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Sample records for neurogenic urinary incontinence

  1. Urinary Incontinence

    Science.gov (United States)

    ... with nerve signals involved in bladder control, causing urinary incontinence. Risk factors Factors that increase your risk of developing urinary incontinence include: Gender. Women are more likely to have ...

  2. Urinary incontinence

    Science.gov (United States)

    Loss of bladder control; Uncontrollable urination; Urination - uncontrollable; Incontinence - urinary ... and take out yourself. Bladder nerve stimulation. Urge incontinence and urinary frequency can sometimes be treated by electrical nerve ...

  3. Urinary Incontinence

    Science.gov (United States)

    ... Why does urinary incontinence affect more women than men? Women have unique health events, such as pregnancy, ... urge incontinence, urine leakage usually happens after a strong, sudden urge to urinate and before you can ...

  4. 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.

  5. Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013.

    Science.gov (United States)

    Drake, Marcus John; Apostolidis, Apostolos; Cocci, Andrea; Emmanuel, Anton; Gajewski, Jerzy B; Harrison, Simon C W; Heesakkers, John P F A; Lemack, Gary E; Madersbacher, Helmut; Panicker, Jalesh N; Radziszewski, Piotr; Sakakibara, Ryuji; Wyndaele, Jean Jacques

    2016-08-01

    Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009. A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and consequently amended to deliver evidence-based conclusions and recommendations in 2013. The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic lower urinary tract dysfunction. The pathophysiology is categorized according to the nature of onset of neurological disease and the part(s) of the nervous system affected. Assessment requires clinical evaluation, general investigations, and specialized testing. Treatment primarily focuses on ensuring safety of the patient and optimizing quality of life. Symptom management covers conservative and interventional measures to aid urine storage and bladder emptying, along with containment of incontinence. A multidisciplinary approach to management is essential. The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. Neurourol. Urodynam. 35:657-665, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. Preventing urinary incontinence in women.

    Science.gov (United States)

    Newman, Diane K; Cardozo, Linda; Sievert, Karl-Dietrich

    2013-10-01

    This review examines the evidence to date, analyzes specific risk factors and assesses the ability to prevent urinary incontinence in women, while providing clinical recommendations. More extraordinary risk factors such as ethnicity and race, mixed and fecal incontinence, iatrogenic and neurogenic factors should be discussed in a follow-up report. Studies have revealed that certain factors place women at risk for developing urinary incontinence, including age, obesity, diabetes, pregnancy and delivery, high-impact physical exercise factors and estrogen deficiency. Healthcare providers should screen women who are at risk for developing urinary incontinence and institute specific interventions, specifically behavioral and even rehabilitative techniques, to prevent this prevalent and distressing condition.

  7. Urinary incontinence - injectable implant

    Science.gov (United States)

    ... repair; ISD repair; Injectable bulking agents for stress urinary incontinence ... and disorders: physiology of micturition, voiding dysfunction, urinary incontinence, urinary tract infections, and painful bladder syndrome. In: Lobo ...

  8. [Male urinary incontinence

    NARCIS (Netherlands)

    Boer, T.A. 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

  9. Urinary incontinence products

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003973.htm Urinary incontinence products To use the sharing features on this ... There are many products to help you manage urinary incontinence . You can decide which product to choose based ...

  10. Urinary incontinence during pregnancy

    OpenAIRE

    Wesnes, Stian Langeland; Rørtveit, Guri; Bø, Kari; Hunskår, Steinar

    2007-01-01

    Objectives: To investigate incidence and prevalence of urinary incontinence during pregnancy, and associated risk factors.Method: The data collection was conducted as part of the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health. We present questionnaire data about urinary incontinence obtained from 43,279 women (response rate 45%) by week 30. We report data on any incontinence in addition to type, frequency and amount of incontinence. Po...

  11. [Treatment of non-neurogenic masculine urinary incontinence due to overactive bladder: a review by the LUTS committee of the French Urological Association].

    Science.gov (United States)

    Lebdai, S; Haillot, O; Azzouzi, A R; Benchikh, A; Campeggi, A; Cornu, J-N; Delongchamps, N B; Dumonceau, O; Faix, A; Fourmarier, M; Lukacs, B; Mathieu, R; Misrai, V; Robert, G; de La Taille, A; Descazeaud, A

    2014-07-01

    To perform an update on the treatment of masculine urinary incontinence due to idiopathic overactive bladder. A systematic review was conducted using PubMed/MEDLINE with the following keywords: "overactive bladder", "male urinary incontinence", "urgency", "antimuscarinic", "onabotulinumtoxinA", "neurostimulation", "cystoplasty". Antimuscarinic treatments were the first line option for overactive bladder incontinence (decreased incontinence under tolterodine versus placebo respectively -71% vs. -40%, P masculine population exclusively. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  12. Urinary Tract Infection and Neurogenic Bladder.

    Science.gov (United States)

    McKibben, Maxim J; Seed, Patrick; Ross, Sherry S; Borawski, Kristy M

    2015-11-01

    Urinary tract infections (UTIs) are frequent, recurrent, and lifelong for patients with neurogenic bladder and present challenges in diagnosis and treatment. Patients often present without classic symptoms of UTI but with abdominal or back pain, increased spasticity, and urinary incontinence. Failure to recognize and treat infections can quickly lead to life-threatening autonomic dysreflexia or sepsis, whereas overtreatment contributes to antibiotic resistance, thus limiting future treatment options. Multiple prevention methods are used but evidence-based practices are few. Prevention and treatment of symptomatic UTI requires a multimodal approach that focuses on bladder management as well as accurate diagnosis and appropriate antibiotic treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. [Urinary incontinence and pregnancy].

    Science.gov (United States)

    Deffieux, X

    2009-12-01

    The goal of the current study was to systematically review the literature concerning urinary incontinence and pregnancy, in order to develop recommendations for clinical practice. The prevalence of urinary stress incontinence and overactive bladder symptoms increase with gestational age during pregnancy (from the first to the third trimester), and decrease during the third months following delivery. Obstetrics factors (position during delivery, length of the second part of the labour, forceps, episiotomy, epidural or pudendal anaesthesia) do not modify the risk of post-partum or long term urinary incontinence. At short term follow-up, caesarean delivery is associated with a lower rate of post-partum urinary incontinence. At long term follow-up, data are lacking. Non elective caesarean section is not associated with a decrease in the rate of post-partum or long-term urinary incontinence. Elective caesarean section and systematic episiotomy are not recommended methods for the prevention of post-partum urinary incontinence (grade B), even in "high risk" women. Pelvic floor muscle therapy is the first line treatment for prenatal or post-partum urinary incontinence (grade A). Copyright © 2009 Elsevier Masson SAS. All rights reserved.

  14. 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.

  15. What is Urinary Incontinence?

    Science.gov (United States)

    ... Causes of urinary incontinence For women, thinning and drying of the skin in the vagina or urethra, ... make some changes in your diet. Alcohol, caffeine, foods high in acid (such as tomato or grapefruit) ...

  16. Urinary incontinence in women

    Science.gov (United States)

    Aoki, Yoshitaka; Brown, Heidi W.; Brubaker, Linda; Cornu, Jean Nicolas; Daly, J. Oliver; Cartwright, Rufus

    2018-01-01

    Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence. PMID:28681849

  17. Urinary incontinence during pregnancy.

    Science.gov (United States)

    Wesnes, Stian Langeland; Rortveit, Guri; Bø, Kari; Hunskaar, Steinar

    2007-04-01

    To investigate incidence and prevalence of urinary incontinence during pregnancy and associated risk factors. The data collection was conducted as part of the Norwegian Mother and Child Cohort Study at the Norwegian Institute of Public Health. We present questionnaire data about urinary incontinence obtained from 43,279 women (response rate 45%) by week 30. We report data on any incontinence, in addition to type, frequency, and amount of incontinence. Potential risk factors were investigated by logistic regression analyses. The prevalence of incontinence increased from 26% before pregnancy to 58% in week 30. The corresponding figures for nulliparous women were 15% and 48%, and for parous women 35% and 67%. The cumulative incidence was 46%. Stress urinary incontinence was the most common type of incontinence in week 30 of pregnancy, experienced by 31% of nulliparous and 42% of parous women. The majority of pregnant women had leakage less than once per week and droplets only, both before and during pregnancy. Parity was a strong and significant risk factor for incontinence in adjusted analyses both before pregnancy (odds ratio [OR] 2.5, 95% confidence interval [CI] 2.4-2.7 for primiparous and OR 3.3, 95% CI 3.1-3.5 for multiparous women) and during pregnancy (ORs 2.0, 95% CI 1.9-2.1 and 2.1, 95% CI 2.0-2.2, respectively). Age and body mass index were weaker, but still statistically significant, risk factors. The prevalence of urinary incontinence increases substantially during pregnancy. Incontinence both before and during pregnancy seems to be associated with parity, age, and body mass index. II.

  18. Female urinary incontinence and sexuality

    Directory of Open Access Journals (Sweden)

    Renato Lains Mota

    Full Text Available 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.

  19. 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

  20. Surgery for Stress Urinary Incontinence

    Science.gov (United States)

    ... Stress Urinary Incontinence Special Procedures What is stress urinary incontinence (SUI)? What causes SUI? What nonsurgical treatment options may help with SUI? What are the surgical treatment options for SUI? What factors are considered when deciding which SUI surgery is ...

  1. Urinary incontinence - vaginal sling procedures

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007376.htm Urinary incontinence - vaginal sling procedures To use the sharing features ... are types of surgeries that help control stress urinary incontinence . This is urine leakage that happens when you ...

  2. Reoperation for urinary incontinence

    DEFF Research Database (Denmark)

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

    2016-01-01

    for urinary incontinence (retropubic midurethral tape, transobturator tape, urethral injection therapy, Burch colposuspension, pubovaginal slings, and miscellaneous operations). Cox proportional hazard models were used to estimate the hazard ratio (HR) with 95% confidence intervals (CIs), adjusted for factors......BACKGROUND: The synthetic midurethral slings were introduced in the 1990s and were rapidly replaced the Burch colposuspension as the gold standard treatment for urinary incontinence. It has been reported that the retropubic midurethral tape has an objective and subjective cure rate of 85% at 5...... years of follow-up, but the rate of reoperation after retropubic midurethral tape at the long-term follow-up is less well described. The existing literature specifies an overall lifetime rate of reoperation of about 8-9% after an initial operation for urinary incontinence. There are, however...

  3. Drug-induced urinary incontinence

    NARCIS (Netherlands)

    Tsakiris, Peter; Oelke, Matthias; Michel, Martin C.

    2008-01-01

    Physiological urinary continence depends on many factors that are potentially vulnerable to adverse drug effects, which may lead to incontinence. In principle, drugs could cause incontinence by lowering bladder outlet resistance and/or by increasing intravesical pressure, which disrupts the normal

  4. Urinary incontinence surgery - female - discharge

    Science.gov (United States)

    ... activities, such as golfing, playing tennis, bowling, running, biking, weight lifting, gardening or mowing, and vacuuming for ... A.D.A.M. Editorial team. Related MedlinePlus Health Topics Urinary Incontinence Browse the Encyclopedia A.D. ...

  5. Artificial urinary sphincter implantation: an important component of complex surgery for urinary tract reconstruction in patients with refractory urinary incontinence.

    Science.gov (United States)

    Zhang, Fan; Liao, Limin

    2018-01-08

    We review our outcomes and experience of artificial urinary sphincter implantation for patients with refractory urinary incontinence from different causes. Between April 2002 and May 2017, a total of 32 patients (median age, 40.8 years) with urinary incontinence had undergone artificial urinary sphincter placement during urinary tract reconstruction. Eighteen patients (56.3%) were urethral injuries associated urinary incontinence, 9 (28.1%) had neurogenic urinary incontinence and 5 (15.6%) were post-prostatectomy incontinence. Necessary surgeries were conducted before artificial urinary sphincter placement as staged procedures, including urethral strictures incision, sphincterotomy, and augmentation cystoplasty. The mean follow-up time was 39 months. At the latest visit, 25 patients (78.1%) maintained the original artificial urinary sphincter. Four patients (12.5%) had artificial urinary sphincter revisions. Explantations were performed in three patients. Twenty-four patients were socially continent, leading to the overall success rate as 75%. The complication rate was 28.1%; including infections (n = 4), erosions (n = 4), and mechanical failure (n = 1). The impact of urinary incontinence on the quality of life measured by the visual analogue scale dropped from 7.0 ± 1.2 to 2.2 ± 1.5 (P urinary sphincter implantation in our center are unique, and the procedure is an effective treatment as a part of urinary tract reconstruction in complicated urinary incontinence cases with complex etiology.

  6. Drug calculations for urinary incontinence in women

    OpenAIRE

    Nuttall, Dilyse

    2015-01-01

    An estimated 3–6 million people are affected by urinary incontinence in the UK, and women are most commonly affected (NHS Choices, 2015). Causes of urinary incontinence vary but urge incontinence is usually caused by over-activity of the bladder's detrusor muscles, and stress incontinence is caused by muscle damage or weakness (NHS Choices, 2015). The management of urinary incontinence may require pharmacological treatment in conjunction with pelvic floor and bladder training exercises (Joint...

  7. 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

  8. 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…

  9. [Male Urinary Incontinence--a Taboo Issue].

    Science.gov (United States)

    Kozomara-Hocke, Marko; Hermanns, Thomas; Poyet, Cédric

    2016-03-02

    Male urinary incontinence is an underestimated and frequently not broached issue. The urinary incontinence is divided into stress-, urge incontinence and hybrid forms as well as overflow incontinence. The fact that there are increasingly more men over 60 means that the prevalence of the urinary incontinence is up to 40%, and urinary incontinence will increasingly gain importance in daily routine practice. Many investigations and therapies can be realized by the general practitioner. Already simple therapy approaches can lead to a considerable clinical improvement of male urinary incontinence. If the initial therapy fails or pathological results (i. e. microhaematuria, recurrent urinary tract infections, raised residual urine and so on) are found, the patient should be referred to a urologist.

  10. Pediatric urinary incontinence: Classification, evaluation, and ...

    African Journals Online (AJOL)

    A.J. Schaeffer

    tinuous incontinence refers to constant leakage of urine and can occur even in .... evaluation of pediatric urinary incontinence and guide which tests, if any, should ..... ments taken during bladder filling and storage include the maximal bladder ...

  11. Sacral Nerve Stimulation For Urinary Urge Incontinence, Urgency-Frequency, Urinary Retention, and Fecal Incontinence

    Science.gov (United States)

    2005-01-01

    indicative analysis” and found that SNS was not more cost-effective than using incontinence supplies. However, the assessment did not account for quality of life. Conversely, the authors of the abstract found that SNS was more cost-effective than incontinence supplies alone; however, they noted that in the first year after SNS, it is much more expensive than only incontinence supplies. This is owing to the cost of the procedure, and the adjustments required to make the device most effective. They also noted the positive effects that SNS had on quality of life. Conclusions and Implications In summary, there is level 2 evidence to support the effectiveness of SNS to treat people with urge incontinence, urgency-frequency, or urinary retention. There is level 4 evidence to support the effectiveness of SNS to treat people with fecal incontinence. To qualify for SNS, people must meet the following criteria: Be refractory to behaviour and/or drug therapy Have had a successful test stimulation before implantation; successful test stimulation is defined by a 50% or greater improvement in voiding function based on the results of a voiding diary. Test stimulation periods range from 3 to 7 days for patients with urinary dysfunctions, and from 2 to 3 weeks for patients with fecal incontinence. Be able to record voiding diary data, so that clinical results of the implantation can be evaluated. Patients with stress incontinence, urinary retention due to obstruction and neurogenic conditions (such as diabetes with peripheral nerve involvement) are ineligible for sacral nerve stimulation. Physicians will need to learn how to use the InterStim System for Urinary Control. Requirements for training include these: Physicians must be experienced in the diagnosis and treatment of lower urinary tract disorders and should be trained in the implantation and use of the InterStim System for Urinary Control. Training should include the following: Participation in a seminar or workshop that includes

  12. Neurogenic Bladder

    Directory of Open Access Journals (Sweden)

    Peter T. Dorsher

    2012-01-01

    Full Text Available Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

  13. 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...

  14. Treatment of stress urinary incontinence

    DEFF Research Database (Denmark)

    Fischer-Rasmussen, W

    1990-01-01

    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...

  15. Urinary Incontinence Surgery: When Other Treatments Aren't Enough

    Science.gov (United States)

    ... Development of overactive bladder, which could include urge incontinence Urinary tract infection Difficult or painful intercourse Talk with ... article: http://www.mayoclinic.org/diseases-conditions/urinary-incontinence/in-depth/urinary-incontinence-surgery/ART-20046858 . Mayo Clinic Footer Legal ...

  16. Surgical Management of Neurogenic Lower Urinary Tract Dysfunction.

    Science.gov (United States)

    Gor, Ronak A; Elliott, Sean P

    2017-08-01

    Surgery for patients with neurogenic urinary tract dysfunction (nLUTD) is indicated when medical therapy fails, to correct conditions affecting patient safety, or when surgery can enhance the quality of life better than nonoperative management. Examples include failure of maximal medical therapy, inability to perform or aversion to clean intermittent catheterization, refractory incontinence, and complications from chronic, indwelling catheters. Adults with nLUTD have competing risk factors, including previous operations, obesity, poor nutritional status, complex living arrangements, impaired dexterity/paralysis, and impaired executive and cognitive function. Complications are common in this subgroup of patients requiring enduring commitments from surgeons, patients, and their caretakers. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Prevalence and Characteristics of Urinary Incontinence in a Treatment Seeking Male Prospective Cohort: Results from the LURN Study.

    Science.gov (United States)

    Helfand, Brian T; Smith, Abigail R; Lai, H Henry; Yang, Claire C; Gore, John L; Erickson, Brad A; Kreder, Karl J; Cameron, Anne P; Weinfurt, Kevin P; Griffith, James W; Lentz, Aaron; Talaty, Pooja; Andreev, Victor P; Kirkali, Ziya

    2018-03-01

    Male urinary incontinence is thought to be infrequent. We sought to describe the prevalence of urinary incontinence in a male treatment seeking cohort enrolled in the LURN (Symptoms of Lower Urinary Tract Dysfunction Research Network). Study inclusion and exclusion criteria, including men with prostate cancer or neurogenic bladder, were previously reported. LURN participants prospectively completed questionnaires regarding lower urinary tract symptoms and other clinical variables. Men were grouped based on incontinence type, including 1) no urinary incontinence, 2) post-void dribbling only and 3) urinary incontinence. Comparisons were made using ANOVA and multivariable regression. Of the 477 men 24% reported no urinary incontinence, 44% reported post-void dribbling only and 32% reported urinary incontinence. African American men and those with sleep apnea were more likely to be in the urinary incontinence group than in the no urinary incontinence group (OR 3.2, p = 0.02 and OR 2.73, p = 0.003, respectively). Urinary incontinence was associated with significantly higher bother compared to men without leakage (p urinary incontinence and men with only post-void dribbling those with urinary incontinence were significantly more likely to report higher scores (more severe symptoms) on the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaire regarding bowel issues, depression and anxiety than men without urinary incontinence (p Urinary incontinence is common among treatment seeking men. This is concerning because the guideline recommended questionnaires to assess male lower urinary tract symptoms do not query for urinary incontinence. Thus, clinicians may be missing an opportunity to intervene and improve patient care. This provides a substantial rationale for a new or updated symptom questionnaire which provides a more comprehensive symptom assessment. Copyright © 2018 American Urological Association Education and Research, Inc. Published by

  18. Urinary incontinence - tension-free vaginal tape

    Science.gov (United States)

    ... ency/article/007377.htm Urinary incontinence - tension-free vaginal tape To use the sharing features on this page, please enable JavaScript. Placement of tension-free vaginal tape is surgery to help control stress urinary ...

  19. Urinary Incontinence: MedlinePlus Health Topic

    Science.gov (United States)

    ... your doctor, or surgery. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Start Here Urinary Incontinence (Mayo Foundation for Medical Education and Research) Urinary Tract Health (National Institute of Child Health and Human Development) ...

  20. [Urinary incontinence in degenerative spinal disease].

    Science.gov (United States)

    De Riggo, J; Benčo, M; Kolarovszki, B; Lupták, J; Svihra, J

    2011-01-01

    The aim of the study was to evaluate the presence of urinary incontinence in patients with chronic degenerative spinal disease and to identify factors affecting the occurrence and changes in urinary incontinence after surgery. The group evaluated comprised 214 patients undergoing surgery for degenerative spinal disease at our department between January 1 and December 31, 2008. The patients were categorised according to the type of their degenerative disease (cervical disc herniation, lumbar disc herniation, spinal stenosis, spinal instability or olisthesis) and the spine level involved (cervical or lumbar spine). The symptoms of urinary incontinence included leakage of urine and non-obstructive chronic urinary retention developing in association with the manifestation of vertebrogenic disorder. Patients with diseases known to increase the risk of incontinence were not included in the study. Based on a retrospective analysis of the patients' clinical notes, the occurrence of urinary incontinence in each type of degenerative spinal disease was assessed. The effect of gender, age, body mass index (BMI), neurological status and spinal disease type on the development of incontinence was statistically evaluated. The efficacy of surgical treatment was assessed on the basis of the patients' subjective complaints at the first follow-up one month after surgery. The data were evaluated by the statistical programme InSTAT (analysis of variance ANOVA, t-test). All tests were two-sided; a 0.05 level of statistical significance was used. Of the 214 patients with degenerative spinal disease, 27 (12.6%) had urinary incontinence. A higher risk of developing incontinence was found in women (p = 0.008) and in patients with radicular weakness (p = 0.023). The patients with urinary incontinence had their BMI significantly lower than patients without this disorder (p = 0.019). Age had no effect. The differences in the occurrence of urinary incontinence amongst the different types of

  1. Surgical aspects of pediatric urinary incontinence

    NARCIS (Netherlands)

    Jong, Thomas Pius Vianney Maria de

    2001-01-01

    This thesis tries to bridge between functional and structural non-neuro- genic incontinence and to give insight in the surgical options. Children with anatomically based bladder neck and urethral insufficiency often present with the same symptoms as children with genuine non-neurogenic functional

  2. Diagnosis and management of urinary incontinence and functional fecal incontinence (encopresis) in children.

    Science.gov (United States)

    Nijman, Rien J M

    2008-09-01

    The ability to maintain normal continence for urine and stools is not achievable in all children by a certain age. Gaining control of urinary and fecal continence is a complex process, and not all steps and factors involved are fully understood. While normal development of anatomy and physiology are prerequisites to becoming fully continent, anatomic abnormalities, such as bladder exstrophy, epispadias, ectopic ureters, and neurogenic disturbances that can usually be recognized at birth and cause incontinence, will require specialist treatment, not only to restore continence but also to preserve renal function. Most forms of urinary incontinence are not caused by an anatomic or physiologic abnormality and, hence, are more difficult to diagnose and their management requires a sound knowledge of bladder and bowel function.

