC). In addition to the N balance, EMPS was calculated from daily excretions of purine derivatives, and the composition of faecal N was determined. There was no effect of QTE and AC supplementation on the intake of organic matter (OM), N and fibre, but apparent total tract digestibility of OM was reduced (p = 0.035). Feeding QTE induced a shift in N excretion from urine to faeces (p ≤ 0.001) without altering N retention. Total N excretion tended to decrease with QTE treatments (p = 0.053), but EMPS was not different between treatments. Faecal C excretion was higher in QTE and AC treatments (p = 0.001) compared with the Control, while the composition of faecal N differed only in concentration of undigested dietary N (p = 0.001). The results demonstrate that QTE can be included into diets of goats up to 40 g/kg, without affecting N utilisation, but simultaneously increasing the

  15. Combined quantification of faecal sterols, stanols, stanones and bile acids in soils and terrestrial sediments by gas chromatography-mass spectrometry.

    Science.gov (United States)

    Birk, Jago Jonathan; Dippold, Michaela; Wiesenberg, Guido L B; Glaser, Bruno

    2012-06-15

    Faeces incorporation can alter the concentration patterns of stanols, stanones, Δ(5)-sterols and bile acids in soils and terrestrial sediments. A joint quantification of these substances would give robust and specific information about the faecal input. Therefore, a method was developed for their purification and determination via gas chromatography-mass spectrometry (GC-MS) based on a total lipid extract (TLE) of soils and terrestrial sediments. Stanols, stanones, Δ(5)-steroles and bile acids were extracted by a single Soxhlet extraction yielding a TLE. The TLE was saponified with KOH in methanol. Sequential liquid-liquid extraction was applied to recover the biomarkers from the saponified extract and to separate the bile acids from the neutral stanoles, stanones and Δ(5)-steroles. The neutral fraction was directly purified using solid phase extraction (SPE) columns packed with 5% deactivated silica gel. The bile acids were methylated in dry HCl in methanol and purified on SPE columns packed with activated silica gel. A mixture of hexamethyldisilazane (HMDS), trimethylchlorosilane (TMCS) and pyridine was used to silylate the hydroxyl groups of the stanols and Δ(5)-sterols avoiding a silylation of the keto groups of the stanones in their enol-form. Silylation of the bile acids was carried out with N,O-bis(trimethylsilyl)trifluoroacetamide (BSTFA) containing N-trimethylsilylimidazole (TSIM). TLEs from a set of soils with different physico-chemical properties were used for method evaluation and for comparison of amounts of faecal biomarkers analysed with saponification and without saponification of the TLE. Therefore, a Regosol, a Podzol and a Ferralsol were sampled. To proof the applicability of the method for faecal biomarker analyses in archaeological soils and sediments, additional samples were taken from pre-Columbian Anthrosols in Amazonia and an Anthrosol from a site in central Europe settled since the Neolithic. The comparison of the amounts of steroids

  16. Defects on endoanal ultrasound and anal incontinence after primary repair of fourth-degree anal sphincter rupture: a study of the anal sphincter complex and puborectal muscle

    DEFF Research Database (Denmark)

    Sakse, A; Secher, N J; Ottesen, M

    2009-01-01

    . There was no difference in the incontinence scores between women who underwent EAUS and those who did not. Eleven of the women who underwent EAUS (33%) were continent, 22 women (67%) had flatus incontinence at least once a month, of whom 12 also had incontinence for liquid stool and two had incontinence for solid stool...

  17. Impact of diets with a high content of greaves-meal protein or carbohydrates on faecal characteristics, volatile fatty acids and faecal calprotectin concentrations in healthy dogs

    NARCIS (Netherlands)

    Hang, I.; Heilmann, R.M.; Grützner, N.; Suchodolski, J.S.; Steiner, J.M.; Atroshi, F.; Sankari, S.; Kettunen, A.; Vos, de W.M.; Zentek, J.; Spillmann, T.

    2013-01-01

    BACKGROUND: Research suggests that dietary composition influences gastrointestinal function and bacteria-derived metabolic products in the dog colon. We previously reported that dietary composition impacts upon the faecal microbiota of healthy dogs. This study aims at evaluating the dietary influenc

  18. An Independent Risk Factor for Quality of Life in Cancer Patients: Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    Kamile Sılay

    2015-12-01

    Full Text Available INTRODUCTION: Urinary incontinence impacts the lives of older individuals and it is considered one of the most important and recurrent geriatric syndromes. The aim of this study is to determine the prevalence of urinary incontinence in cancer patients and to evaluate its association with age and quality of life. METHODS: One hundred and thirty three patients with cancer were assessed at hematology/oncology outpatient clinic. The validated form of the Turkish version of the International Consultation on Incontinence Questionnaire-Short Form was used to evaluate urinary incontinence and quality of life (QOL. Descriptive statistics were used. The association between urinary incontinence and age, gender, cancer type and quality of life were evaluated with chi square. RESULTS: A total of 133 patients including 84 male and 49 female were evaluated. The mean age of patients was 62.5±12.3. While 45.9% of patients are older than 65, 54.1% of them are less than 64. The rate of urinary incontinence was found 40.6% (n=54. The association between urinary incontinence and age, quality of life has been shown statistically significant with chi square (P<0.001, P><0.001 respectively. The mean of ICI-Q and QOL score is 7.6±3.1 and 3.2±1.7 respectively. The most common type of urinary incontinence is urge incontinence following by stress, mix and overflow (12.8%, 12%, 11.3% and 4.5% respectively.> DISCUSSION AND CONCLUSION: Our results suggest that urinary incontinence is a significant problem which is underdiagnosed and undertreated in cancer patients. It inversely affects the quality of life. While focusing on cancer and chemotherapy, this important problem should not be underestimated. This leaves incontinent patients with unresolved physical, functional, and psychological morbidity, and diminished quality of life. The study suggests that awareness and education regarding incontinence should be increased among cancer patients and screening of Urinary

  19. New concept for treating female stress urinary incontinence with radiofrequency.

    Science.gov (United States)

    Lordelo, Patrícia; Vilas Boas, Andrea; Sodré, Danielle; Lemos, Amanda; Tozetto, Sibele; Brasil, Cristina

    2017-06-14

    To evaluate the clinical response and adverse effects of radiofrequency on the urethral meatus in the treatment of stress urinary incontinence in women. This phase one study included ten women with Stress Urinary Incontinence (SUI). The evaluation consisted of 1 hour Pad tests to quantify urine loss and to assess the degree of procedure satisfaction by using the Likert scale. To evaluate safety, we observed the number of referred side effects. Average age was 53.10 years±7.08 years. In assessing the final Pad Test, 70% showed a reduction and 30% a worsening of urinary loss. Using the Pad Test one month later, there was a reduction in all patients (p=0.028). The degree of satisfaction was 90% and no side effects have been observed. One patient reported burning sensation. The treatment of SUI with radiofrequency on the urethral meatus has no adverse effects, being a low risk method that reduces urinary loss in women. However, to increase the validity of the study, larger clinical trials are warranted. Copyright® by the International Brazilian Journal of Urology.

  20. [Telerehabilitation to treat stress urinary incontinence. Pilot study].

    Science.gov (United States)

    Carrión Pérez, Francisca; Rodríguez Moreno, María Sofía; Carnerero Córdoba, Lidia; Romero Garrido, Marina C; Quintana Tirado, Laura; García Montes, Inmaculada

    2015-05-21

    We aimed to test a new telerehabilitation device for stress urinary incontinence (SUI) in order to make an initial assessment of its effectiveness. Randomized, controlled pilot study. experimental group (10 patients): pelvic floor muscle training, device training and home treatment with it; control group (9 patients): conventional rehabilitation treatment. Outcome measures (baseline and 3 months) overall and specific quality of life: International Consultation Incontinence Questionnaire and King's Health Questionnaire, bladder diary, perineometry, satisfaction with the program and degree of compliance. Baseline characteristics were similar in both groups. There was no statistically significant difference for any outcome measures between groups at the end of the follow-up. The change in perineometry values at baseline and after the intervention was significant in the experimental group (23.06 to 32.00, P=.011). No group in this study had any serious adverse effects. The tested device is safe and well accepted. Although there is some evidence of its efficacy in the rehabilitation treatment of SUI, larger trials are needed to appropriately evaluate the potential advantages. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. EAU guidelines on surgical treatment of urinary incontinence.

    Science.gov (United States)

    Lucas, M G; Bosch, R J L; Burkhard, F C; Cruz, F; Madden, T B; Nambiar, A K; Neisius, A; de Ridder, D J M K; Tubaro, A; Turner, W H; Pickard, R S

    2013-09-01

    The European Association of Urology (EAU) guidelines on urinary incontinence published in March 2012 have been rewritten based on an independent systematic review carried out by the EAU guidelines panel using a sustainable methodology. We present a short version here of the full guidelines on the surgical treatment of patients with urinary incontinence, with the aim of dissemination to a wider audience. Evidence appraisal included a pragmatic review of existing systematic reviews and independent new literature searches based on Population, Intervention, Comparator, Outcome (PICO) questions. The appraisal of papers was carried out by an international panel of experts, who also collaborated in a series of consensus discussions, to develop concise structured evidence summaries and action-based recommendations using a modified Oxford system. The full version of the guidance is available online (www.uroweb.org/guidelines/online-guidelines/). The guidance includes algorithms that refer the reader back to the supporting evidence and have greater accessibility in daily clinical practice. Two original meta-analyses were carried out specifically for these guidelines and are included in this report. These new guidelines present an up-to-date summary of the available evidence, together with clear clinical algorithms and action-based recommendations based on the best available evidence. Where high-level evidence is lacking, they present a consensus of expert panel opinion. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

  2. Description of a novel viral tool to identify and quantify ovine faecal pollution in the environment.

    Science.gov (United States)

    Rusiñol, Marta; Carratalà, Anna; Hundesa, Ayalkibet; Bach, Alex; Kern, Anita; Vantarakis, Apostolos; Girones, Rosina; Bofill-Mas, Sílvia

    2013-08-01

    Farmed animals such as sheep, cattle, swine and poultry play an important role in microbial contamination of water, crops and food, and introduce large quantities of pathogens into the environment. The ability to determine the origin of faecal pollution in water resources is essential when establishing a robust and efficient water management system. Animal-specific viruses have previously been suggested as microbial source tracking tools, but specific ovine viral markers have not been reported before now. Previous studies have shown that polyomaviruses are host-specific, highly prevalent and are commonly excreted in urine. Furthermore, they have been reported to infect several vertebrate species but not sheep. That situation encouraged the study of a new putative ovine polyomavirus (OPyV) and its use to determine whether faecal pollution originates from ovine faecal/urine contamination. Putative OPyV DNA was amplified from ovine urine and faecal samples using a broad-spectrum nested PCR (nPCR). Specific nested PCR and quantitative PCR assays were developed and applied to faecal and environmental samples, including sheep slurries, slaughterhouse wastewater effluents, urban sewage and river water samples. Successful amplification by PCR was achieved in sheep urine samples, sheep slaughterhouse wastewater and downstream sewage effluents. The assay was specific and was negative in samples of human, bovine, goat, swine and chicken origin. Ovine faecal pollution was detected in river water samples by applying the designed methods. These results provide a quantitative tool for the analysis of OPyV as a suitable viral indicator of sheep faecal contamination that may be present in the environment.

  3. Bacteriophages and genetic mobilization in sewage and faecally polluted environments

    Science.gov (United States)

    Muniesa, Maite; Imamovic, Lejla; Jofre, Juan

    2011-01-01

    Summary Bacteriophages are one of the most abundant entities on the planet and are present in high concentrations within humans and animals, mostly in the gut. Phages that infect intestinal bacteria are released by defecation and remain free in extra‐intestinal environments, where they usually persist for longer than their bacterial hosts. Recent studies indicate that a large amount of the genetic information in bacterial genomes and in natural environments is of phage origin. In addition, metagenomic analysis reveals that a substantial number of bacterial genes are present in viral DNA in different environments. These facts support the belief that phages can play a significant role in horizontal gene transfer between bacteria. Bacteriophages are known to transfer genes by generalized and specialized transduction and indeed there are some examples of phages found in the environment carrying and transducing genes of bacterial origin. A successful transduction in the environment requires certain conditions, e.g. phage and bacterial numbers need to exceed certain threshold concentrations, the bacteria need to exist in an infection‐competent physiological state, and lastly, the physical conditions in the environment (pH, temperature, etc. of the supporting matrix) have to be suitable for phage infection. All three factors are reviewed here, and the available information suggests: (i) that the number of intestinal bacteria and phages in faecally contaminated environments guarantees bacteria–phage encounters, (ii) that transduction to intestinal bacteria in the environment is probable, and (iii) that transduction is more frequent than previously thought. Therefore, we suggest that phage‐mediated horizontal transfer between intestinal bacteria, or between intestinal and autochthonous bacteria in extra‐intestinal environments, might take place and that its relevance for the emergence of new bacterial strains and potential pathogens should not be ignored. PMID

  4. Locally produced natural conditioners for dewatering of faecal sludge

    Science.gov (United States)

    Gold, Moritz; Dayer, Pauline; Faye, Marie Christine Amie Sene; Clair, Guillaume; Seck, Alsane; Niang, Seydou; Morgenroth, Eberhard; Strande, Linda

    2016-01-01

    ABSTRACT In urban areas of low-income countries, treatment of faecal sludge (FS) is insufficient or non-existent. This results in large amounts of FS being dumped into the environment. Existing treatment technologies for FS, such as settling-thickening tanks and drying beds, are land intensive which is limiting in urban areas. Enhanced settling and dewatering by conditioning was evaluated in order to reduce the treatment footprint (or increase treatment capacity). Conventional wastewater conditioners, such as commercially available lime and polymers, are expensive, and commonly rely on complex supply chains for use in low-income countries. Therefore, the treatment performance of five conditioners which could be produced locally was evaluated: Moringa oleifera seeds and press cake, Jatropha curcas seeds, Jatropha Calotropis leaves and chitosan. M. oleifera seeds and press cake, and chitosan improved settling and dewatering and had a similar performance compared to lime and polymers. Optimal dosages were 400–500 kg M. oleifera/t TS, 300–800 kg lime/t TS and 25–50 kg polymer solution/t TS. In comparison, chitosan required 1.5–3.75 kg/t TS. These dosages are comparable to those recommended for wastewater (sludge). The results indicate that conditioning of FS can reduce total suspended solids (TSS) in the effluent of settling-thickening tanks by 22–81% and reduce dewatering time with drying beds by 59–97%. This means that the area of drying beds could be reduced by 59–97% with end-use as soil conditioner, or 9–26% as solid fuel. Least expensive options and availability will depend on the local context. In Dakar, Senegal, chitosan produced from shrimp waste appears to be most promising. PMID:26984372

  5. Bacteriophages and genetic mobilization in sewage and faecally polluted environments.

    Science.gov (United States)

    Muniesa, Maite; Imamovic, Lejla; Jofre, Juan

    2011-11-01

    Bacteriophages are one of the most abundant entities on the planet and are present in high concentrations within humans and animals, mostly in the gut. Phages that infect intestinal bacteria are released by defecation and remain free in extra-intestinal environments, where they usually persist for longer than their bacterial hosts. Recent studies indicate that a large amount of the genetic information in bacterial genomes and in natural environments is of phage origin. In addition, metagenomic analysis reveals that a substantial number of bacterial genes are present in viral DNA in different environments. These facts support the belief that phages can play a significant role in horizontal gene transfer between bacteria. Bacteriophages are known to transfer genes by generalized and specialized transduction and indeed there are some examples of phages found in the environment carrying and transducing genes of bacterial origin. A successful transduction in the environment requires certain conditions, e.g. phage and bacterial numbers need to exceed certain threshold concentrations, the bacteria need to exist in an infection-competent physiological state, and lastly, the physical conditions in the environment (pH, temperature, etc. of the supporting matrix) have to be suitable for phage infection. All three factors are reviewed here, and the available information suggests: (i) that the number of intestinal bacteria and phages in faecally contaminated environments guarantees bacteria-phage encounters, (ii) that transduction to intestinal bacteria in the environment is probable, and (iii) that transduction is more frequent than previously thought. Therefore, we suggest that phage-mediated horizontal transfer between intestinal bacteria, or between intestinal and autochthonous bacteria in extra-intestinal environments, might take place and that its relevance for the emergence of new bacterial strains and potential pathogens should not be ignored.

  6. Impact of feed restriction on health, digestion and faecal microbiota of growing pigs housed in good or poor hygiene conditions.

    Science.gov (United States)

    Le Floc'h, N; Knudsen, C; Gidenne, T; Montagne, L; Merlot, E; Zemb, O

    2014-10-01

    Feed restriction could be a relevant strategy to preserve gut health, reduce systemic inflammatory response and finally limit antibiotic use. This study assessed the effect of feed restriction on growing pigs submitted to a moderate inflammatory challenge induced by the degradation of the environmental hygiene that is known to alter growth rate. The experiment was run on 80 pigs selected at 7 weeks of age according to a 2×2 factorial design: two feeding levels, ad libitum (AL) and feed restricted (FR) at 60% of AL, and two conditions of environmental hygiene, clean and dirty. Pigs were housed individually throughout the experiment. From 61 to 68 days of age (day 0 to 7), pigs were housed in a post weaning unit and feed restriction was applied to half of the pigs from day 0 to day 29. At 68 days of age (day 7 of the experiment), pigs were transferred in a growing unit where half of FR and half of AL pigs were housed in a dirty environment (poor hygiene) and the other half in a clean environment (good hygiene) until day 42. Growth performance was recorded weekly. Blood and faeces samples were collected to measure indicators of inflammation, nutrient digestibility and microbiota composition. Faecal consistency was monitored daily to detect diarrhoeas. Feed restriction decreased daily weight gain (-35% to -50%, Phygiene conditions. Poor hygiene conditions decreased growth performance (-20%, Phygiene conditions (Phygiene modified the profile of the faecal microbiota. In this study, feed restriction did not reduce the systemic inflammatory response caused by poor hygiene conditions despite the limitation of the occurrence of digestive disorders. However, our study opens discussions regarding the impact of hygiene and feed restriction on gut microbial communities and digestive health.

  7. Use of Sacral Nerve Stimulation for the Treatment of Overlapping Constipation and Fecal Incontinence

    Science.gov (United States)

    Sreepati, Gouri; James-Stevenson, Toyia

    2017-01-01

    Patient: Female, 51 Final Diagnosis: Fecal incontinence Symptoms: Constipation • fecal incontinence Medication: — Clinical Procedure: Sacral nerve stimulator Specialty: Gastroenterology and Hepatology Objective: Rare co-existance of disease or pathology Background: Fecal incontinence and constipation are common gastrointestinal complaints, but rarely occur concurrently. Management of these seemingly paradoxical processes is challenging, as treatment of one symptom may exacerbate the other. Case Report: A 51-year-old female with lifelong neurogenic bladder secondary to spina bifida occulta presented with progressive symptoms of daily urge fecal incontinence as well as hard bowel movements associated with straining and a sensation of incomplete evacuation requiring manual disimpaction. Pelvic floor testing showed poor ability to squeeze the anal sphincter, which indicated sphincter weakness as a major contributor to her fecal incontinence symptoms. Additionally, on defecography she was unable to widen her posterior anorectal angle or relax the anal sphincter during defecation consistent with dyssynergic defecation. A sacral nerve stimulator was placed for management of her fecal incontinence. Interestingly, her constipation also dramatically improved with sacral neuromodulation. Conclusions: This unique case highlights the emerging role of sacral nerve stimulation in the treatment of complex pelvic floor dysfunction with improvement in symptoms beyond fecal incontinence in a patient with dyssynergic-type constipation. PMID:28265107

  8. Prevalence and risk factors for urinary and fecal incontinence in brazilian women

    Directory of Open Access Journals (Sweden)

    Joao L. Amaro

    2009-10-01

    Full Text Available Objective: To evaluate prevalence and risk factors of fecal and urinary incontinence (UI in Brazilian women. Material and Methods: 685 women older than 20 years of age answered a questionnaire about urinary and fecal symptoms, clinical and obstetric antecedents. They were grouped according to presence or absence of UI. Results: Urinary and fecal incontinence was reported in 27% and 2% of cases, respectively. Mean age of incontinent women was significantly higher than continent ones. Incontinent women had a mean number of micturitions significantly higher than the continent ones. On average, incontinent women had higher rate of pregnancies and vaginal delivery when compared to the continent ones. Body mass index (BMI was significantly higher in incontinent participants and in women with no UI complaints (27.35 vs. 24.95, p < 0.05. Fecal incontinence prevalence was 2% and occurred exclusively in patients with UI. Conclusions: Vaginal delivery and high BMI have been identified as risk factors for UI development while aging and number of pregnancies may be correlated factors.

  9. A Qualitative Study of Family Caregiver Experiences of Managing Incontinence in Stroke Survivors

    Science.gov (United States)

    Tseng, Chien-Ning; Huang, Guey-Shiun; Yu, Po-Jui; Lou, Meei-Fang

    2015-01-01

    Background Incontinence is a common problem faced by family caregivers that is recognized as a major burden and predictor of institutionalization. However, few studies have evaluated the experiences of family caregivers caring for stroke survivors with incontinence. Purpose To describe experiences of caregivers managing incontinence in stroke survivors. Design This qualitative descriptive study employed a grounded-theory approach. Methods Semi-structured in-depth interviews with ten family caregivers of stroke survivors with incontinence were conducted during 2011. Audiotaped interviews were transcribed and analyzed using content analysis. Findings Data analysis identified four themes: chaos, hypervigilance, exhaustion, and creating a new life. There were nine related subcategories: fluster, dirtiness, urgency, fear of potential health-hazard, physically demanding and time-consuming, mentally draining, financial burden, learning by doing, and attitude adjustment. Together, these described a process of struggling to cope with the care of stroke survivors with urinary/fecal incontinence. Of the four categories, “creating a new life” developed gradually over time to orient caregivers to their new life, while the other three categories occurred in a chronological order. Conclusion The research highlighted unique caring experiences of family caregivers of stroke patients, which focused solely on the ‘incontinence issue’. Understanding these experiences may help nurses provide better support and resources for family caregivers when caring for stroke survivors with incontinence. PMID:26066345

  10. A Qualitative Study of Family Caregiver Experiences of Managing Incontinence in Stroke Survivors.

    Directory of Open Access Journals (Sweden)

    Chien-Ning Tseng

    Full Text Available Incontinence is a common problem faced by family caregivers that is recognized as a major burden and predictor of institutionalization. However, few studies have evaluated the experiences of family caregivers caring for stroke survivors with incontinence.To describe experiences of caregivers managing incontinence in stroke survivors.This qualitative descriptive study employed a grounded-theory approach.Semi-structured in-depth interviews with ten family caregivers of stroke survivors with incontinence were conducted during 2011. Audiotaped interviews were transcribed and analyzed using content analysis.Data analysis identified four themes: chaos, hypervigilance, exhaustion, and creating a new life. There were nine related subcategories: fluster, dirtiness, urgency, fear of potential health-hazard, physically demanding and time-consuming, mentally draining, financial burden, learning by doing, and attitude adjustment. Together, these described a process of struggling to cope with the care of stroke survivors with urinary/fecal incontinence. Of the four categories, "creating a new life" developed gradually over time to orient caregivers to their new life, while the other three categories occurred in a chronological order.The research highlighted unique caring experiences of family caregivers of stroke patients, which focused solely on the 'incontinence issue'. Understanding these experiences may help nurses provide better support and resources for family caregivers when caring for stroke survivors with incontinence.