  3. Urinary incontinence in patients with cystic fibrosis.

    Science.gov (United States)

    Reichman, Gina; De Boe, Veerle; Braeckman, Johan; Michielsen, Dirk

    2016-01-01

    Owing to evolution in treatment, the average life expectancy of patients with cystic fibrosis (CF) has increased. This has been followed by an increase in urological complications such as urinary incontinence. As stress incontinence occurs during exercise, it may have a negative effect on the implementation of respiratory physiotherapy. The purpose of this study is to determine the prevalence of urinary incontinence and its effect on the quality of life and physiotherapy in a population with CF. Questionnaires were used to determine the prevalence of incontinence in patients of the Cystic Fibrosis Clinic of the University Hospital in Brussels. Two different surveys were used, depending on the age of the patients (incontinence were emphasized. Questionnaires were completed by 122 participants aged 6-59 years, showing an overall prevalence of 27% for urinary incontinence. Mainly adults reported urinary incontinence, with a prevalence of 11% in men and 68% in women aged 12 and above. The amount of urinary leakage was usually only a few drops and it was mainly triggered by coughing. Many of the participants had never mentioned this symptom to anyone. Doctors' and physical therapists' attention should be drawn to the fact that urinary incontinence is part of the complication spectrum of CF. A quarter of the study population refrained from coughing up phlegm and from physiotherapy. It is important to actively question and inform about this problem, to enable its detection and treatment.

  4. 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.

  5. The "costs" of urinary incontinence for women.

    Science.gov (United States)

    Subak, Leslee L; Brown, Jeanette S; Kraus, Stephen R; Brubaker, Linda; Lin, Feng; Richter, Holly E; Bradley, Catherine S; Grady, Deborah

    2006-04-01

    To estimate costs of routine care for female urinary incontinence, health-related quality of life, and willingness to pay for incontinence improvement. In a cross-sectional study at 5 U.S. sites, 293 incontinent women quantified supplies, laundry, and dry cleaning specifically for incontinence. Costs were calculated by multiplying resources used by national resource costs and presented in 2005 United States dollars (2005). Health-related quality of life was estimated with the Health Utilities Index. Participants estimated willingness to pay for 25-100% improvement in incontinence. Potential predictors of these outcomes were examined using multivariable linear regression. Mean age was 56 +/- 11 years; participants were racially diverse and had a broad range of incontinence severity. Nearly 90% reported incontinence-related costs. Median weekly cost (25%, 75% interquartile range) increased from 0.37 dollars (0, 4 dollars) for slight to 10.98 dollars (4, 21 dollars) for very severe incontinence. Costs increased with incontinence severity (P women (P women with urge compared with those having stress incontinence (P lower Health Utilities Index score (mean 0.90 +/- 0.11 for weekly and 0.81 +/- 0.21 for daily incontinence; P = .02). Women were willing to pay a mean of 70 dollars +/- 64 dollars per month for complete resolution of incontinence, and willingness to pay increased with income and greater expected benefit. Women with severe urinary incontinence pay 900 dollars annually for incontinence routine care, and incontinence is associated with a significant decrement in health-related quality of life. Effective incontinence treatment may decrease costs and improve quality of life. III.

  6. Urinary tract infection in the neurogenic bladder

    Science.gov (United States)

    Vigil, Humberto R.

    2016-01-01

    There is a high incidence of urinary tract infection (UTI) in patients with neurogenic lower urinary tract function. This results in significant morbidity and health care utilization. Multiple well-established risk factors unique to a neurogenic bladder (NB) exist while others require ongoing investigation. It is important for care providers to have a good understanding of the different structural, physiological, immunological and catheter-related risk factors so that they may be modified when possible. Diagnosis remains complicated. Appropriate specimen collection is of paramount importance and a UTI cannot be diagnosed based on urinalysis or clinical presentation alone. A culture result with a bacterial concentration of ≥103 CFU/mL in combination with symptoms represents an acceptable definition for UTI diagnosis in NB patients. Cystoscopy, ultrasound and urodynamics should be utilized for the evaluation of recurrent infections in NB patients. An acute, symptomatic UTI should be treated with antibiotics for 5–14 days depending on the severity of the presentation. Antibiotic selection should be based on local and patient-based resistance patterns and the spectrum should be as narrow as possible if there are no concerns regarding urosepsis. Asymptomatic bacteriuria (AB) should not be treated because of rising resistance patterns and lack of clinical efficacy. The most important preventative measures include closed catheter drainage in patients with an indwelling catheter and the use of clean intermittent catheterization (CIC) over other methods of bladder management if possible. The use of hydrophilic or impregnated catheters is not recommended. Intravesical Botox, bacterial interference and sacral neuromodulation show significant promise for the prevention of UTIs in higher risk NB patients and future, multi-center, randomized controlled trials are required. PMID:26904414

  7. 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 ... during sleep (p anxiety (p

  8. 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…

  9. [A prophylactic program for strain urinary incontinence].

    Science.gov (United States)

    Stadnicka, Grazyna; Iwanowicz-Palus, Grazyna J; Bień, Agnieszka M

    2002-01-01

    The aim of the study was to work out a prophylactic program for strain urinary incontinence. Analysis of literature on the subject and results of own investigations presented in the first part of the paper indicate that the program of prophylaxis of strain urinary incontinence should primarily include: (1) Preparation of the medical staff (nurses, midwives) for propagating health education among women on prevention of strain urinary incontinence. (2) Preparation of adequate educational materials in the form of brochures, leaflets, information posters about symptoms, causes and prophylaxis of urinary incontinence indicating health care institutions available to all women when the disease is suspected or already present. (3) Propagation of problems connected with strain urinary incontinence in the mass media providing information to a wide audience in order to make people realize the significance of this social problem and break stereotypes associated with this disease of "shame". (4) Preparation of sets of exercises for the muscles of the base of the pelvis to be performed during pregnancy, confinement and menopause to maintain their proper function. (5) Indicating factors predisposing to strain urinary incontinence with focus on possibilities of their reduction or elimination.

  10. Lower Urinary Tract Symptoms and Urinary Incontinence During Pregnancy.

    Science.gov (United States)

    Balik, Gülşah; Güven, Emine Seda G; Tekin, Yeşim B; Şentürk, Şenol; Kağitci, Mehmet; Üstüner, Işık; Mete Ural, Ülkü; Şahin, Figen K

    2016-05-01

    Lower urinary tract symptoms (LUTS) can frequently be seen in pregnant women. Pregnancy and delivery have been considered as risk factors in the occurrence of pelvic floor dysfunction and determinants of LUTS. The main associated risk factor is parity. In the present study, we aim to determine the frequency of LUTS and urinary incontinence (UI) during pregnancy and the associated risk factors. This prospective study was carried out in a total of 250 women during their 28- and 40-gestational week checks. The Urinary Distress Inventory-6, the Incontinence Impact Questionnaire-7, and International Consultation on Incontinence Questionnaire-Short Form were used to determine LUTS and its effect on quality of life. The mean age and gestational age of the participants were 29.41 ± 5.70 year (range 18-44) and 35.45 ± 2.98 weeks (range 28-40), respectively. The prevalence of LUTS was 81.6%. The prevalence of UI during pregnancy was 37.2%. Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 15.6, 4.8 and 16.8%, respectively. We found that advanced age, smoking and multiparity were risk factors associated with incontinence. Incontinence reduced pregnant women's quality of life. Lower urinary tract symptoms are commonly seen among pregnant women and these symptoms negatively affect the quality of life of pregnant women. Advanced age, smoking and multiparity were risk factors associated with urinary incontinence and LUTS. Obstetricians should be on the lookout for individual urological problems in pregnancy. Resolving any urological issues and cessation of smoking for the affected individuals will help alleviate the problem. © 2014 Wiley Publishing Asia Pty Ltd.

  11. Factors Associated with Urinary Stress Incontinence in Primiparas

    OpenAIRE

    Pei-Ling Chou; Fang-Ping Chen; Li-Fen Teng

    2005-01-01

    Objective: To evaluate obstetric and maternal risk factors for stress urinary incontinence in primiparas. Materials and Methods: From January 2001 to August 2002, 378 primiparas were interviewed about stress urinary incontinence 1 year after delivery. The association between symptoms of urinary stress incontinence and obstetric factors was assessed. Results: Twenty-four (6%) primiparas had urinary stress incontinence after delivery. Maternal age was positively associated with urinary st...

  12. Transcutaneous stimulation of the posterior tibial nerve for treating refractory urge incontinence of idiopathic and neurogenic origin.

    Science.gov (United States)

    Valles-Antuña, C; Pérez-Haro, M L; González-Ruiz de L, C; Quintás-Blanco, A; Tamargo-Diaz, E M; García-Rodríguez, J; San Martín-Blanco, A; Fernandez-Gomez, J M

    2017-09-01

    To assess the efficacy of treatment with transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with urge urinary incontinence, of neurogenic or nonneurogenic origin, refractory to first-line therapeutic options. We included 65 patients with urge urinary incontinence refractory to medical treatment. A case history review, a urodynamic study and a somatosensory evoked potentials (SEP) study were conducted before the TPTNS, studying the functional urological condition by means of a voiding diary. The treatment consisted of 10 weekly sessions of TPTNS lasting 30minutes. Some 57.7% of the patients showed abnormal tibial SEPs, and 42% showed abnormal pudendal SEPs. A statistically significant symptomatic improvement was observed in all clinical parameters after treatment with TPTNS, and 66% of the patients showed an overall improvement, regardless of sex, the presence of underlying neurological disorders, detrusor hyperactivity in the urodynamic study or SEP disorders. There were no adverse effects during the treatment. TPTNS is an effective and well tolerated treatment in patients with urge incontinence refractory to first-line therapies and should be offered early in the treatment strategy. New studies are needed to identify the optimal parameters of stimulation, the most effective treatment protocols and long-term efficacy, as well as its applicability to patients with a neurogenic substrate. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. The female urinary microbiome in urgency urinary incontinence.

    Science.gov (United States)

    Pearce, Meghan M; Zilliox, Michael J; Rosenfeld, Amy B; Thomas-White, Krystal J; Richter, Holly E; Nager, Charles W; Visco, Anthony G; Nygaard, Ingrid E; Barber, Matthew D; Schaffer, Joseph; Moalli, Pamela; Sung, Vivian W; Smith, Ariana L; Rogers, Rebecca; Nolen, Tracy L; Wallace, Dennis; Meikle, Susan F; Gai, Xiaowu; Wolfe, Alan J; Brubaker, Linda

    2015-09-01

    The purpose of this study was to characterize the urinary microbiota in women who are planning treatment for urgency urinary incontinence and to describe clinical associations with urinary symptoms, urinary tract infection, and treatment outcomes. Catheterized urine samples were collected from multisite randomized trial participants who had no clinical evidence of urinary tract infection; 16S ribosomal RNA gene sequencing was used to dichotomize participants as either DNA sequence-positive or sequence-negative. Associations with demographics, urinary symptoms, urinary tract infection risk, and treatment outcomes were determined. In sequence-positive samples, microbiotas were characterized on the basis of their dominant microorganisms. More than one-half (51.1%; 93/182) of the participants' urine samples were sequence-positive. Sequence-positive participants were younger (55.8 vs 61.3 years old; P = .0007), had a higher body mass index (33.7 vs 30.1 kg/m(2); P = .0009), had a higher mean baseline daily urgency urinary incontinence episodes (5.7 vs 4.2 episodes; P urinary incontinence episodes, -4.4 vs -3.3; P = .0013), and were less likely to experience urinary tract infection (9% vs 27%; P = .0011). In sequence-positive samples, 8 major bacterial clusters were identified; 7 clusters were dominated not only by a single genus, most commonly Lactobacillus (45%) or Gardnerella (17%), but also by other taxa (25%). The remaining cluster had no dominant genus (13%). DNA sequencing confirmed urinary bacterial DNA in many women with urgency urinary incontinence who had no signs of infection. Sequence status was associated with baseline urgency urinary incontinence episodes, treatment response, and posttreatment urinary tract infection risk. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Urinary incontinence in pregnant women and their quality of life.

    Science.gov (United States)

    Kocaöz, Semra; Talas, Melek S; Atabekoğlu, Cem S

    2010-12-01

    The aim was to investigate the prevalence of urinary incontinence during pregnancy and the related risk factors as well as to assess its influence on the quality of life. Although urinary incontinence is common during pregnancy and can have a substantial impact on quality of life, women rarely seek help for this symptom. This study was designed as a cross-sectional and descriptive survey. A total of 393 pregnant women participated in the study between March and June 2007. The data was collected using the International Consultation on Incontinence Questionnaire Short Form and Wagner's quality of life scale. Potential risk factors were investigated through logistic regression analysis. The prevalence of urinary incontinence was 27% (106/393). Factors significantly associated with urinary incontinence included age group, parity, previous urinary incontinence, constipation, urinary incontinence in mother and sister, previous urinary incontinence during pregnancy and postpartum. According to the results of our study, urinary incontinence is common in women during pregnancy. The quality of life of pregnant women was found to be either unaffected or affected very little by urinary incontinence. This study reveals that the prevalence of urinary incontinence during pregnancy is very high. The findings will help increase the awareness of health care workers involved in the care of pregnant women about urinary incontinence and aid the design of more intensive education programmes directed towards the prevention of urinary incontinence during pregnancy. © 2010 Blackwell Publishing Ltd.

  15. Bladder Control Problems: Medications for Treating Urinary Incontinence

    Science.gov (United States)

    ... control problems, including how they work to treat urinary incontinence and possible side effects. By Mayo Clinic Staff ... a look at medications commonly prescribed to treat urinary incontinence and their possible side effects. Keep in mind ...

  16. 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

  17. Botulinum toxin A for treatment of neurogenic detrusor overactivity and incontinence in patients with spinal cord lesions

    DEFF Research Database (Denmark)

    Bagi, Per; Biering-Sørensen, Fin

    2004-01-01

    To evaluate the efficacy of intravesical botulinum toxin A (BTA) in the treatment of severe neurogenic detrusor overactivity (NDO) with incontinence in patients with spinal cord lesions (SCLs).......To evaluate the efficacy of intravesical botulinum toxin A (BTA) in the treatment of severe neurogenic detrusor overactivity (NDO) with incontinence in patients with spinal cord lesions (SCLs)....

  18. 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

  19. Prevalence of Urinary Incontinence During Pregnancy and Associated Risk Factors.

    Science.gov (United States)

    Dinç, Ayten

    2017-07-04

    To investigate the prevalence of urinary incontinence during pregnancy and associated risk factors. The study is a cross-sectional and descriptive study. A questionnaire was conducted with a total of 750 pregnant women about their urinary incontinence complaints between April and December 2013. The prevalence of urinary incontinence during pregnancy was 300 in 750 (40%). Stress urinary incontinence was the most common type of incontinence during pregnancy. 41.7% of nulliparous women, 38% of primipara women, and 20.3% of multipara women experienced urinary incontinence. Among women reporting UI, 29.3% experienced leakage a few times a day and the amount of leakage was generally (59.7%) moderate. Factors significantly associated with urinary incontinence included age group, gestational age, parity, previous urinary incontinence, constipation, mode of delivery at last childbirth, previous urinary tract infection, body mass index during pregnancy. But on multivariable analysis, the risk factors for urinary incontinence during pregnancy were previous urinary tract infection (OR = 3.8, 95%CI 1.5-9.3), constipation (OR 3.1, 95%CI 1.7-5.6) and gestational age (OR 0.5, 95%CI 0.3-0.9). As a result of this study, urinary incontinence is a common condition during pregnancy. Results would help the design of more intensive training programs to prevent incontinence during pregnancy by increasing the awareness about urinary incontinence of healthcare staff engaging in the care of pregnant women. © 2017 John Wiley & Sons Australia, Ltd.

  20. [Urinary incontinence 6 months after childbirth].

    Science.gov (United States)

    Ruiz de Viñaspre Hernández, Regina; Rubio Aranda, Encarnación; Tomás Aznar, Concepción

    2013-08-17

    Urinary incontinence initiated before and right after delivery and persisting 3 months after delivery tends to become chronic. We intended to estimate the persistence of urinary incontinence 6 months postpartum and to analyse the different factors associated with it. Follow-up study 6 months after delivery of women presenting urinary incontinence symptoms in gestation or in the first 2 months of postpartum. The dependent variable was the persistence and the independent variables were grouped in obstetric and non-obstetric. Odds ratio (OR) were calculated with their confidence interval at 95% (IC 95%) in the bivariate analysis. The variables that showed an important risk of persistence of incontinence were used to perform a multivariate model of logistic regression. The persistence of incontinence 6 months after delivery was 21.4% (CI 95% 16-26.7). The risk of persistence increased with the Kristeller maneuver (OR 7.89, CI 95% 3.04-20.49), not weight recovery (OR 3.64, CI 95% 1.10-12.02), not practising pelvic floor muscle exercises in postpartum (OR 9.36, CI 95% 2.71-32.33), appearance of incontinence after delivery (OR 6.66, CI 95% 2.37-18.68) and the weight of the newborn>3.5 kg (OR 6.76, CI 95% 2.54-18.03), all of them explaining 58% of the variability of persistence. 21.4% of women with urinary incontinence caused by pregnancy/delivery will continue to have it 6 months postpartum. An important part of this persistence is associated with some factors easy to modify. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  1. 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.

  2. Effect of weight loss on urinary incontinence in women

    Science.gov (United States)

    Whitcomb, Emily L; Subak, Leslee L

    2011-01-01

    Background 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 approaches is effective in reducing urinary incontinence symptoms and should be strongly considered as a first line treatment for overweight and obese women with urinary incontinence. PMID:24198645

  3. Surgery versus physiotherapy for stress urinary incontinence

    NARCIS (Netherlands)

    Labrie, J.; Berghmans, B.L.; Fischer, K.; Milani, A.L.; Wijk, I. van; Smalbraak, D.J.; Vollebregt, A.; Schellart, R.P.; Graziosi, G.C.; Ploeg, J.M. van der; Brouns, J.F.; Tiersma, E.S.; Groenendijk, A.G.; Scholten, P.; Mol, B.W.; Blokhuis, E.E.; Adriaanse, A.H.; Schram, A.; Roovers, J.P.; Lagro-Janssen, A.L.M.; Vaart, C.H. van der

    2013-01-01

    BACKGROUND: Physiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial

  4. Surgery versus Physiotherapy for Stress Urinary Incontinence

    NARCIS (Netherlands)

    Labrie, Julien; Berghmans, Bary L. C. M.; Fischer, Kathelijn; Milani, Alfredo L.; van der Wijk, Ileana; Smalbraak, Dina J. C.; Vollebregt, Astrid; Schellart, Rene P.; Graziosi, Giuseppe C. M.; van der Ploeg, J. Marinus; Brouns, Joseph F. G. M.; Tiersma, E. Stella M.; Groenendijk, Annette G.; Scholten, Piet; Mol, Ben Willem; Blokhuis, Elisabeth E.; Adriaanse, Albert H.; Schram, Aaltje; Roovers, Jan-Paul W. R.; Lagro-Janssen, Antoine L. M.; van der Vaart, Carl H.

    2013-01-01

    BackgroundPhysiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial

  5. A comparison of the treatment recommendations for neurogenic lower urinary tract dysfunction in the national institute for health and care excellence, European Association of Urology and international consultations on incontinence guidelines.

    Science.gov (United States)

    Jaggi, Ashley; Drake, Marcus; Siddiqui, Emad; Fatoye, Francis

    2018-04-17

    Healthcare guidelines are an important vehicle in establishing up-to-date evidence based medicine (EBM) in clinical practice. Due to varying development processes, clinical guidelines created by different institutions can often contain contrasting recommendations. This can have implications for optimal and standardized patient care across management settings. The similarities and differences of treatment recommendations made in the National Institute for Health and Care Excellence (NICE), The European Association of Urology (EAU), and the International Consultation on Continence (ICI) guidelines for neurogenic lower urinary tract dysfunction (NLUTD) were assessed. The guidelines generally agree on their approach to conservative management, including behavioral therapies, and catheterization techniques. There was discrepancy on the benefit of using an alpha blocker in NLUTD and bladder outlet obstruction (BOO) and administering Botulinum toxin A (Onabotulinum-A) in NLUTD. The highest degree of divergence was seen in recommendations for surgical treatments, where the EAU made gender-specific recommendations, and gave continent urinary diversion higher preference than given in the NICE and ICI guidelines. In the absence of high-quality clinical evidence, many of the recommendations made across all three guidelines are based on expert opinion. NICE, the EAU and ICI have similarities but they place differing emphasis on costs and expert opinion, which translated in notably different recommendations. It is evident that increased research efforts, possibly in the form of prospective registries, pragmatic trials, and resource utilization studies are necessary to improve the underlying evidence base for NLUTD, and subsequently the strength and concordance of recommendations across guidelines. © 2018 Wiley Periodicals, Inc.

  6. 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.

  7. [Assessment of Urinary Incontinence in Pregnancy and Postpartum: Observational Study].