  11. Anal plugs and retrograde colonic irrigation are helpful in fecal incontinence or constipation

    Institute of Scientific and Technical Information of China (English)

    Marcel Cazemier; Richelle JF Felt-Bersma; Chris JJ Mulder

    2007-01-01

    AIM: To evaluate the feasibility, clinical effect and predicting factors for favorable outcome of treatment with anal plugs in fecal incontinence and retrograde colonic irrigation (RCI) in patients with fecal incontinence or constipation.METHODS: Patients who received treatment with an anal plug or RCI between 1980 and 2005 were investigated with a questionnaire.RESULTS: Of the 201 patients (93 adults, 108 children), 101 (50%) responded. Adults: anal plugs (8), five stopped immediately, one stopped after 20 mo and two used it for 12-15 mo. RCI (40, 28 fecal incontinence, 12 constipation), 63% are still using it (mean 8.5 years), 88% was satisfied. Younger adults (< 40 years) were more satisfied with RCI (94 % vs 65%, P = 0.05). Children: anal plugs (7), 5 used it on demand for an average of 2.5 years with satisfactory results, one stopped immediately and one after 5 years. RCI (26 fecal incontinence, 22 constipation), 90% are still using it (mean time 6.8 years) and felt satisfied. Children tend to be more satisfied (P = 0.001). Besides age, no predictive factors for success were found. There was no difference in the outcome between patients with fecal incontinence or constipation.CONCLUSION: RCI is more often applied than anal plugs and is helpful in patients with fecal incontinence or constipation, especially for younger patients. Anal plugs can be used incidentally for fecal incontinence, especially in children.

  12. Effect of calcium from dairy and dietary supplements on faecal fat excretion: a meta-analysis of randomized controlled trials

    DEFF Research Database (Denmark)

    Christensen, R.; Lorenzen, Janne Kunchel; Svith, Carina Roholm

    2009-01-01

    in an increase in faecal fat of 5.2 (1.6-8.8) g day(-1). In conclusion, dietary calcium has the potential to increase faecal fat excretion to an extent that could be relevant for prevention of weight (re-)gain. Long-term studies are required to establish its potential contribution.......Observational studies have found that dietary calcium intake is inversely related to body weight and body fat mass. One explanatory mechanism is that dietary calcium increases faecal fat excretion. To examine the effect of calcium from dietary supplements or dairy products on quantitative faecal...

  13. A Group-Based Yoga Therapy Intervention for Urinary Incontinence in Women: A Pilot Randomized Trial

    Science.gov (United States)

    Huang, Alison J.; Jenny, Hillary E.; Chesney, Margaret A.; Schembri, Michael; Subak, Leslee L.

    2015-01-01

    Objective To examine the feasibility, efficacy, and safety of a group-based yoga therapy intervention for middle-aged and older women with urinary incontinence. Methods We conducted a pilot randomized trial of ambulatory women aged 40 years and older with stress, urgency, or mixed-type incontinence. Women were randomized to a 6-week yoga therapy program (N=10) consisting of twice weekly group classes and once weekly home practice or a waitlist control group (N=9). All participants also received written pamphlets about standard behavioral self-management strategies for incontinence. Changes in incontinence were assessed by 7-day voiding diaries. Results Mean (±SD) age was 61.4 (±8.2) years, and mean baseline frequency of incontinence was 2.5 (±1.3) episodes/day. After 6 weeks, total incontinence frequency decreased by 66% (1.8 [±0.9] fewer episodes/day) in the yoga therapy versus 13% (0.3 [±1.7] fewer episodes/day) in the control group (P=0.049). Participants in the yoga therapy group also reported an average 85% decrease in stress incontinence frequency (0.7 [±0.8] fewer episodes/day) compared to a 25% increase in controls (0.2 [± 1.1] more episodes/day) (P=0.039). No significant differences in reduction in urgency incontinence were detected between the yoga therapy versus control groups (1.0 [±1.0] versus 0.5 [±0.5] fewer episodes/day, P=0.20). All women starting the yoga therapy program completed at least 90% of group classes and practice sessions. Two participants in each group reported adverse events unrelated to the intervention. Conclusions Findings provide preliminary evidence to support the feasibility, efficacy, and safety of a group-based yoga therapy intervention to improve urinary incontinence in women. PMID:24763156

  14. Hidden female urinary incontinence in urology and obstetrics and gynecology outpatient clinics in Turkey: what are the determinants of bothersome urinary incontinence and help-seeking behavior?

    Science.gov (United States)

    Cetinel, Bulent; Demirkesen, Oktay; Tarcan, Tufan; Yalcin, Onay; Kocak, Taner; Senocak, Mustafa; Itil, Ismail

    2007-06-01

    The purpose of this study was to assess the prevalence of female urinary incontinence (UI) and risk factors of bothersomeness and help-seeking behavior of hidden female UI in urology and obstetrics and gynecology outpatient clinics. This multicentric and cross-sectional study was conducted as a part of the Turkish Overactive Bladder Study. Female patients (n = 5,565) who were referred with complaints other than UI and overactive bladder symptoms were surveyed using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) with supplementation of five more questions. The crude prevalence of UI was found to be 35.7%. The prevalence of frequent and severe incontinence was 8.2 and 6.8%, respectively. The mean age of incontinent patients was significantly higher (p < 0.001). The prevalence of stress, urge, and mixed UI was 39.8, 24.8, and 28.9%, respectively. More than half (53%) of incontinent patients were not bothered by UI, and only 12% of incontinent patients had previously sought medical help for their problem. Frequency, severity, and type of UI were independent factors for predicting bothersome UI, while only bothersomeness increased help-seeking behavior. The ICIQ-SF score of 8 has been found to be the best cutoff value to delineate the bothersome UI. Although the crude prevalence of female UI was found to be high, bothersome UI was not so common. The majority of incontinent female patients did not seek medical help. Frequency, severity, and mixed type of UI were found to be the determinants of bothersome UI for which the ICIQ-SF cutoff score of 8 was obtained.

  15. Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth and obstetric techniques

    DEFF Research Database (Denmark)

    Foldspang, Anders; Mommsen, Søren; Djurhuus, Jens Christian

    1999-01-01

    OBJECTIVES: This study examined the association between pregnancy, vaginal childbirth and obstetric techniques, and the prevalence of urinary incontinence among adult women aged 20 to 59 years. METHODS: A cross-sectional survey enrolled a random sample of 6240 women aged 20 to 59 years who were......, or perineal suturing. CONCLUSION: Not only the process of childbirth itself but also processes during pregnancy seem to be strongly associated with prevalent urinary incontinence. Perineal suturing may be associated with prevalent urinary incontinence, whereas other obstetric techniques inspected do not seem...

  16. Management of daytime urinary incontinence and lower urinary tract symptoms in children.

    Science.gov (United States)

    Deshpande, Aniruddh V; Craig, Jonathan C; Smith, Grahame H H; Caldwell, Patrina H Y

    2012-02-01

    Lower urinary tract symptoms, particularly urgency, frequency and incontinence are common in school-aged children but are often overlooked. They may cause considerable physical, social and psychological difficulties to children and their families, and usually are manifestations of underlying non-neurogenic voiding disorders. The differential diagnoses include overactive bladder syndrome, dysfunctional voiding and vaginal reflux as well as less common conditions like giggle incontinence, voiding postponement, pollakiuria and diabetes insipidus. In this paper, we discuss an evidence-based approach to the management of conditions causing daytime urinary incontinence and lower urinary tract symptoms in children from a general paediatrician's perspective.

  17. Bacteriophages as indicators of human and animal faecal contamination in raw and treated wastewaters from Tunisia.

    Science.gov (United States)

    Yahya, M; Hmaied, F; Jebri, S; Jofre, J; Hamdi, M

    2015-05-01

    We aimed at quantifying bacteriophages in raw and treated wastewaters of human and animal origin in Tunisia to assess their usefulness for tracking the origin of faecal pollution and in the follow-up of effectiveness of water treatments process. The concentrations of bacteriophages in wastewater samples were determined by double layer agar technique. Somatic coliphages and F-specific RNA bacteriophages were present in all types of samples in high concentrations. The values of Escherichia coli were variable depending on geographical location. On the other hand, bacteriophages infecting strain GA17 were detected preferably when human faecal contamination was occurred. Bacteriophages appear as a feasible and widely applicable manner to detect faecal contamination in Tunisia. On the other hand, phages infecting GA17 could be good markers for tracking the origin of faecal pollution in the area studied. The reuse of treated wastewaters can be a solution to meet the needs of water in the geographical area of study. Bacteriophages seem to predict differently the presence of faecal contamination in water than bacterial indicators. Consequently, they can be a valuable additional tool to improve water resources management for minimizing health risks. © 2015 The Society for Applied Microbiology.

  18. Faecal Waste Disposal and Environmental Health Status in a Nigerian Coastal Settlement of Oron

    Directory of Open Access Journals (Sweden)

    Edet E. Ikurekong

    2008-10-01

    Full Text Available AIM/BACKGROUND: This research investigated the relationship between faecal waste disposal and the environmental health status of the inhabitants of Oron LGA, of Akwa Ibom State, Nigeria. The objectives were to identify the methods of faecal disposal; identify the incidence of faecal waste related diseases and the pattern and types of diseases occurrence in the study area. METHOD: 400 households were randomly selected for interview from 17 villages of the study area. Ground and surface water samples were spatially collected and analysed to determine their quality. These include streams, boreholes pipe-borne, and rain and river water from the 17 villages. RESULTS: The result shows that both the qualitative and quantitative aspect of the major sources of drinking water supply are at variance with the established national and international standards. The stepwise multiple regression models applied proved the validity of population demographic characteristics, unhygienic environment and poor quality of water supply as factors that enhance the incidence and vulnerability of the population to faecal waste related disease occurrence. CONCLUSION: The study recommends sustainable strategies towards the management of human faecal waste and related diseases in the study area. [TAF Prev Med Bull 2008; 7(5.000: 363-368

  19. Relationship Between Gastrointestinal Parasite Infection and Faecal Protein Excretion in Moghani ewes

    Directory of Open Access Journals (Sweden)

    S. Hassanpour

    2011-06-01

    Full Text Available The aim of this study was to investigate relationship between Faecal Egg Counts (FECs and protein excretion in naturally acquired nematode infected Moghani ewes. Thirty-five Moghani ewes (aged from 6 to 12 months and average of body weight 32±3 kg were selected among the naturally acquired nematode infected animals which their infection had confirmed by McMaster flotation method. The animals were divided into 5 groups according to the FECs (470. Faecal samples were taken directly from the rectum of each animal in early morning and kept in individual sampling containers under 4ºC. Faecal parameters such as Crude Protein (CP, Dry Matter (DM, Organic Matter (OM and ash were determined using the Kjeldahl method following the standard procedures. Data were processed in excel and statistical analysis was performed using SPSS/ver. 17 software. Our data indicates that there was a significant difference among groups for the faecal ash and OM values (p0.1, r = - 0.290 in the naturally acquired nematode infected Moghani ewes. In conclusion, the FECs was not a good indication for interpretation of faecal protein excretion in nematode infected sheep.

  20. Functional disability among older women with fecal incontinence.

    Science.gov (United States)

    Erekson, Elisabeth A; Ciarleglio, Maria M; Hanissian, Paul D; Strohbehn, Kris; Bynum, Julie P W; Fried, Terri R

    2015-03-01

    The prevalence of functional disability for basic activities of daily living (ADLs) in older women with fecal incontinence (FI) is not well characterized. Our objective was to determine the prevalence of functional disability among community-dwelling older women with FI. We conducted a secondary database analysis of the 2005-2006 National Social Life, Health and Aging Project, a cross-sectional study of community-dwelling older adults that had been conducted by single in-home interviews. FI was defined as an affirmative answer to the question, "Have you lost control of your bowels (stool incontinence or anal incontinence)?" with a frequency of "at least monthly." We then examined functional status. Women were asked about 7 basic ADLs. Statistical analyses with percentage estimates and 95% confidence intervals (CIs) were performed. We included 1412 women in our analysis. FI, at least monthly, was reported by 5.5% of community-dwelling older women (n = 77); 63.2% (95% CI, 50.1-76.4) of the women with FI reported difficulty or dependence with ≥1 ADLs, and 31.2% (95% CI, 18.9-43.6) of the women specifically reported difficulty or dependence with using the toilet. After adjustment for age category, race/ethnicity, education level, women with FI had 2.6 increased odds (95% CI, 1.26-5.35) of difficulty or dependence compared with women with no FI. Other significant risk factors for increased functional difficulty/dependence included obesity (body mass index, ≥30 kg/m(2)) and depressive symptoms. Consistent with other large epidemiologic studies, we found monthly FI was reported by 5.5% of older women (n/N = 77/1412). More than 60% of community-dwelling older women with FI report functional difficulty or dependence with ≥1 ADL and specifically; more than 30% of women with FI report difficulty or dependence using/reaching the toilet. Because of the high prevalence of functional disability in older women with FI, we purpose that initial evaluation and treatment of FI

  1. Pressure Ulcer Risk in the Incontinent Patient: Analysis of Incontinence and Hospital-Acquired Pressure Ulcers From the International Pressure Ulcer Prevalence™ Survey.

    Science.gov (United States)

    Lachenbruch, Charlie; Ribble, David; Emmons, Kirsten; VanGilder, Catherine

    2016-01-01

    To measure the prevalence of incontinence in the 2013-2014 International Pressure Ulcer Prevalence (IPUP) surveys and determine the relative risk of developing a facility-acquired pressure ulcers (FAPUs) by stage and by Braden Scale score groupings. The IPUP survey is an observational, cross-sectional cohort database designed to determine the frequency and severity of pressure ulcers in various populations. The survey includes acute care (91.4%), long-term acute care (1.7%), rehabilitation patients (1.7%) and long-term care residents (5.2%). Geographic distribution included 182,832 patients in the United States, 22,282 patients in Canada, and the rest of the world, primarily in Europe and the Middle East. We analyzed data from the 2013 and 2014 IPUP surveys to better understand the relationship between incontinence and the frequency and severity of FAPUs. The IPUP survey is an annual voluntary survey of patients who are hospitalized or who reside in long-term care facilities. Data were collected over a 24-hour period within each participating facility. Data collection included limited demographics, presence and stage of pressure ulcers, and pressure ulcer risk assessment score (Braden Scale for Pressure Sore Risk, Braden Q, Norton, Waterlow, and others). In addition, data were collected on pertinent pressure ulcer risk factors including the number of linen layers, use of a pressure redistributing surface, adherence to repositioning schedule, and whether moisture management was provided in the last 24 hours. We aggregated data by urinary, urinary catheter, fecal, fecal management system, double (urinary and fecal), and ostomy incontinence category. If patients were managed by indwelling urinary catheter or fecal management systems, they were considered incontinent in this analysis. In order to analyze ulcers likely to be affected by incontinence, we defined a subset of ulcers as Relevant Pressure Ulcers, which are ulcers that are facility-acquired, non

  2. The influence of Lactobacillus casei DN 114 001 on the activity of faecal enzymes and genotoxicity of faecal water in the presence of heterocyclic aromatic amines.

    Science.gov (United States)

    Nowak, Adriana; Śliżewska, Katarzyna; Błasiak, Janusz; Libudzisz, Zdzisława

    2014-12-01

    High activity of bacterial enzymes in human colon and genotoxicity of faecal water (FW) are biomarkers of the harmful action of microbiota. The aim of the present study was to assess the activity of β-glucuronidase and β-glucosidase and the genotoxicity of FW in vitro after incubation with 2-amino-3-methyl-3H-imidazo[4,5-f]quinoline (IQ) or 2-amino-1-methyl-6-phenyl-1H-imidazo[4,5-b]pyridine (PhIP) and probiotic Lactobacillus casei DN 114 001 (Actimel). Our results indicate, that IQ and PhIP greatly increased the activity of faecal enzymes (it was up to four times higher, as measured by spectrophotometric methods) and the genotoxicity of FW (% DNA in the tail was up to 3.2 times higher, as evaluated by the comet assay on Caco-2 cells) in 15 individuals from three age-dependent groups (breast-fed children, adults aged 30-40 years, elderly aged 75-85 years). Lb. casei DN 114 001 decreased the activity of faecal enzymes and the genotoxicity of FW exposed to PhIP and IQ mostly to control values. The activity of faecal enzymes after incubation with IQ was reduced by 71.8% in the FW of children, 37.5% in adults and 64.2% in elderly (β-glucuronidase); as well as by 59.9% in children and 87.9% in elderly (β-glucosidase). For PhIP the reduction was by 59.0% in the FW of children, 50.0% in adults and 81.2% in elderly (β-glucuronidase) and by 20.2% in children, 20.7% in adults and 84.1% in elderly (β-glucosidase). Lb. casei DN 114 001 also decreased the genotoxicity of FW to the greatest extent in adults after incubation with IQ (by 65.4%) and PhIP (by 69.6%) and it was found to correlate positively with the decrease in faecal enzymes activity. In conclusion, Lb. casei DN 114 001 may exert the protective effects against genotoxic and possibly pro-carcinogenic effects of food processing-derived chemicals present in faecal water. Copyright © 2014. Published by Elsevier Ltd.

  3. External Quality Assessment in the Evaluation of Laboratory Performance of Faecal Culture.

    Science.gov (United States)

    Kiiskinen, Salla J; Ojanen, Tarja; Björkman, Yvonne; Laitinen, Harri; Siitonen, Anja

    2017-01-01

    In Finland, all laboratories carrying out diagnostics of infectious diseases in humans are approved by the Regional State Administrative Agencies and are obligated to participate in External Quality Assurance rounds. Performance in these rounds is thought to reflect the quality of laboratory work. In the 6-year study period, 17 Finnish laboratories received 48 simulated faecal specimens for the culturing of diarrhoeal pathogens, yielding altogether 586 faecal culture External Quality Control specimens and 581 reports. The results were correct in 92% of all reports and in 67% of all specimens. False-negative Salmonella results were given for 2 of the 18 specimens, one with biochemically atypical Salmonella strain and the other with a low count of Salmonella cells. False-negative Shigella report was given for 6 of the 7 specimens in some participating laboratory. Detection of all common faecal pathogens is especially relevant to patient safety, public health, and epidemiological surveillance.

  4. Do women of reproductive age presenting with pelvic floor dysfunction have undisclosed anal incontinence: A retrospective cohort study.

    Science.gov (United States)

    Tucker, Julie; Grzeskowiak, Luke; Murphy, Elizabeth Mary Ann; Wilson, Anne; Clifton, Vicki L

    2017-02-01

    Indirect and direct trauma following vaginal birth can negatively impact on the pelvic floor function increasing the risk of anal incontinence. It is often difficult for women to openly disclose that they have anal incontinence and there are limited data collection tools available for the identification of these women in a clinical setting. This study aims to describe the prevalence of undisclosed anal incontinence in antenatal and postnatal women with pelvic floor dysfunction. Retrospective cohort study of 230 antenatal and postnatal women referred to a Continence Nursing Service in a large tertiary hospital in South Australia, Australia, with pelvic floor dysfunction. A criteria list was utilised to access the primary reason for referral, anal incontinence assessments and attendance to an appointment. Anal incontinence was identified in 26% of women (n=59). Anal incontinence was the primary reason for referral amongst 8 women, with the remaining 51 women identified as having anal incontinence following clinical screening via phone consultation. Eighty six percent of women stated they had not previously disclosed anal incontinence to health professionals. Overall, 71% of symptomatic women (n=28 antenatal and n=14 postnatal women) attended appointments to a service specialising in pelvic floor dysfunction. Women presenting with urinary incontinence or other markers of pelvic floor dysfunction should be actively screened for anal incontinence as the prevalence of this condition is high amongst childbearing women. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  5. Incontinence pads: clinical performance, design and technical properties.

    Science.gov (United States)

    Cottenden, A M

    1988-11-01

    The paper describes the functional requirements of urinary incontinence pads and reviews the results of several studies which seek to relate the clinical performance of pads to their design and the technical properties of their constituent materials. Pad designs covered include: simple rectangular (for use with conventional pants or marsupial pants containing a pouch); wing-folded; shaped; and all-in-one infant-style diapers. Data on the clinical and technical properties of fluff wood pulp and hydrogel absorbents, and viscose rayon, polyester, polypropylene and polyethylene coverstocks are presented. Attention is focussed on four major aspects of pad function: freedom from leakage; freedom from discomfort and skin damage; ease of application and removal; and aesthetic properties. The relationships established between clinical and technical data will be of interest to health care professionals selecting products; organizations seeking to create standards; and pad designers.

  6. Role of urodynamics in stress urinary incontinence: A critical appraisal

    Directory of Open Access Journals (Sweden)

    Shirish Dattatraya Yande

    2016-01-01

    Conclusions: Urodynamic study in SUI has a potential of giving much more information than demonstration of Detrusor Overactivity alone. The predominant symptom of urge urinary incontinence can predictably diagnose detrusor overactivity in these cases. However, the incidence of asymptomatic detrusor overactivity remains as high as 15% and may have implication in postoperative results. This study clearly shows that there is a definite incidence of significant voiding dysfunction, which cannot be reliably evaluated without properly conducted pressure flow study. This factor may govern the choice of correct treatment which also predicts the outcome more reliably. Preoperative urodynamic study thus adds a dimension of precision to evaluation of the patients of SUI and may also influence technique and outcome measures in this group of patients.

  7. Transient bladder and fecal incontinence following epidural blood patch

    Science.gov (United States)

    Palomero-Rodríguez, Miguel Angel; Palacio-Abinzada, Francisco J.; Campollo, Sara Chacón; Laporta-Báez, Yolanda; Mendez Cendón, Jose Carlos; López-García, Andres

    2015-01-01

    Epidural blood patch (EBP) is the currently accepted treatment of choice for postdural puncture headache because of its high initial success rates and infrequent complications. Many authors recommended a small volume (10-20 mL) of blood to be delivered for an effective EBP. Here, we report an obstetric patient who developed a transient bladder and fecal incontinence after 19 mL of blood EBP at L1 -L2 level. Since the magnetic resonance image did not demonstrate any definitive spinal cord lesion, the exact mechanism remains unclear. We suggest that accumulation of blood performed at L1 to L2 level in a closed relationship with the sacral cord, may have trigger a significant pressure elevation of the epidural space at this level, resulting in a temporal spinal cord-related injury in the sacral cord. PMID:26543470

  8. Body mass index and adult female urinary incontinence

    DEFF Research Database (Denmark)

    Mommsen, Søren; Foldspang, Anders

    1994-01-01

    rate of response was 85%, and the present analysis comprises 2,589 women who supplied information about their body weight and height. The period prevalence of all UI, stress UI, urge UI, and mixed stress and urge UI was 17%, 15%, 9%, and 7%, respectively. The mean body mass index (BMI) was 22.7 kg/m2......The aim of the present investigation was to study the possible role of obesity in the etiology of adult female urinary incontinence (UI). A random population sample of 3,114 women aged 30–59 years were mailed a questionnaire concerning UI and, among other things, body weight and height. The overall....... Irrespective of other risk indicators, BMI was positively associated with UI prevalence (OR, 1.07/BMI unit; PBMI interacted with childbirth in predicting stress UI prevalence, with cystitis in predicting urge UI, and with both in predicting mixed UI. Stress UI proved to be the UI type most closely...

  9. Dietary fiber supplementation for fecal incontinence: a randomized clinical trial.

    Science.gov (United States)

    Bliss, Donna Z; Savik, Kay; Jung, Hans-Joachim G; Whitebird, Robin; Lowry, Ann; Sheng, Xiaoyan

    2014-10-01

    Dietary fiber supplements are used to manage fecal incontinence (FI), but little is known about the fiber type to recommend or the level of effectiveness of such supplements, which appears related to the fermentability of the fiber. The aim of this single-blind, randomized controlled trial was to compare the effects of three dietary fiber supplements (carboxymethylcellulose [CMC], gum arabic [GA], or psyllium) with differing levels of fermentability to a placebo in community-living individuals incontinent of loose/liquid feces. The primary outcome was FI frequency; secondary outcomes included FI amount and consistency, supplement intolerance, and quality of life (QoL). Possible mechanisms underlying supplement effects were also examined. After a 14-day baseline, 189 subjects consumed a placebo or 16 g total fiber/day of one of the fiber supplements for 32 days. FI frequency significantly decreased after psyllium supplementation versus placebo, in both intent-to-treat and per-protocol mixed model analyses. CMC increased FI frequency. In intent-to-treat analysis, the number of FI episodes/week after supplementation was estimated to be 5.5 for Placebo, 2.5 for Psyllium, 4.3 for GA, and 6.2 for CMC. Only psyllium consumption resulted in a gel in feces. Supplement intolerance was low. QoL scores did not differ among groups. Patients with FI may experience a reduction in FI frequency after psyllium supplementation, and decreased FI frequency has been shown to be an important personal goal of treatment for patients with FI. Formation of a gel in feces appears to be a mechanism by which residual psyllium improved FI.

  10. Incontinence medication response relates to the female urinary microbiota.

    Science.gov (United States)

    Thomas-White, Krystal J; Hilt, Evann E; Fok, Cynthia; Pearce, Meghan M; Mueller, Elizabeth R; Kliethermes, Stephanie; Jacobs, Kristin; Zilliox, Michael J; Brincat, Cynthia; Price, Travis K; Kuffel, Gina; Schreckenberger, Paul; Gai, Xiaowu; Brubaker, Linda; Wolfe, Alan J

    2016-05-01

    Many adult women have resident urinary bacteria (urinary microbiome/microbiota). In adult women affected by urinary urgency incontinence (UUI), the etiologic and/or therapeutic role of the urinary microbiome/microbiota remains unknown. We hypothesized that microbiome/microbiota characteristics would relate to clinically relevant treatment response to UUI medication per os. Adult women initiating medication treatment orally for UUI and a comparator group of unaffected women were recruited in a tertiary care health-care system. All participants provided baseline clinical data and urine samples. Women with UUI were given 5 mg solifenacin, with potential dose escalation to 10 mg for inadequate UUI symptom control at 4 weeks. Additional data and urine samples were collected from women with UUI at 4 and 12 weeks. The samples were assessed using 16S ribosomal RNA (rRNA) gene sequencing and enhanced quantitative urine culturing. The primary outcome was treatment response as measured by the validated Patient Global Symptom Control (PGSC) questionnaire. Clinically relevant UUI symptom control was defined as a 4 or 5 score on the PGSC. Diversity and composition of the urinary microbiome/microbiota of women with and without UUI differed at baseline. Women with UUI had more bacteria and a more diverse microbiome/microbiota. The clinical response to solifenacin in UUI participants was related to baseline microbiome/microbiota, with responders more likely to have fewer bacteria and a less diverse community at baseline. Nonresponders had a more diverse community that often included bacteria not typically found in responders. Knowledge of an individual's urinary microbiome/microbiota may help refine UUI treatment. Complementary tools, DNA sequencing, and expanded urine culture provide information about bacteria that appear to be related to UUI incontinence status and treatment response in this population of adult women.

  11. Stress urinary incontinence: What, when, why, and then what?

    Directory of Open Access Journals (Sweden)

    Navneet Magon

    2011-01-01

    Full Text Available Stress urinary incontinence (SUI has a significant impact on the quality of life for many women. Most women do not seek medical attention for this condition. Treatment for this problem includes initial conservative therapies and then surgery is an option. More than 200 surgical procedures have been described in the literature for the treatment of stress incontinence. The gold-standard surgical treatment of SUI in patients with a mobile bladder neck and normally functioning urethra has been accomplished through a retropubic approach using either a Burch or Marshall-Marchetti-Krantz procedure. By the absolute success of Trans obturator tape (TOT application in treatment of SUI and the niche it has created for itself in the maze of treatment modalities available for SUI, there seems to be little doubt that TOT is all set to become the new Gold Standard for treatment of SUI in times to come. It is difficult to imagine any further improvements in the midurethral sling procedures or surgeries for SUI. However 10 years ago, no one could have imagined the progress and development that has been seen over these few short years in the treatment of SUI. The future may hold promise in technologies such as stem cells that may be injected in or around the urethral support structures and provide regeneration of the lacking support structures. What so ever, it′s definitely time to provide millions of women with knowledge that empowers them to make lifestyle changes to decrease their risk of SUI and to understand the reality that they are not alone if they have SUI.

  12. Voiding trial outcome following pelvic floor repair without incontinence procedures

    Science.gov (United States)

    Wang, Rui; Won, Sara; Haviland, Miriam J.; Bargen, Emily Von; Hacker, Michele R.; Li, Janet

    2016-01-01

    Introduction and hypothesis Our aim was to identify predictors of postoperative voiding trial failure among patients who had a pelvic floor repair without a concurrent incontinence procedure in order to identify low-risk patients in whom postoperative voiding trials may be modified. Methods We conducted a retrospective cohort study of women who underwent pelvic floor repair without concurrent incontinence procedures at two institutions from 1 November 2011 through 13 October 2013 after abstracting demographic and clinical data from medical records. The primary outcome was postoperative retrograde voiding trial failure. We used modified Poisson regression to calculate the risk ratio (RR) and 95 % confidence interval (CI). Results Of the 371 women who met eligibility criteria, 294 (79.2 %) had complete data on the variables of interest. Forty nine (16.7%) failed the trial, and those women were less likely to be white (p = 0.04), more likely to have had an anterior colporrhaphy (p = 0.001), and more likely to have had a preoperative postvoid residual (PVR) ≥150 ml (p = 0.001). After adjusting for race, women were more likely to fail their voiding trial if they had a preoperative PVR of ≥150 ml (RR: 1.9; 95 % CI: 1.1–3.2); institution also was associated with voiding trial failure (RR: 3.0; 95 % CI: 1.6–5.4). Conclusions Among our cohort, postoperative voiding trial failure was associated with a PVR of ≥150 ml and institution at which the surgery was performed. PMID:26886553

  13. Decomposition of oak leaf litter and millipede faecal pellets in soil under temperate mixed oak forest

    Science.gov (United States)

    Tajovský, Karel; Šimek, Miloslav; Háněl, Ladislav; Šantrůčková, Hana; Frouz, Jan

    2015-04-01

    The millipedes Glomeris hexasticha (Diplopoda, Glomerida) were maintained under laboratory conditions and fed on oak leaf litter collected from a mixed oak forest (Abieto-Quercetum) in South Bohemia, Czech Republic. Every fourth day litter was changed and produced faecal pellets were separated and afterwards analysed. Content of organic carbon and C:N ratio lowered in faecal pellets as compared with consumed litter. Changes in content of chemical elements (P, K, Ca, Mg, Na) were recognised as those characteristic for the first stage of degradation of plant material. Samples of faecal pellets and oak leaf litter were then exposed in mesh bags between the F and H layers of forest soil for up to one year, subsequently harvested and analysed. A higher rate of decomposition of exposed litter than that of faecal pellets was found during the first two weeks. After 1-year exposure, the weight of litter was reduced to 51%, while that of pellets to 58% only, although the observed activity of present biotic components (algae, protozoans, nematodes; CO2 production, nitrogenase activity) in faecal pellets was higher as compared with litter. Different micro-morphological changes were observed in exposed litter and in pellets although these materials originated from the same initial sources. Comparing to intact leaf litter, another structural and functional processes occurred in pellets due to the fragmentation of plant material by millipedes. Both laboratory and field experiments showed that the millipede faecal pellets are not only a focal point of biodegradation activity in upper soil layers, but also confirmed that millipede feces undergo a slower decomposition than original leaf litter.

  14. Critical evaluation of electro-stimulation for management of female urinary incontinence.

    Science.gov (United States)

    Yasuda, K; Yamanishi, T

    1999-10-01

    Electro-stimulation has been reported to be effective in the relief of stress and urge urinary incontinence. The rates of cure and improvement brought about by pelvic floor electro-stimulation in patients with urinary incontinence are 30-50% and 60-90%, respectively. In clinical practice, vaginal, anal and surface electrodes are used for external, short-term stimulation, and sacral root stimulation for internal, chronic (long-term) stimulation. The effectiveness of electro-stimulation has been verified in a randomized, placebo-controlled study. However, its superiority over other conservative treatments, such as pelvic floor exercise, has not been confirmed. A long-term effect has also been reported. In conclusion, pelvic floor exercise together with electro-stimulation is the mainstay of conservative management for the treatment of stress incontinence. For urge and mixed stress plus urge incontinence, electro-stimulation may be the first choice alternative treatment to drug therapy.

  15. Evaluating and managing urinary incontinence after prostatectomy: beyond pads and diapers.

    Science.gov (United States)

    Atiemo, Humphrey O; Moy, Louis; Vasavada, Sandip; Rackley, Raymond

    2007-01-01

    Men who become persistently incontinent after undergoing prostatectomy have a variety of options for regaining control, ranging from behavioral changes to surgery. To determine the best therapy, one should define the problem with a thorough urologic evaluation.

  16. Prospective regenerative medicine therapies for obstetric trauma-induced fecal incontinence.

    Science.gov (United States)

    Parmar, Nina; Kumar, Lalit; Emmanuel, Anton; Day, Richard M

    2014-01-01

    Fecal incontinence is a major public health issue that has yet to be adequately addressed. Obstetric trauma and injury to the anal sphincter muscles are the most common cause of fecal incontinence. New therapies are emerging aimed at repair or regeneration of sphincter muscle and restoration of continence. While regenerative medicine offers an attractive option for fecal incontinence there are currently no validated techniques using this approach. Although many challenges are yet to be resolved, the advent of regenerative medicine is likely to offer disruptive technologies to treat and possibly prevent the onset of this devastating condition. This article provides a review on regenerative medicine approaches for treating fecal incontinence and a critique of the current landscape in this area.

  17. [Results of electrical sensitivity tests of the urethra and vagina in functional urinary incontinence].

    Science.gov (United States)

    Hegenscheid, F; Fischer, W; Murawski, B

    1986-01-01

    Urethral and vaginal sensibility has been tested in 90 patients with urinary incontinence by means of urethral catheter and vaginal electrodes. Monophasic rectangular impulses with a frequency of 2 Hz, a duration of 2 msec and a variable intensity were used. The urethral sensibility threshold was 10.5 mA in patients with urge incontinence and 14.8 mA with stress incontinence. The vaginal sensibility threshold was by 20 mA higher and correlated well with the urethral one in its differentation of stress and urge incontinence. Because the big scattering of the values there was no statistical significance. Therefore this method is only valid to clarify patients complaints and to define impulse parameters for therapeutic intravaginal electric stimulation.

  18. Prevalent urinary incontinence as a correlate of pregnancy, vaginal childbirth and obstetric techniques

    DEFF Research Database (Denmark)

    Foldspang, Anders; Mommsen, Søren; Djurhuus, Jens Christian

    1999-01-01

    OBJECTIVES: This study examined the association between pregnancy, vaginal childbirth and obstetric techniques, and the prevalence of urinary incontinence among adult women aged 20 to 59 years. METHODS: A cross-sectional survey enrolled a random sample of 6240 women aged 20 to 59 years who were...... mailed a self-administered questionnaire focusing on urinary incontinence and other health variables. More than 75% of the women responded. The present analysis includes 4345 women who were not pregnant and did not experience a vaginal childbirth during 1994. RESULTS: Multivariate prevalence odds ratios...... showed increases in relation to urinary incontinence during pregnancy, urinary incontinence immediately after a vaginal childbirth, and age of 30 years or more at the second vaginal childbirth. No multivariate associations were found for forceps delivery or vacuum extraction delivery, episiotomy...

  19. Prevalence and risk factors of urinary incontinence in Indian women: A hospital-based survey

    Directory of Open Access Journals (Sweden)

    Uma Singh

    2013-01-01

    Conclusion: Urinary incontinence is a bothersome problem for women. Simple questionnaire can help to detect this problem and diagnose associated risk factors, so that necessary steps can be taken in its prevention and treatment.

  20. Evaluation of endoscopic laser excision of polypropylene mesh/sutures following anti-incontinence procedures.

    LENUS (Irish Health Repository)

    Davis, N F

    2012-11-01

    We reviewed our experience with and outcome of the largest series to our knowledge of patients who underwent endoscopic laser excision of eroded polypropylene mesh or sutures as a complication of previous anti-incontinence procedures.

  1. Relief of fecal incontinence by sacral nerve stimulation linked to focal brain activation

    DEFF Research Database (Denmark)

    Lundby, Lilli; Møller, Arne; Buntzen, Steen

    2011-01-01

    This study aimed to test the hypothesis that sacral nerve stimulation affects afferent vagal projections to the central nervous system associated with frontal cortex activation in patients with fecal incontinence....

  2. Faecal Excretion of Glycosphingolipids of Breast-fed and Formula-fed Infants

    OpenAIRE

    Larson, G.; Falk, P; Hynsjö, L.; Midtvedt, A. -C.; Midtvedt, T

    2011-01-01

    Faecal samples of six healthy breast-fed, or formula-fed, infants were collected at intervals up to 9 mth of age and analysed for their contents of sphingolipids. Comparisons were made with faecal samples of one older child and one adult. The mean faccal content of sphingolipids during the first 9 mth of life (8.2 μmol sphingosine/g dry stool) was significantly less than that of meconium samples (23.3 μmol/gj but higher than that of adult stools (1.2 μmol/g). Sphingomyelin excretion ...

  3. The ameliorating effect of Yucca schidigera extract on canine and feline faecal aroma.

    Science.gov (United States)

    Lowe, J A; Kershaw, S J

    1997-01-01

    Addition of Yucca schidigera extract (YSE) products to canine or feline diets improved the character and reduced the intensity of faecal aroma as monitored by a human panel. The general condition of the animals was not adversely affected as monitored by faecal pH, food retention time, and blood cell counts. Blood urea increased significantly in YSE-treated cats, possibly due to the saponins of YSE affecting gut wall permeability. This finding contrasts with previously published reports of a reduction in blood urea on the addition of sarsaponin (from YSE) to rat diets and of YSE products to poultry and cattle diets.

  4. Analysis of the microbial diversity in faecal material of the endangered blue whale, Balaenoptera musculus.

    Science.gov (United States)

    Guass, Olivia; Haapanen, Lisa Meier; Dowd, Scot E; Širović, Ana; McLaughlin, Richard William

    2016-07-01

    Using bacterial and fungal tag-encoded FLX-Titanium amplicon pyrosequencing, the microbiota of the faecal material of two blue whales living in the wild off the coast of California was investigated. In both samples the most predominant bacterial phylum was the Firmicutes with Clostridium spp. being the most dominant bacteria. The most predominant fungi were members of the phylum Ascomycota with Metschnikowia spp. being the most dominant. In this study, we also preliminarily characterised the culturable anaerobic bacteria from the faecal material, using traditional culture and 16S rRNA gene sequencing approaches. In total, three bacterial species belonging to the phylum Firmicutes were identified.

  5. Faecal carriage of Staphylococcus aureus in the hospital and community setting: a systematic review

    Directory of Open Access Journals (Sweden)

    Shantelle eClaassen-Weitz

    2016-05-01

    Full Text Available Background and rationale: Staphylococcus aureus faecal carriage has been identified as a potential source for nosocomial transmission and a risk factor for disease development. This systematic review determined the overall S. aureus (including methicillin susceptible and resistant S. aureus (MSSA and MRSA faecal carriage rates within the community and healthcare settings.Methodology: Peer-reviewed articles indexed in Medline, Scopus, Academic Search Premier, Africa-Wide Information, CINAHL, and Web of Science were identified using applicable and controlled vocabulary through to 11 November 2015. Eligible studies were ascertained by three independent reviewers. Random-effects meta-analyses of proportions were performed to determine S. aureus, MSSA and MRSA faecal carriage rates reported by eligible studies.Results: Twenty six studies were included in this review. The pooled estimates for S. aureus, MSSA and MRSA faecal carriage were 26 % (95 % confidence interval (CI: 16.8 % - 36.3 %, 86 % (95 % confidence interval (CI: 65.9 % - 97.9 % and 10 % (95 % CI: 0.7 % - 27.0 %, respectively. Faecal S. aureus carriage rates increased on average from 10 % to 65 % during the first eight weeks of life, followed by an average carriage rate of 64 % at six months and 46 % at one year of life. Genotyping techniques were employed mainly in studies conducted in developed countries and comprised largely of gel-based techniques. Six studies reported on the role of S. aureus faecal strains in diarrhoea (n = 2 and the risk for acquiring infections (n = 4. Eight of the 26 studies included in this review performed antibiotic susceptibility testing of S. aureus faecal isolates.Conclusion: This study provides evidence that screening for S. aureus faecal carriage, at least in populations at high risk, could be an effective measure for the prevention of S. aureus transmission and infection in the healthcare and community setting. More well-structured studies need to be

  6. Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome

    NARCIS (Netherlands)

    Kaiser, T; Langhorst, J; Wittkowski, H; Becker, K; Friedrich, A W; Rueffer, A; Dobos, G J; Roth, J; Foell, D

    2007-01-01

    OBJECTIVE: S100A12 is a pro-inflammatory protein that is secreted by granulocytes. S100A12 serum levels increase during inflammatory bowel disease (IBD). We performed the first study analysing faecal S100A12 in adults with signs of intestinal inflammation. METHODS: Faecal S100A12 was determined by E

  7. Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome

    NARCIS (Netherlands)

    Kaiser, T; Langhorst, J; Wittkowski, H; Becker, K; Friedrich, A W; Rueffer, A; Dobos, G J; Roth, J; Foell, D

    2007-01-01

    OBJECTIVE: S100A12 is a pro-inflammatory protein that is secreted by granulocytes. S100A12 serum levels increase during inflammatory bowel disease (IBD). We performed the first study analysing faecal S100A12 in adults with signs of intestinal inflammation. METHODS: Faecal S100A12 was determined by

  8. Faecal S100A12 as a non-invasive marker distinguishing inflammatory bowel disease from irritable bowel syndrome

    NARCIS (Netherlands)

    Kaiser, T; Langhorst, J; Wittkowski, H; Becker, K; Friedrich, A W; Rueffer, A; Dobos, G J; Roth, J; Foell, D

    2007-01-01

    OBJECTIVE: S100A12 is a pro-inflammatory protein that is secreted by granulocytes. S100A12 serum levels increase during inflammatory bowel disease (IBD). We performed the first study analysing faecal S100A12 in adults with signs of intestinal inflammation. METHODS: Faecal S100A12 was determined by E

  9. What Is the Real Impact of Urinary Incontinence on Female Sexual Dysfunction? A Case Control Study

    OpenAIRE

    Mariana Rhein Felippe, ScM; Joao Paulo Zambon, MD, PhD; Marcia Eli Girotti, ScM; Juliana Schulze Burti, ScM; Claudia Rosenblatt Hacad, ScM; Lina Cadamuro, PT; Fernando Almeida, MD, PhD

    2017-01-01

    Introduction: Urinary incontinence (UI) has been associated with negative effects on women's sexuality. Women's sexuality and sexual function are a complex issue, and the role of UI is not completely clear. Aim: To assess the impact of UI on female sexual function by comparing this population with a control group of continent women. Methods: We performed a case-control study from August 2012 to September 2013. We evaluated continent and incontinent women (age range = 30–70 years) for th...

  10. Voiding patterns and prevalence of incontinence in women. A questionnaire survey

    DEFF Research Database (Denmark)

    Sommer, P; Bauer, T; Nielsen, K K

    1990-01-01

    A detailed questionnaire on the occurrence of irritative and obstructive voiding symptoms, incontinence and the number of childbirths was sent out to 600 women aged between 20 and 79 years, randomly selected from the National Register; 432 (72%) returned the questionnaire and 414 (69%) were...... the tendency to wear nappies or sanitary towels increased with age, the increase was not statistically significant. There was a positive correlation between the occurrence of stress incontinence and childbirth in the group as a whole....

  11. Prevalence and risk factors of urinary incontinence among Chinese women in Shanghai

    OpenAIRE

    Liu, Bo; Wang, Lei; Huang, Sheng-Song; Wu, Qiang; Wu, Deng-Long

    2014-01-01

    Objective: A group of healthy females were randomly sampled in Shanghai for the purpose of evaluating the prevalence of urinary incontinence (UI) among Chinese women and its associated risk factors. Methods: 5,467 registered female residents aged from 20 years were randomly sampled from four communities in Shanghai, and the Bristol Female Lower Urinary Tract Symptoms Questionnaire (the International Consultation Incontinence Questionnaire) was adopted. Detailed information regarding pregnancy...

  12. [Epidemiology and treatment for urinary incontinence and pelvic organ prolapse in women].

    Science.gov (United States)

    Starczewski, Andrzej; Brodowska, Agnieszka; Brodowski, Jacek

    2008-07-01

    Urinary incontinence (UI) is defined as uncontrolled urine leakage through an urethra. At present, the following types of UI can be specified: stress incontinence (SI), urge incontinence (UI), mixed incontinence (MI), overflow incontinence (OI) in which the bladder becomes too full because it cannot be fully emptied, and functional incontinence (FI). Incontinence is one of the most common chronic diseases in women and is found in 17-60% of the whole population. In most patients, SI is combined with pelvic organ prolapse. The basic risk factors mentioned as contributing to these two conditions are obstetrical past and gynaecological history and atrophic changes in the urogenital area. There are also a number of diseases related to the increase in intra-abdominal pressure, such as obesity chronic constipation and diseases associated with persistent cough. Other factors leading to pelvic organ prolapse include hard physical work, some professional sports, connective tissue disorders, neuropathy and disturbed innervation of the pelvic floor. To deal with stress incontinence (SI), conservative and surgical treatment is employed. In the first degree intensity, it is mainly physiotherapy, electrical stimulation of the pelvic floor muscles, lifestyle modification and reduction of body mass. When the SI symptoms are more severe, surgical treatment is usually preferred. From among many methods, these presently used are Burch and sling operations. On the other hand, surgical treatment for pelvic organ prolapse involves colpoperineoplasty with the use of polypropylene mesh (Prolift), colporrhaphy by double TOT approach method, median colporrhaphy, Cooper's ligament or sacrospinous ligament colpopexy, and attachment of the uterus to the sacrum. The results of surgical treatment depend on co-occurrence of risk factors, the surgical method chosen, the lapse of time from the surgery and the type of the applied biomedical material.

  13. The effect of pelvic muscle exercises on urinary incontinency and self-esteem of elderly females with stress urinary incontinency, 2013.