    Science.gov (United States)

    Rocha, Juliana; Brandão, Pedro; Melo, Anabela; Torres, Silvia; Mota, Lurdes; Costa, Fernanda

    2017-08-31

    The urinary incontinence can affect up to 50% of women at some stage of their lives, particularly during pregnancy and postpartum. This study was designed in order to identify and assess the prevalence and risk factors for urinary incontinence during the third trimester of pregnancy and three months postpartum. Observational and cross-sectional study. The population of the study was composed of 268 women who delivered and were admitted to the Centro Hospitalar Tâmega e Sousa in the years 2013 and 2014, and who agreed to participate in this study. Postpartum women were asked to fill out a questionnaire adapted from the International Consultation on Incontinence Questionnaire - Short Form, for urinary incontinence research in the third trimester of pregnancy. Three months after delivery, they were contacted by telephone and asked to answer the same questions about the urinary incontinence postpartum. Of the 268 women interviewed, 31 were excluded from the study, taking into account the defined inclusion and exclusion criteria. In total (n = 237), 51.89% of women included in the study, reported the occurrence of urinary incontinence during pregnancy. The prevalence of urinary incontinence in pregnancy by parity (primiparous versus multiparous) was statistically significant (p = 0.006). At postpartum (n = 237), 28.69% of women with urinary incontinence had vaginal delivery and 5.91% of women underwent cesarean delivery (p = 0.001). In these group of women with postpartum urinary incontinence (n = 82), 31.69% have had urinary incontinence only in the postpartum and 68.31% of women have had symptoms during pregnancy (p urinary incontinence in pregnancy and the respective decrease in postpartum. Multiparity and occurrence of urinary incontinence in pregnancy appear as potential risk factors in the emergence of the urinary incontinence.

  8. Urinary incontinence after vaginal delivery or cesarean section.

    Science.gov (United States)

    Borges, João Bosco Ramos; Guarisi, Telma; Camargo, Ana Carolina Marchesini de; Gollop, Thomaz Rafael; Machado, Rogério Bonassi; Borges, Pítia Cárita de Godoy

    2010-06-01

    To assess the prevalence of stress urinary incontinence, urge incontinence and mixed urinary incontinence among women residing in the city of Jundiaí (São Paulo, Brazil), and the relation between the type of incontinence and the obstetric history of these women. A cross-sectional community-based study was conducted. A total of 332 women were interviewed; they were seen for whatever reason at the public primary healthcare units of the city of Jundiaí, from March 2005 to April 2006. A pre-tested questionnaire was administered and consisted of questions used in the EPINCONT Study (Epidemiology of Incontinence in the County of Nord-Trondelag). Statistical analysis was carried out using the χ2 test and odds ratio (95%CI). Urinary incontinence was a complaint for 23.5% of the women interviewed. Stress urinary incontinence prevailed (50%), followed by mixed urinary incontinence (35%) and urge incontinence (15%). Being in the age group of 35-64 years, having a body mass index of 30 or greater and having had only vaginal delivery or cesarean section, with uterine contraction, regardless of the number of pregnancies, were factors associated with stress urinary incontinence. However, being in the age group of 55 or older, having a body mass index of 30 or greater and having had three or more pregnancies, only with vaginal deliveries, were factors associated with mixed urinary incontinence. One third of the interviewees complained of some type of urinary incontinence, and half of them presented stress urinary incontinence. Cesarean section, only when not preceded by contractions, was not associated with stress urinary incontinence. The body mass index is only relevant when the stress factor is present.

  9. [Women's strategies for coping with urinary incontinence].

    Science.gov (United States)

    Delarmelindo, Rita de Cássia Altino; Parada, Cristina Maria Garcia de Lima; Rodrigues, Rosalina Aparecida Partezani; Bocchi, Silvia Cristina Mangini

    2013-04-01

    This article is part of a more comprehensive qualitative study which used grounded theory and symbolic interactionism as theoretical and methodological frameworks, resulting in the theoretical model entitled, Between suffering and hope: rehabilitation of urinary incontinence as an intervenient component. In order to communicate all the knowledge produced, part of this model is presented, and it refers to the process of coping with urinary incontinence by women without perspectives of access to surgical treatment after failure of conservative procedures. When interrelating the components (categories and subcategories) of these women's experience in order to compare and analyze them to understand their interaction, moral and psychosocial vulnerability were noticed within the experience of the group, which makes them susceptible to health risks and to compromise of their quality of life, observed in the movement of the group's experience. Research is needed to further understand experiences in which there are barriers to surgical treatment due to physicians' disbelief in its effectiveness.

  10. Effective Factors on Urinary Incontinence in Natural Menopausal Women

    OpenAIRE

    Shohani; V Carson; Sayehmiri; Shohani

    2015-01-01

    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 fro...

  11. Risk factors for postpartum urinary incontinence

    OpenAIRE

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

    2016-01-01

    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...

  12. Female urinary incontinence, from pregnancy to menopause: a review of epidemiological and pathophysiological findings. : Female urinary incontinence, a review

    OpenAIRE

    Fritel , Xavier; Ringa , Virginie; Quiboeuf , Emeline; Fauconnier , Arnaud

    2012-01-01

    International audience; Hypotheses that might explain urinary incontinence during pregnancy and after childbirth have been examined. The prevalence of urinary incontinence reaches a maximum during pregnancy and decreases after childbirth. Cesarean delivery is associated with lower rates of stress incontinence than vaginal delivery. Women delivered by cesarean section differ from women who had a vaginal delivery through pre-existing characteristics associated with the incontinence risk, produc...

  13. Urinary stress incontinence in postpartum women. Bibliographic review

    OpenAIRE

    Jose Manuel Barranco Cuadros; Irene Herrera Vargas; Raquel Rodríguez-Blanque; Juan Carlos Sánchez-García

    2017-01-01

    Introduction: Both pregnancy and childbirth are important risk factors for urinary stress incontinence in women. For its prevention, exercies of the pelvic floor musculature have been shown to be effective. Guidelines for urinary stress incontinence management recommend offering pelvic floor muscle training to women during their first pregnancy as a preventive measure. Objective: To update the information provided in the scientific literature on urinary stress incontinence during postpartu...

  14. Neurological aspects of urinary incontinence in the elderly

    OpenAIRE

    Vladimir Anatolyevich Parfenov

    2013-01-01

    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...

  15. 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.

  16. Urinary incontinence in primigravida: the neglected pregnancy predicament.

    Science.gov (United States)

    Abdullah, B; Ayub, S H; Mohd Zahid, A Z; Noorneza, A R; Isa, Mohamad Rodi; Ng, P Y

    2016-03-01

    To determine the prevalence of urinary incontinence among primigravida in the third trimester, its risk factors and its effect to quality of life. This is a cross sectional study involving primigravida in their third trimester of pregnancy, who attended the Patient Assessment Centre of a tertiary referral hospital in Klang Valley from July 2012 to June 2013. The participants were chosen randomly using convenience sampling. A face-to-face interview and a review of their antenatal record were done by trained interviewers. Data on sociodemographic and risk factors were obtained followed by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF). The data was analysed using Statistical Package for Social Science version 20.0. A total of 306 women were involved. The prevalence of urinary incontinence during third trimester was 34.3% (95%CI: 29.0, 39.7). Stress incontinence (64.8%) is the commonest followed by mixed incontinence (24.8%) and urge incontinence (6.7%). Childhood enuresis (p=0.003) and previous history of urinary incontinence (purinary incontinence. More than 50 percent of women with urinary incontinence in the third trimester felt that it did not affect their daily activities at all. Only 10% of women felt greatly affected by this problem. Urinary incontinence is not uncommon among primigravida however many women did not feel that it affected their quality of life. Childhood enuresis and history of urinary incontinence were proven risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Impact of urinary incontinence types on women's quality of life.

    Science.gov (United States)

    Saboia, Dayana Maia; Firmiano, Mariana Luisa Veras; Bezerra, Karine de Castro; Vasconcelos, José Ananias; Oriá, Mônica Oliveira Batista; Vasconcelos, Camila Teixeira Moreira

    2017-12-21

    To identify the most frequent type of urinary incontinence in women assisted in two outpatient clinics of urogynecology, and to compare general and specific quality of life among the different types of incontinence measured through validated questionnaires. Cross-sectional study conducted at the urogynecology outpatient clinic. The following questionnaires were used for quality of life assessment: Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), International Consultation Incontinence Questionnaire Short-Form (ICIQ-SF), King's Health Questionnaire (KHQ), and Pelvic Organ Prolapse Incontinence Sexual Questionnaire (PISQ-12). The study included 556 women. Mixed Urinary Incontinence was the most frequent type (n=348/62.6%), followed by Stress Urinary Incontinence (n=173/31.1%) and Urge Urinary Incontinence (n=35/6.3%). Women with mixed urinary incontinence had greater impact on the general (SF-36) and specific quality of life (KHQ and ICIQ-SF) compared to the others (p<0.05). In the evaluation of sexual function (PISQ-12), there was no difference between groups (p=0.28). All types of urinary incontinence interfere both in the general and specific quality of life, but women with mixed urinary incontinence are the most affected.

  18. 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.

  19. [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.

  20. 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

  1. Sling surgery for stress urinary incontinence; the perfect solution?

    NARCIS (Netherlands)

    Hogewoning, C.R.C.

    2017-01-01

    Stress urinary incontinence (SUI) is the most observed type of urinary incontinence and is defined as the loss of urine following a rise in abdominal pressure. The TVT (Tension-free Vaginal Tape), a mid-urethral sling (MUS), was introduced in 1996 and soon became the gold standard in the surgical

  2. 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…

  3. Can low urinary tract symptoms influence postprostatectomy urinary incontinence?

    Science.gov (United States)

    Tienza, Antonio; Hevia, Mateo; Merino, Imanol; Diez-Caballero, Fernando; Rosell, David; Pascual, Juan I; Zudaire, Juan J; Robles, José E

    2016-08-01

    The aim of this study was to analyze what kind of urinary symptoms patients have before receiving treatment by radical prostatectomy (RP), and to evaluate their influence on urinary incontinence (UI). Between 2002 and 2012, 758 consecutive patients underwent RP for clinically localized prostate cancer (PCa). Surgery was carried out by open retropubic RP in 545 (73.1%) of patients and laparoscopic RP in 201 (27%) by 5 surgeons who were excluded from data collection and analysis. The following symptoms were collected from the last urological check-ups or pre-operative consultation and classified as: storage symptoms, voiding symptoms, post micturition symptoms, history of acute urinary retention, benign prostatic hyperplasia treatment, history of transurethral resection of the prostate (TURP). A total of 661 patients were included on analysis: 136 (20.6%) patients reported low urinary tract symptoms (LUTS), 162 (24.5%) were considered incontinent after RP, and 45 (33.1%) of them reported LUTS before surgery. Postprostatectomy urinary incontinence (PPUI) was significantly different in patients with LUTS (117 [22.3%] vs. 45 [33.1%], P=0.009). The presence of any LUTS influence significantly in the appearance of PPUI (OR=1.72 [95% CI: 1.14-2.6), P=0.01). TURP is independently influential in PPUI (OR=6.13 [95% CI: 1.86-20.18], P=0.003). A patient with LUTS before surgery has an increased risk of 70% or even 200% to suffer PPUI and a patient who received treatment by TURP is 6 times at higher risk of PPUI. In conclusion, patients with LUTS are likely to present PPUI. History of TURP is influential by itself over PPUI. A good preoperative consultation is important to assess continence status and to create realistic expectations to patients before RP.

  4. Quality of life in women with urinary incontinence

    Directory of Open Access Journals (Sweden)

    DraLjiljana Mladenović Segedi

    2011-08-01

    Full Text Available Aim To determine the characteristics of urinary incontinence and its impact on the quality of life in adult women with urinary incontinence who presented to a tertiary care clinic of Vojvodina from September 2008 to May 2009 for treatment Methods We used a prospective case-control study. Cases were defined as patients (47 with urinary incontinence symptoms. Controls(50 were defined as patients without urinary incontinence who presented to a tertiary care gynecology clinic for other reasons. Both, cases and controls, completed two questionnaires recommended for the evaluation of symptoms, The Urinary Distress Inventory, and quality of life impact The Urinary Impact Questionnaire. Results There was a significant correlation between aging(r=0.614; p<0.01, body mass index (r=0.357; p<0.01 and menopause(r= -0.572; p<0.01 and urinary incontinence. All patients had symptoms of stress incontinence, 61.7% had urge incontinence symptoms, 21.3% voiding difficulty and 85.1% dysuria. Ninety-four patients believed that urinary incontinence impaired their quality of life: 50% of patients reported an impaired ability to do household activities, 59.1% avoided social activities, 70.4% reported an impaired ability to travel more than 30 minutes by car or bus, 88.6% avoided leisure activities, 45.5% of patients had impaired emotional health and 34% felt frustrated. Conclusion The dominant type of urinary incontinence in more than half of the respondents was a mixed type, with moderate to very severe problems. Symptoms of urinary incontinence interfere with the performance of everyday household and social activities, causing the appearance of anxiety, depression and frustration, and in more than 50% of women leads to reduced quality of life.

  5. Stress urinary incontinence in the female

    International Nuclear Information System (INIS)

    Baldelli, S.; Giovagnoni, A.; Bichi Secchi, E.; Argaglia, G.; Caraceni, E.; Muzzonigro, G.

    1988-01-01

    This work is aimed at demonstrating the validity of conventional radiological procedures, correlated with urodynamics, in the study of female urinary stress incontinence. In a study population of 110 patients with a clinical-urodynamic diagnosis of stress incontinence, radiological evaluation was performed by means of retrograde cystography, bead chain cystourethrography, and voiding cystourethrography. Radiographic findings were correlated with urodynamic data, and in particular with urethral pressure profile (fuctional lenght of the urethra, maximum closing pressure, maximum urethral pressure). In all patients the posterior urethro-vesical angle values were higher than 100 grade centigrades; moreover, a correlation was proven to exist between an increase in the angle of front urethral inclination, the lowering and mobility of the urethro-vesical junction, and the severeness of urodynamic findings. Furtheremore, in the different stages of urodynamic severeness, urethral funnelling was most frequent, and the flattening of the posterior vesical floor in voiding cystourethrography. The high reliability of the radiographic findings, although obtained by means of conventional techniques, and the variability of the morphodynamic results confirm the importance of a combined radiographic and urodynamic study in the evaluation of stress incontinence

  6. An Unusual Cause of Urinary Incontinence: Ewing's Sarcoma

    Directory of Open Access Journals (Sweden)

    Serhan Kupeli

    2015-03-01

    Full Text Available Urinary incontinence in children can be originated mostly from urinary tract infections, but constipation, neurologic disorders, obstruction and tumors can also be considered among other causes. Pelvic tumors may present with back pain, bladder or bowel dysfunction. Ewing's sarcoma is among the small round-cell tumors of the childhood and potentially can arise from any part of the body. Here, we report an 11-year-old male presented with urinary incontinence and diagnosed as Ewing's sarcoma after 6 weeks' delay. Clinicians should suspect from pelvic tumors in the presence of urinary incontinence especially associated with low back pain. [Cukurova Med J 2015; 40(Suppl 1: 94-96

  7. Major Odorants Released as Urinary Volatiles by Urinary Incontinent Patients

    Directory of Open Access Journals (Sweden)

    In Young Sa

    2013-07-01

    Full Text Available In this study, volatile urinary components were collected using three different types of samples from patients suffering from urinary incontinence (UI: (1 urine (A; (2 urine + non-used pad (B; and (3 urine + used pad (C. In addition, urine + non-used pad (D samples from non-patients were also collected as a reference. The collection of urinary volatiles was conducted with the aid of a glass impinger-based mini-chamber method. Each of the four sample types (A through D was placed in a glass impinger and incubated for 4 hours at 37 °C. Ultra pure air was then passed through the chamber, and volatile urine gas components were collected into Tedlar bags at the other end. These bag samples were then analyzed for a wide range of VOCs and major offensive odorants (e.g., reduced sulfur compounds (RSCs, carbonyls, trimethylamine (TMA, ammonia, etc.. Among the various odorants, sulfur compounds (methanethiol and hydrogen sulfide and aldehydes (acetaldehyde, butylaldehyde, and isovaleraldehyde were detected above odor threshold and predicted to contribute most effectively to odor intensity of urine incontinence.

  8. Surgery versus physiotherapy for stress urinary incontinence.

    Science.gov (United States)

    Labrie, Julien; Berghmans, Bary L C M; Fischer, Kathelijn; Milani, Alfredo L; van der Wijk, Ileana; Smalbraak, Dina J C; Vollebregt, Astrid; Schellart, René P; Graziosi, Giuseppe C M; van der Ploeg, J Marinus; Brouns, Joseph F G M; Tiersma, E Stella M; Groenendijk, Annette G; Scholten, Piet; Mol, Ben Willem; Blokhuis, Elisabeth E; Adriaanse, Albert H; Schram, Aaltje; Roovers, Jan-Paul W R; Lagro-Janssen, Antoine L M; van der Vaart, Carl H

    2013-09-19

    Physiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial therapy. We performed a multicenter, randomized trial to compare physiotherapy and midurethral-sling surgery in women with stress urinary incontinence. Crossover between groups was allowed. The primary outcome was subjective improvement, measured by means of the Patient Global Impression of Improvement at 12 months. We randomly assigned 230 women to the surgery group and 230 women to the physiotherapy group. A total of 49.0% of women in the physiotherapy group and 11.2% of women in the surgery group crossed over to the alternative treatment. In an intention-to-treat analysis, subjective improvement was reported by 90.8% of women in the surgery group and 64.4% of women in the physiotherapy group (absolute difference, 26.4 percentage points; 95% confidence interval [CI], 18.1 to 34.5). The rates of subjective cure were 85.2% in the surgery group and 53.4% in the physiotherapy group (absolute difference, 31.8 percentage points; 95% CI, 22.6 to 40.3); rates of objective cure were 76.5% and 58.8%, respectively (absolute difference, 17.8 percentage points; 95% CI, 7.9 to 27.3). A post hoc per-protocol analysis showed that women who crossed over to the surgery group had outcomes similar to those of women initially assigned to surgery and that both these groups had outcomes superior to those of women who did not cross over to surgery. For women with stress urinary incontinence, initial midurethral-sling surgery, as compared with initial physiotherapy, results in higher rates of subjective improvement and subjective and objective cure at 1 year. (Funded by ZonMw, the Netherlands Organization for Health Research and Development; Dutch Trial Register number, NTR1248.).

  9. Quality of life in women with urinary incontinence.

    Science.gov (United States)

    Mladenović Segedi, Ljiljana; Segedi, Dimitrije; Parezanović Ilić, Katarina

    2011-08-01

    To determine the characteristics of urinary incontinence and its impact on the quality of life in adult women with urinary incontinence who presented to a tertiary care clinic of Vojvodina from September 2008 to May 2009 for treatment We used a prospective case-control study. Cases were defined as patients (47) with urinary incontinence symptoms. Controls (50) were defined as patients without urinary incontinence who presented to a tertiary care gynecology clinic for other reasons. Both, cases and controls, completed two questionnaires recommended for the evaluation of symptoms, The Urinary Distress Inventory, and quality of life impact The Urinary Impact Questionnaire. There was a significant correlation between aging (r=0.614; ptravel more than 30 minutes by car or bus, 88.6% avoided leisure activities, 45.5% of patients had impaired emotional health and 34% felt frustrated. The dominant type of urinary incontinence in more than half of the respondents was a mixed type, with moderate to very severe problems. Symptoms of urinary incontinence interfere with the performance of everyday household and social activities, causing the appearance of anxiety, depression and frustration, and in more than 50% of women leads to reduced quality of life.

  10. 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...

  11. 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.

  12. Combined stress urinary incontinence surgery at the time of ...

    African Journals Online (AJOL)

    2009-09-18

    Sep 18, 2009 ... Stanton SL, Hilton P, Norton C, Cardozo L. Clinical and urodynamic effects of anterior colporrhaphy and vaginal hysterectomy for prolapse with and without incontinence. Br J Obstet Gynaecol 1982; 89: 459-463. 2. Borstad E, Rud T. The risk of developing urinary stress-incontinence after vaginal repair in ...

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

    African Journals Online (AJOL)

    2010-12-02

    Dec 2, 2010 ... Demographic and Health Survey (SADHS) measured the prevalence of stress urinary incontinence (SUI) in South. Africa for the first time, but only among women who had had children.2. In 1998, the World Health Organization's first International. Consultation on Incontinence classified UI as a disease,.

  14. The Sexual Function and Influence of Urinary Incontinence ...

    African Journals Online (AJOL)

    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 clinics at Tygerberg ...

  15. 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

    • Anterior vaginal wall repair (surgical treatment of urinary incontinence) - slideshow

      Science.gov (United States)

      ... page: //medlineplus.gov/ency/presentations/100110.htm Anterior vaginal wall repair (surgical treatment of urinary incontinence) - series— ... to slide 4 out of 4 Overview The vaginal opening lies just below the urethral opening, and ...

    • Combined stress urinary incontinence surgery at the time of ...

      African Journals Online (AJOL)

      based approach to the problem of preventing stress urinary incontinence (SUI) following prolapse surgery. Design. We reviewed the current English language literature available on PubMed (Medline), as well as current relevant textbooks in print.

    • Duloxetine in the treatment of stress urinary incontinence

      NARCIS (Netherlands)

      Michel, Martin C.; Oelke, Matthias

      2005-01-01

      This manuscript reviews the pharmacodynamics and pharmacokinetics of duloxetine and its efficacy and safety in women with stress urinary incontinence. Duloxetine is a selective inhibitor of neuronal serotonin and norepinephrine uptake which increases urethral striated muscle activity and bladder

    • Behavior profiles in children with functional urinary incontinence before and after incontinence treatment

      NARCIS (Netherlands)

      A. Bael (An); P. Winkler (Pauline); H. Lax (Hildegard); H. Hirche (Herbert); E. Gäbel (Elisabeth); M. Vijverberg (Marianne); R. van Zon (Roelie); E. van Hoecke (Eline); J.D. van Gool (Jan)

      2008-01-01

      textabstractOBJECTIVE. The purpose of this work was to analyze prospectively the prevalence of behavioral disorders in children with urinary incontinence because of nonneuropathic bladder-sphincter dysfunction before and after treatment for incontinence. METHODS. A total of 202 children with

    • Behavior profiles in children with functional urinary incontinence before and after incontinence treatment

      NARCIS (Netherlands)

      Bael, An; Winkler, Pauline; Lax, Hildegard; Hirche, Herbert; Gaebel, Elisabeth; Vijverberg, Marianne; van Zon, Roelie; Van Hoecke, Eline; van Gool, Jan D.

      OBJECTIVE. The purpose of this work was to analyze prospectively the prevalence of behavioral disorders in children with urinary incontinence because of nonneuropathic bladder-sphincter dysfunction before and after treatment for incontinence. METHODS. A total of 202 children with nonneuropathic

  1. 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.

  2. Diagnosis and conservative management of female stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Anil Krishna Dass

    2013-05-01

    Full Text Available Urinary incontinence affects 17–45% of women worldwide and stress urinary incontinence is responsible for 48% of all cases. Detailed history, physical examination and investigations are crucial to identify the diagnosis underlying the incontinence symptoms to select effective therapy. Although mid-urethral sling procedures are considered to be ‘gold standard’ treatment of SUI, conservative treatment with pelvic floor muscle training and lifestyle modification is still the first line of management. This article discusses the diagnosis and conservative management of female SUI.

  3. Parturition events and risk of urinary incontinence in later life.

    Science.gov (United States)

    Thom, David H; Brown, Jeanette S; Schembri, Michael; Ragins, Arona I; Creasman, Jennifer M; Van Den Eeden, Stephen K

    2011-11-01

    To examine the association between specific events during vaginal deliveries and urinary incontinence later in life. A retrospective cohort study of 1,521 middle-aged and older women with at least one vaginal delivery who were long-term members of an integrated health delivery system. Age, race/ethnicity, current incontinence status, medical, surgical history, pregnancy and parturition history, menopausal status, hormone replacement, health habits, and general health were obtained by questionnaire. Labor and delivery records, archived since 1948, were abstracted by professional medical record abstractors to obtain parturition events including induction, length of labor stages, type of anesthesia, episiotomy, instrumental delivery, and birth weight. The primary dependent variable was current weekly urinary incontinence (once per week or more often) versus urinary incontinence less than monthly (including no incontinence) in past 12 months. Associations of parturition events and later incontinence were assessed in multivariate analysis with logistic regression. The mean age of participants was 56 years. After adjustment for multiple risk factors, weekly urinary incontinence significantly associated with age at first birth (P = 0.036), greatest birth weight (P = 0.005), and ever having been induced for labor (OR = 1.51; 95%CI = 1.06-2.16, P = 0.02). Risk of incontinence increased from OR = 1.35 (95%CI = 0.92-1.97, P = 0.12) for women with one induction to OR = 2.67 (95%CI = 1.25-5.71, P = 0.01) for women with two or more inductions (P = 0.01 for trend). No other parturition factors were associated with incontinence. Younger age at first birth, greatest birth weight, and induction of labor were associated with an increased risk of incontinence in later life. Copyright © 2011 Wiley Periodicals, Inc.

  4. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women

    NARCIS (Netherlands)

    Herderschee, Roselien; Hay-Smith, E. Jean C.; Herbison, G. Peter; Roovers, Jan Paul; Heineman, Maas Jan

    2011-01-01

    Pelvic floor muscle training (PFMT) is an effective treatment for stress urinary incontinence in women. Whilst most of the PFMT trials have been done in women with stress urinary incontinence, there is also some trial evidence that PFMT is effective for urgency urinary incontinence and mixed urinary

  5. Experiences Related to Urinary Incontinence of Stroke Patients: A Qualitative Descriptive Study.

    Science.gov (United States)

    Arkan, Gulcihan; Beser, Ayse; Ozturk, Vesile

    2018-02-01

    Poststroke urinary incontinence is a common problem, with a prevalence ranging from 32% to 79%. Urinary incontinence after stroke has negative physiological, psychological, and economic effects, which lead to lifestyle changes for both patients and caregivers. Nurses play an important role in preventing and improving incontinence, understanding the experiences of individuals experiencing incontinence, providing healthcare for them, and implementing behavioral therapy methods. The aim of this study was to determine the experience related to urinary incontinence of stroke patients. In this qualitative descriptive study, using semistructured interviews, 15 participants with urinary incontinence after stroke selected through purposeful sampling were interviewed. Data were collected with a semistructured interview form prepared within the framework of the Health Belief Model. All data were analyzed using content analysis. Three main themes were identified: "perception of urinary incontinence," "effects of urinary incontinence," and "management of urinary incontinence." The respondents explained that urinary incontinence also adversely affected their caregivers. They experienced many daily life and psychological problems because of urinary incontinence. In addition, they made several changes to management urinary incontinence such as limiting fluid intake, changing underwear frequently, using waterproof mattress protectors, applying traditional practice, and taking medicine. This study revealed that stroke patients needed help and support for urinary incontinence management. Nurses should provide information about management and urinary incontinence after stroke.

  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, ppregnancy 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. Investigar os fatores de risco para a incontinência urinária (IU) no puerpério e as suas características. Trata-se de estudo caso-controle com 344 puérperas (77 casos e 267 controles), com até 90 dias pós-parto. Foi aplicado, em um único momento, um questionário para os dados sociodemográficos e clínicos, e dois outros para avaliar a perda urinária, situações de perda e o tipo de IU. Apresentaram IU de esforço 45,5%, perda urinária diversas vezes ao dia 44,2%, sendo 71,4% em pequena quantidade e 57,1% ao tossir ou espirrar. Em 70,1% dos casos a IU iniciou-se na gestação e permaneceu no puerpério. Ao ajustar-se um modelo de regressão logística binária, apenas IU na gestação (OR 12,82, IC 95% 6,94 - 23,81, p<0,0001), multiparidade (OR 2,26, IC 95% 1,22 - 4,19, p=0,009), idade gestacional no parto maior ou igual a 37 semanas (OR 2,52, IC 95% 1,16 - 5,46, p=0,02) e constipação (OR 1,94, IC

  7. Stress urinary incontinence: effect of pelvic muscle exercise

    NARCIS (Netherlands)

    Ferguson, K. L.; McKey, P. L.; Bishop, K. R.; Kloen, P.; Verheul, J. B.; Dougherty, M. C.

    1990-01-01

    Twenty women with stress urinary incontinence diagnosed by urodynamic testing participated in a 6-week pelvic muscle exercise program. The aim of the study was to evaluate the effectiveness of the exercise program, with or without an intravaginal balloon, on urinary leakage as determined by a

  8. Urinary incontinence, pelvic floor dysfunction, exercise and sport.

    Science.gov (United States)

    Bø, Kari

    2004-01-01

    Urinary incontinence is defined as "the complaint of any involuntary leakage of urine" and is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 64-year-old women. The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as "involuntary leakage on effort or exertion, or on sneezing or coughing". The aim of this article is to systematically review the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes. Stress urinary incontinence is a barrier to women's participation in sport and fitness activities and, therefore, it may be a threat to women's health, self-esteem and well-being. The prevalence during sports among young, nulliparous elite athletes varies between 0% (golf) and 80% (trampolinists). The highest prevalence is found in sports involving high impact activities such as gymnastics, track and field, and some ball games. A 'stiff' and strong pelvic floor positioned at an optimal level inside the pelvis may be a crucial factor in counteracting the increases in abdominal pressure occurring during high-impact activities. There are no randomised controlled trials or reports on the effect of any treatment for stress urinary incontinence in female elite athletes. However, strength training of the pelvic floor muscles has been shown to be effective in treating stress urinary incontinence in parous females in the general population. In randomised controlled trials, reported cure rates, defined as athletes than in other women. There is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor muscle training in female elite athletes.

  9. Diabetes, glycemic control, and urinary incontinence in women

    Science.gov (United States)

    Wang, Rui; Lefevre, Roger; Hacker, Michele R.; Golen, Toni H.

    2015-01-01

    OBJECTIVES To estimate the association between urinary incontinence and glycemic control in women ages 20 to 85. METHODS We included 7,270 women from the 2005–2010 National Health and Nutrition Examination Survey, stratified into three groups of glycemic control defined by hemoglobin A1c (HbA1c): i) those below the diagnostic threshold (HbA1c8.5%) to allow for a different relationship between glycemic control and urinary incontinence within each group. The primary outcomes were the presence of any, only stress, only urgency, and mixed urinary incontinence. We calculated adjusted risk ratios using Poisson regressions with robust variance estimates. RESULTS The survey-weighted prevalence was 52.9% for any, 27.2% for only stress, 9.9% for only urgency, and 15.8% for mixed urinary incontinence. Among women with relatively controlled diabetes, each one-unit increase in HbA1c was associated with a 13% (95% CI: 1.03–1.25) increase for any urinary incontinence and a 34% (95% CI 1.06–1.69) increase in risk for only stress incontinence but was not significantly associated with only urgency and mixed incontinence. Other risk factors included body mass index, hormone replacement therapy, smoking, and physical activity. CONCLUSIONS Worsening glycemic control is associated with an increased risk for stress incontinence for women with relatively controlled diabetes. For those either below the diagnostic threshold or with poorly controlled diabetes, the risk may be driven by other factors. Further prospective investigation of HbA1c as a modifiable risk factor may motivate measures to improve continence in women with diabetes. PMID:26313496

  10. Evaluation of a behavioral treatment for female urinary incontinence

    Directory of Open Access Journals (Sweden)

    Santacreu M

    2011-06-01

    Full Text Available Marta Santacreu, Rocío Fernández-BallesterosBiological and Health Psychology, Autonomous University of Madrid, Madrid, SpainAbstract: Urinary incontinence is a medical, psychological, social, economic, and hygienic problem. Although it is difficult to state its prevalence, all authors agree that it is related to age and gender. This study aimed to carry out a urinary incontinence behavioral treatment in order to reduce urine leakages in 14 participants recruited from a senior center. The program consists of daily training of the pelvic floor muscles with a weekly control by a supervisor during a 2-month period and follow-up of results 2 months after the last control session. Urinary incontinence episodes were reduced by 75.67% after program completion. It appears that pelvic floor muscles training, carried out under controlled and constant supervision, significantly reduces urinary leakage. Moreover, maintaining this improvement after treatment depends on the continuation of the exercises as well as on the urinary leakage frequency baseline and the urinary leakage frequency during the last treatment session.Keywords: urinary incontinence, pelvic floor muscle training, quasi-experimental design

  11. Urinary stress incontinence in postpartum women. Bibliographic review

    Directory of Open Access Journals (Sweden)

    Jose Manuel Barranco Cuadros

    2017-11-01

    Full Text Available Introduction: Both pregnancy and childbirth are important risk factors for urinary stress incontinence in women. For its prevention, exercies of the pelvic floor musculature have been shown to be effective. Guidelines for urinary stress incontinence management recommend offering pelvic floor muscle training to women during their first pregnancy as a preventive measure. Objective: To update the information provided in the scientific literature on urinary stress incontinence during postpartum and possible forms of treat it. Methodology: A systematic bibliographic review was carried out in the following databases: PUBMED, COCHRANE, CINHAL, MEDLINE, SciELO and SCOPUS. The date was restricted to the last 5 years (2012-2017, in Spanish, English and Portuguese. Restrictions were made regarding the type of study, and Randomized Clinical Trials (RCTs were considered for this review. Results: After reviewing the literature consulted, it is concluded that the training of the pelvic floor musculature is beneficial to prevent the occurrence of urinary stress incontinence during pregnancy and the postpartum period. Conclusions: The results obtained in this review are consistent with previous studies and bibliographic reviews of the same topic. It follows that training of the pelvic floor muscles is beneficial in preventing the occurrence of urinary stress incontinence during pregnancy or postpartum.

  12. Urinary incontinence in women in relation to occupational status.

    Science.gov (United States)

    Kim, Yoonjung; Kwak, Yeunhee

    2017-01-01

    Through this cross-sectional study the authors explore urinary incontinence in women in relation to occupational status and environment. Data from the fourth Korea National Health and Nutrition Examination Survey (2008-2009) were used (n = 5,928) excluding those aged under 19 or over 65 years, male, with renal disease, and with missing data. Urinary incontinence was prevalent in working women. Compared to unemployed women, the adjusted odds ratio (95% confidence intervals) for women working in services/sales was 1.62 (1.21-2.19); for paid workers was 1.81 (1.20-2.73); and for self-employed workers was 1.46 (1.05-2.03). Compared to unemployed women, the adjusted odds ratio for working women with a daytime work schedule was 2.14 (1.18-3.87), while for those with evening work schedules, it was 1.35 (1.05-1.74). Urinary incontinence was significantly associated with various occupational environments: an unclean and uncomfortable workplace, dangerous job and probability of accidents, feeling pressed for time, awkward position for long periods, and carrying heavy weights. These findings suggest that urinary incontinence was prevalent in working women and was associated with occupational status and working environment. Therefore, improving occupational status and environment for working women-such as modifying the working schedule, posture, and workplace atmosphere-are needed to prevent urinary incontinence.

  13. 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

  14. 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...

  15. 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)

  16. Urinary incontinence monitoring system using laser-induced graphene sensors

    KAUST Repository

    Nag, Anindya

    2017-12-25

    This paper presents the design and development of a sensor patch to be used in a sensing system to deal with the urinary incontinence problem primarily faced by women and elderly people. The sensor patches were developed from laser-induced graphene from low-cost commercial polyimide (PI) polymers. The graphene was manually transferred to a commercial tape, which was used as sensor patch for experimentation. Salt solutions with different concentrations were tested to determine the most sensitive frequency region of the sensor. The results are encouraging to further develop this sensor in a platform for a fully functional urinary incontinence detection system.

  17. Effect of Age, Educational Status, Parity and BMI on Development of Urinary Incontinence - a Cross Sectional Study in Saudi Population

    OpenAIRE

    Saadia, Zaheera

    2015-01-01

    Background: The research article looks at the background of women with urinary incontinence and exposed to different demographic factors. Women who had urinary incontinence and women without urinary incontinence were compared with regards to their demographic features and risk of development of urinary problems. These risk factors can either cause short term or temporary urinary incontinence or they can cause long term or permanent urinary incontinence. This article explores the association o...

  18. [Analysis of risk factors about stress urinary incontinence in female].

    Science.gov (United States)

    Song, Yan-feng; Lin, Jian; Li, Ya-qin; He, Xiao-yu; Xu, Bo; Hao, Lan; Song, Jian

    2003-12-01

    The aim was to assess the prevalence of stress urinary incontinence (SUI) in community dwelling women and to assess the relationship between the various risk factors and this disease. Selecting the community of Gulou at random and sending questionnaires to 6,066 women who living there. The questionnaire was designed to investigate the lower urinary tract symptoms, especially urinary incontinence. The questionnaire included some questions such as: age, weight, occupation, the level of education, menopause pregnancy and delivery, delivery through vagina or by cesarean section, the maximum body weight of fetus, chronic disease (hypertension, diabetes mellitus, cough, constipation), operation in abdomen and pelvis, the behaviour of life (smoking, alcohol abuse, exercise), the prevalence and frequency of urinary incontinence, the quality of life and the recognition of this disease. The collecting rate was 92.1% (5,587/6,066). The prevalence of urinary incontinence was 18.1% and the prevalence of SUI was 8.8%. Age (OR: 1.010, 95% CI: 1.001 - 1.025), higher body mass index (OR: 1.092, 95% CI: 1.054 - 1.132), hypertension (OR: 2.342, 95% CI: 1.026 - 5.349), constipation (OR: 1.448, 95% CI: 1.216 - 1.725), multiple abortion (OR: 1.306, 95% CI: 1.113 - 1.533), multipara (OR: 1.205, 95% CI: 1.009 - 1.440), using abdominal pressure in laboring (OR: 1.684, 95% CI: 1.140 - 2.489), straight cutting of perineum (OR: 2.244, 95% CI: 1.162 - 4.334), perineum tear (OR: 2.576, 95% CI: 1.724 - 3.851), infection of perineal incision (OR: 5.988, 95% CI: 1.936 - 18.616) were risk factors of SUI in women. Many risk factors can cause urinary incontinence, among them age, pregnancy and childbirth are most important ones.

  19. 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.

  20. 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.

  1. Prevalence of Stress Urinary Incontinence in Elite Female Endurance Athletes

    Directory of Open Access Journals (Sweden)

    Poświata Anna

    2014-12-01

    Full Text Available The goal of the study was to assess the prevalence of stress urinary incontinence in a group of elite female endurance athletes, as professional sport is one of the risk factors for stress urinary incontinence. SUI rates in the groups of female cross-country skiers and runners were compared to determine whether the training weather conditions like temperature and humidity influenced the prevalence of urinary incontinence. An anonymous questionnaire was distributed among 112 elite female athletes ie., 57 cross-country skiers and 55 runners. We used a short form of the Urogenital Distress Inventory (UDI-6 to assess the presence of SUI symptoms and the level of urogenital distress. Only women who had been practicing sport professionally for at least 3 years, on an international and national level, were included in the research. The study group consisted of 76% nulliparous and 24% parous women. 45.54% of all participants reported leakage of urine associated with sneezing or coughing which indicates stress urinary incontinence. 29.46% were not bothered by the urogenital distress symptoms. 42.86% of the participants were slightly bothered by the symptoms, 18.75% were moderately bothered, 8.04% were significantly bothered and 0.89% were heavily bothered. The absence of statistically significant differences between both groups seems to indicate that training weather conditions did not influence the prevalence of SUI in elite female endurance athletes.

  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,

  3. Yoga for treatment of urinary incontinence in women

    Science.gov (United States)

    Wieland, L. Susan; Shrestha, Nipun; Lassi, Zohra S; Panda, Sougata; Chiaramonte, Delia; Skoetz, Nicole

    2017-01-01

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effectiveness and safety of yoga for treatment of urinary incontinence in women, compared to no specific treatment, to another active treatment, or to an active treatment without adjuvant yoga, with a focus on patient symptoms and quality of life. PMID:29081716

  4. [Increase in number of operations for stress urinary incontinence

    NARCIS (Netherlands)

    Vierhout, M.E.

    2005-01-01

    Since the introduction of the minimally invasive tension-free vaginal tape (TVT) the number of operations performed for treatment of stress urinary incontinence has increased dramatically from over 1600 in 1999 to more than 4200 in 2003. Both gynaecologists and urologists now perform more TVTs and

  5. Development of hydrogel implants for urinary incontinence treatment

    Czech Academy of Sciences Publication Activity Database

    Šefc, L.; Přádný, Martin; Vacík, Jiří; Michálek, Jiří; Povýšil, C.; Vítková, I.; Halaška, M.; Šimon, V.

    2002-01-01

    Roč. 23, č. 17 (2002), s. 3711-3715 ISSN 0142-9612 R&D Projects: GA AV ČR KSK4050111 Institutional research plan: CEZ:AV0Z4050913 Keywords : urinary incontinence * swelling materials * artificial obstruction Subject RIV: FJ - Surgery incl. Transplants Impact factor: 3.008, year: 2002

  6. Rectus Fascia Sling for the Treatment of Total Urethral Incontinence ...

    African Journals Online (AJOL)

    Objectives: Urinary incontinence in patients with neurological disease is a major health problem. A modified rectus fascial sling has been assessed in incontinent male patients. Patients and Methods: Fourteen adult male patients with total incontinence due to neurogenic or post-traumatic and etiology were included in this ...

  7. The Burden of Urinary Incontinence and Urinary Bother Among Elderly Prostate Cancer Survivors

    Science.gov (United States)

    Kopp, Ryan P.; Marshall, Lynn M.; Wang, Patty Y.; Bauer, Douglas C.; Barrett-Connor, Elizabeth; Parsons, J. Kellogg

    2014-01-01

    Background Data describing urinary health in elderly, community-dwelling prostate cancer (PCa) survivors are limited. Objective To elucidate the prevalence of lower urinary tract symptoms, urinary bother, and incontinence in elderly PCa survivors compared with peers without PCa. Design, setting, and participants A cross-sectional analysis of 5990 participants in the Osteoporotic Fractures in Men Research Group, a cohort study of community-dwelling men ≥65 yr. Outcome measurements and statistical analysis We characterized urinary health using self-reported urinary incontinence and the American Urological Association Symptom Index (AUA-SI). We compared urinary health measures according to type of PCa treatment in men with PCa and men without PCa using multivariate log-binomial regression to generate prevalence ratios (PRs). Results and limitations At baseline, 706 men (12%) reported a history of PCa, with a median time since diagnosis of 6.3 yr. Of these men, 426 (60%) reported urinary incontinence. In adjusted analyses, observation (PR: 1.92; 95% confidence interval [CI], 1.15–3.21; p = 0.01), surgery (PR: 4.68; 95% CI, 4.11–5.32; p incontinence. Daily incontinence risk increased with time since diagnosis independently of age. Observation (PR: 1.33; 95% CI, 1.00–1.78; p = 0.05), surgery (PR: 1.25; 95% CI, 1.10–1.42; p = 0.0008), and ADT (PR: 1.50; 95% CI, 1.26–1.79; p urinary incontinence, which rose with increasing survivorship duration. Observation, surgery, and ADT were each associated with increased urinary bother. These data suggest a substantially greater burden of urinary health problems among elderly PCa survivors than previously recognized. PMID:23587870

  8. 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

  9. Diagnostic agreement of the 3 Incontinence Questionnaire to video-urodynamics findings in women with urinary incontinence

    Science.gov (United States)

    Omar, Mohammad Ali; Laniado, Marc

    2017-01-01

    Introduction There are limited studies evaluating the 3 Incontinence Questionnaire (3IQ) against urodynamics based diagnosis as a reference standard. The 3IQ has been proposed to be useful to evaluate women at the level of primary care. The aim of this study was to determine correlation between 3IQ and video-urodynamics (VUDS) in diagnosing types of urinary incontinence. Material and methods Prospective data was collected on 200 consecutive female patients referred by primary care physicians for urinary incontinence. The mean age was 55 years (range 15–83 years). The patients were evaluated using the 3IQ and video-urodynamics. The 3IQ-based diagnosis of type of female urinary incontinence was compared to VUDS-based results. Sensitivity, specificity, positive likelihood ratios and positive predictive values were calculated. Results On 3IQ based self-evaluation, 28% of patients were classified as having stress urinary incontinence, 20% with urge incontinence and 40% with mixed incontinence. On video-urodynamics, urodynamic stress urinary incontinence (UDSUI) was detected in 56% of patients, detrusor overactivity (DO) in 15% and mixed urinary incontinence (MUI) in 19%. The 3IQ had a sensitivity and specificity respectively of 43% and 92% for UDSUI, 57% and 86% for DO and 58% and 64% for MUI. The corresponding positive likelihood ratios (CI, 95%) were 5.4 (CI 2.6 to 11.3) for stress urinary incontinence, 4.0 (CI 2.5 to 6.5) for DO and 1.62 (1.2 to 2.3) for MUI. The respective positive predictive values were 87% (CI 75% to 95%), 42% (CI 26% to 58%) and 28% (18% to 39%). Conclusions In our study population, stress urinary incontinence was reasonably well predicted by the 3IQ, but the questionnaire under-performed in the diagnoses of detrusor overactivity and mixed urinaryincontinence. PMID:29732212

  10. Quality of life in women with urinary incontinence

    Directory of Open Access Journals (Sweden)

    Cláudia Senra

    2015-04-01

    Full Text Available Summary The aim of this study is to examine the relationship among psychological, clinical and sociodemographic variables, and quality of life in women with urinary incontinence. The sample consisted of 80 women diagnosed with urinary incontinence (UI followed in a Northern Central Hospital in Portugal. Participants answered the Incontinence Quality of Life (I-QOL; Satisfaction with Sexual Relationship Questionnaire (SSRQ; Hospital Anxiety and Depression Scales (HADS and the Brief Cope. The results revealed that women with higher quality of life considered their symptoms of urine loss as mild or moderated compared to those with severe urine loss. The less severe urine loss was associated with greater sexual satisfaction and less use of religion and self-blame as coping strategies. In terms of coping, women who considered the loss of urine as severe expressed more feelings regarding UI. Stress urinary incontinence, high sexual satisfaction, and less use of denial, distraction, and religion as coping strategies, predicted higher quality of life. According to the results, UI has an impact on women’s sexual satisfaction and quality of life. Therefore, intervention programs should target these women, including their partners, helping them to adjust to their condition and teaching effective coping strategies in order to improve their sexual satisfaction and quality of life.