    Science.gov (United States)

    Kargar Jahromi, Marzieh; Talebizadeh, Malihe; Mirzaei, Maryam

    2014-09-28

    Millions of women are afflicted with stress urinary incontinence. Urinary incontinence is mentioned as one of the geriatric syndromes, together with pressure ulcers, functional decline, falls, and low self-esteem. The aim of the present study was to determine the effect of pelvic muscle exercises on urinary incontinency and self- esteem of elderly females with stress urinary incontinency in Shiraz, Iran, 2013. In this interventional study, 50 old females aged 60-74 years were chosen among the members of Jahandidegan center, and they were asked to sign the informed consent form and complete the demographic questionnaire. Then, Quid questionnaire was used for choosing the type of incontinence in the elderly females. Next, the participants completed the ICIQ and self-esteem questionnaires. Then, they were randomly assigned to case and control groups. Each participant took part in 8 training classes. Finally, the subjects filled the ICIQ and self-esteem questionnaires before and 2 months after the intervention. The results is shown that after the intervention, ICIQ score has a significant difference between the two groups (P=0.001). Also, after the treatment, self-esteem average scores of studied unit indicated a significant statistical difference in experimental group. In other words, the training sessions improved the score of self-esteem in the experimental group (Pwomen in improving their quality of life and self-esteem, so recommended that such these exercising programs be used in elderly health care centers as a factor to improve health promotion of elderlies 'that are suffering from urinary incontinence.

  14. Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations.

    Science.gov (United States)

    Orme, Susie; Morris, Vikky; Gibson, William; Wagg, Adrian

    2015-07-01

    Urinary incontinence and lower urinary tract symptoms are highly prevalent in late life and are strongly associated with dementia and frailty. Incontinence is extremely common among those living in long-term care and is most commonly due to urgency incontinence. Although national and international guidelines for continence care exist, they often fail to consider the complex comorbidity found in patients with dementia and are often not followed; continence practices in long-term care may promote rather than prevent incontinence. The majority of those with dementia living in the community can be managed successfully with standard treatments, both pharmacological and non-pharmacological; the expectations and aims of treatment of both the patient and their caregivers should be considered. A dementia diagnosis does not preclude management of incontinence, but treatment options may be more limited in those with advanced dementia who are unable to retain information and modify behaviors. High-quality data to guide the choice of pharmacological agent in those with dementia are lacking. Oxybutynin has been shown to have significant adverse cognitive effects, but data to support the use of trospium, solifenacin, darifenacin, and fesoterodine are limited. No data are available for mirabegron. Neither age, frailty, nor dementia should be considered a barrier to pharmacological management, but consideration should be given to the total anticholinergic load. Evidence to guide the treatment of incontinence in this vulnerable patient group is scarce, and available guidelines adapted for each individual's situation should be applied.

  15. [Prevalence of urinary and anal incontinence in women from metropolitan area of Guadalajara].

    Science.gov (United States)

    Martínez Espinoza, Claudia Josefina; Flores Carreras, Oscar; García de Alba García, Javier E; Velázquez Castellanos, Patricia Inés; González Ruiz, María Isabel; Márquez Allegre, René

    2006-06-01

    Female urinary and anal incontinence are common entities in pelvic floor dysfunction. The most frequently age affected range from 45 to 69 years. Previous studies performed in the United States report a prevalence of 24-62% for urinary incontinence and 3-60% for anal incontinence. To determine the prevalence of these disorders in the Guadalajara metropolitan area because we do not know it. A transversal and various stage study was performed recollecting blocks first, then houses, finally interviewing women and applying a structured questionnaire with somatometric and social-demographic data and also clinical-pathological antecedents. The data obtained was registered and processed first manually then using Excel and Epi-Info software. The group of women interviewed (n = 352) were between 15-85 years. The majority were married, housewives, 33% with grammar school, 23% finished high school, 25% professionists and 19% did not finish school; with an average of three pregnancies and with a body mass index (BMI) positive for overweight and obesity. The prevalence for urinary incontinence was 27.8% and anal incontinence of 3.4%. These are results compatible with those reported in the United States. Women living in Guadalajara have the same behavior that European and American women about prevalence of urinary incontinence. We recommend the performance of this type of studies in other states of this country in order to enrich the present information.

  16. Incontinence pad absorption and skin barrier creams: a non-patient study.

    Science.gov (United States)

    Dykes, Peter; Bradbury, Sarah

    2016-12-08

    Exposure of the skin to excessive moisture, such as in cases of incontinence, can damage its natural barrier function and lead to tissue damage and breakdown. Common methods for managing incontinence and preventing related skin damage include the use of incontinence pads and the application of skin barrier creams to reduce exposure to moisture and irritants. Previous reports have indicated that barrier creams can transfer onto incontinence pads from the skin and reduce their absorbency, and thus the efficacy of both products. This study, using non-patient volunteers, investigated the effect on incontinence pad absorbency of Medi Derma-S and Medi Derma-Pro; two products from the Medi Skin Protection range, in comparison with other market-leading products. Results indicated that, while there was a small degree of product transfer onto the incontinence pads, this did not have a major impact on the absorption of synthetic urine. Medi Derma-S and Medi Derma-Pro performed consistently with other similar market-leading products.

  17. Impact of Cantienica® Method to Improve Urinary Incontinence and Quality of Life

    Directory of Open Access Journals (Sweden)

    Adriana Repková

    2016-03-01

    Full Text Available Background: The aim of this study was to determine the impact of symptoms of urinary incontinence by individuals, with the help of pelvic floor muscle's activation using Cantienica® and the subsequent effect on the quality of women's life. Patients and methods: The selected sample consists of two groups - experimental and control. The experimental group consisted of 31 female patients with incontinence, who completed therapeutic exercises using features of Cantienica® method. Control group consisted of 31 female patients with incontinence, which had taken a different way of conservative therapy. Results: The research has found that in the group of female patients who completed the therapeutic exercise by Benita Cantieni method, came in both phases to significantly greater change in the quality of life and greater alleviation of incontinence among the women who completed the other conservative treatments of incontinence. Conclusion: It can be alleged by the observed results, that the evaluated method has an effect on improving the quality of life and alleviating the symptoms of urinary incontinence in women.

  18. Evaluation of the urinary microbiota of women with uncomplicated stress urinary incontinence.

    Science.gov (United States)

    Thomas-White, Krystal J; Kliethermes, Stephanie; Rickey, Leslie; Lukacz, Emily S; Richter, Holly E; Moalli, Pamela; Zimmern, Philippe; Norton, Peggy; Kusek, John W; Wolfe, Alan J; Brubaker, Linda

    2017-01-01

    Female urinary microbiota are associated with urgency urinary incontinence and response to medication. The urinary microbiota of women with stress urinary incontinence has not been described. We sought to study the cross-sectional relationships between urinary microbiota features and demographic and clinical characteristics of women undergoing stress urinary incontinence surgery. Preoperative urine specimens were collected from women without urinary tract infection and were available from 197 women (174 voided, 23 catheterized) enrolled in a multicenter prospective randomized trial, the Value of Urodynamic Evaluation study. Demographic and clinical variables were obtained including stress and urgency urinary incontinence symptoms, menopausal status, and hormone use. The bacterial composition of the urine was qualitatively assessed by sequencing the bacterial 16S ribosomal RNA gene. Phylogenetic relatedness and microbial alpha diversity were compared to demographics and symptoms using generalized estimating equation models. The majority of 197 urine samples (86%) had detectable bacterial DNA. Bacterial diversity was significantly associated with higher body mass index (P = .02); increased Medical, Epidemiologic, and Social Aspects of Aging urge index score (P = .04); and hormonal status (P microbiota. This cross-sectional analysis revealed that increased diversity of the microbiota was associated with urgency urinary incontinence symptoms, hormonal status, and body mass index. In contrast, the female urinary microbiota were not associated with stress urinary incontinence symptoms. Published by Elsevier Inc.

  19. Low-Dose Intravaginal Estriol and Pelvic Floor Rehabilitation in Post-Menopausal Stress Urinary Incontinence.

    Science.gov (United States)

    Castellani, Daniele; Saldutto, Pietro; Galica, Vikiela; Pace, Gianna; Biferi, Daniela; Paradiso Galatioto, Giuseppe; Vicentini, Carlo

    2015-01-01

    Pelvic floor muscle training (PFMT) and electrical stimulation (ES) are conservative models of therapy for treating female stress urinary incontinence (SUI). The presence of estradiol receptors in the lower urinary tract advances the case for estradiol therapy in SUI. The aim of our study was to investigate the effects of the combination of pelvic floor rehabilitation and intravaginal estriol (IE) on SUI treatment in postmenopausal women. Sixty-two women with SUI were randomized to PFMT, ES and biofeedback (Group 1) or the same treatment plus 1 mg IE (Group 2) for 6 months. Patients were evaluated with medical history, pelvic examination, urodynamics, 24-hour pad test. Urinary incontinence was evaluated using the International Consultation on Incontinence questionnaire on urinary incontinence short form and quality of life using the Incontinence Impact Questionnaire-Short Form. Two patients were lost at follow-up and one discontinued the study. Mean urine leakage at the 24-hour pad test dropped from 42.3 ± 20.2 g/die to 31.5 ± 14.2 g/die in Group 1 and from 48.3 ± 19.8 g/die to 22.3 ± 10.1 g/die in Group 2. Symptoms scores and incontinence status were statistically significant better in Group 2 when compared to Group 1. IE added to PFMT, ES and BF is a safe and efficacious first-line therapy in postmenopausal women with SUI. © 2015 S. Karger AG, Basel.

  20. Outcomes of surgical treatment in women with anal incontinence secondary to trauma of delivery

    Directory of Open Access Journals (Sweden)

    Akın Önder

    2011-12-01

    Full Text Available Objectives: Anal incontinence is the involuntary loss of flatus and feces and often occurs, as a reason of trauma due to the vaginal delivery in women. In this study, we aimed to evaluate the results of the patients, who underwent surgery, with anal incontinence due to the vaginal delivery.Materials and methods: Between January 2005 and December 2010, 15 patients, who had anal incontinence due to the vaginal delivery and underwent overlapping sphincteroplasty, were analyzed retrospectively.Results: The mean age was 34.7 (range 18-49 years. Sphincter injuries were grade 4 in all patients. The time for the surgery after the formation of vaginal tear varies between the first day after injury and 17 years. Wound infection developed in 2 of the patients. Anal incontinence was revealed in 4 patients in the postoperative period, 3 of them had incontinence of the flatus and 1 of them had flatal and fecal incontinence. Total continence was achieved in 11 patients.Conclusion: The sphincter injuries due to the vaginal delivery traumas can be easily defined with a detailed physical examination and careful questioning of the medical history. Satisfactory results can be achieved with the surgical treatment.

  1. Effects of feeding metabolite combinations produced by Lactobacillus plantarum on growth performance, faecal microbial population, small intestine villus height and faecal volatile fatty acids in broilers.

    Science.gov (United States)

    Thanh, N T; Loh, T C; Foo, H L; Hair-Bejo, M; Azhar, B K

    2009-05-01

    1. Four combinations of metabolites produced from strains of Lactobacillus plantarum were used to study the performance of broiler chickens. 2. A total of 432 male Ross broilers were raised from one-day-old to 42 d of age in deep litter pens (12 birds/pen). These birds were divided into 6 groups and fed on different diets: (i) standard maize-soybean-based diet (negative control); (ii) standard maize-soybean-based diet + Neomycin and Oxytetracycline (positive control); (iii) standard maize-soybean-based diet + 0.3% metabolite combination of Lactobacillus plantarum RS5, RI11, RG14 and RG11 strains (com3456); (iv) standard maize-soybean-based diet + 0.3% metabolite combination of L. plantarum TL1, RI11 and RG11 (Com246); (v) standard maize-soybean-based diet + 0.3% metabolite combination of L. plantarum TL1, RG14 and RG11 (Com256) and (vi) standard maize-soybean-based diet + 0.3% metabolite combination of L. plantarum TL1, RS5, RG14 and RG11 (Com2356). 3. Higher final body weight, weight gain, average daily gain and lower feed conversion ratio were found in all 4 treated groups. 4. The addition of a metabolite combination supplementation also increased faecal lactic acid bacteria population, small intestine villus height and faecal volatile fatty acids and faecal Enterobacteriaceae population.

  2. Faecal sterols as indicators of sewage contamination in estuarine sediments of the Tay Estuary, Scotland: an extended baseline survey

    Science.gov (United States)

    Reeves, A. D.; Patton, D.

    2005-06-01

    Sterol ratios are used to identify sources, occurrence and partitioning of faecal matter in sediments of the Tay Estuary, Scotland. The 5β/(5α+5β) ratio is used to discriminate between sewage and biogenic sterol sources by comparing the concentrations of coprostanols to cholesterol plus coprostanols. This index shows unambiguous sewage pollution in the Invergowrie Bay area (values >0.7). The coprostanol/epicoprostanol index is used to differentiate between human and non-human faecal inputs. Ratios confirmed the primary source as human-derived faecal material. The coprostanol/cholesterol ratio was calculated in order to elucidate the contribution of different biogenic sources to the sedimentary sterol budget. Ratios of >1 clearly indicate faecal sterol sources. Invergowrie Bay displayed no sterol signature other than sewage. A biogenic source of cholesterol influenced total sterol concentrations upstream of the City of Dundee. Attention is directed to the potential role of density fronts in compartmentalization of faecal material in bottom sediments.

  3. Effect of yoghurt containing Bifidobacterium lactis Bb12® on faecal excretion of secretory immunoglobulin A and human beta-defensin 2 in healthy adult volunteers.

    Science.gov (United States)

    Kabeerdoss, Jayakanthan; Devi, R Shobana; Mary, R Regina; Prabhavathi, D; Vidya, R; Mechenro, John; Mahendri, N V; Pugazhendhi, Srinivasan; Ramakrishna, Balakrishnan S

    2011-12-23

    Probiotics are used to provide health benefits. The present study tested the effect of a probiotic yoghurt on faecal output of beta-defensin and immunoglobulin A in a group of young healthy women eating a defined diet. 26 women aged 18-21 (median 19) years residing in a hostel were given 200 ml normal yoghurt every day for a week, followed by probiotic yoghurt containing Bifidobacterium lactis Bb12® (10⁹ in 200 ml) for three weeks, followed again by normal yoghurt for four weeks. Stool samples were collected at 0, 4 and 8 weeks and assayed for immunoglobulin A and human beta-defensin-2 by ELISA. All participants tolerated both normal and probiotic yoghurt well. Human beta-defensin-2 levels in faeces were not altered during the course of the study. On the other hand, compared to the basal sample, faecal IgA increased during probiotic feeding (P = 0.0184) and returned to normal after cessation of probiotic yoghurt intake. Bifidobacterium lactis Bb12® increased secretory IgA output in faeces. This property may explain the ability of probiotics to prevent gastrointestinal and lower respiratory tract infections.

  4. Effect of yoghurt containing Bifidobacterium lactis Bb12® on faecal excretion of secretory immunoglobulin A and human beta-defensin 2 in healthy adult volunteers

    Directory of Open Access Journals (Sweden)

    Kabeerdoss Jayakanthan

    2011-12-01

    Full Text Available Abstract Background Probiotics are used to provide health benefits. The present study tested the effect of a probiotic yoghurt on faecal output of beta-defensin and immunoglobulin A in a group of young healthy women eating a defined diet. Findings 26 women aged 18-21 (median 19 years residing in a hostel were given 200 ml normal yoghurt every day for a week, followed by probiotic yoghurt containing Bifidobacterium lactis Bb12® (109 in 200 ml for three weeks, followed again by normal yoghurt for four weeks. Stool samples were collected at 0, 4 and 8 weeks and assayed for immunoglobulin A and human beta-defensin-2 by ELISA. All participants tolerated both normal and probiotic yoghurt well. Human beta-defensin-2 levels in faeces were not altered during the course of the study. On the other hand, compared to the basal sample, faecal IgA increased during probiotic feeding (P = 0.0184 and returned to normal after cessation of probiotic yoghurt intake. Conclusions Bifidobacterium lactis Bb12® increased secretory IgA output in faeces. This property may explain the ability of probiotics to prevent gastrointestinal and lower respiratory tract infections.

  5. Efficacy of antibiotherapy for treating flatus incontinence associated with small intestinal bacterial overgrowth: A pilot randomized trial

    OpenAIRE

    Melchior, Chlo?; Gourcerol, Guillaume; Bridoux, Val?rie; Ducrott?, Philippe; Quinton, Jean-Fran?ois; Leroi, Anne-Marie

    2017-01-01

    Aim An increase in intestinal gas production due to small intestinal bowel overgrowth (SIBO) is a contributing factor for flatus incontinence. The aims of our study were to assess the efficacy of metronidazole in a select population of patients with flatus incontinence associated with SIBO and to compare its efficacy with that of a combination of simethicone and activated charcoal (SC; Carbosylane) in randomized experimental arms. Methods Adult patients suffering from flatus incontinence asso...

  6. [Sorption isotherms and sorption thermodynamics of faecal sterols on offshore sediment].

    Science.gov (United States)

    Zhang, Xiao-Lei; Xue, Wen-Ping; Xu, Heng-Zhen; Ma, Xin-Dong

    2012-10-01

    Experiments of faecal sterols adsorption from aqueous solutions onto Dalian offshore sediment were done by a batch equilibrium method,and the sorption of 12 kinds of faecal sterols in sediment were investigated in this paper. It was shown that the adsorption equilibrium time was 24 h, and after 24 h the variation tendency of 5 kinds of fingerprint values was stable. It indicated that adsorption isothermal data was interpreted by the Henry, Freundlich, Langmuir, Duhinin-Radushkevich(D-R) and Temkin equations, and demonstrated that the other 4 isotherms provided stronger data fitting than the Langumir isotherm. It inferred that from D-R model the mean free energy of adsorption process of 12 kinds of faecal sterols was from 7 071.1 J x mol(-1) to 9 128.7 J x mol(-1), and concluded that it was mainly physical adsorption of the sorptive process of 12 kinds of faecal sterols in sediment. It discovered that from the Temkin model the value of K(f) of cholestanone was the maximum, and extrapolated that cholestanone was adsorbed most easily on sediment. It stated that the enthalpy and entropy change of the adsorption were both less than zero, and inferred that the adsorption process was exothermic and spontaneous.

  7. FRNA Bacteriophages as Viral Indicators of Faecal Contamination in Mexican Tropical Aquatic Systems

    Science.gov (United States)

    Diaz-Avalos, Carlos; Lopez-Vidal, Yolanda; Castillo-Rojas, Gonzalo; Mazari-Hiriart, Marisa

    2017-01-01

    A particular challenge to water safety in populous intertropical regions is the lack of reliable faecal indicators to detect microbiological contamination of water, while the numerical relationships of specific viral indicators remain largely unexplored. The aim of this study was to investigate the numerical relationships of FRNA-bacteriophage genotypes, adenovirus 41, and human adenoviruses (HADV) in Mexican surface water systems to assess sewage contamination. We studied the presence of HADV, HADV41 and FRNA bacteriophage genotypes in water samples and quantified by qPCR and RT-qPCR. Virus and water quality indicator variances, as analyzed by principal component analysis and partial least squared regression, followed along the major percentiles of water faecal enterococci. FRNA bacteriophages adequately deciphered viral and point source water contamination. The strongest correlation for HADV was with FRNA bacteriophage type II, in water samples higher than the 50th percentiles of faecal enterococci, thus indicating urban pollution. FRNA bacteriophage genotypes I and III virus indicator performances were assisted by their associations with electrical conductivity and faecal enterococci. In combination, our methods are useful for inferring water quality degradation caused by sewage contamination. The methods used have potential for determining source contamination in water and, specifically, the presence of enteric viruses where clean and contaminated water have mixed. PMID:28114378

  8. Genotyping faecal samples of Bengal tiger Panthera tigris tigris for population estimation: A pilot study

    Directory of Open Access Journals (Sweden)

    Singh Lalji

    2006-10-01

    Full Text Available Abstract Background Bengal tiger Panthera tigris tigris the National Animal of India, is an endangered species. Estimating populations for such species is the main objective for designing conservation measures and for evaluating those that are already in place. Due to the tiger's cryptic and secretive behaviour, it is not possible to enumerate and monitor its populations through direct observations; instead indirect methods have always been used for studying tigers in the wild. DNA methods based on non-invasive sampling have not been attempted so far for tiger population studies in India. We describe here a pilot study using DNA extracted from faecal samples of tigers for the purpose of population estimation. Results In this study, PCR primers were developed based on tiger-specific variations in the mitochondrial cytochrome b for reliably identifying tiger faecal samples from those of sympatric carnivores. Microsatellite markers were developed for the identification of individual tigers with a sibling Probability of Identity of 0.005 that can distinguish even closely related individuals with 99.9% certainty. The effectiveness of using field-collected tiger faecal samples for DNA analysis was evaluated by sampling, identification and subsequently genotyping samples from two protected areas in southern India. Conclusion Our results demonstrate the feasibility of using tiger faecal matter as a potential source of DNA for population estimation of tigers in protected areas in India in addition to the methods currently in use.

  9. FRNA Bacteriophages as Viral Indicators of Faecal Contamination in Mexican Tropical Aquatic Systems.

    Science.gov (United States)

    Arredondo-Hernandez, Luis Jose Rene; Diaz-Avalos, Carlos; Lopez-Vidal, Yolanda; Castillo-Rojas, Gonzalo; Mazari-Hiriart, Marisa

    2017-01-01

    A particular challenge to water safety in populous intertropical regions is the lack of reliable faecal indicators to detect microbiological contamination of water, while the numerical relationships of specific viral indicators remain largely unexplored. The aim of this study was to investigate the numerical relationships of FRNA-bacteriophage genotypes, adenovirus 41, and human adenoviruses (HADV) in Mexican surface water systems to assess sewage contamination. We studied the presence of HADV, HADV41 and FRNA bacteriophage genotypes in water samples and quantified by qPCR and RT-qPCR. Virus and water quality indicator variances, as analyzed by principal component analysis and partial least squared regression, followed along the major percentiles of water faecal enterococci. FRNA bacteriophages adequately deciphered viral and point source water contamination. The strongest correlation for HADV was with FRNA bacteriophage type II, in water samples higher than the 50th percentiles of faecal enterococci, thus indicating urban pollution. FRNA bacteriophage genotypes I and III virus indicator performances were assisted by their associations with electrical conductivity and faecal enterococci. In combination, our methods are useful for inferring water quality degradation caused by sewage contamination. The methods used have potential for determining source contamination in water and, specifically, the presence of enteric viruses where clean and contaminated water have mixed.

  10. Faecal SIgA secretion in infants fed on pre- or probiotic infant formula

    NARCIS (Netherlands)

    Bakker-Zierikzee, A.; Tol, van E.A.F.; Kroes, H.; Alles, M.S.; Kok, F.J.; Bindels, J.G.

    2006-01-01

    Secretory immunoglobulin A (SIgA) plays an important role in the defence of the gastrointestinal tract. The level of faecal SIgA antibody is associated with increased neutralization and clearance of viruses. Formula-fed infants who lack the transfer of protective maternal SIgA from breast milk may b

  11. Faecal SIgA secretion in infants fed on pre- or probiotic infant formula

    NARCIS (Netherlands)

    Bakker-Zierikzee, A.; Tol, van E.A.F.; Kroes, H.; Alles, M.S.; Kok, F.J.; Bindels, J.G.

    2006-01-01

    Secretory immunoglobulin A (SIgA) plays an important role in the defence of the gastrointestinal tract. The level of faecal SIgA antibody is associated with increased neutralization and clearance of viruses. Formula-fed infants who lack the transfer of protective maternal SIgA from breast milk may

  12. Faecal SIgA secretion in infants fed on pre- or probiotic infant formula

    NARCIS (Netherlands)

    Bakker-Zierikzee, A.; Tol, van E.A.F.; Kroes, H.; Alles, M.S.; Kok, F.J.; Bindels, J.G.