  11. 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.)

  12. [Surgical treatment of prolapse by abdominal route and effort-related urinary incontinence].

    Science.gov (United States)

    Wagner, L; Fatton, B; Delmas, V; Haab, F; Costa, P

    2009-12-01

    Stress urinary incontinence is often associated with prolapse. The suburethral tapes have modified the indication for a preventive treatment of incontinence. The tapes are necessary in case of patent or masked incontinence, discussed in case of potential incontinence. The diagnosis of incontinence is done on questions to the patient, clinical exam, more than in urodynamic study. There is no absolute sign allowing to predict postoperative incontinence after surgery for prolapse. A continent woman can be incontinent postoperatively. If a potential incontinence is treated in the same as the prolapse, the patient must be informed of risk of obstruction and/or urgency.

  13. [Established treatment options for male stress urinary incontinence].

    Science.gov (United States)

    Hampel, C; Gillitzer, R; Wiesner, C; Thüroff, J W

    2007-03-01

    Nowadays, male stress urinary incontinence is rare and almost always of iatrogenic origin (radiotherapy, pelvic surgery). However, the prognosis of urinary incontinence following surgery is good and can be improved by pelvic floor muscle exercises in combination with biofeedback systems. For the remaining patient cohort with persistent urinary incontinence, several established surgical treatment options are available. Suburothelial injections of bulking agents can easily be performed in an ambulatory setting. However, regardless of the material used, long-term results are disappointing. Moreover, the residual urethral function deteriorates due to cicatrization of the suburothelial plexus with consequent loss of urethral elasticity. The fascial sling procedure in males has to be performed in preoperated areas and is as technically demanding for the surgeon as it is burdening for the patient. Alloplastic material is not used, thus minimizing risks for arrosion or infection. Since the sling tension can neither be standardized nor postoperatively readjusted, the risk of overcorrection is considerable and the success of the procedure is heavily dependent on the surgeon's experience. Despite wear and high revision rates, the technically mature artificial sphincter produces excellent continence results and has become the gold standard in the therapy of male stress urinary incontinence. The circumferential and continuous urethral compression by the cuff is highly effective, but at the price of an almost inevitable urethral atrophy. To overcome this problem, various surgical techniques have been developed (tandem cuff, cuff downsizing, transcorporal cuff placement). However, the expensive artificial sphincter is not a nostrum for every incontinent man, since it requires certain minimal cognitive and manual capabilities. Therefore, the search for less demanding treatment alternatives seems to be necessary, even if one has to accept lower continence rates.

  14. Urinary leakage during sexual intercourse among women with incontinence: Incidence and risk factors.

    Directory of Open Access Journals (Sweden)

    Hui-Hsuan Lau

    Full Text Available Coital incontinence is an under-reported disorder among women with urinary incontinence. Women seldom voluntarily report this condition, and as such, related data remains limited and is at times conflicting.To investigate the incidence and quality of life in women with coital incontinence and to determine associated predictors.This observational study involved 505 sexually active women attending the urogynecologic clinic for symptomatic urinary incontinence at a tertiary medical center. All of the patients were consulted about the experience of coital incontinence and completed evaluations including urodynamics, and valid questionnaires including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, the Urogenital Distress Inventory and the Incontinence Impact Questionnaire.Of these women, 281 (56% had coital incontinence, while 224 (44% did not. Among women with coital incontinence, 181 (64% had urodynamic-proven stress incontinence, 29 (10% had mixed incontinence, and 15 (5% had detrusor overactivity. Only 25 (9% sought consultation for this disorder before direct questioning. Fifty percent (84/281 of the women rarely or sometimes had incontinence during coitus, while 33% (92/281 often had incontinence, and 17% (48/281 always had incontinence. The frequency of coital incontinence was not different regarding the types of incontinence (p = 0.153. Women with mixed incontinence had the worst sexual quality of life and incontinence-related symptom distress. Based on univariate analysis, higher body mass index (OR 2.47, p = 0.027, and lower maximal urethral closure pressure (≤ 30 cmH2O (OR 4.56, p = 0.007 were possible predictors for coital incontinence. Multivariate analysis showed lower MUCP was independently significant predictors (OR3.93, p = 0.042.The prevalence of coital intercourse in urinary incontinence women was high. Coital incontinence in these women was associated with abnormal urodynamic diagnosis and

  15. 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.

  16. Pathophysiology of nocturnal lower urinary tract symptoms in older patients with urinary incontinence.

    Science.gov (United States)

    Denys, Marie-Astrid; Decalf, Veerle; Kumps, Candy; Petrovic, Mirko; Goessaert, An-Sofie; Everaert, Karel

    2017-11-01

    To explore the mismatch between functional bladder capacity and nocturnal urine production, and to study the pathophysiology of an increased nocturnal urine production in older patients with urinary incontinence. The present prospective observational study included adults aged ≥65 years with urinary incontinence. Participants completed questionnaires, frequency volume charts and renal function profiles. The nocturnal lower urinary tract symptom index was defined as nocturnal urine output/maximum voided volume; the nocturnal polyuria index as nocturnal/24 h urine output. The median age (n = 95) was 74 years (69-79), 87% were women and 73% had nocturnal lower urinary tract symptoms (nocturnal urinary incontinence or nocturia ≥2). Participants with nocturnal lower urinary tract symptoms had a significantly higher nocturnal urine output (809 mL vs 650 mL; P = 0.001) and no significant difference in maximum voided volume (350 mL vs 437 mL; P = 0.079) compared with participants without nocturnal lower urinary tract symptoms. Participants (nocturnal polyuria index >33% [n = 56], nocturnal polyuria index >40% [n = 42], nocturnal lower urinary tract symptom index >1.87 [n = 51]) showed higher night-time diuresis rates, free water and sodium clearance compared with during the daytime. Controls (nocturnal polyuria index ≤33% [n = 26], nocturnal polyuria index ≤40% [n = 40], nocturnal lower urinary tract symptom index ≤1.87 [n = 44]) had no circadian rhythm in their diuresis rate or sodium clearance, but more nocturnal free water clearance compared with during the daytime. The majority of older adults with urinary incontinence present nocturnal lower urinary tract symptoms. An increased nocturnal sodium diuresis seems to be the only mechanism differentiating patients with nocturnal lower urinary tract symptoms from controls. © 2017 The Japanese Urological Association.

  17. Epidemiology of mixed, stress, and urgency urinary incontinence in middle-aged/older women: the importance of incontinence history.

    Science.gov (United States)

    Komesu, Yuko M; Schrader, Ronald M; Ketai, Loren H; Rogers, Rebecca G; Dunivan, Gena C

    2016-05-01

    Urinary incontinence (UI) is common and the relationship among its subtypes complex. Our objective was to describe the natural history and predictors of the incontinence subtypes stress, urgency, and mixed, in middle-aged and older US women. We tested our hypothesis that UI subtype history predicted future occurrence, evaluating subtype incidence/remission over multiple time points in a stable cohort of women. We analyzed longitudinal urinary incontinence data in 10,572 community-dwelling women aged ≥50 in the 2004-2010 Health and Retirement Study. Mixed, stress, and urgency incontinence prevalence (2004, 2006, 2008, 2010) and 2-year cumulative incidence and remissions (2004-2006, 2006-2008, 2008-2010) were estimated. Patient characteristics and incontinence subtype status 2004-2008 were entered into a multivariable, transition model to determine predictors for incontinence subtype occurrence in 2010. The prevalence of each subtype in this population (median age 63-66) was 2.6-8.9 %. Subtype incidence equaled 2.1-3.5 % and remissions for each varied between 22.3 and 48.7 %. Incontinence subtype incidence predictors included ethnicity/race, age, body mass index, and functional limitations. Compared with white women, black women had decreased odds of incident stress incontinence and Hispanic women had increased odds of stress incontinence remission. The age range 80-90 and severe obesity predicted incident mixed incontinence. Functional limitations predicted mixed and urgency incontinence. The strongest predictor of incontinence subtype was subtype history. The presence of the respective incontinence subtypes in 2004 and 2006 strongly predicted 2010 recurrence (odds ratio [OR] stress incontinence = 30.7, urgency OR = 47.4, mixed OR = 42.1). Although the number of remissions was high, a previous history of incontinence subtypes predicted recurrence. Incontinence status is dynamic, but tends to recur over the longer term.

  18. Effects of stigma on Chinese women's attitudes towards seeking treatment for urinary incontinence.

    Science.gov (United States)

    Wang, Cuili; Li, Jingjing; Wan, Xiaojuan; Wang, Xiaojuan; Kane, Robert L; Wang, Kefang

    2015-04-01

    To examine whether and how stigma influences attitudes towards seeking treatment for urinary incontinence, and whether its effect varies by symptom severity. Urinary incontinence is prevalent among women, but few seek treatment. Negative attitudes towards urinary incontinence treatment inhibit from seeking care. Urinary incontinence is a stigmatised attribute. However, the relationship between stigma and attitudes towards seeking treatment for urinary incontinence has not been well understood. This was a cross-sectional community-based study. We enrolled a sample of 305 women aged 40-65 years with stress urinary incontinence from three communities in a Chinese city between May-October in 2011. Data were collected on socio-demographic characteristics, urinary incontinence symptoms, stigma and attitudes towards seeking treatment for urinary incontinence using a self-reported questionnaire. Effects of stigma were analysed using path analysis. Attitudes towards seeking treatment for urinary incontinence were generally negative. For the total sample, all the stigma domains of social rejection, social isolation and internalised shame had direct negative effects on treatment-seeking attitudes. The public stigma domain of social rejection also indirectly affected treatment-seeking attitudes through increasing social isolation, as well as through increasing social isolation and then internalised shame. The final model accounted for 28% of the variance of treatment-seeking attitudes. Symptom severity influenced the strength of paths: the effect of internalised shame was higher in women with more severe urinary incontinence. Stigma enhances the formation of negative attitudes towards seeking treatment for urinary incontinence; public stigma affects treatment-seeking attitudes through internalisation of social messages. Stigma reduction may help incontinent women to form positive treatment-seeking attitudes and engage them in treatment. Interventions should specifically target

  19. Assessment and management of urinary incontinence in women.

    Science.gov (United States)

    Stewart, Ellie

    2018-05-02

    Urinary incontinence is a common and usually hidden issue that can affect women of all ages. It is often ignored by the patient because of their misconception that incontinence is an inevitable consequence of ageing and their low expectations of successful treatment. There are various types of incontinence, with symptoms that can significantly affect patients' quality of life. This article aims to enhance nurses' understanding of the types of urinary incontinence affecting women, associated risk factors and continence assessment, as well as the initial investigations and conservative treatments that can be instigated by general nurses. It also discusses some of the advanced treatments offered by specialist services. The article emphasises the importance of undertaking a holistic continence assessment to ensure appropriate continence care is provided, and how tailoring this care to the individual can improve adherence to treatment plans. © 2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

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

    Directory of Open Access Journals (Sweden)

    Preshani Reddy

    2015-05-01

    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.

  1. Management of occult stress urinary incontinence with prolapse surgery.

    Science.gov (United States)

    Al-Mandeel, H; Al-Badr, A

    2013-08-01

    Pelvic organ prolapse (POP) and stress urinary incontinence (SUI), are two common health-related conditions, each affecting up to 50% women worldwide. Stress urinary incontinence only observed after the reduction of co-existent prolapse is called occult SUI (OSUI), and is found in up to 80% of women with advanced POP. Although there is no consensus on how to diagnose OSUI, there are several reported methods to better diagnose. Counseling symptomatically continent women with POP concerning the potential risk for developing SUI postoperatively cannot be overstated. Evidence suggests that positive OSUI in symptomatically continent women who are planning to have POP repair is associated with a high risk of POSUI, furthermore, adding continence procedure is found to reduce postoperative SUI. Therefore, adding continence surgery at the time of POP surgery in patients who are found to have OSUI preoperatively is advocated.

  2. Dietary Macronutrient and Energy Intake and Urinary Incontinence in Women

    OpenAIRE

    Maserejian, Nancy N.; Giovannucci, Edward L.; McVary, Kevin T.; McGrother, Catherine; McKinlay, John B.

    2010-01-01

    Weight loss involving diet modification improves urinary incontinence (UI) in women, but little is known about dietary correlates of UI. The authors examined intakes of total energy, carbohydrate, protein, and fats in relation to UI in a cross-sectional sample of 2,060 women in the population-based Boston Area Community Health Survey (2002–2005). Data were collected from in-person home interviews and food frequency questionnaires. Logistic regression was used to calculate odds ratios and 95% ...

  3. 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...

  4. Surgery for stress urinary incontinence in women: A 2006 review

    Directory of Open Access Journals (Sweden)

    Bertil FM Blok

    2007-01-01

    Full Text Available The surgical treatment of female stress urinary incontinence is a rapidly changing field. This review discusses recent advances in various injectables, minimally invasive techniques and open procedures. It particularly evaluates data from long-term outcome studies and describes peri- and postoperative complications from several procedures, such as bulking agents, tension-free vaginal tape and its modifications (TOT, TVT-O as well as open and laparoscopic colposuspension.

  5. 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.

  6. Urinary incontinence in hospital patients: prevalence and associated factors

    Directory of Open Access Journals (Sweden)

    Jaqueline Betteloni Junqueira

    2018-01-01

    Full Text Available ABSTRACT Objectives: to analyze the prevalence of urinary incontinence and its associated factors in hospital patients. Method: this is a cross-sectional epidemiological study whose data were collected using the instruments Sociodemographic and Clinical Data, Characteristics of Urinary Leakage and International Consultation on Incontinence Questionnaire - Short Form. Prevalence was surveyed on a single day for four consecutive months. Data were analyzed using Chi-square test, Fisher’s exact test, Student t-test, Mann-Whitney test and logistic regression (forward stepwise. Results: the final sample consisted of 319 hospital adults (57.1% female, mean age of 47.9 years (SD=21.1. The prevalence of urinary incontinence was 22.9% (28% in women and 16.1% in men and the associated factors were: female sex (OR=3.89, age (OR=1.03, asthma (OR=3.66, use of laxatives (OR=3.26, use of diaper during the evaluation (OR=2.75, use of diaper at home (OR=10.29, and use of diaper at some point during the hospital stay (OR=6.74. Conclusion: the findings of this study differ from those found in the scarce existing literature on the subject in hospital patients. There is a need for previous studies such as this before proposing the implementation of preventive and therapeutic actions during the hospital stay.

  7. EFFICACY OF PELVIC FLOOR THERAPY IN TREATING URINARY INCONTINENCE AMONG FEMALE COPD PATIENTS

    OpenAIRE

    Mohankumar Thekkinkattil; T. S. Muthukumar; R. Monisha

    2016-01-01

    Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The major manifestation of COPD includes dyspnea, decreased oxygenation and reduced exercise tolerance. The other manifestations such as urinary incontinence are less noted and treated inadequately. The prevalence of urinary incontinence in Indian COPD population has not been well documented. The treatment of urinary incontinence includes pelvic floor exercises (Kegel’s exercises)...

  8. Effects of physiotherapy treatment for urinary incontinence in patient with multiple sclerosis

    OpenAIRE

    Pereira, Carla Maria de Abreu; Castiglione, Mariane; Kasawara, Karina Tamy

    2017-01-01

    [Purpose] The aim of the study was to evaluate the benefits of physical therapy for urinary incontinence in patients with multiple sclerosis and to verify the impact of urinary incontinence on the patient?s quality of life. [Subject and Methods] A case study of a 55-year-old female patient diagnosed with multiple sclerosis and mixed urinary incontinence was conducted. Physical therapy sessions were conducted once a week, in total 15 sessions, making use of targeted functional electrical vagin...

  9. 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....

  10. Treatment of urinary incontinence in women in general practice: observational study.

    OpenAIRE

    Seim, A.; Sivertsen, B.; Eriksen, B. C.; Hunskaar, S.

    1996-01-01

    OBJECTIVE--To examine what is attainable when treating urinary incontinence in women in general practice. DESIGN--Observational study with 12 months' follow up. Interview and clinical examination before, during, and after treatment of women seeking help for urinary incontinence in general practice. SETTING--General practice in the rural district of Rissa, Norway. SUBJECTS--105 women aged 20 or more with urinary incontinence. INTERVENTIONS--Treatment with pelvic floor exercises, electrostimula...

  11. Urinary incontinence and indwelling urinary catheters in acutely admitted elderly patients: relationship with mortality, institutionalization, and functional decline

    NARCIS (Netherlands)

    Bootsma, A. M. Jikke; Buurman, Bianca M.; Geerlings, Suzanne E.; de Rooij, Sophia E.

    2013-01-01

    To study differences in functional status at admission in acutely hospitalized elderly patients with urinary incontinence, a catheter, or without a catheter or incontinence (controls) and to determine whether incontinence or a catheter are independent risk factors for death, institutionalization, or

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

    OpenAIRE

    Opara, J?zef; Czerwi?ska-Opara, Wioletta Ewa

    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...

  13. The effect of urinary incontinence status during pregnancy and delivery mode on incontinence postpartum. A cohort study

    OpenAIRE

    Wesnes, Stian Langeland; Hunskår, Steinar; Bø, Kari; Rørtveit, Guri

    2009-01-01

    Objective: The objectives of this study were to investigate prevalence of urinary incontinence at 6 months postpartum and to study how continence status during pregnancy and mode of delivery influence urinary incontinence at 6 months postpartum in primiparous women.Design: Cohort study.Setting: Pregnant women attending routine ultrasound examination were recruited to the Norwegian Mother and Child Cohort Study (MoBa).Population A total of 12 679 primigravidas who were contin...

  14. Inertia in nursing care of hospitalised patients with urinary incontinence.

    Science.gov (United States)

    Artero-López, Consuelo; Márquez-Hernández, Verónica V; Estevez-Morales, María Teresa; Granados-Gámez, Genoveva

    2018-04-01

    To assess the existence of therapeutic inertia in the nursing care of patients with urinary incontinence during the patient's time in hospital, together with the sociodemographic and professional variables involved. Inertia in care is a problem which appears in the nursing care process. Actions related to inertia can be attributed to not adhering to protocols, clinical guidelines and the lack of prevention measures which have undesirable effects on the efficiency of care. This was a prospective observational study. A total of 132 nursing professionals participated over two consecutive months. Data were collected randomly through the method of systematic, nonparticipative observation of medical practice units and patients' medical records. The results showed a pattern of severely compromised action in the assessment of the pattern of urinary elimination, in actions related to urinary continence, in therapeutic behaviour and in patient satisfaction and were found to be consistent with professional experience (p inertia exists in nursing care in the hospital environment while the patient is hospitalised, in prevention care, in the treatment of urinary incontinence and in the management of records. Contributing to the understanding of the existence of inertia in nursing care raises questions regarding its causes and interventions to predict or monitor it. © 2018 John Wiley & Sons Ltd.

  15. Role of urodynamics in stress urinary incontinence: A critical appraisal

    Science.gov (United States)

    Yande, Shirish Dattatraya; Joglekar, Omkar Vinay; Joshi, Maya

    2016-01-01

    Introduction: Role of urodynamics prior to surgery of stress urinary incontinence (SUI) is under constant debate. Demonstration of the presence of detrusor overactivity is the only aspect that has been emphasized in the literature so far. We believe that there are number of other factors which may influence the evaluation and in turn the choice of surgical management and prediction of outcome of treatment. They are as follows: (1) Presence of voiding inefficiency, (2) asymptomatic detrusor overactivity, (3) and severity of SUI. These features may complicate the precise evaluation of patients of SUI. The main objective of this study is to analyze the dynamics of leakage and voiding using urodynamics. This study also aims at correlating these findings with clinical information. Materials and Methods: One hundred consecutive cases referred to our center for preoperative evaluation of SUI were recruited in the study prospectively. All patients were interrogated using International Consultation on Incontinence Questionnaire. All patients underwent complete urodynamic evaluation including uroflowmetry, filling cystometry, leak point pressure measurement, and pressure flow studies, according to Good Urodynamic Practice guidelines. Patients’ symptoms were correlated with urodynamic findings, with special emphasis on the presence of detrusor overactivity, severity of SUI, voiding efficiency, and presence of bladder outlet obstruction. Clinical information and urodynamic findings were correlated using Chi-square test. Results: There is a statistically significant correlation between the presence of symptoms of urge urinary incontinence and urodynamic findings of detrusor overactivity at P incontinence (in addition to SUI) and urodynamic findings of intrinsic sphincter deficiency at P incontinence and incidental finding of detrusor overactivity at P urinary incontinence can predictably diagnose detrusor overactivity in these cases. However, the incidence of asymptomatic

  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. Risperidone-associated urinary incontinence in patients with autistic disorder with mental retardation.