    2006-01-01

    Secretory immunoglobulin A (SIgA) plays an important role in the defence of the gastrointestinal tract. The level of faecal SIgA antibody is associated with increased neutralization and clearance of viruses. Formula-fed infants who lack the transfer of protective maternal SIgA from breast milk may b

  13. Antimicrobial resistance in the Bacteroides fragilis group in faecal microbiota from healthy Danish children

    DEFF Research Database (Denmark)

    Sydenham, Thomas Vognbjerg; Jensen, Betina Hebbelstrup; Petersen, Andreas Munk

    2017-01-01

    The Bacteroides fragilis group constitute a significant portion of the human gut microbiota and comprise a major proportion of anaerobic bacteria isolated in human infections. We established a baseline of antimicrobial susceptibility rates in the B. fragilis group in the intestinal tract...... in faecal microbiota exists....

  14. Validation and comparison of methods for enumeration of faecal coliforms and Escherichia coli in bivalve molluscs

    NARCIS (Netherlands)

    Mooijman KA; Poelman M; Stegeman H; Warmerdam C; Teunis PFM; Roda Husman AM de; RIKILT; MGB

    2007-01-01

    The main result of the validation study to show the equivalence of two methods for the enumeration of faecal coliforms in bivalve molluscs is that the plate count method on Mac Conkey agar was indeed found to be equivalent to the MPN method. Meaning that the Netherlands fulfilled the demands as stat

  15. Prospective evaluation of faecal fatty acid excretion in short bowel syndrome in newborns.

    NARCIS (Netherlands)

    Heineman, E.; Dejong, C.H.C.; Piena-Spoel, M.; Liefaard, G.; Molenaar, J.C.; Tibboel, D.

    1996-01-01

    Prospective evaluation of faecal fatty acid excretion in short bowel syndrome in newborns. Heineman E, Dejong CH, Piena-Spoel M, Liefaard G, Molenaar JC, Tibboel D. Department of Paediatric Surgery, Sophia Children's Hospital, Rotterdam, The Netherlands. Short bowel syndrome (SBS) in the newborn res

  16. Lactic Acid Fermentation, Urea and Lime Addition: Promising Faecal Sludge Sanitizing Methods for Emergency Sanitation

    NARCIS (Netherlands)

    Anderson, C.; Malambo, D.H.; Gonzalez Perez, M.E.; Nobela, H.N.; De Pooter, L.; Spit, J.; Hooijmans, C.M.; Van de Vossenberg, J.; Greya, W.; Thole, B.; Van Lier, J.B.; Brdjanovic, D.

    2015-01-01

    In this research, three faecal sludge sanitizing methods—lactic acid fermentation, urea treatment and lime treatment—were studied for application in emergency situations. These methods were investigated by undertaking small scale field trials with pit latrine sludge in Blantyre, Malawi. Hydrated lim

  17. Correlation of neomycin, faecal neutral and acid sterols with colon carcinogenesis in rats.

    Science.gov (United States)

    Panda, S K; Chattoraj, S C; Broitman, S A

    1999-06-01

    High fat diets have been implicated in incidence of colon cancer both in epidemiological and animal studies. Present investigation deals with the incidence, location and numbers of large and small bowel tumours induced by 1,2-dimethyl hydrazine (DMH) in rats fed high fat diets and neomycin. Neomycin was used to modify the faecal sterol metabolism and the relationship of the high fat diet and faecal neutral and acid sterols to the large bowel tumorigenesis was evaluated. DMH administered rats were fed with (a) 20% safflower oil; (b) 20% safflower oil and neomycin; (c) 20% safflower oil, cholesterol and cholic acid; and (d) 20% safflower oil, cholesterol, cholic acid and neomycin. Neomycin was found to be associated with both increase and decrease of tumour numbers. The faecal sterols lithocholic and deoxycholic acids were found to have no participation, while cholesterol and cholic acid were found to decrease with increase in tumour numbers. However, faecal coprostanol has been found to have a significant positive correlation with tumorigenesis in all dietary groups. Therefore coprostanol might possibly be associated with colon carcinogenesis in DMH-fed rats and cholesterol metabolism in gut appears to be related to the development of tumours.

  18. Prebiotics affect nutrient digestibility but not faecal ammonia in dogs fed increased dietary protein levels.

    Science.gov (United States)

    Hesta, M; Roosen, W; Janssens, G P J; Millet, S; De Wilde, R

    2003-12-01

    An increased protein content and less digestible protein sources in the diet can induce bad faecal odour. The present study investigated the effect of adding prebiotics to dog diets enriched with animal-derived protein sources on apparent digestibilities and faecal ammonia concentration. In three subsequent periods eight healthy beagle dogs were fed a commercial dog diet that was gradually supplemented by up to 50 % with meat and bone meal (MBM), greaves meal (GM) or poultry meal (PM) respectively. Afterwards, 3 % fructo-oligosaccharides or 3 % isomalto-oligosaccharides were substituted for 3 % of the total diet. Supplementation with animal-derived protein sources did not decrease the apparent N digestibility significantly but oligosaccharides did. On the other hand the bacterial N content (% DM) in the faeces was highest in the oligosaccharide groups followed by the protein-supplemented groups and lowest in the control groups. When the apparent N digestibility was corrected for bacterial N no significant differences were noted anymore except for the GM group where the corrected N digestibility was still lower after oligosaccharide supplementation. The amount of faecal ammonia was significantly increased by supplementing with protein or oligosaccharides in the MBM and GM groups but not in the PM group. When apparent N digestibility is interpreted, a correction for bacterial N should be taken into account, especially when prebiotics are added to the diet. Oligosaccharides did not reduce the faecal ammonia concentrations as expected.

  19. Evaluation of a method of assessing faecal loading on plain abdominal radiographs in children

    Energy Technology Data Exchange (ETDEWEB)

    Leech, S.C.; Sullivan, P.B. [Dept. of Paediatrics, John Radcliffe Hospital, Oxford (United Kingdom); McHugh, K. [Department of Radiology, John Radcliffe Hospital, Oxford (United Kingdom)

    1999-04-01

    Background. Childhood constipation is common and assessment is often difficult. Plain abdominal radiography is simple and commonly used to assess constipation. The role of radiography with the use of a simple scoring system has not been fully evaluated. Objective. To assess the reliability of scoring faecal loading on plain abdominal radiographs in children with intractable constipation. Materials and methods. Plain abdominal radiographs from 33 constipated and 67 control children were independently assessed by three observers on two separate occasions. A scoring system was devised with scores from 0 (no stool) to 5 (gross faecal loading with bowel dilatation) in three areas of the colon, giving a total score of 0-15. Results. There were significant differences between the scores of the constipated and control radiographs for each observer (P = 0.05). There was no intra-observer variation (P = 0.12-0.69), but significant inter-observer variation was demonstrated (P = 0.00). Conclusions. We have found this scoring system to be a clinically useful and a reproducible tool in assessing childhood constipation. Assessment of faecal loading is subjective and varies between observers, although one observer will consistently score faecal loading on the same radiograph on successive occasions. To limit exposure to ionising radiation, we recommend that radiography be reserved for the investigation of intractable constipation, and its accuracy is improved if all radiographs are scored by the same observer. (orig.) With 2 figs., 1 tab., 14 refs.

  20. Correlation between urinary incontinence and localization of brain lesion and severity of neurological lesion caused by a stroke

    Directory of Open Access Journals (Sweden)

    Vetra A.

    2012-10-01

    Full Text Available Urinary incontinence is one of the medical problems, which may develop as a result of a stroke, and, according to several authors, its occurrence frequency may reach up to 80%. Clinical symptoms of urinary incontinence are considered to be one of the symptoms, which, along with the severity of the stroke and the level of functional limitations, allows to develop reliable predictions and to make targeted use of resources. Aim of the study, materials and methods. The aim of the study is to explore whether post-stroke urinary incontinence correlates with localization of lesion and clinical symptoms. The study includes 180 patients after a stroke, who have received treatment at Riga Eastern Clinic University Hospital Stroke Unit. All had a comprehensive clinical and functional assessment and cerebral computed tomography (CT. The examination took place at the hospital a few days after the stroke had occurred. Results. There are 180 participants to the study. Symptoms of urinary incontinence were reported for 70.6% of study participants. In 64% of cases new incontinence problems had developed, while in 6.5% of cases the previous symptoms of urinary incontinence (prior to the stroke had worsened. The most common types of urinary incontinence in the acute period were urge and mixed incontinence (functional and urge incontinence. Patients with low Barthel Index showed higher frequency of urinary incontinence. A comparison of patient groups with and without symptoms of urinary incontinence showed that patients older than 75 years showed more symptoms of urinary incontinence (p = 0.013, and the same can be said about patients with low indicators of Barthel (p = 0.001 and patients with cognitive disorders (p = 0.001. Severity of paresis, aphasia and sensory disorders show a reliable correlation with the type of urinary incontinence. Conclusion. Symptoms of post-stroke urinary incontinence are linked both to a person's age, and functional and cognitive

  1. Contamination of faecal coliforms in ice cubes sampled from food outlets in Kubang Kerian, Kelantan.

    Science.gov (United States)

    Noor Izani, N J; Zulaikha, A R; Mohamad Noor, M R; Amri, M A; Mahat, N A

    2012-03-01

    The use of ice cubes in beverages is common among patrons of food outlets in Malaysia although its safety for human consumption remains unclear. Hence, this study was designed to determine the presence of faecal coliforms and several useful water physicochemical parameters viz. free residual chlorine concentration, turbidity and pH in ice cubes from 30 randomly selected food outlets in Kubang Kerian, Kelantan. Faecal coliforms were found in ice cubes in 16 (53%) food outlets ranging between 1 CFU/100mL to >50 CFU/ 100mL, while in the remaining 14 (47%) food outlets, in samples of tap water as well as in commercially bottled drinking water, faecal coliforms were not detected. The highest faecal coliform counts of >50 CFU/100mL were observed in 3 (10%) food outlets followed by 11-50 CFU/100mL and 1-10 CFU/100mL in 7 (23%) and 6 (20%) food outlets, respectively. All samples recorded low free residual chlorine concentration (<0.10mg/L) with the pH ranging between 5.5 and 7.3 and turbidity between 0.14-1.76 NTU. Since contamination by faecal coliforms was not detected in 47% of the samples, tap water and commercially bottled drinking water, it was concluded that (1) contamination by faecal coliforms may occur due to improper handling of ice cubes at the food outlets or (2) they may not be the water sources used for making ice cubes. Since low free residual chlorine concentrations were observed (<0.10mg/ L) in all samples as well as in both tap water and commercially bottled drinking water, with the pH ranged between 5.5-7.3, ineffective disinfection of water source as a contributing factor to such high counts of faecal coliforms in ice cubes also could not be ruled out. Therefore, a periodical, yet comprehensive check on the food outlets, including that of ice cube is crucial in ensuring better food and water for human consumption.

  2. Lifetime physical activity and female stress urinary incontinence.

    Science.gov (United States)

    Nygaard, Ingrid E; Shaw, Janet M; Bardsley, Tyler; Egger, Marlene J

    2015-07-01

    We sought to estimate whether moderate/severe stress urinary incontinence (SUI) in middle-aged women is associated with overall lifetime physical activity (including leisure, household, outdoor, and occupational), as well as lifetime leisure (recreational), lifetime strenuous, and strenuous activity during the teen years. Recruitment for this case-control study was conducted in primary-care-level family medicine and gynecology clinics. A total of 1538 enrolled women ages 39-65 years underwent a Pelvic Organ Prolapse Quantification examination to assess vaginal support. Based on Incontinence Severity Index scores, cases had moderate/severe and controls had no/mild SUI. We excluded 349 with vaginal descent at/below the hymen (pelvic organ prolapse), 194 who did not return questionnaires, and 110 with insufficient activity data for analysis. In all, 213 cases were frequency matched 1:1 by age group to controls. Physical activity was measured using the Lifetime Physical Activity Questionnaire, in which women recall activity from menarche to present. We created separate multivariable logistic regression models for activity measures. SUI odds increased slightly with overall lifetime activity (odds ratio [OR], 1.20 per 70 additional metabolic equivalent of task-h/wk; 95% confidence interval [CI], 1.02-1.41), and were not associated with lifetime strenuous activity (OR, 1.11; 95% CI, 0.99-1.25). In quintile analysis of lifetime leisure activity, which demonstrated a nonlinear pattern, all quintiles incurred about half the odds of SUI compared to reference (second quintile; P = .009). Greater strenuous activity in teen years modestly increased SUI odds (OR, 1.37 per 7 additional h/wk; 95% CI, 1.09-1.71); OR, 1.75; 95% CI, 1.15-2.66 in sensitivity analysis adjusting for measurement error. The predicted probability of SUI rose linearly in women exceeding 7.5 hours of strenuous activity/wk during teen years. Teen strenuous activity had a similar effect on SUI odds when

  3. Improving diaper design to address incontinence associated dermatitis

    Directory of Open Access Journals (Sweden)

    Zöllner Petra

    2010-11-01

    Full Text Available Abstract Background Incontinence associated dermatitis (IAD is an inflammatory skin disease mainly triggered by prolonged skin contact with urine, feces but also liberal detergent use when cleansing the skin. To minimize the epidermal barrier challenge we optimized the design of adult incontinence briefs. In the fluid absorption area we interposed a special type of acidic, curled-type of cellulose between the top sheet in contact with the skin and the absorption core beneath containing the polyacrylate superabsorber. The intention was to minimize disturbance of the already weak acid mantle of aged skin. We also employed air-permeable side panels to minimize skin occlusion and swelling of the stratum corneum. Methods The surface pH of diapers was measured after repeated wetting with a urine substitute fluid at the level of the top sheet. Occlusive effects and hydration of the stratum corneum were measured after a 4 hour application of different side panel materials by corneometry on human volunteers. Finally, we evaluated skin symptoms in 12 patients with preexisting IAD for 21 days following the institutional switch to the optimized diaper design. Local skin care protocols remained in place unchanged. Results The improved design created a surface pH of 4.6 which was stable even after repeated wetting throughout a 5 hour period. The "standard design" briefs had values of 7.1, which is alkaline compared to the acidic surface of normal skin. Side panels made from non-woven material with an air-permeability of more than 1200 l/m2/s avoided excessive hydration of the stratum corneum when compared to the commonly employed air-impermeable plastic films. Resolution of pre-existing IAD skin lesions was noted in 8 out of 12 patients after the switch to the optimized brief design. Conclusions An improved design of adult-type briefs can create an acidic pH on the surface and breathable side panels avoid over-hydration of the stratum corneum and occlusion

  4. Evaluation of Faecal Salmonella Shedding Among Dogs at Seven Animal Shelters across Texas.

    Science.gov (United States)

    Leahy, A M; Cummings, K J; Rodriguez-Rivera, L D; Rankin, S C; Hamer, S A

    2016-11-01

    Estimates of prevalence of faecal Salmonella shedding among dogs in the United States have varied widely. Surveillance among shelter dogs has been limited, although dogs in animal shelters may be at elevated risk of Salmonella infection because of their previous exposure history as well as factors inherent to shelter environments. Our objectives were to estimate the prevalence of Salmonella shedding among shelter dogs across Texas, to identify risk factors for shedding and to characterize the isolates. Using a repeated cross-sectional study design, we collected faecal samples from dogs on two or three visits to each of seven Texas animal shelters between May 2013 and December 2014. Standard bacteriologic culture methods were used to isolate Salmonella from samples, and isolates were characterized via serotyping and anti-microbial susceptibility testing. The prevalence of faecal Salmonella shedding among sampled dogs was 4.9% (27/554), and within-shelter prevalence ranged from 1.9% to 8.3%. There was a marginal association (P = 0.09) between watery faecal samples and positive Salmonella status, as estimated by a logistic regression model that controlled for shelter as a random effect. However, over 60% of Salmonella-positive dogs had grossly normal faeces. Salmonella prevalence did not vary significantly by age group or sex. The most common serovars were Newport (22%) and Javiana (15%), both of which were widespread among shelters. Resistance to anti-microbial agents was uncommon. The prevalence of faecal Salmonella shedding among shelter dogs in Texas appears to be comparable to that seen among pet dogs in general. © 2016 Blackwell Verlag GmbH.

  5. Steroid Biomarkers Revisited – Improved Source Identification of Faecal Remains in Archaeological Soil Material

    Science.gov (United States)

    Prost, Katharina; Birk, Jago Jonathan; Lehndorff, Eva; Gerlach, Renate; Amelung, Wulf

    2017-01-01

    Steroids are used as faecal markers in environmental and in archaeological studies, because they provide insights into ancient agricultural practices and the former presence of animals. Up to now, steroid analyses could only identify and distinguish between herbivore, pig, and human faecal matter and their residues in soils and sediments. We hypothesized that a finer differentiation between faeces of different livestock animals could be achieved when the analyses of several steroids is combined (Δ5-sterols, 5α-stanols, 5β-stanols, epi-5β-stanols, stanones, and bile acids). We therefore reviewed the existing literature on various faecal steroids from livestock and humans and analysed faeces from old livestock breed (cattle, horse, donkey, sheep, goat, goose, and pig) and humans. Additionally, we performed steroid analyses on soil material of four different archaeological periods (sites located in the Lower Rhine Basin, Western Germany, dating to the Linearbandkeramik, Urnfield Period / Bronze Age, Iron Age, Roman Age) with known or supposed faecal inputs. By means of already established and newly applied steroid ratios of the analysed faeces together with results from the literature, all considered livestock faeces, except sheep and cattle, could be distinguished on the basis of their steroid signatures. Most remarkably was the identification of horse faeces (via the ratio: epi-5β-stigmastanol: 5β-stigmastanol + epicoprostanol: coprostanol; together with the presence of chenodeoxycholic acid) and a successful differentiation between goat (with chenodeoxycholic acid) and sheep/cattle faeces (without chenodeoxycholic acid). The steroid analysis of archaeological soil material confirmed the supposed faecal inputs, even if these inputs had occurred several thousand years ago. PMID:28060808

  6. Effect of oral spiramycin on the faecal and oral bacteria in human volunteers.

    Science.gov (United States)

    Andremont, A; Trancrède, C; Desnottes, J F

    1991-03-01

    Six healthy adult volunteers were treated with 1 g of oral spiramycin twice daily for five days, and their oral and faecal microbial flora were studied. Mean saliva and serum concentrations of the antibiotic never exceeded 2.1 +/- 1.1 mg/l. The number of volunteers whose oral cavity was colonized by Enterobacteriaceae, group D streptococci, staphylococci, and fungi remained unchanged following treatment. The mean count of anaerobic faecal bacteria was 10.3 +/- 0.6 log10 cfu/g initially. This did not change significantly during the treatment, nor did the composition of the predominant anaerobic flora. Mean counts of group D streptococci were 1000 times lower than those of anaerobes before treatment, and also remained unchanged during therapy. No overgrowth of fungi, staphylococci, or Pseudomonas aeruginosa was observed. No significant modifications occurred in the mean total count of faecal Enterobacteriaceae (7.9 +/- 0.4 versus 7.4 +/- 1.0 log10 cfu/g of faeces before and during treatment respectively). However, faecal concentrations of highly spiramycin-resistant Enterobacteriaceae (MIC greater than or equal to 512 mg/l) increased from 4.8 +/- 1.2 to 7.0 +/- 1.8 log10 cfu/g during treatment. The MIC50 value of spiramycin for anaerobes, Enterobacteriaceae, and group D streptococci were 0.125, 64, and 0.5 mg/l respectively before treatment, and these increased to 1024, 512 and 1024 mg/l respectively during treatment. This was attributed to the rise in the faecal concentrations of spiramycin, which reached 689 +/- 48 micrograms/g of faeces on the fifth day of treatment. These concentrations decreased rapidly on cessation of treatment.

  7. Urinary Incontinence and Psychosocial Factors Associated With Intimate Relationship Satisfaction Among Midlife Women.

    Science.gov (United States)

    Saiki, Lori; Meize-Grochowski, Robin

    To explore associations among symptoms of urinary incontinence, severity of symptoms, and measures of psychosocial health that may be assessed during a well-woman screening examination and the possible contribution of these variables to the relationship satisfaction of partnered midlife women living with urinary incontinence. Exploratory correlational design using self-report questionnaires. Community recruitment by posted fliers, advertisements, and social media. Partnered women, ages 45 to 65 years, with urinary incontinence (N = 57). Self-report measures of severity of incontinence symptoms, relationship satisfaction, self-concept/emotional health (self-esteem, body image, depression, anxiety), and relationship factors (sexual quality of life, incontinence-related communication). Data were analyzed using Spearman rho correlation with an exploration of the contribution of study factors to relationship satisfaction through standard multiple regression. The severity of urinary incontinence symptoms had no significant correlation with scores on relationship satisfaction or psychosocial health. Measures of self-concept/emotional health and relationship factors were significantly correlated with each other (rs = .40-.75, p satisfaction (rs = .35-.71, p satisfaction through exploratory regression analysis showed unique contributions from sexual quality of life (18.7%, p depression (8.7%, p = .004). Midlife women with urinary incontinence, regardless of symptom severity, might benefit from screening for poorer sexual quality of life and mild depression symptoms because these two study factors significantly contributed to poorer intimate relationship satisfaction among this study's participants. Copyright © 2017 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  8. Blog text about female incontinence: presentation of self, disclosure, and social risk assessment.

    Science.gov (United States)

    Saiki, Lori S; Cloyes, Kristin G

    2014-01-01

    Female urinary incontinence is a significant health concern that often remains undisclosed to healthcare providers, often because of embarrassment and fear of a negative response. The purpose of this study was to explore communication patterns found in blog text regarding self-presentation by women living with incontinence for clues to facilitate disclosure. This is a descriptive, empirical study of publically archived blog text (years inclusive 2006-2011; N = 16,629 words from 19 bloggers) by women communicating about urinary incontinence, utilizing methods of content analysis. Valence and word concordance analysis showed that words indicative of facilitating social connections were used more often in proximity with close contacts (Z = -2.68, p = .004) and words indicative of blocking social connections were used more often in proximity with community contacts (Z = -2.97, p = .002). Differences between descriptions of facilitative and blocking reactions from healthcare providers were not significant (Z = -0.28, p = .39). Cluster analysis indicated a decreasing level of negatively charged descriptors of incontinence-related communications as the context moved from the hidden self to close contacts and then to the public sphere. Word frequency analysis identified a pattern in the blog text about urinary incontinence of self-presenting as otherwise fit, healthy, and competent. Study results suggest that any report of incontinence concerns, including joking or casual references, should be addressed because women may not disclose the degree to which symptoms affect their psychosocial health. Further research is needed to explore whether providers might facilitate disclosure of urinary incontinence by first acknowledging the woman's strengths, thereby creating a sense of safety and acceptance.

  9. Occurrence rates and predictors of lower urinary tract symptoms and incontinence in female athletes.

    Science.gov (United States)

    Simeone, C; Moroni, A; Pettenò, A; Antonelli, A; Zani, D; Orizio, C; Cosciani Cunico, S

    2010-01-01

    To assess the prevalence of lower urinary tract symptoms (LUTS) and incontinence in female athletes and to determine the etiological factors. An anonymous self-questionnaire was collected from 623 casual female athletes aged 18 to 56 years, who were involved in 12 different sports. The surveys were distributed by hand to the athletes, during their sports fitness tests, in a sports center. We investigated the relationship between urinary disorders and factors such as age, body mass index (BMI), parity, duration of physical exercise, and type of sport. The prevalence of LUTS was 54.7%, and 30% for urinary incontinence. Changes in urinary frequency were detected in 91 (14.6%) women. Prevalence of dysuria was 13.3%, urinary straining was present in 173 (27.8%) athletes, whereas urinary urgency had an estimated prevalence of 37.2% with 232 athletes suffering from this disorder. Urgency was very common in volleyball players, as was dysuria among hockey and basketball players, whereas straining mainly affected aerobic participants and cyclists. Long training hours and competitive practices were correlated with the onset of LUTS. High-impact sports were more frequently associated with incontinence, while low-impact sports with LUTS. The sport with the main number of incontinent people was football. Urge incontinence affected a lot of athletes, mainly cyclists and football players. Stress incontinence was more frequent in hockey and volleyball players. LUTS and incontinence are prevalent in female athletes. In many cases, the disorders were present only during sports activities. In this sample, the presence of urinary disorders did not seem to be a barrier during sports or exercise.

  10. The diagnostic value of oral lacerations and incontinence during convulsive "seizures".

    Science.gov (United States)

    Oliva, Megan; Pattison, Claire; Carino, John; Roten, Annie; Matkovic, Zelko; O'Brien, Terence J

    2008-06-01

    Oral lacerations and urinary incontinence have long been considered useful clinical features for the diagnosis of epileptic seizures; however, both are also reported in patients with psychogenic nonepileptic seizures (PNES). The aims of the study were (1) to investigate whether the presence and nature of oral lacerations or incontinence during convulsive seizures of patients with epilepsy differed from those with PNES, and (2) whether the side of the oral laceration has any correlation with the epilepsy syndrome or lateralization. Eighty-four consecutive patients who experienced at least one convulsive event during video-EEG monitoring (VEM) were questioned and examined for oral lacerations and incontinence. Seizure classification was determined by a team of epileptologists based on the VEM findings and other clinical and investigational data, blinded to the oral laceration and incontinence information. The presence of oral lacerations among patients with epileptic seizures was 26% (17/66), in contrast it was 0% (0/18) with PNES (p = 0.01). Of the oral lacerations sustained by patients during an epileptic seizure, 14 were to the side of the tongue, one to the tip of the tongue, two to the cheek, and three to the lip. No significant relationships were observed between seizure lateralization and oral lacerations. Incontinence occurred in 23% (15/66) of epilepsy patients and 6% (1/18) of PNES patients (p = 0.09). There was no relationship between epilepsy type or lateralization and the prevalence of incontinence. Despite frequent reports of oral lacerations and incontinence by patients with PNES, objective evidence for this is highly specific to convulsive epileptic seizures.

  11. Brain Mechanisms Underlying Urge Incontinence and its Response to Pelvic Floor Muscle Training

    Science.gov (United States)

    Griffiths, Derek; Clarkson, Becky; Tadic, Stasa D.; Resnick, Neil M.

    2016-01-01

    Purpose Urge urinary incontinence is a major problem, especially in the elderly, and to our knowledge the underlying mechanisms of disease and therapy are unknown. We used biofeedback assisted pelvic floor muscle training and functional brain imaging (functional magnetic resonance imaging) to investigate cerebral mechanisms, aiming to improve the understanding of brain-bladder control and therapy. Materials and Methods Before receiving biofeedback assisted pelvic floor muscle training functionally intact, older community dwelling women with urge urinary incontinence as well as normal controls underwent comprehensive clinical and bladder diary evaluation, urodynamic testing and brain functional magnetic resonance imaging. Evaluation was repeated after pelvic floor muscle training in those with urge urinary incontinence. Functional magnetic resonance imaging was done to determine the brain reaction to rapid bladder filling with urgency. Results Of 65 subjects with urge urinary incontinence 28 responded to biofeedback assisted pelvic floor muscle training with 50% or greater improvement of urge urinary incontinence frequency on diary. However, responders and nonresponders displayed 2 patterns of brain reaction. In pattern 1 in responders before pelvic floor muscle training the dorsal anterior cingulate cortex and the adjacent supplementary motor area were activated as well as the insula. After the training dorsal anterior cingulate cortex/supplementary motor area activation diminished and there was a trend toward medial prefrontal cortex deactivation. In pattern 2 in nonresponders before pelvic floor muscle training the medial prefrontal cortex was deactivated, which changed little after the training. Conclusions In older women with urge urinary incontinence there appears to be 2 patterns of brain reaction to bladder filling and they seem to predict the response and nonresponse to biofeedback assisted pelvic floor muscle training. Moreover, decreased cingulate

  12. Variation in faecal water content may confound estimates of gastro-intestinal parasite intensity in wild African herbivores.

    Science.gov (United States)

    Turner, W C; Cizauskas, C A; Getz, W M

    2010-03-01

    Estimates of parasite intensity within host populations are essential for many studies of host-parasite relationships. Here we evaluated the seasonal, age- and sex-related variability in faecal water content for two wild ungulate species, springbok (Antidorcas marsupialis) and plains zebra (Equus quagga). We then assessed whether or not faecal water content biased conclusions regarding differences in strongyle infection rates by season, age or sex. There was evidence of significant variation in faecal water content by season and age for both species, and by sex in springbok. Analyses of faecal egg counts demonstrated that sex was a near-significant factor in explaining variation in strongyle parasite infection rates in zebra (P = 0.055) and springbok (P = 0.052) using wet-weight faecal samples. However, once these intensity estimates were re-scaled by the percent of dry matter in the faeces, sex was no longer a significant factor (zebra, P = 0.268; springbok, P = 0.234). These results demonstrate that variation in faecal water content may confound analyses and could produce spurious conclusions, as was the case with host sex as a factor in the analysis. We thus recommend that researchers assess whether water variation could be a confounding factor when designing and performing research using faecal indices of parasite intensity.

  13. Gram-negative bacteria account for main differences between faecal microbiota from patients with ulcerative colitis and healthy controls

    DEFF Research Database (Denmark)

    Vigsnæs, Louise Kristine; Brynskov, J.; Steenholdt, C.

    2012-01-01

    Detailed knowledge about the composition of the intestinal microbiota may be critical to unravel the pathogenesis of ulcerative colitis (UC), a human chronic inflammatory bowel disease, since the intestinal microbes are expected to influence some of the key mechanisms involved in the inflammatory...... that the microbiota in UC patients with active disease differ from that in healthy controls. Our findings indicate that alterations in the composition of the Gram-negative bacterial population, as well as reduced numbers of lactobacilli and A. muciniphila may play a role in UC.......Detailed knowledge about the composition of the intestinal microbiota may be critical to unravel the pathogenesis of ulcerative colitis (UC), a human chronic inflammatory bowel disease, since the intestinal microbes are expected to influence some of the key mechanisms involved in the inflammatory...... process of the gut mucosa. The aim of this study was to investigate the faecal microbiota in patients either with UC in remission (n=6) or with active disease (n=6), and in healthy controls (n=6). The composition of Gram-negative bacteria and Gram-positive bacteria was examined. Antigenic structures...

  14. Transobturator tape for female stress incontinence: A day surgery case

    Directory of Open Access Journals (Sweden)

    Al Taweel Waleed

    2009-01-01

    Full Text Available Aim: To evaluate the effectiveness of transobturator vaginal tape (TOT in the treatment of female stress urinary incontinence (SUI and to analyze functional results and quality of life after12 months follow up. Materials and Methods : All women with SUI who underwent TOT procedure from outside to inside under general or regional anesthesia from December 2004 to January 2007 were included in the study. All must have had a minimal follow up of one year. The patients were prospectively evaluated with history including pads use/day, physical examination - pelvic examination, urinalysis, urogenital distress inventory (UDI-6, and analog global satisfaction scale - and urodynamic studies - filling cystometry, pressure-flow studies, and Valsalva leak point pressure. Results: Sixty two consecutive patients who fulfilled the inclusion criteria underwent TOT procedure by one surgeon. The mean age was 52 ± 9 years (range, 34-70 years and minimal follow up was one year (12-24 months. The mean operative time was 17 ± 4 minutes (15-31 with average amount of bleeding 62 ± 22 cc. We found objectively 89% cure or improvement rate after one year. Conclusion: The out-in transobturator approach is a very effective treatment of SUI with low morbidity and high success rate. However, longer follow up in larger populations should assess the long-term reliability of this attractive procedure.

  15. A Wireless Self-Powered Urinary Incontinence Sensor System

    Science.gov (United States)

    Tanaka, Ami; Utsunomiya, Fumiyasu; Douseki, Takakuni

    A self-powered urinary incontinence sensor system consisting of a urine-activated coin battery and a wireless transmitter has been developed as an application for wireless biosensor networks. The urine-activated battery makes possible both the sensing of urine leakage and self-powered operation. An intermittent power-supply circuit that uses an electric double-layer capacitor (EDLC) with a small internal resistance suppresses the supply voltage drop due to the large internal resistance of the battery. This circuit and a 1-V surface acoustic wave (SAW) oscillator reduce the power dissipation of a wireless transmitter. The SAW oscillator quickly responds to the on-off control of the power supply, which is suitable for intermittent operation. To verify the effectiveness of the circuit scheme, the authors fabricated a prototype sensor system. When the volume of urine is 0.2 ml, the battery outputs a voltage of over 1.3 V; and the sensor system can transmit signals over a distance of 5 m.

  16. Physiotherapy for women with stress urinary incontinence: a review article.

    Science.gov (United States)

    Ghaderi, Fariba; Oskouei, Ali E

    2014-09-01

    [Purpose] This review article is designed to expose physiotherapists to a physiotherapy assessment of stress urinary incontinence (SUI) and the treatment and possibly preventive roles that they might play for women with SUI. Specifically, the goal of this article is to provide an understanding of pelvic floor muscle function and the implications that this function has for physiotherapy treatment by reviewing articles published in this area. [Methods] A range of databases was searched to identify articles that address physiotherapy for SUI, including the Cochrane Library, Medline, and CINAHL. [Results] According to the articles identified in our databases research, greater improvements in SUI occur when women receive a supervised exercise program of at least three months. The effectiveness of physiotherapy treatment is increased if the exercise program is based on some principles, such as intensity, duration, resembling functional task, and the position in which the exercise for pelvic floor muscles is performed. Biofeedback and electrical stimulation may also be clinically useful and acceptable modalities for some women with SUI. [Conclusion] We concluded that the plan for physiotherapy care should be individualized for each patient and include standard physiotherapy interventions.

  17. Anal incontinence in women with recurrent obstetric anal sphincter rupture

    DEFF Research Database (Denmark)

    Bøgeskov, Reneé; Nickelsen, Carsten Nahne Amtoft; Secher, Niels Jørgen

    2015-01-01

    UNLABELLED: Abstract Objectives: To determine the risk of recurrent anal sphincter rupture (ASR), and compare the risk of anal incontinence (AI) after recurrent ASR, with that seen in women with previous ASR who deliver by caesarean section or vaginally without sustaining a recurrent ASR. METHODS...... uncomplicated vaginal delivery or caesarean section. RESULTS: There were 93 437 vaginal deliveries. ASR occurred in 5.5% (n = 2851) of the nulliparous and 1.5% (n = 608) of the multiparous women. Recurrent ASR occurred in 8% (n = 49) of whom 50% reported symptoms of AI. We found no difference in the occurrence...... of AI between women with recurrent ASR, and those who delivered vaginally without repeat ASR (p = 0.37; OR = 2.0) or by caesarean section (p = 0.77; OR = 1.3). CONCLUSION: Women with a past history of ASR have an 8% risk of recurrence. AI affects half of the women with recurrent ASR. Larger studies...

  18. Associated factors to urinary incontinence in women undergoing urodynamic testing

    Directory of Open Access Journals (Sweden)

    Juliana Cristina Pereira da Silva

    Full Text Available Abstract OBJECTIVE Analyzing factors associated with urinary incontinence (UI among women submitted to urodynamic testing. METHOD A cross-sectional study of 150 women attended at a urological center. Data were analyzed using univariate and multivariate statistics. RESULTS White women (79.3%, overweight (45.3%, menopausal (53.3%, who drink coffee (82.7%, sedentary (65.3%, who had vaginal birth (51.4%, with episiotomy (80%, and who underwent the Kristeller maneuver (69%. 60.7% had Urethral Hypermobility (UH. A statistical association was found between: weight change and UH (p = 0.024; menopause, Intrinsic Sphincter Deficiency (ISD and Detrusor Instability (DI (p = 0.001; gynecological surgery, ISD and DI (p = 0.014; hysterectomy and all types of UI (p = 0.040; physical activity and mixed UI (p = 0.014. CONCLUSION Interventions and guidance on preventing UI and strengthening pelvic muscles should be directed at women who present weight changes, who are sedentary menopausal women, and those who have undergone hysterectomy or other gynecological surgery. Studies on pelvic strengthening methods are needed in order to take into account the profile of the needs presented by women.

  19. Physiotherapy for Women with Stress Urinary Incontinence: A Review Article

    Science.gov (United States)

    Ghaderi, Fariba; Oskouei, Ali E.

    2014-01-01

    [Purpose] This review article is designed to expose physiotherapists to a physiotherapy assessment of stress urinary incontinence (SUI) and the treatment and possibly preventive roles that they might play for women with SUI. Specifically, the goal of this article is to provide an understanding of pelvic floor muscle function and the implications that this function has for physiotherapy treatment by reviewing articles published in this area. [Methods] A range of databases was searched to identify articles that address physiotherapy for SUI, including the Cochrane Library, Medline, and CINAHL. [Results] According to the articles identified in our databases research, greater improvements in SUI occur when women receive a supervised exercise program of at least three months. The effectiveness of physiotherapy treatment is increased if the exercise program is based on some principles, such as intensity, duration, resembling functional task, and the position in which the exercise for pelvic floor muscles is performed. Biofeedback and electrical stimulation may also be clinically useful and acceptable modalities for some women with SUI. [Conclusion] We concluded that the plan for physiotherapy care should be individualized for each patient and include standard physiotherapy interventions. PMID:25276044

  20. Recurrent obstetric anal sphincter injury and the risk of long-term anal incontinence.

    Science.gov (United States)

    Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne; Sakse, Abelone

    2017-06-01

    Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether the recurrence of obstetric anal sphincter injury affects the risk of anal and fecal incontinence at long-term follow-up. The objective of the study was to evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal and fecal incontinence more than 5 years after the second vaginal delivery. We performed a secondary analysis of data from a postal questionnaire study in women with obstetric anal sphincter injury in the first delivery and 1 subsequent vaginal delivery. The questionnaire was sent to all Danish women who fulfilled inclusion criteria and had 2 vaginal deliveries 1997-2005. We performed uni- and multivariable analyses to assess how recurrent obstetric anal sphincter injury affects the risk of anal incontinence. In 1490 women with a second vaginal delivery after a first delivery with obstetric anal sphincter injury, 106 had a recurrent obstetric anal sphincter injury. Of these, 50.0% (n = 53) reported anal incontinence compared with 37.9% (n = 525) of women without recurrent obstetric anal sphincter injury. Fecal incontinence was present in 23.6% (n = 25) of women with recurrent obstetric anal sphincter injury and in 13.2% (n = 182) of women without recurrent obstetric anal sphincter injury. After adjustment for third- or fourth-degree obstetric anal sphincter injury in the first delivery, maternal age at answering the questionnaire, birthweight of the first and second child, years since first and second delivery, and whether anal incontinence was present before the second pregnancy, the risk of flatal and fecal incontinence was still increased in patients with recurrent obstetric anal sphincter injury (adjusted odds ratio, 1.68 [95% confidence interval, 1.05-2.70), P = .03, and adjusted odds ratio, 1.98 [95% confidence interval, 1

  1. Effects of coffee and tea consumption on urinary incontinence in female twins

    Science.gov (United States)

    Tettamanti, G; Altman, D; Pedersen, NL; Bellocco, R; Milsom, I; Iliadou, AN

    2011-01-01

    Objectives To assess the effect of coffee and tea consumption on symptoms of urinary incontinence. Design Population based study Setting The Swedish Twin Register Population In 2005, all twins born between 1959–1985 in Sweden (n = 42 852) were invited to participate in a web-based survey to screen for common complex diseases and common exposures. The present study was limited to female twins with information about at least one urinary symptoms and coffee and tea consumption (n = 14 031). Main outcome measure The association between coffe and tea consumption and urinary incontinence, as well as, nocturia was estimated as odds ratios (ORs) with 95% confidence intervals (CIs). Results Women with a high coffee intake were at lower risk of any urinary incontinence (OR 0.78, 95% confidence intervals (CI) 0.64-0.98) compared to women not drinking coffee. Coffee intake and incontinence subtypes showed no significant associations whereas high tea consumption was specifically associated with a risk for overactive bladder (OR 1.34, 95% CI 11.07-1.67) and nocturia (OR 1.18, 95% CI 1.01-1.38). Results from co-twin control analysis suggested that the associations observed in logistic regression were mainly due to familial effects. Conclusions This study suggests that coffee and tea consumption has a limited effect on urinary incontinence symptoms. Familial and genetic effects may have confounded the associations observed in previous studies. PMID:21401855

  2. [Electrostimulation in therapy of postoperative urinary incontinence. Therapeutic value for quality of life].

    Science.gov (United States)

    Hoffmann, W; Liedke, S; Dombo, O; Otto, U

    2005-01-01

    Worldwide use of electrical stimulation for therapy of postoperative incontinence is based on a few prospective randomized controlled studies. We present a three-arm prospective randomized study evaluating physiotherapeutic pelvic floor training alone and in combination with transanal or perineal electrical stimulation. The study compared specific continence training (CT) and a combination of CT with transanal or perineal electrostimulation. The groups included 60 patients each and were analyzed with regard to self-assessment, objective characteristics of incontinence, standard quality of life questionnaire (QLQ-C 30), and recorded data of the stimulation device. The patients participated in a specific inpatient rehabilitation program and were assessed at the time of admittance, upon discharge, and again after 3 months. Significant improvement could be achieved in every group concerning urinary incontinence and quality of life. Additional use of electrical stimulation was significantly superior to physiotherapeutic training alone. However, these results could only be detected in a highly compliant subgroup. Analysis of device data indicated a high score of errors and lack of patient compliance. Perineal electrical stimulation was better accepted than transanal and showed less side effects and better outcome in the characteristics of incontinence. Improvement in the quality of life was mostly achieved during the weeks of inpatient rehabilitation. Electrical stimulation could not improve quality of life items. Electrical stimulation is an efficient instrument for treatment of postoperative high-grade incontinence, however, only with sufficient patient compliance.

  3. 卒中后尿失禁%Post-stroke urinary incontinence

    Institute of Scientific and Technical Information of China (English)

    李彦丽; 武如冰

    2014-01-01

    Urinary incontinence is a common complication of stroke,40% to 60% of inpatients with stroke have urinary incontinence.Post-stroke urinary incontinence is a strong predictor of death,functional disability,and admission of rehabilitation institutions.Recovery of urinary incontinence is associated with a better stroke outcome.This article reviews the epidemiology,causes and classification,effects on stroke outcome,and treatment strategies of post-stroke urinary incontinence.%尿失禁是卒中的一种常见并发症,40%~60%的卒中住院患者存在尿失禁.卒中后尿失禁是患者死亡、功能残疾和入住康复机构的强烈预测因素.尿失禁的恢复与卒中转归更好相关.文章对卒中后尿失禁的流行病学、原因和分类、对卒中转归的影响以及治疗策略进行了综述.

  4. Urinary Incontinency in Women in Uyo Metropolis, South-South, Nigeria

    Directory of Open Access Journals (Sweden)

    N. E Udokang

    2016-02-01

    Full Text Available This study was a cross sectional study which examined urinary incontinence in women within Uyometropolis of Akwa Ibom State, Nigeria. The survey was carried out among women within the agesof 16-75 years. Questionnaire was the instrument used for data collection and total sample of 254women were selected using simple random sampling univariate association between thedemographic characteristics of the subject. Urinary incontinence was examined using Chi-SquareTest and multiple variate association was tested using multiple logistic regression. Results showedthat Prolong Labour (OR = 3.01, C.I = 1.545 – 6.80, P<0.05, Episiotomy (OR = 1.82, C.I = 1.547-5.001, Vaginal Infection (OR = 3.08, C.I = 1.544-10.899 and High Birth Weight (OR = 2.66, C.I =1.961-7.370 were the factors were significantly associated with urinary incontinency in women.Hence, it could be concluded that prolong labour, episiotomy, vaginal infection and high birthweight babies are significantly related to urinary incontinence in women.Keywords: Urinary-incontinence; Episiotomy; Women; Infection; Labour

  5. Managing female urinary incontinence: A regional prospective analysis of cost-utility ratios (curs and effectiveness

    Directory of Open Access Journals (Sweden)

    Elisabetta Costantini

    2014-06-01

    Full Text Available Introduction: To evaluate the cost-utility of incontinence treatments, particularly anticholinergic therapy, by examining costs and quality-adjusted life years. Materials and methods: A prospective cohort study of women who were consecutively referred by general practitioners (GPs to the Urology Department because of urinary incontinence. The primary outcome was evaluation of the cost-utility of incontinence treatments (surgery, medical therapy and physiotherapy for stress and/or urgency incontinence by examining costs and quality-adjusted life years. Results: 137 consecutive female patients (mean age 60.6 ± 11.6; range 36-81 were enrolled and stratified according to pathologies: SUI and UUI. Group A: SUI grade II-III: 43 patients who underwent mid-urethral sling (MUS; Group B: SUI grade I-II 57 patients who underwent pelvic floor muscle exercise and Group C: UUI: 37 patients who underwent antimuscarinic treatment with 5 mg solifenacin daily. The cost utility ratio (CUR was estimated as saving more than €1200 per QALY for surgery and physiotherapy and as costing under € 100 per QALY for drug therapy. Conclusions: This study shows that appropriate diagnosis and treatment of a patient with incontinence lowers National Health Service costs and improves the benefits of treatment and quality of life.

  6. Detection of intracellular bacteria in exfoliated urothelial cells from women with urge incontinence.

    Science.gov (United States)

    Cheng, Ying; Chen, Zhuoran; Gawthorne, Jayde A; Mukerjee, Chinmoy; Varettas, Kerry; Mansfield, Kylie J; Schembri, Mark A; Moore, Kate H

    2016-10-01

    The role of subclinical infection in patients with urge incontinence has been largely ignored. The aim of this study was to test for the presence of intracellular bacteria in exfoliated urothelial cells obtained from the urine of patients with detrusor overactivity or mixed incontinence +/- a history of UTI, and compare this to a control group of patients with stress incontinence and no history of infection. Bacterial cystitis was assessed by routine microbiology and compared to microscopic analysis of urine by Wright staining. Subsequent analysis of urothelial cells by confocal microscopy was performed to determine the existence of intracellular bacteria. Bacterial cystitis was seen in 13% of patients based on routine microbiology. Wright staining of concentrated urothelial cells demonstrated the presence of bacteria in 72% of samples. Filamentous bacterial cells were observed in 51% of patients and were significantly more common in patients with detrusor overactivity. Intracellular Escherichia coli were observed by confocal microscopy. This study supports the possibility that a subset of patients with urge incontinence may have unrecognised chronic bacterial colonisation, maintained via an intracellular reservoir. In patients with negative routine microbiology, application of the techniques used in this study revealed evidence of infection, providing further insights into the aetiology of urge incontinence.

  7. A incontinência urinária em mulheres e os aspectos raciais: uma revisão de literatura

    OpenAIRE

    Leroy,Lígia da Silva; Lopes, Maria Helena Baena de Moraes; Shimo, Antonieta Keiko Kakuda

    2012-01-01

    Literature review aimed to identify associations between urinary incontinence in women and racial aspects. We used the databases MEDLINE and LILACS for research articles published in the years 2003 to 2010. It were analyzed 30 publications that indicated different relationships between incontinence and race. The prevalence of incontinence was higher among white women. The stress urinary incontinence was more common among white and urgency among black. White and Asian have urinary leakage in s...