    Science.gov (United States)

    Kumazaki, Hirokazu; Watanabe, Koichiro; Imasaka, Yasushi; Iwata, Kazuhiko; Tomoda, Akemi; Mimura, Masaru

    2014-10-01

    We report several cases in which patients with autistic disorder with mental retardation who received risperidone experienced urinary incontinence. We retrospectively investigated the medical records of patients housed in facilities for patients with autistic disorder with mental retardation. Those who had undergone a medical examination at a hospital in Tokyo from April 1999 to March 2009 were included in the study.Retrospective data were gathered including age, sex, IQ, birth weight, dosage of risperidone, urinary density, as well as existence of urinary and fecal incontinence. We divided the participants into those who did and did not experience urinary incontinence after taking risperidone and compared the 2 groups. Risperidone had been prescribed to 35 patients. In spite of the fact that no patient had a history of urinary incontinence, 14 patients experienced urinary incontinence after receiving risperidone. Moreover, 4 of these 14 patients also had fecal incontinence. Among the variables we examined, the only significant difference between groups was in sex, with significantly more women experiencing incontinence compared with men. When the dose of risperidone was reduced or the patients switched to other drugs, urinary incontinence of the patients improved.Hence, risperidone may have a casual relationship with urinary incontinence. Further research is needed to understand the pathophysiology of possible effect.

  18. Open and Laparoscopic Colposuspension in Girls with Refractory Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    Barbara Anna Dobrowolska-Glazar

    2017-12-01

    Full Text Available IntroductionLower urinary tract symptoms (LUTS are very common in children. Standard treatments consist of urotherapy, antibiotic prophylaxis, anti-muscarinics, physical therapy, and the treatment of coexisting constipation. A small group of girls also present with stress incontinence or with stress-induced urge incontinence. In cases of persistent LUTS due to congenital bladder neck insufficiency (BNI, surgical treatment might be considered. The aim of this paper is to assess the results of open and laparoscopic colposuspension in children with refractory urinary incontinence (UI.Materials and methodsThe results of 18 open and 18 laparoscopic consecutive colposuspensions were analyzed. All patients had UI and failed conservative treatment. BNI was proven by repeated perineal ultrasound and video-urodynamic study. The laparoscopic procedure was performed preperitoneally and the open procedure was via a transverse lower abdominal incision. The same postoperative protocol was used in both groups.ResultsThe mean operation time was 65 min for the open and 90 min for the lap procedure (p < 0.05. Full success was achieved in 7/18 in the open and in 8/18 in the lap group and partial response was seen in 3/18 and in 5/18, respectively (p = 0.64. No intraoperative complications occurred in this cohort.ConclusionOpen and laparoscopic colposuspension can be used to treat refractory UI in children with BNI when non-invasive methods fail.

  19. 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.

  20. Urinary incontinence in frail elderly persons: Report from the 5th International Consultation on Incontinence.

    Science.gov (United States)

    Wagg, Adrian; Gibson, William; Ostaszkiewicz, Joan; Johnson, Theodore; Markland, Alayne; Palmer, Mary H; Kuchel, George; Szonyi, George; Kirschner-Hermanns, Ruth

    2015-06-01

    Evidence based guidelines for the management of frail older persons with urinary incontinence are rare. Those produced by the International Consultation on Incontinence represent an authoritative set of recommendations spanning all aspects of management. To update the recommendations of the 4th ICI. A series of systematic reviews and evidence updates were performed by members of the working group in order to update the 2009 recommendations. The resulting guidelines were presented at the 2012 meeting of the European Associatioon of Urology. Along with the revision of the treatment algorithm and accompanying text. There have been significant advances in several areas including pharmacological treatment of overactive bladder. The committee continue to notes the relative paucity of data concerning frail older persons and draw attention to knowledge gaps in this area. © 2014 Wiley Periodicals, Inc.

  1. Risk of stress urinary incontinence twelve years after the first pregnancy and delivery.

    Science.gov (United States)

    Viktrup, Lars; Rortveit, Guri; Lose, Gunnar

    2006-08-01

    To estimate the impact of onset of stress urinary incontinence in first pregnancy or postpartum period, for the risk of symptoms 12 years after the first delivery. In a longitudinal cohort study, 241 women answered validated questions about stress urinary incontinence after first delivery and 12 years later. Twelve years after first delivery the prevalence of stress urinary incontinence was 42% (102 of 241). The 12-year incidence was 30% (44 of 146). The prevalence of stress urinary incontinence 12 years after first pregnancy and delivery was significantly higher (Ppregnancy (56%, 37 of 66) and in women with onset shortly after delivery (78%, 14 of 18) compared with those without initial symptoms (30%, 44 of 146). In 70 women who had onset of symptoms during first pregnancy or shortly after the delivery but remission 3 months postpartum, a total of 40 (57%) had stress urinary incontinence 12 years later. In 11 women with onset of symptoms during the first pregnancy or shortly after delivery but no remission 3 months postpartum, a total of 10 (91%) had stress urinary incontinence 12 years later. Cesarean during first delivery was significantly associated with a lower risk of incontinence. Other obstetric factors were not significantly associated with the risk of incontinence 12 years later. Patients who were overweight before their first pregnancy were at increased risk. Onset of stress urinary incontinence during first pregnancy or puerperal period carries an increased risk of long-lasting symptoms.

  2. [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.

  3. 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......, and had a positive and clinically relevant effect on urethral closure function and symptoms of stress urinary incontinence....... 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...

  4. High-power Magnetotherapy: A New Weapon in Urinary Incontinence?

    Science.gov (United States)

    Vadalà, Maria; Palmieri, Beniamino; Malagoli, Andrea; Laurino, Carmen

    2017-06-18

    Urinary incontinence (UI) is one of the most common urinary system diseases that mostly affects women but also men. We evaluated the therapeutic efficacy of functional magnetic stimulation (FMS) as potential UI treatment with improvements in the pelvic floor musculature, urodynamic tests and quality of life. A total of 20 UI patients (10 females and 10 men, mean age 64, 14 years), including 10 with stress UI, four with urgency UI and six with mixed UI, were treated with FMS (20 min/session) twice a week for 3 weeks. The patients' impressions, records in urinary diaries, and scores of three life stress questionnaires (overactive bladder symptom questionnaire [OAB-q], urogenital distress inventory questionnaire-short form [UDI-6], incontinence impact questionnaire-short form [IIQ-7]) were performed pre- and post-treatment. Significant reductions (P < 0.01) of micturition number and nocturia after magnetic treatment were evidenced. The urodynamic tests recorded a significant increase in cystometric capacity (147 ± 51.3%), in maximum urethral closure pressure (110 ± 34%), in urethral functional length (99.8 ± 51.8%), and in pressure transmission ratio (147 ± 51.3%) values compared with the baseline values. These preliminary findings suggest that FMS with Magneto STYM (twice weekly for 3 weeks) improves the UI and may be an effective treatment for this urogenital disease. © 2017 John Wiley & Sons Australia, Ltd.

  5. [Urinary incontinence as a risk factor for pressure sores does not withstand a critical examination].

    Science.gov (United States)

    Krause, Tom; Anders, Jennifer; von Renteln-Kruse, Wolfgang

    2005-10-01

    The association between urinary incontinence and pressure sores is put down to various causes. Most frequently urinary wet and following maceration of the skin are mentioned. However, it is possible that urinary incontinence is only an indicator for other risk factors or a measure of the need for care without any causal relation to pressure sores. There are hardly any controlled or randomised studies; this lack of scientific evidence is problematic. Based on a case-control-study including data of 200 patients as well as on the existing models of explanation, the following study tries to examine critically the connections between pressure sores and urinary incontinence. Out of the patients in our study population 97.5 percent were incontinent. Different categories of the risk factor urinary incontinence and different dichotomisations have led to different statistical results. Statements concerning the connection between urinary incontinence and pressure sores have to be interpreted critically. The dependence of urinary incontinence on other risk factors such as patients' need for care or compliance suggests that the causal connection to pressure sores be not reduced to the influence of wetness. We advise to research connections between urinary incontinence and pressure sores in a methodologically appropriate setting.

  6. Impact of urinary incontinence on sexual functioning in community-dwelling older women

    NARCIS (Netherlands)

    Visser, Els; de Bock, Geertruida H.; Berger, Marjolein Y.; Dekker, Janny H.

    Introduction. Knowledge on the sexual health of patients with urinary incontinence in primary care is scarce; therefore, the impact of urinary incontinence on sexual functioning was examined in community-dwelling older women. Aim. The aim of this study was to provide primary health care

  7. Urinary incontinence in older people living in the community: examining help-seeking behaviour.

    NARCIS (Netherlands)

    Teunissen, T.A.M.; Weel, C. van; Lagro-Janssen, A.L.M.

    2005-01-01

    BACKGROUND: Only a small proportion of older people with urinary incontinence seek help, despite the availability of adequate treatment. AIM: To ascertain the patient- and disease-specific factors that determine whether medical care for urinary incontinence is sought by independently living older

  8. Surgical management of urinary stress incontinence in women: a historical and clinical overview

    NARCIS (Netherlands)

    Hinoul, Piet; Roovers, Jan-Paul; Ombelet, Willem; Vanspauwen, Ruben

    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

  9. Health-related quality of life and mental health in older women with urinary incontinence.

    Science.gov (United States)

    Kwak, YeunHee; Kwon, HaeJin; Kim, YoonJung

    2016-07-01

    The purpose of this cross-sectional study was to compare health-related quality of life (QOL) and mental health between older women with and without urinary incontinence. This study is a secondary data analysis using raw data from 1874 women aged 65 years or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) IV (2008-2009), a nationally representative sample. In the pain/discomfort dimension of the EuroQol-5, 25.4% of the participants experienced urinary incontinence and 14.7% did not (p = .001). In the anxiety/depression dimension, urinary incontinence was present in 8.3% of the participants and absent in 3.6% (p = 0.012). In addition, the results of an ANCOVA showed that scores in both the EuroQol visual analogue scale and the EQ-5D index were significantly lower in participants with urinary incontinence relative to those without. The risk of stress and depression in older women with urinary incontinence was approximately 2 and 1.5 times higher, respectively, than that of participants without urinary incontinence. Health-related QOL in older women with urinary incontinence was relatively low, while levels of stress and depression were high. Therefore, in order to improve QOL and mental health in older women, the understanding and management of urinary incontinence interventions is required.

  10. 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…

  11. Electronic Monitoring Systems to Assess Urinary Incontinence: A Health Technology Assessment.

    Science.gov (United States)

    2018-01-01

    Urinary incontinence is involuntary leakage of urine and can affect people of all ages. Incidence rises as people age, often because of reduced mobility or conditions affecting the nervous system, such as dementia and stroke. Urinary incontinence can be a distressing condition and can harm a person's physical, financial, social, and emotional well-being. People with urinary incontinence are susceptible to skin irritation, pressure sores, and urinary tract infections. Urinary incontinence is also associated with an increased risk of falls in older adults.This health technology assessment examined the effectiveness of, budget impact of, and patient values and preferences about electronic monitoring systems to assess urinary incontinence for residents of long-term care homes or geriatric hospital inpatients with complex conditions. A clinical evidence review of the published clinical literature was conducted to June 9, 2017. Critical appraisal of the clinical evidence included assessment of risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria to reflect the certainty of the evidence.We calculated the funding required for an electronic urinary incontinence monitoring system in the first year of implementation (when facilities would buy the systems) and in subsequent years.We interviewed six people with urinary incontinence and two caregivers, who described ways urinary incontinence affected daily life. We included one observational study in the clinical review. Most of the 31 participants in the observational study were female (78%) and required high levels of care, primarily because of cognitive impairment. The quality of evidence for all outcomes was very low owing to potential risk of bias and indirectness. We are consequently uncertain about how electronic monitoring systems affect management of urinary incontinence.For patients living in long-term care homes who are eligible for the technology, we

  12. Stress Urinary Incontinence in Women With Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Caroline Massot

    2016-09-01

    Full Text Available Purpose To report the prevalence and risk factors of stress urinary incontinence (SUI and the prevalence of intrinsic sphincter deficiency in women with multiple sclerosis (MS. Methods We conducted a retrospective study. Female patients with MS, followed for lower urinary tract symptoms (LUTS during a 15-year period were included. Demographic data, MS history, expanded disability status scale (EDSS score at the urodynamic visit, obstetrical past, birth weight, LUTS, and urodynamic findings were collected. SUI was defined as incontinence during cough, or any effort. A maximum urethral closure pressure less than 30 cm H2O defined intrinsic sphincter deficiency. Results We included 363 women with a mean age of 46.7±10.8 years and a mean disease duration of 12.9±8.7 years. The incidence of relapsing remitting MS, a secondary progressive form, and a primary progressive form was 60.6%, 32.8%, and 6.6%, respectively. The prevalence of SUI was 31.4%. The prevalence of intrinsic sphincter deficiency was 1.4% and 0.8% of these patients had a SUI (P=0.300. In a multivariate analysis, women with a SUI had significantly higher birth weight (P=0.030, a pelvic organ prolapse (P=0.021, urgent urinary incontinence (P=0.006, a lower EDSS score (P=0.019, and a weaker containing effort (P<0.001. Conclusions The prevalence of SUI in women with MS was 31.4%. This symptom could affect the quality of life of women with MS.

  13. Urinary leakage during sexual intercourse among women with incontinence: Incidence and risk factors

    OpenAIRE

    Lau, Hui-Hsuan; Huang, Wen-Chu; Su, Tsung-Hsien

    2017-01-01

    Background Coital incontinence is an under-reported disorder among women with urinary incontinence. Women seldom voluntarily report this condition, and as such, related data remains limited and is at times conflicting. Aims and objectives To investigate the incidence and quality of life in women with coital incontinence and to determine associated predictors. Methods This observational study involved 505 sexually active women attending the urogynecologic clinic for symptomatic urinary inconti...

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

    OpenAIRE

    Bernards, Arnold T. M.; Berghmans, Bary C. M.; Slieker-ten Hove, Marijke C. Ph.; Staal, J. Bart; de Bie, Rob A.; Hendriks, Erik J. M.

    2013-01-01

    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 clinical practice guidelines (CPGs) for physiotherapy management of patients with stress urinary incontinence (SUI) in order to support physiotherapists in decision making and improving efficacy and...

  15. 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...... observed. This intervention is associated with a minimum of discomfort for the patient and hospitalization can be limited to 48-72 h. The procedure can be carried out with good effect on women previously classically operated on without success and it does not prevent subsequent surgical intervention...

  16. Review on midurethral sling procedures for stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Nazura Bt Karim

    2015-05-01

    Full Text Available Minimally invasive suburethral slings, namely the retropubic suburethral sling or the tension-free vaginal tape (TVT, has become the mainstay for surgical management of moderate to severe stress urinary incontinence (SUI taking over the place of Burch's colposuspension after its introduction in the 1990s. Following the introduction of retropubic sling procedures are the transobturator (TVT-O procedures and the mini-sling procedures. This review attempts to summarize the current trend of midurethral sling (MUS procedures in the management of SUI.

  17. Retropubic cartilaginous cyst presenting as stress urinary incontinence

    DEFF Research Database (Denmark)

    Elmelund, Marlene; Thind, Peter; Klarskov, Niels

    2015-01-01

    A pubic cartilaginous cyst is a rare condition and is considered a result of degenerative changes in the symphysis pubis, mainly described in elderly multiparous women. There are only a few reported cases in the literature, and patients presented most frequently with a painful vaginal/vulvar mass....... This case report is the first to describe a patient with rapidly progressing stress urinary incontinence (SUI) due to a retropubic cartilaginous cyst. The patient in this case underwent surgical intervention; symptoms improved postoperatively, suggesting that surgical intervention in symptomatic patients...

  18. Could Urinary Tract Infection Cause Female Stress Urinary Incontinence? A Clinical Study.

    Science.gov (United States)

    Heydari, Fatemeh; Motaghed, Zahra; Abbaszadeh, Fatemeh

    2016-01-01

    Stress urinary incontinence (SUI), the most common type of urinary incontinence (UI), is usually defined as leakage of urine during movement or activity which puts pressure on the bladder, such as coughing, sneezing, running or heavy lifting. It is reported in most countries that 15% to 40% of women struggle with SUI and its severe implications for daily life, including social interactions, sexuality, and psychological wellbeing. The aim of our study was to assess the relationship between urinary tract infection and the severity of stress urinary incontinence (SUI). This research was a cross-sectional study conducted in a public urology clinic in Tehran. The study population was all females with complaints of SUI who visited the clinic during 2014. We compared Valsalva leak point pressure (VLPP) in two groups of patients, with and without history of urinary tract infection (UTI). According to the findings of our study, the mean VLPP was 83.10 cm H2O in the group with UTI history, and 81.29 cm H2O in those without history of UTI. The difference in VLPP between the two groups was not significant (P < 0.05), even after controlling for confounding variables including age, body mass index, history of hysterectomy and number of deliveries. Our study did not confirm a significant relationship between UTI and severity of SUI as measured by VLPP. A decisive opinion would require extensive future studies by prospective methods.

  19. Prevalence of urinary incontinence and lower urinary tract symptoms in school-age children.

    Science.gov (United States)

    Akil, Ipek Ozunan; Ozmen, Dilek; Cetinkaya, Aynur Cakmakci

    2014-07-08

    To investigate the prevalence of lower urinary tract symptoms (LUTS) and urinary incontinence (UI) in elementary school aged children in Manisa. Dysfunctional Voiding and Incontinence Scoring System (DVIS) which was developed in Turkey is used. A total of 416 children, 216 (51.9%) male and 200 (48.1%) female were recruited in this study. Mean age of children was 10.35 ± 2.44 years (median10 years). Daytime UI frequency was 6.7% (28 child), nocturnal incontinence 16.6% (69 child) and combined daytime and nocturnal incontinence 4.1% (17 child). There was no statistically significant difference in the prevalence of nocturnal and or daytime UI between male and female gender. Mean DVIS score was 2.65 ± 3.95 and gender did not affect total DVIS points. The mean ages of achieving daytime bowel and bladder control were all significantly correlated with DVIS points. DVIS points were positively correlated with the history of UI of the family. Total points were increased when the father was unemployed. UI negatively influences health related quality of life of the family and child, so it is important that awareness of the UI and symptoms of lower urinary tract dysfunction.

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

    International Nuclear Information System (INIS)

    Perneczky, Robert; Diehl-Schmid, Janine; Foerstl, Hans; Kurz, Alexander; Drzezga, Alexander; May, Florian

    2008-01-01

    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 18 F-fluoro-2-deoxy-glucose ( 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.)

  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. A Behavioral Weight Loss Program and Nonurinary Incontinence Lower Urinary Tract Symptoms in Overweight and Obese Women with Urinary Incontinence: A Secondary Data Analysis of PRIDE.

    Science.gov (United States)

    Breyer, Benjamin N; Creasman, Jennifer M; Richter, Holly E; Myers, Deborah; Burgio, Kathryn L; Wing, Rena R; West, Delia Smith; Kusek, John W; Subak, Leslee L

    2018-01-01

    We sought to determine whether a behavioral weight reduction intervention would improve nonurinary incontinence lower urinary tract storage symptoms at 6 months, including urinary frequency, nocturia and urgency, compared to a structured education program serving as the control group among overweight and obese women with urinary incontinence. PRIDE (Program to Reduce Incontinence by Diet and Exercise) was a randomized clinical trial performed in 338 overweight or obese women with urinary incontinence. Participants were randomized, including 226 to 6-month behavioral weight loss intervention and 112 to the control group. All participants received a self-help behavioral treatment booklet to improve bladder control. On this secondary data analysis we examined changes in nonurinary incontinence lower urinary tract storage symptoms from baseline to 6 months and the impact of treatment allocation (intervention vs control), weight loss and physical activity. Nonurinary incontinence lower urinary tract storage symptoms were common at baseline, varying from 48% to 62%. In the 2 groups combined women experienced significant improvement in nocturia, urgency and International Prostate Symptom Score at 6 months (all p urinary tract storage symptom outcomes at 6 months did not differ between the intervention and control groups. Similarly no difference was observed in the amount of weight lost (5% or greater vs less than 5%) or physical activity (1,500 kcal or greater expenditure per week compared to less than 1,500 kcal). Lower urinary tract storage symptoms were common among overweight and obese women with urinary incontinence. The prevalence decreased significantly after 6 months independent of treatment group assignment, amount of weight lost or physical activity. These improvements may have been due to self-help behavioral educational materials, trial participation or repeat assessment of symptoms. Copyright © 2018 American Urological Association Education and Research, Inc

  3. The impact of incontinence etiology on artificial urinary sphincter outcomes

    Directory of Open Access Journals (Sweden)

    Adam R. Miller

    2017-07-01

    Full Text Available Purpose: To evaluate the impact of incontinence etiology on artificial urinary sphincter (AUS device outcomes. Materials and Methods: We identified 925 patients who underwent primary AUS placement from 1983 to 2011. The etiology of incontinence was categorized as radical prostatectomy alone, radical prostatectomy with radiation, benign prostate resection, and those with cryotherapy as a salvage prostate cancer treatment. Hazard regression and competing risk analyses were used to determine the association of the etiology of incontinence with device outcomes. Results: The distribution of the 4 etiologies of incontinence included: 598 patients (64.6% treated with prostatectomy alone, 206 (22.2% with prostatectomy and pelvic radiation therapy, 104 (11.2% with benign prostate resection, and 17 (1.8% with prior cryotherapy. With a median follow-up of 4.9 years (interquartile range, 1.2–8.8 years, there was significant difference in the cumulative incidence of device infection/urethral erosion events between the four etiologies (p=0.003. On multivariable analysis, prior cryotherapy (reference prostatectomy alone; hazard ratio [HR], 3.44; p=0.01, older age (HR, 1.07; p=0.0009 and history of a transient ischemic attack (HR, 2.57; p=0.04 were associated with an increased risk of device infection or erosion. Notably, pelvic radiation therapy with prostatectomy was not associated with an increased risk of device infection or erosion (reference prostatectomy alone, p=0.30. Conclusions: Compared to prostatectomy alone, prior treatment with salvage cryotherapy for recurrent prostate cancer was associated with an increased risk of AUS infection/erosion, whereas radiation (in addition to prostatectomy was not.