  8. Protocol for the CUPIDO trials; multicenter randomized controlled trials to assess the value of combining prolapse surgery and incontinence surgery in patients with genital prolapse and evident stress incontinence (CUPIDO I and in patients with genital prolapse and occult stress incontinence (CUPIDO II

    Directory of Open Access Journals (Sweden)

    van der Vaart Huub

    2010-05-01

    Full Text Available Abstract Background About 40% of all patients with genital prolapse report stress-incontinence. In about half of the 60% patients that do not report stress-incontinence, occult urinary stress-incontinence can be detected. In these patients stress-incontinence is masked due to kinking or compression of the urethra by the prolapse. In case surgical correction is indicated there are two strategies to manage patients with combined prolapse and (occult stress incontinence. This strategy is either (i a combination of prolapse surgery and stress-incontinence surgery or (ii to correct the prolapse first and evaluate afterwards whether additional stress-incontinence surgery is indicated. The advantage of combining prolapse and stress-incontinence surgery is that only few patients report stress-incontinence following such combination. However, this combination has been associated with an increased risk on complications, of which the development of obstructive micturition symptoms, overactive bladder symptoms and bladder retention are the most important ones. Furthermore, combining two procedures may be unnecessary as performing only prolapse surgery may cure stress-incontinence In the randomized CUPIDO trials both strategies are compared in patients with prolapse and evident stress incontinence (CUPIDO I trial and in patients with prolapse and occult stress incontinence (CUPIDO II trial. Methods/Design The CUPIDO trials are two multicenter randomized controlled trials in which women with stress urinary incontinence (SUI or occult stress urinary incontinence (OSUI are randomized to prolapse surgery combined with anti incontinence surgery (concomitant surgery or to prolapse surgery only. Patients with at least stage 2 POP are eligible, women with evident SUI are randomized in CUPIDO I. Patients without SUI are eligible for CUPIDO II and will have urodynamic evaluation or a standardized redression test. Women with OSUI are randomized, women without OSUI are

  9. Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization.

    Science.gov (United States)

    Di Cagno, Raffaella; De Angelis, Maria; De Pasquale, Ilaria; Ndagijimana, Maurice; Vernocchi, Pamela; Ricciuti, Patrizia; Gagliardi, Francesca; Laghi, Luca; Crecchio, Carmine; Guerzoni, Maria Elisabetta; Gobbetti, Marco; Francavilla, Ruggiero

    2011-10-04

    Epidemiology of celiac disease (CD) is increasing. CD mainly presents in early childhood with small intestinal villous atrophy and signs of malabsorption. Compared to healthy individuals, CD patients seemed to be characterized by higher numbers of Gram-negative bacteria and lower numbers Gram-positive bacteria. This study aimed at investigating the microbiota and metabolome of 19 celiac disease children under gluten-free diet (treated celiac disease, T-CD) and 15 non-celiac children (HC). PCR-denaturing gradient gel electrophoresis (DGGE) analyses by universal and group-specific primers were carried out in duodenal biopsies and faecal samples. Based on the number of PCR-DGGE bands, the diversity of Eubacteria was the higher in duodenal biopsies of T-CD than HC children. Bifidobacteria were only found in faecal samples. With a few exceptions, PCR-DGGE profiles of faecal samples for Lactobacillus and Bifidobacteria differed between T-CD and HC. As shown by culture-dependent methods, the levels of Lactobacillus, Enterococcus and Bifidobacteria were confirmed to be significantly higher (P = 0.028; P = 0.019; and P = 0.023, respectively) in fecal samples of HC than in T-CD children. On the contrary, cell counts (CFU/ml) of presumptive Bacteroides, Staphylococcus, Salmonella, Shighella and Klebsiella were significantly higher (P = 0.014) in T-CD compared to HC children. Enterococcus faecium and Lactobacillus plantarum were the species most diffusely identified. This latter species was also found in all duodenal biopsies of T-CD and HC children. Other bacterial species were identified only in T-CD or HC faecal samples. As shown by Randomly Amplified Polymorphic DNA-PCR analysis, the percentage of strains identified as lactobacilli significantly (P = 0.011) differed between T-CD (ca. 26.5%) and HC (ca. 34.6%) groups. The metabolome of T-CD and HC children was studied using faecal and urine samples which were analyzed by gas-chromatography mass spectrometry

  10. Duodenal and faecal microbiota of celiac children: molecular, phenotype and metabolome characterization

    Directory of Open Access Journals (Sweden)

    Guerzoni Maria

    2011-10-01

    Full Text Available Abstract Background Epidemiology of celiac disease (CD is increasing. CD mainly presents in early childhood with small intestinal villous atrophy and signs of malabsorption. Compared to healthy individuals, CD patients seemed to be characterized by higher numbers of Gram-negative bacteria and lower numbers Gram-positive bacteria. Results This study aimed at investigating the microbiota and metabolome of 19 celiac disease children under gluten-free diet (treated celiac disease, T-CD and 15 non-celiac children (HC. PCR-denaturing gradient gel electrophoresis (DGGE analyses by universal and group-specific primers were carried out in duodenal biopsies and faecal samples. Based on the number of PCR-DGGE bands, the diversity of Eubacteria was the higher in duodenal biopsies of T-CD than HC children. Bifidobacteria were only found in faecal samples. With a few exceptions, PCR-DGGE profiles of faecal samples for Lactobacillus and Bifidobacteria differed between T-CD and HC. As shown by culture-dependent methods, the levels of Lactobacillus, Enterococcus and Bifidobacteria were confirmed to be significantly higher (P = 0.028; P = 0.019; and P = 0.023, respectively in fecal samples of HC than in T-CD children. On the contrary, cell counts (CFU/ml of presumptive Bacteroides, Staphylococcus, Salmonella, Shighella and Klebsiella were significantly higher (P = 0.014 in T-CD compared to HC children. Enterococcus faecium and Lactobacillus plantarum were the species most diffusely identified. This latter species was also found in all duodenal biopsies of T-CD and HC children. Other bacterial species were identified only in T-CD or HC faecal samples. As shown by Randomly Amplified Polymorphic DNA-PCR analysis, the percentage of strains identified as lactobacilli significantly (P = 0.011 differed between T-CD (ca. 26.5% and HC (ca. 34.6% groups. The metabolome of T-CD and HC children was studied using faecal and urine samples which were analyzed by gas

  11. Integrated analysis of water quality parameters for cost-effective faecal pollution management in river catchments.

    Science.gov (United States)

    Nnane, Daniel Ekane; Ebdon, James Edward; Taylor, Huw David

    2011-03-01

    In many parts of the world, microbial contamination of surface waters used for drinking, recreation, and shellfishery remains a pervasive risk to human health, especially in Less Economically Developed Countries (LEDC). However, the capacity to provide effective management strategies to break the waterborne route to human infection is often thwarted by our inability to identify the source of microbial contamination. Microbial Source Tracking (MST) has potential to improve water quality management in complex river catchments that are either routinely, or intermittently contaminated by faecal material from one or more sources, by attributing faecal loads to their human or non-human sources, and thereby supporting more rational approaches to microbial risk assessment. The River Ouse catchment in southeast England (U.K.) was used as a model with which to investigate the integration and application of a novel and simple MST approach to monitor microbial water quality over one calendar year, thereby encompassing a range of meteorological conditions. A key objective of the work was to develop simple low-cost protocols that could be easily replicated. Bacteriophages (viruses) capable of infecting a human specific strain of Bacteroides GB-124, and their correlation with presumptive Escherichia coli, were used to distinguish sources of faecal pollution. The results reported here suggest that in this river catchment the principal source of faecal pollution in most instances was non-human in origin. During storm events, presumptive E. coli and presumptive intestinal enterococci levels were 1.1-1.2 logs higher than during dry weather conditions, and levels of the faecal indicator organisms (FIOs) were closely associated with increased turbidity levels (presumptive E. coli and turbidity, r = 0.43). Spatio-temporal variation in microbial water quality parameters was accounted for by three principal components (67.6%). Cluster Analysis, reduced the fourteen monitoring sites to six

  12. Knowledge and Attitudes of Nursing Home Staff and Surveyors about the Revised Federal Guidance for Incontinence Care

    Science.gov (United States)

    DuBeau, Catherine E.; Ouslander, Joseph G.; Palmer, Mary H.

    2007-01-01

    Purpose: We assessed nursing home staff and state nursing home surveyors regarding their knowledge and attitudes about urinary incontinence, its management, and the revised federal Tag F315 guidance for urinary incontinence. Design and Methods: We conducted a questionnaire survey of a convenience sample of nursing home staff and state nursing home…

  13. How do patients with urinary incontinence perceive care given by their general practitioner? A cross-sectional study.

    NARCIS (Netherlands)

    Albers-Heitner, P.; Berghmans, L.C.M.; Nieman, F.H.; Lagro-Janssen, A.L.M.; Winkens, R.A.G.

    2008-01-01

    BACKGROUND: Urinary incontinence (UI) is a widespread problem, affecting quality of life and leading to high costs, mainly caused by incontinence pads. It seems that, despite guidelines, many UI patients get pads from their general practitioner (GP) without adequate diagnostics or treatment. OBJECTI

  14. Effect of Kegel Exercises on the Management of Female Stress Urinary Incontinence: A Systematic Review of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Seong-Hi Park

    2014-01-01

    Full Text Available Objective. The purpose of this study was to evaluate the effect of Kegel exercises on reducing urinary incontinence symptoms in women with stress urinary incontinence. Methods. Randomized controlled trials (RCTs were conducted on females with stress urinary incontinence who had done Kegel exercises and met inclusion criteria in articles published between 1966 and 2012. The articles from periodicals indexed in KoreaMed, NDSL, Ovid Medline, Embase, Scopus, and other databases were selected, using key terms such as “Kegel” or “pelvic floor exercise.” Cochrane’s risk of bias was applied to assess the internal validity of the RCTs. Eleven selected studies were analyzed by meta-analysis using RevMan 5.1. Results. Eleven trials involving 510 women met the inclusion criteria. All trials contributed data to one or more of the main or secondary outcomes. They indicated that Kegel exercises significantly reduced the urinary incontinence symptoms of female stress urinary incontinence. There was no heterogeneity in the selected studies except the standardized bladder volumes of the pad test. Conclusion. There is some evidence that, for women with stress urinary incontinence, Kegel exercises may help manage urinary incontinence. However, while these results are helpful for understanding how to treat or cure stress urinary incontinence, further research is still required.

  15. Transcutaneous mechanical nerve stimulation using perineal vibration: a novel method for the treatment of female stress urinary incontinence

    DEFF Research Database (Denmark)

    Sønksen, Jens; Ohl, Dana A; Bonde, Birthe;

    2007-01-01

    We defined basic guidelines for transcutaneous mechanical nerve stimulation in modifying pelvic floor responses in women and determined the efficacy of transcutaneous mechanical nerve stimulation in treating stress urinary incontinence.......We defined basic guidelines for transcutaneous mechanical nerve stimulation in modifying pelvic floor responses in women and determined the efficacy of transcutaneous mechanical nerve stimulation in treating stress urinary incontinence....

  16. Labial fusion causing urinary incontinence and recurrent urinary tract infection in a postmenopausal female: a case report.

    Science.gov (United States)

    Dirim, Ayhan; Hasirci, Eray

    2011-01-01

    A 73-year-old postmenopausal woman was admitted with recurrent urinary tract infection and a history of incontinence. General physical examination was normal. Complete labial fusion was noticed on genital examination. Surgical intervention was performed. This therapy alleviated incontinence and recurrent urinary tract infection.

  17. Sex differences in the use of absorbent (incontinence) pads in independently living elderly people: do men receive less care?

    NARCIS (Netherlands)

    Teunissen, T.A.M.; Lagro-Janssen, A.L.M.

    2009-01-01

    AIM: To examine the use and satisfaction of absorbent (incontinence) pads in independently living men and women aged 60 and above with urinary incontinence (UI). METHODS: The subjects participated in a large-scale study about the prevalence of UI. All the independently living patients in nine family

  18. Conservative management of post-surgical urinary incontinence in an adolescent using applied kinesiology: a case report.

    Science.gov (United States)

    Cuthbert, Scott C; Rosner, Anthony L

    2011-06-01

    This case report describes the successful treatment of an adolescent female suffering daily stress and occasional total urinary incontinence with applied kinesiology methods and chiropractic manipulative therapy. A 13-year-old female developed unpredictable urinary incontinence and right hip pain immediately following emergency open appendectomy surgery. The patient was forced to wear an incontinence pad throughout the day and night for 10 months because of unpredictable urinary incontinence. ASSESSMENT AND INTERVENTION: Chiropractic and applied kinesiology (AK) methods - a multi-modal diagnostic technique that utilizes manual muscle tests (MMT) for the detection of musculoskeletal impairments and specific AK techniques for correction of identified issues - were utilized to diagnose and treat this patient for muscle impairments in the lumbar spine and pelvis. Patient experienced a rapid resolution of her urinary incontinence and hip pain. A six-year follow-up confirmed complete resolution of symptoms. In this case, utilization of MMT allowed for the identification of several inhibited muscles. Utilizing the appropriate corrective techniques improved the strength of these muscles and resulted in their being graded as facilitated. Symptoms of urinary incontinence and hip pain resolved with this diagnostic and treatment approach. AK methods were useful for the discovery of a number of apparent causative factors underlying this patient's urinary incontinence and hip pain. Treatment for these pelvic-floor muscle and joint abnormalities resulted in rapid, long-lasting resolution of her urinary incontinence and hip pain.

  19. Long-term follow-up of sexual function in women after tension-free vaginal tape operation for stress urinary incontinence

    DEFF Research Database (Denmark)

    Glavind, Karin; Lindquist, Anna Sofie Inger

    and Obstetrics, between November 2008 and June 2010. Patients completed the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) before undergoing surgery, 6 months...

  20. Incontinência urinária entre mulheres climatéricas brasileiras: inquérito domiciliar Urinary incontinence among climateric Brazilian women: household survey

    Directory of Open Access Journals (Sweden)

    Telma Guarisi

    2001-10-01

    Full Text Available OBJETIVO: Por inquérito populacional domiciliar, investigar a prevalência de incontinência urinária de esforço e os fatores a ela associados em mulheres climatéricas. MÉTODOS: Realizou-se análise secundária de dados de um inquérito populacional domiciliar sobre o climatério e a menopausa em mulheres do município de Campinas, SP, Brasil. Foram selecionadas, por meio de estudo descritivo e exploratório de corte transversal, por processo de amostragem, 456 mulheres, na faixa etária de 45 a 60 anos de idade. Exploraram-se a queixa de incontinência urinária e os fatores de risco possivelmente relacionados -- idade, estrato socioeconômico, escolaridade, cor, paridade, tabagismo, índice de massa corpórea, cirurgias ginecológicas anteriores, estado menopausal e uso de terapia de reposição hormonal. Os dados foram coletados por entrevistas domiciliares, com questionários estruturados e pré-testados, adaptados pelos autores e fornecidos pela Fundação Internacional de Saúde, pela Sociedade Internacional de Menopausa e pela Sociedade Norte-Americana de Menopausa. A análise dos dados foi realizada por razão de prevalência (IC 95%. RESULTADOS: Das mulheres entrevistadas, 35% referiram perda urinária aos esforços. Nenhum dos fatores sociodemográficos estudados se mostrou associado ao risco de incontinência urinária. Também a paridade não alterou significativamente esse risco. Outros fatores como cirurgias ginecológicas anteriores, índice de massa corpórea e tabagismo não se mostraram associados à prevalência de incontinência urinária. O estado menopausal e o uso de terapia de reposição hormonal não modificaram o risco de incontinência urinária de esforço. CONCLUSÃO: Apesar de a prevalência de incontinência urinária em mulheres climatéricas ter sido alta, não se mostrou associada aos fatores socioeconômicos e reprodutivos abordados.OBJECTIVE: To investigate the prevalence of stress urinary incontinence

  1. Avaliação da qualidade de vida na incontinência anal: validação do questionário FIQL (Fecal Incontinence Quality of Life Evaluation of quality of life in anal incontinence: validation of the questionnaire FIQL (Fecal Incontinence Quality of Life

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    Sonia Ahlaim Ibrahim Yusuf

    2004-09-01

    Full Text Available RACIONAL: A incontinência anal acarreta incapacitação física e psicológica, determinando impacto na qualidade de vida. Para quantificar esse impacto em nosso meio, não existem instrumentos específicos validados. OBJETIVOS: Avaliar a qualidade de vida na incontinência anal, através da validação do questionário "Fecal Incontinence Quality of Life" (FIQL, que é composto por 29 questões distribuídas em 4 domínios: estilo de vida, comportamento, depressão e constrangimento, sua escala de pontuação varia de 1 a 4 com exceção das questões 1 e 4 que variam de 1 a 5 e 1 a 6, respectivamente. MATERIAL E MÉTODO: Após tradução e adaptação cultural, estudou-se a validação do instrumento através das propriedades de medida de reprodutibilidade e validade. Para a avaliação da reprodutibilidade aplicou-se o questionário em 50 pacientes com incontinência anal por dois examinadores, sendo reaplicado por um dos examinadores após período de 7 a 10 dias. A validade construtiva foi testada através da comparação do FIQL e o SF-36, questionário genérico de qualidade de vida e entre o FIQL e um índice de incontinência anal. O índice de incontinência anal utilizado foi o de Jorge-Wexner, que varia de 0 (continência perfeita a 20 (incontinência total. A validade discriminativa foi avaliada através da aplicação do FIQL em dois grupos controle: indivíduos voluntários hígidos e portadores de constipação intestinal. RESULTADOS: Verificou-se que o FIQL apresentou correlação significativa com outros instrumentos (SF-36 e índice de incontinência e que a qualidade de vida no portador de incontinência anal está comprometida em todos os domínios: estilo de vida: 2,4 comportamento: 2,0, depressão: 2,5 e constrangimento: 1,9, quando comparado com os indivíduos voluntários hígidos (3,9, 3,9, 4,1 e 4,0, e pacientes com constipação intestinal (3,7, 3,8, 3,6 e 3,8, respectivamente. CONCLUSÃO: O FIQL é útil para a

  2. Late Fecal Incontinence After High-Dose Radiotherapy for Prostate Cancer: Better Prediction Using Longitudinal Definitions

    Energy Technology Data Exchange (ETDEWEB)

    Fiorino, Claudio, E-mail: fiorino.claudio@hsr.it [Department of Medical Physics, San Raffaele Scientific Institute, Milano (Italy); Rancati, Tiziana [Prostate Program, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano (Italy); Fellin, Gianni [Department of Radiotherapy, Ospedale Santa Chiara, Trento (Italy); Vavassori, Vittorio [Department of Radiotherapy, Cliniche Humanitas Gavazzeni, Bergamo (Italy); Cagna, Emanuela [Department of Radiotherapy, Ospedale Sant' Anna, Como (Italy); Casanova Borca, Valeria [Department of Medical Physics, Ospedale di Ivrea, Turin (Italy); Girelli, Giuseppe [Department of Radiotherapy, Ospedale di Ivrea, Turin (Italy); Menegotti, Loris [Department of Medical Physics, Ospedale Santa Chiara, Trento (Italy); Monti, Angelo Filippo [Department of Medical Physics, Ospedale Sant' Anna, Como (Italy); Tortoreto, Francesca [Department of Radiotherapy, Ospedale Fatebenefratelli, Roma (Italy); Delle Canne, Stefania [Department of Medical Physics, Ospedale Fatebenefratelli, Roma (Italy); Valdagni, Riccardo [Prostate Program, Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano (Italy)

    2012-05-01

    Purpose: To model late fecal incontinence after high-dose prostate cancer radiotherapy (RT) in patients accrued in the AIROPROS (prostate working group of the Italian Association of Radiation Oncology) 0102 trial using different endpoint definitions. Methods and Materials: The self-reported questionnaires (before RT, 1 month after RT, and every 6 months for {<=}3 years after RT) of 586 patients were available. The peak incontinence (P{sub I}NC) and two longitudinal definitions (chronic incontinence [C{sub I}NC], defined as the persistence of Grade 1 or greater incontinence after any Grade 2-3 event; and mean incontinence score [M{sub I}NC], defined as the average score during the 3-year period after RT) were considered. The correlation between the clinical/dosimetric parameters (including rectal dose-volume histograms) and P{sub I}NC (Grade 2 or greater), C{sub I}NC, and M{sub I}NC of {>=}1 were investigated using multivariate logistic analyses. Receiver operating characteristic curves and the area under the curve were used to assess the predictive value of the different multivariate models. Results: Of the 586 patients, 36 with a Grade 1 or greater incontinence score before RT were not included in the present analysis. Of the 550 included patients, 197 (35.8%) had at least one control with a Grade 1 or greater incontinence score (M{sub I}NC >0). Of these 197 patients, 37 (6.7%), 22 (4.0%), and 17 (3.1%) were scored as having P{sub I}NC, M{sub I}NC {>=}1, and C{sub I}NC, respectively. On multivariate analysis, Grade 2 or greater acute incontinence was the only predictor of P{sub I}NC (odds ratio [OR], 5.9; p = .0009). Grade 3 acute incontinence was predictive of C{sub I}NC (OR, 9.4; p = .02), and percentage of the rectal volume receiving >40 Gy of {>=}80% was predictive of a M{sub I}NC of {>=}1 (OR, 3.8; p = .008) and of C{sub I}NC (OR, 3.6; p = .03). Previous bowel disease, previous abdominal/pelvic surgery, and the use of antihypertensive (protective factor

  3. Recurrent obstetric anal sphincter injury and the risk of long term anal incontinence

    DEFF Research Database (Denmark)

    Jangö, Hanna; Langhoff-Roos, Jens; Rosthøj, Susanne

    2017-01-01

    BACKGROUND: Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether recurrence of obstetric anal sphincter injury affects the risk of anal- and fecal incontin......BACKGROUND: Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether recurrence of obstetric anal sphincter injury affects the risk of anal- and fecal...... incontinence at long term follow up. OBJECTIVE: To evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal- and fecal incontinence more than 5 years after the second vaginal delivery. STUDY DESIGN: We performed a secondary analysis of data from a postal questionnaire study...

  4. Split-appendix technique: Alternative urinary diversion for pediatric complete incontinence

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    Elisa Cerchia

    2017-01-01

    Full Text Available We report our series of selected patients with complete incontinence in whom the appendix was divided and utilized for creating two continent catheterizable stomas. All patients were treated for urinary and fecal incontinence by split appendix technique. The appendix was divided into two different parts preserving adequate perfusion and used for creating an appendicocecostomy (ACE and an appendicovesicostomy at the same time. After a clinical and radiological follow up, our patients referred a good acceptance and an easily management of the stomas in order to stay dry for all day from urine and feces with improving of their quality of life. The combination of ACE and Mitrofanoff principle have revolutionized the management of urinary and fecal incontinence in patients who are unable to utilize their urethra to keep themselves dry.

  5. Reducing fluxes of faecal indicator compliance parameters to bathing waters from diffuse agricultural sources: the Brighouse Bay study, Scotland.