  4. Risk factors for urinary tract infection following incontinence surgery.

    Science.gov (United States)

    Nygaard, Ingrid; Brubaker, Linda; Chai, Toby C; Markland, Alayne D; Menefee, Shawn A; Sirls, Larry; Sutkin, Gary; Zimmern, Phillipe; Arisco, Amy; Huang, Liyuan; Tennstedt, Sharon; Stoddard, Anne

    2011-10-01

    The purpose of this study is to describe risk factors for post-operative urinary tract infection (UTI) the first year after stress urinary incontinence surgery. Multivariable logistic regression analyses were performed on data from 1,252 women randomized in two surgical trials, Stress Incontinence Surgical Treatment Efficacy trial (SISTEr) and Trial Of Mid-Urethral Slings (TOMUS). Baseline recurrent UTI (rUTI; ≥3 in 12 months) increased the risk of UTI in the first 6 weeks in both study populations, as did sling procedure and self-catheterization in SISTEr, and bladder perforation in TOMUS. Baseline rUTI, UTI in the first 6 weeks, and PVR > 100 cc at 12 months were independent risk factors for UTI between 6 weeks and 12 months in the SISTEr population. Few (2.3-2.4%) had post-operative rUTI, precluding multivariable analysis. In women with pre-operative rUTI, successful surgery (negative cough stress test) at 1 year did not appear to decrease the risk of persistent rUTI. Pre-operative rUTI is the strongest risk factor for post-operative UTI.

  5. THE CHOICE OF TREATMENT OF STRESS URINARY INCONTINENCE IN WOMEN

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    Božo Kralj

    2003-12-01

    Full Text Available Background. The important factors for successful treatment of female stress urinary incontinence (SUI are described: type of urinary incontinence (UI, degree of UI, pelvic floor relaxation and associated diseases (genital and extragenital. Indications for conservative and operative treatment are presented.Methods. Conservative treatment: pelvic floor exercises – Kegel’s exercises and functional electrical stimulation (FES are proposed to female patients with mild and moderate degree of SUI. Separate indications for vaginal and retopubic operations are quoted.Results. With conservative treatment of SUI – pelvic floor exercises, 33.3% of female patients were cured and 36.7% were improved. With FES treatment of SUI, 50% of patients were cured and 23.4% were improved.Results of operative treatment of SUI: vaginal approach – our modification of vaginal operation with preparation of pubovesico-cervical fascia and suburethral application – 97.5% of female patients were primary cured and recurrence after 2 years was found in 9% of female patients. In retropubic operation – Burch colposuspension – 99.1% of female patients were primary cured and recurrence after 2 years was found in 1.3% of female patients.Conclusions. Although the results of classical operations for SUI are favourable, trends for SUI operations are nowadays in miniinvasive surgery, especially in TVT operation.

  6. Prevalence and treatment of post partum urinary incontinence

    Directory of Open Access Journals (Sweden)

    Siv Mørkved

    2009-10-01

    Full Text Available  SUMMARYChildbirth is often considered the main etiological factor in the development of female urinary incontinence(UI. For that reason women in the western countries have been encouraged to engage in post partumpelvic floor muscle (PFM exercise in order to strengthen the pelvic floor. However, the effect of post partumPFM exercise has been sparsely documented. The aim of this article is to review and discuss literaturerelated to prevalence of post partum UI and effect of post partum PFM exercise in the treatment of UI. Thereported prevalence of UI post partum varies from 0.7% to 44%. The variation may be explained bydifferent definitions of UI used in the questionnaires and that the registration of incontinence was done atdifferent intervals after delivery. A few studies have tried to evaluate the effect of post natal PFM exercise.Some have evaluated PFM strength, others the frequency of UI. PFM strength is difficult to measure andthe reliability and validity of the methods used is open to question. Another flaw in some of the previousstudies is the training protocol applied to improve PFM strength. Mørkved and Bø tried to take intoaccount the above mentioned methodological considerations, in a study aiming to evaluate the effect ofpost partum PFM exercise. The results demonstrate that post partum PFM exercise is effective instrengthening the PFM and in the treatment of UI. However, success of PFM exercise is dependent uponboth the training frequency and intensity. This requires a closer follow up of the post partum women, thanthe written information that usually serves this purpose at the present time.Key words  : physiotherapy, pelvic floor muscles, urinary incontinence, post partum exercise, prevalence

  7. 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 ...

  8. Urinary and fecal incontinence in a community-residing older population in Japan.

    Science.gov (United States)

    Nakanishi, N; Tatara, K; Naramura, H; Fujiwara, H; Takashima, Y; Fukuda, H

    1997-02-01

    To estimate the prevalence and risk factors of urinary and fecal incontinence among a community-residing older population in Japan. Population-based cross-sectional study. A randomly selected sample of 1473 people aged 65 years and older living in the City of Settsu, Osaka, in 1992. Data collected via in-home visits were used to estimate the prevalence of urinary and fecal incontinence and to provide information regarding potential risk factors of urinary and fecal incontinence. Data were obtained from 1405 older adults, a response rate of 95.4%. The prevalence of any degree of urinary incontinence was 98/1000 in both sexes, and 87/ 1000 men and 66/1000 women admitted to some degree of fecal incontinence. Daily, 34/1000 and 20/1000 of the population were incontinent of urine and feces, respectively. There was an increasing prevalence of urinary and fecal incontinence with age in both sexes, but the expected greater prevalence in women was not found. By univariate analyses, age older than 75 years, poor general health as measured by Activities of Daily Living, stroke, dementia, no participation in social activities, and lack of life worth living (Ikigai) were associated significantly with both urinary and fecal incontinence. In the multivariate analyses using logistic regression, age older than 75 years, poor general health, and stroke were independent risk factors for any type of incontinence. Diabetes was an independent risk factor for isolated fecal incontinence, and dementia and no participation in social activities were independent risk factors for double incontinence. Incontinence of urine and feces is a prevalent condition among very old people living in the community in Japan and is associated highly with health and psychosocial conditions.

  9. Prevalence and risk factors for urinary incontinence in pregnant women during late third trimester

    OpenAIRE

    Aruna Nigam; Ayesha Ahmad; Diksha Gaur; Arifa A. Elahi; Swaraj Batra

    2016-01-01

    Background: Urinary incontinence (UI) is defined as any involuntary urinary leakage by the International continence society (ICS). The objective of this study was to analyze the prevalence and risk factors of urinary incontinence in pregnant women in late third trimester. Methods: A questionnaire based survey done on 400 pregnant women in third trimester beyond 34 weeks of gestation. A pretested, semi structured questionnaire was used to enquire about demographic and personal information r...

  10. Effect of Delivery and Episiotomy on the Emergence of Urinary Incontinence in Women: Review of Literature

    Science.gov (United States)

    Živković, Krešimir; Živković, Nikica; Župić, Tomislav; Hodžić, Damir; Mandić, Vjekoslav; Orešković, Slavko

    2016-12-01

    Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed medio-laterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine medio-lateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased. The role of episiotomy in development of pelvic floor dysfunction remains quite unclear. Due to the mentioned reason, restricted episiotomy approach should be accepted. The origin of stress incontinence during pregnancy is controversial and not definitely scientifically proven. Pregnancy per se and older age at first delivery may have impact on the onset of pelvic floor dysfunction. Urinary incontinence in pregnancy increases the risk of later urinary incontinence, both postpartum and later in life. Vaginal delivery is just one of the potential risk factors for development of urinary incontinence. Mechanical pressure by fetus on the pelvic floor structures, limited denervation of the pelvic floor and soft tissue damage during delivery are some of explanations for the onset of stress urinary incontinence. On the other hand, cesarean delivery might not be protective against emergence of urinary incontinence. Further research in this field is needed.

  11. [Prevalence and associated factors of female urinary incontinence in Hebei province].

    Science.gov (United States)

    Jiang, Y; Yan, L; Du, F D; Zheng, P T; Zhang, L; Jiang, L; Huang, X H

    2016-12-25

    Objective: To estimate the prevalence and associated factors of adult female urinary incontinence in Hebei province. Methods: Stratified and multistage sampling method was used, between January 2016 to May 2016, to investigate the target population in Hebei province. While, logistic regression was used to analyse datas. Results: A population-based survey was conducted in 2 450 women in Hebei province, there were 2 408 effective questionnaires after deleting 48 invalid questionnaires. According to the results, the average age of subjects was (56±15) years old, and the urinary incontinence prevalence of adult female in Hebei province was 27.70% (667/2 408). Stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were diagnosed as 23.13% (557/2 408), 1.58% (38/2 408) and 2.99% (72/2 408), respectively. There were only 2.85% (19/667) urinary incontinence patients seeking medical help. The results of logistic regression analysis showed that age, daily water intake, pulmonary diseases, urinary tract infection, hypertension, chronic low back pain, dysmenorrhea, vaginitis, abortion, mode of delivery, postpartum infection were statistically significant (all P ≤0.05). Among these factors, cesarean section was the protective factor for urinary incontinence ( OR= 0.365, 95 % CI: 0.195-0.685, P urinary incontinence in adult female in Hebei province is high, and there are few patients seeking medical help. It is a common disorder in women and is associated with many factors; among these factors, cesarean section is the protective factor for urinary incontinence.

  12. Effects of carrying a pregnancy and of method of delivery on urinary incontinence: a prospective cohort study

    OpenAIRE

    Eason, Erica; Labrecque, Michel; Marcoux, Sylvie; Mondor, Myrto

    2004-01-01

    Abstract Background This study was carried out to identify risk factors associated with urinary incontinence in women three months after giving birth. Methods Urinary incontinence before and during pregnancy was assessed at study enrolment early in the third trimester. Incontinence was re-assessed three months postpartum. Logistic regression analysis was used to assess the role of maternal and obstetric factors in causing postpartum urinary incontinence. This prospective cohort study in 949 p...

  13. Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up

    Science.gov (United States)

    Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

    2016-01-01

    This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70–2.34, p urinary tract stones (both p-values urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76–2.26, p urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones. PMID:27536881

  14. Patients with Urinary Incontinence Appear More Likely to Develop Upper Urinary Tract Stones: A Nationwide, Population-Based Study with 8-Year Follow-Up.

    Science.gov (United States)

    Chung, Hsiao-Jen; Lin, Alex Tong-Long; Lin, Chih-Chieh; Chen, Tzeng-Ji; Chen, Kuang-Kuo

    2016-01-01

    This study aimed to investigate associations between primary urinary incontinence and development of upper urinary tract stones in a nationwide population in Taiwan. Data of 1,777 adults with primary urinary incontinence and 26,655 controls (groups A, B, and C) without urinary incontinence at study inception were retrieved from the National Health Insurance System database in Taiwan and were analyzed retrospectively. No enrolled subjects had previous diagnosis of upper urinary tract stones or spinal cord injury. All subjects were followed through end of 2009, with a minimum follow-up of 8 years. A greater percentage of study subjects (334/1777, 18.8%) developed upper urinary tract stones than that of control groups A (865/8885, 9.7%) and B (888/8885, 10%), and C (930/8885, 10.5%) (all p-values Urinary incontinence was associated with significantly increased risk of developing urinary tract stones (HR 1.99, 95% CI, 1.70-2.34, p urinary tract stones (both p-values urinary incontinence was still associated with a significantly increased risk of developing upper urinary tract stones (HR 1.99, 95% CI = 1.76-2.26, p urinary incontinence suggests that urinary incontinence is associated with a significantly increased risk of developing upper urinary tract stones. Study findings suggest that physicians treating patients with urinary incontinence should give attention to early detection of upper urinary tract stones.

  15. Urinary incontinence and weight changes during pregnancy and post partum: a pending challenge.

    Science.gov (United States)

    Ruiz de Viñaspre Hernández, Regina; Rubio Aranda, Encarnación; Tomás Aznar, Concepción

    2013-12-01

    to analyse the association between urinary incontinence and maternal weight, and its variations in pregnancy and post partum. observational study of a cohort of women from the start of pregnancy until six months post partum. Hospital San Pedro in La Rioja, Spain. 402 pregnant women without urinary incontinence at the start of pregnancy. the dependent variable was urinary incontinence, assessed using the Urogenital Distress Inventory-Short Form questionnaire. The main independent variables were body mass index (BMI) at the first antenatal visit and six months post partum, weight gain during pregnancy, postpartum weight loss, and weight retained from the start of pregnancy to six months post partum. The association between urinary incontinence and the main independent variables was measured using Student's t-test. Three simple logistic regression models were used to assess the strength of this association, one for each of the independent variables that showed a significant association with urinary incontinence (p<0.05), and three multiple regression models that included the possible variable effect modifiers were also used. At the start of pregnancy, 20.1% of the women were overweight and 8.7% were obese. Six months post partum, 30.3% of the women were overweight and 11.4% were obese. The mean (±standard deviation) retained weight was 2 (±3.1) kg. Postpartum urinary incontinence was associated with BMI at six months post partum, postpartum weight loss and retained weight at six months post partum (p<0.05). The association of urinary incontinence with these variables was significant, and remained stable in both simple and multiple regression analyses with BMI at six months post partum [odds ratio (OR) 1.09 versus 1.08], weight loss from delivery to six months post partum (OR 0.88 versus 0.88), and retained weight from the beginning of pregnancy until six months post partum (OR 1.23 versus 1.19). high BMI and weight retention at six months post partum increase the

  16. Influence of secondary diagnoses in the development of urinary incontinence after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Bárbara Padilla-Fernández

    2017-03-01

    Full Text Available Objective: To study whether there are factors related to secondary diagnoses (SDg present in patients with prostate cancer that influence the development of urinary incontinence after radical prostatectomy (RP. Materials and methods: A retrospective multicenter observational study was performed reviewing the medical records of 430 men who underwent RP due to organ-confined prostate cancer in 9 different hospitals. Two study groups were distinguished: Group A (GA: Patients without urinary incontinence after RP; Group B (GB: patients with any degree of post-surgical urinary incontinence. Results: Average age at surgery was 63.42 years (range 45-73. 258 patients were continent after surgery and 172 patients complaint of any degree of incontinence after RP. A higher percentage of healthy patients was found in group A (continent after surgery than in group B (p = 0.001. The most common SDg prior to surgery were hypertension, lower urinary tract symptoms, dyslipidemia, diabetes mellitus and erectile dysfunction, but none did show a greater trend towards post-surgical incontinence. Conclusions: A better health status prior to surgery is associated to a lower incidence of new-onset urinary incontinence after radical prostatectomy. However, no correlation was found between the most common medical disorders and the development of post-surgical urinary incontinence.

  17. Investigating the mechanism underlying urinary continence recovery after radical prostatectomy: effectiveness of a longer urethral stump to prevent urinary incontinence.

    Science.gov (United States)

    Kadono, Yoshifumi; Nohara, Takahiro; Kawaguchi, Shohei; Naito, Renato; Urata, Satoko; Nakashima, Kazufumi; Iijima, Masashi; Shigehara, Kazuyoshi; Izumi, Kouji; Gabata, Toshifumi; Mizokami, Atsushi

    2018-02-28

    To assess the chronological changes in urinary incontinence and urethral function before and after radical prostatectomy (RP), and to compare the findings of pelvic magnetic resonance imaging (MRI) before and after RP to evaluate the anatomical changes. In total, 185 patients were evaluated with regard to the position of the distal end of the membranous urethra (DMU) on a mid-sagittal MRI slice and urethral sphincter function using the urethral pressure profilometry. The patients also underwent an abdominal leak point pressure test before RP and at 10 days and 12 months after RP. The results were then compared with the chronological changes in urinary incontinence. The MRI results showed that the DMU shifted proximally to an average distance of 4 mm at 10 days after RP and returned to the preoperative position at 12 months after RP. Urethral sphincter function also worsened 10 days after RP, with recovery after 12 months. The residual length of the urethral stump and urinary incontinence were significantly associated with the migration length of the DMU at 10 days after RP. The residual length of the urethral stump was a significant predictor of urinary incontinence after RP. This is the first study to elucidate that the slight vertical repositioning of the membranous urethra after RP causes chronological changes in urinary incontinence. A long urethral residual stump reduces urinary incontinence after RP. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

  18. 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; Pstress 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...

  19. 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.

  20. Radiation therapy in carcinoma of the prostate: a contributing cause of urinary incontinence

    International Nuclear Information System (INIS)

    Kaufman, J.J.; Smith, R.B.; Raz, S.

    1984-01-01

    The authors believe that radiation therapy as a postoperative adjuvant or preceding salvage prostatectomy for carcinoma is particularly conducive to the complication of urinary incontinence by virtue of its sclerosing effect on residual sphincter mechanisms. Obviously, such dual therapy will continue to prevail in the foreseeable future but patients should be notified of the added risk and be prepared for further treatment of the incontinence. Unfortunately, these patients have an extra risk of complications and failure from anti-incontinence operations

  1. Specific obstetrical risk factors for urinary versus anal incontinence 4years after first delivery.

    OpenAIRE

    Fritel , Xavier; Khoshnood , Babak; Fauconnier , Arnaud

    2013-01-01

    International audience; AIM: Delivery can be complicated by urinary or anal incontinence (UI or AI). We hypothesized that the mechanisms of injury may differ for UI and AI. Hence, obstetrical risk factors may be specific for different types of incontinence. DESIGN: Data on maternal characteristics were collected at first delivery. Data on incontinence were obtained by a questionnaire completed by 627 women 4years after first delivery. UI was defined by "Do you have involuntary loss of urine" ...

  2. Why Irish women delay seeking treatment for urinary incontinence : a focus group study

    OpenAIRE

    Ni Aileasa, Mairead

    2011-01-01

    non-peer-reviewed Background: Urinary Incontinence is defined as "any involuntary leakage of urine" (Abrams et al, 2002). Living with incontinence can effect one's life greatly. Many women delay seeking treatment and often do not seek any help (Dolan et al, 1999), despite physiotherapy being an effective treatment (Neumann et al, 2005). Therefore, there is a need to discover why women delay seeking help, such as physiotherapy and continue to live with incontinence. Objectives: To establ...

  3. 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.

  4. 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

  5. Effects of physiotherapy treatment for urinary incontinence in patient with multiple sclerosis.

    Science.gov (United States)

    Pereira, Carla Maria de Abreu; Castiglione, Mariane; Kasawara, Karina Tamy

    2017-07-01

    [Purpose] The aim of the study was to evaluate the benefits of physical therapy for urinary incontinence in patients with multiple sclerosis and to verify the impact of urinary incontinence on the patient's quality of life. [Subject and Methods] A case study of a 55-year-old female patient diagnosed with multiple sclerosis and mixed urinary incontinence was conducted. Physical therapy sessions were conducted once a week, in total 15 sessions, making use of targeted functional electrical vaginal stimulation, along with active exercises for the pelvic floor muscles and electrical stimulation of the posterior tibial nerve, behavioral rehabilitation and exercise at home. [Results] After 15 physical therapy sessions, a patient diagnosed with multiple sclerosis and mixed urinary incontinence showed continued satisfactory results after five months. She showed better quality of life, higher strength of pelvic floor muscle and reduced urinary frequency without nocturia and enuresis. [Conclusion] The physical therapy protocol in this patient with multiple sclerosis and mixed urinary incontinence showed satisfactory results reducing urinary incontinence symptomatology and improving the patient's quality of life.

  6. 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

  7. 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

  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

  9. 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

  10. 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

  11. 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.

    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

  12. Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study.

    Science.gov (United States)

    Barbosa, Angélica Mércia Pascon; Marini, Gabriela; Piculo, Fernanda; Rudge, Cibele Vieira Cunha; Calderon, Iracema Mattos Paranhos; Rudge, Marilza Vieira Cunha

    2013-01-01

    There is uncertainty in the literature regarding the theory that obstetric events and pelvic floor injuries give rise to lower risk of subsequent urinary incontinence among women delivering via cesarean section than among women delivering vaginally. The objective of this study was to assess the two-year postpartum prevalence of urinary incontinence and pelvic floor muscle dysfunction and the factors responsible for them. Cross-sectional study, conducted in a public university. 220 women who had undergone elective cesarean section or vaginal childbirth two years earlier were selected. Their urinary incontinence symptoms were investigated, and their pelvic floor muscle dysfunction was assessed using digital palpation and a perineometer. The two-year urinary incontinence prevalences following vaginal childbirth and cesarean section were 17% and 18.9%, respectively. The only risk factor for pelvic floor muscle dysfunction was weight gain during pregnancy. Body mass index less than 25 kg/m 2 and normal pelvic floor muscle function protected against urinary incontinence. Gestational urinary incontinence increased the risk of two-year postpartum urinary incontinence. Gestational urinary incontinence was a crucial precursor of postpartum urinary incontinence. Weight gain during pregnancy increased the subsequent risk of pelvic floor muscle dysfunction, and elective cesarean section did not prevent urinary incontinence.

  13. Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study

    Directory of Open Access Journals (Sweden)

    Angélica Mércia Pascon Barbosa

    Full Text Available CONTEXT AND OBJECTIVE There is uncertainty in the literature regarding the theory that obstetric events and pelvic floor injuries give rise to lower risk of subsequent urinary incontinence among women delivering via cesarean section than among women delivering vaginally. The objective of this study was to assess the two-year postpartum prevalence of urinary incontinence and pelvic floor muscle dysfunction and the factors responsible for them. DESIGN AND SETTING Cross-sectional study, conducted in a public university. METHODS 220 women who had undergone elective cesarean section or vaginal childbirth two years earlier were selected. Their urinary incontinence symptoms were investigated, and their pelvic floor muscle dysfunction was assessed using digital palpation and a perineometer. RESULTS The two-year urinary incontinence prevalences following vaginal childbirth and cesarean section were 17% and 18.9%, respectively. The only risk factor for pelvic floor muscle dysfunction was weight gain during pregnancy. Body mass index less than 25 kg/m 2 and normal pelvic floor muscle function protected against urinary incontinence. Gestational urinary incontinence increased the risk of two-year postpartum urinary incontinence. CONCLUSION Gestational urinary incontinence was a crucial precursor of postpartum urinary incontinence. Weight gain during pregnancy increased the subsequent risk of pelvic floor muscle dysfunction, and elective cesarean section did not prevent urinary incontinence.

  14. 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...

  15. 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 (Pexercises were an empowerment mechanism for incontinent women 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.