    Science.gov (United States)

    Kay, D; Aitken, M; Crowther, J; Dickson, I; Edwards, A C; Francis, C; Hopkins, M; Jeffrey, W; Kay, C; McDonald, A T; McDonald, D; Stapleton, C M; Watkins, J; Wilkinson, J; Wyer, M D

    2007-05-01

    The European Water Framework Directive requires the integrated management of point and diffuse pollution to achieve 'good' water quality in 'protected areas'. These include bathing waters, which are regulated using faecal indicator organisms as compliance parameters. Thus, for the first time, European regulators are faced with the control of faecal indicator fluxes from agricultural sources where these impact on bathing water compliance locations. Concurrently, reforms to the European Union (EU) Common Agricultural Policy offer scope for supporting on-farm measures producing environmental benefits through the new 'single farm payments' and the concept of 'cross-compliance'. This paper reports the first UK study involving remedial measures, principally stream bank fencing, designed to reduce faecal indicator fluxes at the catchment scale. Considerable reduction in faecal indicator flux was observed, but this was insufficient to ensure bathing water compliance with either Directive 76/160/EEC standards or new health-evidence-based criteria proposed by WHO and the European Commission.

  6. Comparison of the faecal microflora of patients with ankylosing spondylitis and controls using molecular methods of analysis

    NARCIS (Netherlands)

    Stebbings, S; Munro, K; Simon, MA; Tannock, G; Highton, J; Harmsen, H; Welling, G; Seksik, P; Dore, J; Grame, G; Tilsala-Timisjarvi, A

    2002-01-01

    Objectives. To determine whether differences within the complex intestinal microflora can be demonstrated between patients with ankylosing spondylitis (AS) and healthy individuals. Methods. The composition of the faecal microflora of 15 ankylosing spondylitis patients and 15 matched controls was det

  7. Associated factors to urinary incontinence in women undergoing urodynamic testing.

    Science.gov (United States)

    Silva, Juliana Cristina Pereira da; Soler, Zaida Aurora Sperli Geraldes; DominguesWysocki, Anneliese

    2017-04-03

    Analyzing factors associated with urinary incontinence (UI) among women submitted to urodynamic testing. A cross-sectional study of 150 women attended at a urological center. Data were analyzed using univariate and multivariate statistics. White women (79.3%), overweight (45.3%), menopausal (53.3%), who drink coffee (82.7%), sedentary (65.3%), who had vaginal birth (51.4%), with episiotomy (80%), and who underwent the Kristeller maneuver (69%). 60.7% had Urethral Hypermobility (UH). A statistical association was found between: weight change and UH (p = 0.024); menopause, Intrinsic Sphincter Deficiency (ISD) and Detrusor Instability (DI) (p = 0.001); gynecological surgery, ISD and DI (p = 0.014); hysterectomy and all types of UI (p = 0.040); physical activity and mixed UI (p = 0.014). Interventions and guidance on preventing UI and strengthening pelvic muscles should be directed at women who present weight changes, who are sedentary menopausal women, and those who have undergone hysterectomy or other gynecological surgery. Studies on pelvic strengthening methods are needed in order to take into account the profile of the needs presented by women. Analisar os fatores associados à Incontinência Urinária (IU) entre mulheres submetidas a estudo urodinâmico. Estudo transversal realizado com 150 mulheres atendidas em um centro urológico. Os dados foram analisados por meio de estatística uni e multivariada. Mulheres brancas (79,3%), com sobrepeso (45,3%), na menopausa (53,3%), que ingeriam café (82,7%), sedentárias (65,3%), que fizeram parto normal (51,4%), com episiotomia (80%), que sofreram Manobra de Kristeller (69%). 60,7% apresentavam HipermobilidadeUretral (HU).Houve associação estatística entre: mudança de peso e HU (p=0,024); menopausa,Deficiência Esfincteriana Intrínseca (DEI) e Instabilidade Detrusora (ID) (p=0,001); cirurgia ginecológica, DEI e ID (p=0,014); histerectomia etodos os tipos de IU (p=0,040); realização de atividade física eIU mista

  8. [Translabial ultrasonography in pelvic floor prolapse and urinary incontinence diagnostics].

    Science.gov (United States)

    Pietrus, Miłosz; Pityński, Kazimierz; Bałajewicz-Nowak, Marta; Wiecheć, Marcin; Knafel, Anna; Ludwin, Artur; Dziechciowski, Marek; Nocuń, Agnieszka

    2012-09-01

    Technological advances in the construction of sonographic devices and increasingly universal access to such tests considerably widens the range of diagnostic application of the sonographic examination. This situation also refers to pelvic organs prolapse. At present, sonographic sets used in everyday obstetrical-gynecological practice allow for insight into the structures forming the female pelvic floor, and the obtained images constitute a valuable addition to the physical examination. Positioning the sonographic transducer on a the perineum enables to visualize the three compartments of the female pelvis minor. After freezing the image, it is possible to assess the position of anatomical structures in relation to bones and designated surfaces, establish mutual distances and measure appropriate angles. Most information can be obtained in this manner within the range of the frontal compartment, whose damage is often linked with urinary incontinence. The examination standards developed so far, including the analysis of the quantitative parameters, greatly minimize the potential subjectivity of the assessment of the existing disorders. Apart from its low costs, the main value of the sonographic examination of the pelvic floor is the possibility to dynamically assess the changes in statics which take place during functional testing. Not only does it have a cognitive significance, but also it allows to adjust the scope of the surgical correction to the existing damages. Thus, indirectly it can contribute to the reduction of a number of subsequent remedial surgeries. Three-dimensional sonography allows to thoroughly examine the construction and functioning of the anal levators and to detect their possible damage. It is the trauma to these muscles--occurring, among others, during childbirth--that is one of the major causes of pelvic organs descent and prolapse in women. Sonographic examination also enables to visualize the artificial material, the use of which is

  9. Gracilis muscle transposition as a workhorse flap for anal incontinence: Quality of life and functional outcome in adults

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    Guru Dayal Singh Kalra

    2016-01-01

    Full Text Available Background/Purpose: Anal incontinence is one of the most psychologically and socially debilitating conditions in an otherwise healthy individual. It can lead to social isolation, loss of self-esteem, self-confidence and depression. This study is devoted to the problem of anal incontinence in the adult patients. The aim of our study is to analyse the results of gracilis muscle transposition for anal incontinence and improvement in quality of life (QOL of patients. Materials and Methods: This was a retrospective study. A total of 18 patients with complaint of anal incontinence were enrolled in this study. All patients were treated with gracilis muscle transposition. Results: All patients are continent, and there is an improvement in their QOL. Conclusion: Gracilis muscle transposition is a good option for patients of anal incontinence who are not treated by non-surgical means.

  10. Genetic Contributions to Urgency Urinary Incontinence in Women

    Science.gov (United States)

    RICHTER, Holly E; WHITEHEAD, Nedra; ARYA, Lily; RIDGEWAY, Beri; ALLEN-BRADY, Kristina; NORTON, Peggy; SUNG, Vivian; SHEPHERD, Jonathan P.; KOMESU, Yuko; GADDIS, Nathan; FRASER, Matthew; TAN-KIM, Jasmine; MEIKLE, Susan; PAGE, Grier P

    2015-01-01

    Purpose To identify genetic variants associated with urgency urinary incontinence (UUI) in post-menopausal women. Materials and Methods A two-stage genome wide association analysis was conducted to identify variants associated with UUI. The Women’s Health Initiative-Genomics & Randomized Trials Network (GARNET) sub-study with 4,894 genotyped post-reproductive white women was randomly split into independent discovery and replication cohorts. Genome-wide imputation was performed using IMPUTE2 with the 1000-Genomes-ALL-Phase-I integrated variant set as a reference. Controls reported no UUI at enrollment or follow-up; cases reported monthly or greater UUI and leaked sufficiently to wet/soak underpants/clothes. Logistic regression models were used to predict UUI case versus control status based on genotype, assuming additive inheritance. Age, obesity, diabetes and depression were included in the models as covariates. Results Following quality control, 975,508 single nucleotide polymorphisms (SNPs) in 2,241 cases (discovery=1,102, replication=1,133) and 776 controls (discovery=405, replication=371) remained. Genotype imputation resulted in 9,077,347 SNPs and insertions/deletions with minor allele frequency >0.01 available for analysis. Meta-analysis of the discovery and replication samples identified six loci on chromosomes 5, 10, 11, 12 & 18 associated with UUI at p<10−6. Three of the loci were within genes, the zinc finger protein 521 (ZFP521) gene on chromosome 18q11, the ADAMTS16 gene on chromosome 5p15, and the CIT gene on chromosome 12q24. The other three loci were intergenic. Conclusions Although environmental factors also likely contribute, this first exploratory Genome-Wide Associated Study (GWAS) for UUI suggests that genetic variants in the ZFP521, CIT, and ADAMTS16 genes might account for some of the observed heritability of the condition. PMID:25524241

  11. High faecal glucocorticoid levels predict mortality in ring-tailed lemurs (Lemur catta)

    Science.gov (United States)

    Ethan Pride, R

    2005-01-01

    Glucocorticoid levels are commonly used as measures of stress in wild animal populations, but their relevance to individual fitness in a wild population has not been demonstrated. In this study I followed 93 ring-tailed lemurs (Lemur catta) at Berenty Reserve in Madagascar, collecting 1089 faecal samples from individually recognized animals, and recording their survival over a 2 year period. I evaluated faecal glucocorticoid levels as predictors of individual survival to the end of the study. Animals with high glucocorticoid levels had a significantly higher mortality rate. This result suggests that glucocorticoid measures can be useful predictors of individual survival probabilities in wild populations. The ‘stress landscape’ indicated by glucocorticoid patterns may approximate the fitness landscape to which animals adapt. PMID:17148128

  12. Antimicrobial resistance in the Bacteroides fragilis group in faecal microbiota from healthy Danish children.

    Science.gov (United States)

    Sydenham, Thomas Vognbjerg; Jensen, Betina Hebbelstrup; Petersen, Andreas Munk; Krogfelt, Karen Angeliki; Justesen, Ulrik Stenz

    2017-05-01

    The Bacteroides fragilis group constitute a significant portion of the human gut microbiota and comprise a major proportion of anaerobic bacteria isolated in human infections. We established a baseline of antimicrobial susceptibility rates in the B. fragilis group in the intestinal tract of relatively antibiotic-naive healthy Danish children. From 174 faecal samples collected from children attending day care, 359 non-duplicate isolates were screened for antimicrobial susceptibility. Of these, 0.0%, 1.9%, 5.0% and 21.2% of isolates were intermediate-susceptible or resistant to metronidazole, meropenem, piperacillin/tazobactam and clindamycin, respectively. Eighteen additional studies reporting susceptibility rates in the B. fragilis group bacteria were identified by conducting a literature search. Heterogeneity among results from studies of B. fragilis group antimicrobial susceptibility rates in faecal microbiota exists. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  13. Reducing sampling error in faecal egg counts from black rhinoceros (Diceros bicornis).

    Science.gov (United States)

    Stringer, Andrew P; Smith, Diane; Kerley, Graham I H; Linklater, Wayne L

    2014-04-01

    Faecal egg counts (FECs) are commonly used for the non-invasive assessment of parasite load within hosts. Sources of error, however, have been identified in laboratory techniques and sample storage. Here we focus on sampling error. We test whether a delay in sample collection can affect FECs, and estimate the number of samples needed to reliably assess mean parasite abundance within a host population. Two commonly found parasite eggs in black rhinoceros (Diceros bicornis) dung, strongyle-type nematodes and Anoplocephala gigantea, were used. We find that collection of dung from the centre of faecal boluses up to six hours after defecation does not affect FECs. More than nine samples were needed to greatly improve confidence intervals of the estimated mean parasite abundance within a host population. These results should improve the cost-effectiveness and efficiency of sampling regimes, and support the usefulness of FECs when used for the non-invasive assessment of parasite abundance in black rhinoceros populations.

  14. Consecutive monitoring of faecal calprotectin during mesalazine suppository therapy for active rectal inflammation in ulcerative colitis.

    Science.gov (United States)

    Yamamoto, T; Shimoyama, T; Matsumoto, K

    2015-09-01

    No studies have monitored the levels of faecal calprotectin (FC) during mesalazine suppository therapy for proctitis in ulcerative colitis (UC). To evaluate the value of consecutive monitoring of FC in patients with UC during mesalazine suppository therapy. One hundred and sixty patients with active inflammation limited to the rectum were treated with mesalazine 1 g suppository once daily for 8 weeks. Patients who achieved clinical remission were advised to maintain the treatment, and were followed up for further 40 weeks. FC levels were measured every 8 weeks during the study. At week 8, 118 patients (74%) went into clinical remission, of whom 88 achieved endoscopic healing. The median FC level significantly decreased in patients with clinical and endoscopic remission (both P suppositories. Serial monitoring of faecal calprotectin appears to be valuable for the prediction and early diagnosis of relapse during maintenance therapy. © 2015 John Wiley & Sons Ltd.

  15. Análise da resposta ao biofeedback nos pacientes com incontinência fecal Analysis of biofeedback for fecal incontinence

    Directory of Open Access Journals (Sweden)

    André Figueiredo Accetta

    2011-06-01

    Full Text Available Incontinência fecal é uma condição com importante impacto na qualidade de vida, e inúmeras formas de tratamento são descritas. Objetivo: Avaliar a resposta ao tratamento por biofeedback e o perfil epidemiológico dos pacientes com incontinência fecal, descrevendo os critérios de seleção e a técnica utilizada. Métodos: Estudo retrospectivo dos pacientes tratados em três anos (junho de 2005 a junho de 2008. Resultados: Trinta pacientes, sendo 26 mulheres e 4 homens, com idade média de 66 anos. O número de gestações e partos normais variou de nenhuma a seis e a histerectomia esteve presente em nove casos. Todos os pacientes apresentavam hipotonia na manometria. Dezoito pacientes ficaram satisfeitos com o tratamento proposto, dez ficaram parcialmente satisfeitos, nenhum ficou completamente insatisfeito, e dois abandonaram a terapia. Conclusão: O tratamento clínico associado ao biofeedback pode ser eficaz para a melhoria dos sintomas; entretanto, o entendimento e compreensão do problema por parte do paciente parece ser o efeito mais importante para esses resultados. A presença de diabetes mellitus, cirurgias orificiais e histerectomia podem ter relação com as queixas de incontinência.Fecal incontinence is a disabling condition with relevant social costs. Many therapies are described. Objective: To evaluate the response to biofeedback and epidemiological profile, describing the used technique. Methods: A retrospective study in 3 years (June 2005 - June 2008. Results: Thirty patients, 26 women and 4 men, with an average age of 66. The number of normal pregnancies and births varied from none to six and hysterectomy was present in nine. Hypotonia in manometry was present in all patients. Eighteen patients were satisfied, ten were partially met, none was completely dissatisfied, and two have abandoned the therapy. Conclusion: The clinical therapy to biofeedback can be effective for incontinence, but the comprehension by patient

  16. Urinary incontinence in bitches under primary veterinary care in England: prevalence and risk factors.

    Science.gov (United States)

    O'Neill, D G; Riddell, A; Church, D B; Owen, L; Brodbelt, D C; Hall, J L

    2017-09-07

    To estimate prevalence and demographic risk factors for urinary incontinence in bitches under primary veterinary care in England. The study population included all bitches within the VetCompass database from September 1, 2009 to July 7, 2013. Electronic patient records were searched for urinary incontinence cases and additional demographic and clinical information was extracted. Of 100,397 bitches attending 119 clinics in England, an estimated 3108 were diagnosed with urinary incontinence. The prevalence of urinary incontinence was 3·14% (95% confidence intervals: 2·97 to 3·33). Medical therapy was prescribed to 45·6% cases. Predisposed breeds included the Irish setter (odds ratio: 8·09; 95% confidence intervals: 3·15 to 20·80; P< 0·001) and Dobermann (odds ratio: 7·98; 95% confidence intervals: 4·38 to 14·54; P< 0·001). Increased odds of a diagnosis of urinary incontinence were associated with: (1) weight at or above the mean adult bodyweight for the breed (odds ratio: 1·31; 95% confidence intervals: 1·12 to 1·54; P< 0·001), (2) age 9 to 12 years (odds ratio: 3·86; 95% confidence intervals: 2·86 to 5·20, P< 0·001), (3) neuter status (odds ratio: 2·23; 95% confidence intervals: 1·52 to 3·25, P< 0·001) and (4) being insured (odds ratio: 1·59; 95% confidence intervals: 1·34 to 1·88, P< 0·001). Clinical Impact: Urinary incontinence affects just over 3% of bitches overall but affects more than 15% of bitches in high-risk breeds including the Irish setter, Dobermann, bearded collie, rough collie and Dalmatian. These results provide an evidence base for clinicians to enhance clinical recommendations on neutering and weight control, especially in high-risk breeds. © 2017 British Small Animal Veterinary Association.

  17. Urinary incontinence in children in Cipto Mangunkusumo Hospital, Jakarta: a serial case report

    Directory of Open Access Journals (Sweden)

    Taralan Tambunan

    2001-06-01

    Full Text Available Urinary incontinence in children is a complex problem of varying causes. Most children brought to physician for evaluation of difficulties with urinary control will have single or diurnal enuresis, or will be experiencing urgency associated with functional or organic incontinence. To find out the magnitude of urinary incontinence problems in Child Health Department Cipto Mangunkusumo Hospital Jakarta, we retrospectively looked at medical report of such cases between the years of 1989-2001. During eleven years there were 20 cases, consisted of 10 males and 10 females, aged ranged between 3 months up to 16 years. Nineteen children showed significant bacteriuria defined as a urinary tract infection. Ten children were diagnosed as having neurogenic bladder, all had spinal lesions; 7 children had spinal dysraphyism while 3 others had osteolityc lesions in vertebrae due to malignancy. Non neurogenic bladder was defined in 6 children, while in other 4 children we defined that urinary incontinence was caused by anatomical abnormalities. Vesico-ureteral reflux in various degree were found in 9 children, while 11 out of 20 (55% cases were experiencing chronic renal failure on their first visit. Although the annual incidence of urinary incontinence is low, these difficult cases causing many problems. Breakthrough infection was almost unpreventable and in most cases had progressed to renal failure. Many factors such as invasive procedures and prolonged treatment causing fear and frustration to the patients and their parents leading to poor compliance and lost to follow up. In summary we can conclude that urinary incontinence in children is a complex problem include medically, economically, and socially, not only for the patient and their parents, but also for medical profession.

  18. Isolation of bacteriophage host strains of Bacteroides species suitable for tracking sources of animal faecal pollution in water.

    Science.gov (United States)

    Gómez-Doñate, Marta; Payán, Andrey; Cortés, Ivania; Blanch, Anicet R; Lucena, Francisco; Jofre, Juan; Muniesa, Maite

    2011-06-01

    Microbial source tracking (MST) methods allow the identification of specific faecal sources. The aim is to detect the sources of faecal pollution in a water body to allow targeted, efficient and cost-effective remediation efforts in the catchment. Bacteriophages infecting selected host strains of Bacteroides species are used as markers to track faecal contaminants in water. By using a suitable Bacteroides host from a given faecal origin, it is possible to specifically detect bacteriophages of this faecal origin. It can thus be used to detect specific phages of Bacteroides for MST. With this objective, we isolated several Bacteroides strains from pig, cow and poultry faeces by applying a previously optimized methodology used to isolate the host strains from humans. The isolated strains belonged to Bacteroides fragilis and Bacteroides thetaiotaomicron. These strains, like most Bacteroides species, detected phages of the Siphoviridae morphology. Using the newly isolated host strains for phage enumeration in a range of samples, we showed that these detect phages in faecal sources that coincide with their own origin (70-100% of the samples), and show no detection or very low percentages of detection of phages from other animal origins (from 0 to 20% of the samples). Only strains isolated from pig wastewater detected phages in 50% of human sewage samples. Nevertheless, those strains detecting phages from faecal origins other than their own detected fewer phages (2-3 log₁₀ pfu·100 ml⁻¹) than the phages detected by the specific strain of the same origin. On the basis of our results, we propose that faecal source tracking with phages infecting specific Bacteroides host strains is a useful method for MST. In addition, the method presented here is feasible in laboratories equipped with only basic microbiological equipment, it is more rapid and cost-effective than other procedures and it does not require highly qualified staff. © 2011 Society for Applied Microbiology

  19. Cow-specific diet digestibility predictions based on near-infrared reflectance spectroscopy scans of faecal samples.

    Science.gov (United States)

    Mehtiö, T; Rinne, M; Nyholm, L; Mäntysaari, P; Sairanen, A; Mäntysaari, E A; Pitkänen, T; Lidauer, M H

    2016-04-01

    This study was designed to obtain information on prediction of diet digestibility from near-infrared reflectance spectroscopy (NIRS) scans of faecal spot samples from dairy cows at different stages of lactation and to develop a faecal sampling protocol. NIRS was used to predict diet organic matter digestibility (OMD) and indigestible neutral detergent fibre content (iNDF) from faecal samples, and dry matter digestibility (DMD) using iNDF in feed and faecal samples as an internal marker. Acid-insoluble ash (AIA) as an internal digestibility marker was used as a reference method to evaluate the reliability of NIRS predictions. Feed and composite faecal samples were collected from 44 cows at approximately 50, 150 and 250 days in milk (DIM). The estimated standard deviation for cow-specific organic matter digestibility analysed by AIA was 12.3 g/kg, which is small considering that the average was 724 g/kg. The phenotypic correlation between direct faecal OMD prediction by NIRS and OMD by AIA over the lactation was 0.51. The low repeatability and small variability estimates for direct OMD predictions by NIRS were not accurate enough to quantify small differences in OMD between cows. In contrast to OMD, the repeatability estimates for DMD by iNDF and especially for direct faecal iNDF predictions were 0.32 and 0.46, respectively, indicating that developing of NIRS predictions for cow-specific digestibility is possible. A data subset of 20 cows with daily individual faecal samples was used to develop an on-farm sampling protocol. Based on the assessment of correlations between individual sample combinations and composite samples as well as repeatability estimates for individual sample combinations, we found that collecting up to three individual samples yields a representative composite sample. Collection of samples from all the cows of a herd every third month might be a good choice, because it would yield a better accuracy.

  20. Predicting help-seeking intention of women with urinary incontinence in Jinan, China: a theory of planned behaviour model.

    Science.gov (United States)

    Wu, Chen; Wang, Kefang; Sun, Tao; Xu, Dongjuan; Palmer, Mary H

    2015-02-01

    To develop and test a predictive model of women's help-seeking intention for urinary incontinence that was developed using the theory of planned behaviour and to identify factors that influenced women's help-seeking intention. Urinary incontinence is a chronic progressive condition if left untreated, but few women seek help from healthcare providers. Reasons for not seeking help have been studied in Western countries while relatively little information is available from mainland China. Questionnaire-based cross-sectional survey was performed in this study. From May-October 2011, a cross-sectional survey was conducted with a representative sample of 346 incontinent women from three communities in Jinan using strict inclusion and exclusion criteria. Data were collected via a self-administered pencil-and-paper survey that consisted of a multi-item questionnaire. Predictive model estimation was performed using structural equation model. The resultant model demonstrated that incontinent women's help-seeking intention could be predicted by their perceived self-efficacy and perceived social impact from urine loss. Perceived self-efficacy was the negative predictor, while the perceived social impact was the positive one. Overall, the predictive model explained 36% of the variance for incontinent women's help-seeking intention. The theory of planned behaviour can be used to predict help-seeking intention in women who have urinary incontinence. Community nurses should increase patients' help-seeking intention by addressing perceived social impact and perceived self-efficacy in managing incontinent symptoms. Our findings suggest that high perceived self-efficacy in dealing with incontinent symptoms could hinder incontinent women from seeking help from healthcare providers. The strong social impact women perceived, however, facilitates intention to seek help. Nurses should understand and address these factors through education and evidence-based practices to increase help