  16. The predictive value of demonstrable stress incontinence during basic office evaluation and urodynamics in women without symptomatic urinary incontinence undergoing vaginal prolapse surgery

    NARCIS (Netherlands)

    van der Ploeg, J. Marinus; Zwolsman, Sandra E.; Posthuma, Selina; Wiarda, Hylco S.; van der Vaart, C. Huub; Roovers, Jan-Paul W. R.

    2017-01-01

    Women with pelvic organ prolapse without symptoms of urinary incontinence (UI) might demonstrate stress urinary incontinence (SUI) with or without prolapse reduction. We aimed to determine the value of demonstrable SUI during basic office evaluation or urodynamics in predicting SUI after vaginal

  17. Lower Urinary Tract Symptoms and Incontinence in Children with Pompe Disease.

    Science.gov (United States)

    Ajay, Divya; McNamara, Erin R; Austin, Stephanie; Wiener, John S; Kishnani, Priya

    2016-01-01

    Pompe disease (PD) is a disorder of lysosomal glycogen storage. The introduction of enzyme replacement therapy (ERT) has shifted the focus of care from survival to quality of life. The presence of lower urinary tract symptoms (LUTS) and incontinence has not been previously described in children with PD. Children with PD followed in the Duke Lysosomal Storage Disease Clinic completed a validated bladder control symptom score (BCSS) and additional questions regarding urinary tract infections (UTIs), giggle, and stress incontinence. Descriptive statistics were used to discriminate urinary symptoms between gender, age, and different types of PD. Sixteen of 23 children (aged 4-14 years) seen in our clinic participated. Seven were girls; ten had classic infantile PD, two atypical infantile PD, and four childhood presentation late-onset PD (LOPD). When stratified by PD subtype, median BCSS was worst for the classic PD subtype followed by atypical PD and LOPD. Daytime urinary incontinence accompanied by constipation was noted in six. Eight reported urinary incontinence with laughing: giggle incontinence in six and stress incontinence in two. Four girls reported a history of UTI. Longitudinal follow-up in 11 patients showed stable BCSS in six, improvement in three, and worsening in two. Worsening corresponded with changes in bowel function and improvement with increase in ERT dose or treatment of constipation. LUTS and incontinence are common in children with PD with greater symptoms noted with infantile-type PD. Improved bowel function and increase in ERT dose may lead to improvements in BCSS.

  18. The mediating effect of 'bothersome' urinary incontinence on help-seeking intentions among community-dwelling women.

    Science.gov (United States)

    Xu, Dongjuan; Wang, Xiaojuan; Li, Jingjing; Wang, Kefang

    2015-02-01

    To explore the mediating effect of bother of urinary incontinence between urinary incontinence severity and help-seeking intentions and detect whether the International Consultation on Incontinence Questionnaire-UI Short Form could be a valid measure to delineate bothersome urinary incontinence. Urinary incontinence is a common condition among women, which has a profound adverse effect on quality of life. However, many of them experiencing significant clinical symptoms do not seek medical help. A cross-sectional survey design. Women with urinary incontinence (N = 620) from three randomized selected community health service centres from May-October 2011 participated in the study. Data were collected using a pencil-and-paper questionnaire. Multivariate regression models were used to test the role of bother as a mediator in the relation between urinary incontinence severity and help-seeking intentions. Receiver operating characteristic analysis was used to find the best cut-off International Consultation on Incontinence Questionnaire-UI Short Form score (range: 0-21) to delineate the bother of urinary incontinence. Bothersome urinary incontinence mediated the relationship between urinary incontinence severity and help-seeking intentions. Age and duration of urine leakage had a negative association on help-seeking intentions, while educational level and previous help-seeking behaviours had a positive association. Bother was a mediator in the relation between urinary incontinence severity and help-seeking intentions. The International Consultation on Incontinence Questionnaire-UI Short Form was a discriminative measure to delineate the bothersome urinary incontinence. © 2014 John Wiley & Sons Ltd.

  19. Parameters of two-dimensional perineal ultrasonography for evaluation of urinary incontinence after Radical Prostatectomy

    OpenAIRE

    Danilo Souza Lima da Costa Cruz; Carlos Arturo Levi D’Ancona; Jamal Baracat; Marco Antonio Dionisio Alves; Marcelo Cartapatti; Ronaldo Damião

    2014-01-01

    Introduction Urinary incontinence remains a major concern for patients undergoing radical prostatectomy. Its prevalence can reach 20% in the late postoperative period. Materials and Methods This clinical study investigated the differences of a dynamic evaluation of the urethra and pelvic floor contraction using perineal ultrasound in men without prostate surgery and in men submitted to radical prostatectomy with and without stress urinary incontinence. Ninety two male patients were includ...

  20. TVT versus TVT-O for minimally invasive surgical correction of stress urinary incontinence

    OpenAIRE

    Sola, Vicente; Pardo, Jack; Ricci, Paolo; Guiloff, Enrique; Chiang, Humberto

    2007-01-01

    OBJECTIVE: The present work describes our experience in surgical correction of stress urinary incontinence, comparing both the TVT and the TVT-O techniques. METHOD: Between October 2001 and March 2004, 76 patients underwent the TVT procedure. Between January 2004 and January 2005, 98 surgical corrections of urinary incontinence were carried out using the TVT-O technique. RESULTS: Median operative time was 28 minutes for TVT and 7 minutes for TVT-O. Intraoperative complications for TVT occurre...

  1. Electrostimulation, response of the pelvic floor muscles, and urinary incontinence in elderly patients post prostatectomy

    OpenAIRE

    Zaidan,Patrícia; Silva,Elirez Bezerra da

    2014-01-01

    Objective to investigate the response of the pelvic floor muscles (PFM), and urinary incontinence (UI), in patients having undergone a prostatectomy, after treatment using electrical stimulation. Materials and methods this observational study was conducted in an outpatient urogynecologic physical therapy clinic of Hospital dos Servidores in Rio de Janeiro, Brazil from August to September 2012. Ten patients (aged, 64 ± 7 years) with urinary incontinence resulting from radical prostatectom...

  2. Lower urinary tract symptoms and urinary incontinence in a geriatric cohort - a population-based analysis.

    Science.gov (United States)

    Wehrberger, Clemens; Madersbacher, Stephan; Jungwirth, Susanne; Fischer, Peter; Tragl, Karl-Heinz

    2012-11-01

    To assess prevalence and severity of lower urinary tract function in 85-year-old men and women. Little is known on the prevalence of lower urinary tract dysfunction in this geriatric age group, which is now the fastest growing sector of the population worldwide. The Vienna Trans-Danube Aging study (VITA) is a longitudinal, population-based study initiated in 2000 that included men/women aged 75 years living in a well-defined area in Vienna. The main purpose of the VITA study was to identify risk factors for incident Alzheimer's disease. All study participants alive in 2010 were contacted by mail to complete a detailed questionnaire on various aspects of lower urinary tract symptoms (LUTS) and urinary incontinence (UI). The response rate was 68%, resulting in a total of 262 questionnaires available for analysis (men n= 96; women n= 166). All study participants were 85 years of age. Urinary incontinence defined as any involuntary loss during the past 4 weeks was reported by 24% of men and 35% of women (P= 0.04). Stress UI was more frequent in women (39%) than in men (14%, P 0.05). Nocturia more often than twice was more prevalent in men (69%) than in women (49%) (P= 0.02). Overactive bladder, according to International Continence Society criteria, was present in 55% of women and 50% of men. No difference regarding quality of life impairment as the result of LUTS and UI was noticed between sexes. A few co-morbidities were identified to correlate with UI and storage symptoms. These data provide insights into the prevalence and severity of LUTS and UI in individuals in their eighties, to our knowledge the largest population-based study in this age group. Demographic changes in upcoming decades underline the importance of a thorough understanding of lower urinary tract dysfunction in a geriatric population. © 2012 BJU INTERNATIONAL.

  3. The evidence for urodynamic investigation of patients with symptoms of urinary incontinence

    Science.gov (United States)

    2013-01-01

    Urodynamic studies are the gold standard to objectively diagnose dysfunction of the lower urinary tract. The widely available evidence for the clinical relevance is, however, fragmented. This article summarizes the published knowledge supporting the use of urodynamic studies in urinary incontinence in female, male and frail patients, as well as patients with relevant neurological disease. Five technological innovations are discussed briefly. Standard urodynamic cystometry can, on the basis of a solid body of evidence, objectively unveil the entire function of the lower urinary tract in all patients with urinary incontinence, regardless of the patients' perception of (ab-)normality of signs and or symptoms. PMID:23513180

  4. Primary Prevention of Urinary Incontinence: A Case Study of Prenatal and Intrapartum Interventions.

    Science.gov (United States)

    Kissler, Katherine; Yount, Susan M; Rendeiro, Melissa; Zeidenstein, Laura

    2016-07-01

    A wealth of information is available regarding the diagnosis and treatment of urinary incontinence. However, there is a dearth of quality information and clinical practice guidelines regarding the primary prevention of urinary incontinence. Given the high prevalence of this concern and the often cited correlation between pregnancy, childbirth, and urinary incontinence, women's health care providers should be aware of risk factors and primary prevention strategies for stress urinary incontinence (SUI) in order to reduce associated physical and emotional suffering. This case report describes several common risk factors for SUI and missed opportunities for primary prevention of postpartum urinary incontinence. The most effective methods for preventing urinary incontinence include correct teaching of pelvic floor muscle training (PFMT; specifically Kegel exercises), moderate combined physical exercise regimens, counseling and support for weight loss, counseling against smoking, appropriate treatment for asthma and constipation, and appropriate labor management to prevent pelvic organ prolapse, urethral injury, and pelvic floor muscle damage. © 2016 by the American College of Nurse-Midwives.

  5. [Postpartum urinary and fecal incontinence in gemelar pregnancy according to route and mode of delivery].

    Science.gov (United States)

    Cuerva González, Marcos Javier; López Carpintero, Nayara; de la Calle Fernández, Miranda María; Usandizaga, Ramón; González, Antonio

    2011-09-01

    The incidence of multiple pregnancies increased in the last two decades. Several studies seeking the incidence of pelvic floor pathology, particularly urinary incontinence and its risk factors, conclude that a previous cesarean and vaginal delivery even more, carry an increased risk for developing urinary and fecal incontinence, compared with patients nulligravida. To determine the different risk factors for urinary incontinence after a twin pregnancy. 331 women from 20 to 50 years of age without symptoms prior to pregnancy were interviewed, attending antenatal care of twin pregnancy in the Hospital La Paz, Madrid. The interview included the ICIQ-SF (International Consultation on Incontinence Questionnaire-Short Form). We recorded maternal age, gestational age, parity, episiotomy, weights of both newborns, the need for urinary protectors and fecal or gas incontinence. The prevalence of urinary incontinence postpartum according ICIQ-SF >0 was 23%; 20.4% in the caesarean group, 25.3% in the eutocic delivery group and 35.5% in the instrumental delivery group (p = 0.033). The prevalence of moderate to severe incontinence (ICIQ-SF >6) was 14.8%; 12.3% in caesarean group, 14.5% in the eutocic delivery group and 32.3% in the instrumental delivery group (p = 0.005). The prevalence of fecal incontinence was 3.4%; 4.8% in eutocic delivery group, 1.9% in the caesarean group and 9.7% in the instrumental delivery group (p = 0.058). The risk of urinary incontinence after a twin pregnancy was higher among patients who had an instrumental delivery when compared with patients with eutocic delivery or cesarean section. The total fetal weight and maternal age did not appear as risk factors in our study. Any woman who had an instrumental delivery for twins should be followed up by a pelvic floor specialist.

  6. Urinary incontinence at orgasm: relation to detrusor overactivity and treatment efficacy.

    Science.gov (United States)

    Serati, Maurizio; Salvatore, Stefano; Uccella, Stefano; Cromi, Antonella; Khullar, Vik; Cardozo, Linda; Bolis, Pierfrancesco

    2008-10-01

    To understand the pathophysiological mechanism of incontinence during orgasm and to compare women affected by symptomatic detrusor overactivity (DO) with and without incontinence at orgasm in terms of efficacy of antimuscarinic treatment. All consecutive sexually active women with incontinence during intercourse were prospectively included and divided into two groups: women with coital incontinence at orgasm or at penetration. The two forms of coital incontinence were correlated to the urodynamic finding of DO. Women complaining of overactive bladder (OAB) symptoms, with urinary incontinence at orgasm and urodynamically proven DO (cases), were prescribed tolterodine 4 mg extended release for at least 12 wk. The cases were compared in terms of efficacy of treatment on OAB symptoms to consecutive patients with symptomatic DO without coital incontinence (control group). Among the 1133 women who underwent urodynamic testings during the study period, 132 patients were eligible for final analysis. A significant difference in DO was observed in women with incontinence at orgasm (34 of 49; 69.4%) compared with women with incontinence during penetration (24 of 83; 28.9%) (porgasm associated with DO were given antimuscarinics treatment and were compared with 53 controls. Fourteen of 34 (41.2%) and 9 of 53 (17%) women did not respond to antimuscarinics in the cases and in the control group, respectively (p=0.023). Incontinence at orgasm is associated with DO in the majority of cases. This is the first study showing an inferior efficacy of antimuscarinic treatment in women with DO complaining of incontinence at orgasm.

  7. Artificial urinary sphincter for urinary incontinence after radical prostatectomy: a historical cohort from 2004 to 2015

    Directory of Open Access Journals (Sweden)

    Augusto Cesar Soares dos Santos Junior

    Full Text Available ABSTRACT This study aimed to retrospectively evaluate a cohort of patients with prostate cancer and persistent urinary incontinence after radical prostatectomy. From January 2004 to December 2015, eighty-six individuals were identified to have received an AUS implant, provided by a private nonprofit HMO operating in Belo Horizonte, Brazil. On total, there were 91 AUS implants, with a median interval between radical prostatectomy and AUS implant of 3.6 years (IQR 1.9 to 5.5. The rate of AUS cumulative survival, after a median follow-up of 4.1 years (IQR 1.7-7.2 years, was 44% (n=40. The median survival of AUS implants was 2.9 years (IQR 0.5-7.9 years. Thirty-seven AUS implants (40.7% resulted in grade III surgical complications. There were 5 deaths at 2.1, 4.7, 5.7, 5.7 and 6.5 years of follow-up, but none due to causes directly associated to the AUS implant. Persistent severe incontinence was documented in 14 (15.3% additional patients. From the 51 AUS implants which resulted in grade III surgical complications or persistent severe incontinence, 24 (47.1% underwent surgical revisions. Explantation of the sphincter or its components was observed in 6 cases (25.0%. Mechanical failure, described as fluid loss and/or inability to recycle the AUS device, was observed in 4 devices (16.7%. In conclusion, although AUS implants are recommended as the gold-standard treatment of severe urinary incontinence after prostatectomy, the observed high rates of malfunction and grade III adverse events are a matter of concern warranting further assessment on the safety and efficacy of these devices.

  8. Urinary and anal incontinence during pregnancy and postpartum: incidence, severity, and risk factors.

    Science.gov (United States)

    Solans-Domènech, Maite; Sánchez, Emília; Espuña-Pons, Montserrat

    2010-03-01

    To estimate frequency and severity and to identify risk factors of urinary incontinence (UI) and anal incontinence during pregnancy and after delivery in previously continent nulliparous women. We designed a cohort study of healthy, continent, nulliparous pregnant women attending public health care services. The field work was conducted during the control visits of the three trimesters of pregnancy, at the time of delivery, and postpartum. A self-administered questionnaire was used to assess UI (validated and adapted) and anal incontinence. Frequency of UI and anal incontinence and their confidence intervals (95% CIs) were calculated. The correlations between the severity of UI and the degree of effect on daily life were also estimated. Multivariable Cox models were applied to estimate hazard ratios for both incontinences (urinary/anal) during pregnancy and postpartum. The cumulative incidence rate during pregnancy was 39.1% (95% CI 36.3-41.9) for UI and 10.3% (95% CI 8.3-12.3) for anal incontinence. The correlation between severity of UI and effect on daily life was moderate. Age, baseline body mass index, and family history of UI were significantly associated with the occurrence of UI during pregnancy, while age and excess weight gain during pregnancy were associated with the occurrence of anal incontinence during pregnancy. Postpartum, the identified risk factors for both incontinences were incontinence during pregnancy and vaginal delivery. The occurrence of UI and anal incontinence during the postpartum period is related to the presence of incontinence in pregnancy, and vaginal delivery increases the risk of persistent incontinence. Some risk factors for both incontinences during pregnancy and postpartum are related to lifestyles and obstetric practices.

  9. Prevention of urinary and anal incontinence: role of elective cesarean delivery.

    Science.gov (United States)

    Lal, Mira

    2003-10-01

    Currently, prophylactic elective cesarean to prevent incontinence is being promoted without robust evidence supporting it, this has created confusion among health personnel [corrected]. Past research centered on defining the damaging effect of vaginal birth on continence whilst the limited research on elective cesarean considered it protective. Cesarean delivery has economic, obstetric, gynecological and psychosocial consequences, but incontinence is not uncommon with a persistent morbidity. There is confusion among health personnel about advocating elective cesarean delivery to prevent incontinence. Reviewing current research would facilitate obstetric thinking. Multiplanar endosonography and three-dimensional magnetic resonance imaging scanning are reportedly better in delineating structural alterations in the continence mechanism following vaginal birth and could be applied to postcesarean incontinence. Incontinence can follow vaginal or elective cesarean delivery and the severity following either mode is comparable. Urinary incontinence can resolve, persist or start de novo and the primiparous prevalence is similar following cesarean or vaginal birth. Transient anal incontinence can manifest during pregnancy. Paradoxically, pelvic floor strengthening exercises are beneficial for pregnancy-related incontinence, yet urinary incontinence occurs in nulliparas notwithstanding a strong pelvic floor. Improved imaging techniques should promote a better understanding of postcesarean incontinence. Since severe incontinence can occur after elective cesarean, its reportedly preventative role deserves more scrutiny. When incontinence occurs without labor, it is transient or shows exercise-related improvement; the role of elective cesarean delivery seems tenuous and needs careful evaluation. Current evidence does not support the routine use of elective cesarean to prevent incontinence so the delivery mode should continue to be dictated by obstetric considerations.

  10. Risk of urinary incontinence following prostatectomy: the role of physical activity and obesity.

    Science.gov (United States)

    Wolin, Kathleen Y; Luly, Jason; Sutcliffe, Siobhan; Andriole, Gerald L; Kibel, Adam S

    2010-02-01

    Urinary incontinence is one of the most commonly reported and distressing side effects of radical prostatectomy for prostate carcinoma. Several studies have suggested that symptoms may be worse in obese men but to our knowledge no research has addressed the joint effects of obesity and a sedentary lifestyle. We evaluated the association of obesity and lack of physical activity with urinary incontinence in a sample of men who had undergone radical prostatectomy. Height and weight were abstracted from charts, and obesity was defined as body mass index 30 kg/m(2) or greater. Men completed a questionnaire before surgery that included self-report of vigorous physical activity. Men who reported 1 hour or more per week of vigorous activities were considered physically active. Men reported their incontinence to the surgeon at their urology visits. Information on incontinence was abstracted from charts at 6 and 58 weeks after surgery. At 6 weeks after surgery 59% (405) of men were incontinent, defined as any pad use. At 58 weeks after surgery 22% (165) of men were incontinent. At 58 weeks incontinence was more prevalent in men who were obese and physically inactive (59% incontinent). Physical activity may offset some of the negative consequences of being obese because the prevalence of incontinence at 58 weeks was similar in the obese and active (25% incontinent), and nonbese and inactive (24% incontinent) men. The best outcomes were in men who were nonobese and physically active (16% incontinent). Men who were not obese and were active were 26% less likely to be incontinent than men who were obese and inactive (RR 0.74, 95% CI 0.52-1.06). Pre-prostatectomy physical activity and obesity may be important factors in post-prostatectomy continence levels. Interventions aimed at increasing physical activity and decreasing weight in patients with prostate cancer may improve quality of life by offsetting the negative side effects of treatment. Copyright 2010 American Urological

  11. 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...... repair. In a second period, another 19 consecutive patients had a colposuspension a.m. Burch. The patients have been evaluated 6 months postoperatively and at a long-term follow-up. No significant difference was found postoperatively in the frequency of symptoms and signs of stress incontinence, either...

  12. 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.

  13. Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence

    Science.gov (United States)

    Liu, Zhishun; Liu, Yan; Xu, Huanfang; He, Liyun; Chen, Yuelai; Fu, Lixin; Li, Ning; Lu, Yonghui; Su, Tongsheng; Sun, Jianhua; Wang, Jie; Yue, Zenghui; Zhang, Wei; Zhao, Jiping; Zhou, Zhongyu; Wu, Jiani; Zhou, Kehua; Ai, Yanke; Zhou, Jing; Pang, Ran; Wang, Yang; Qin, Zongshi; Yan, Shiyan; Li, Hongjiao; Luo, Lin

    2017-01-01

    Importance Electroacupuncture involving the lumbosacral region may be effective for women with stress urinary incontinence (SUI), but evidence is limited. Objective To assess the effect of electroacupuncture vs sham electroacupuncture for women with SUI. Design, Setting, and Participants Multicenter, randomized clinical trial conducted at 12 hospitals in China and enrolling 504 women with SUI between October 2013 and May 2015, with data collection completed in December 2015. Interventions Participants were randomly assigned (1:1) to receive 18 sessions (over 6 weeks) of electroacupuncture involving the lumbosacral region (n = 252) or sham electroacupuncture (n = 252) with no skin penetration on sham acupoints. Main Outcomes and Measures The primary outcome was change from baseline to week 6 in the amount of urine leakage, measured by the 1-hour pad test. Secondary outcomes included mean 72-hour urinary incontinence episodes measured by a 72-hour bladder diary (72-hour incontinence episodes). Results Among the 504 randomized participants (mean [SD] age, 55.3 [8.4] years), 482 completed the study. Mean urine leakage at baseline was 18.4 g for the electroacupuncture group and 19.1 g for the sham electroacupuncture group. Mean 72-hour incontinence episodes were 7.9 for the electroacupuncture group and 7.7 for the sham electroacupuncture group. At week 6, the electroacupuncture group had greater decrease in mean urine leakage (−9.9 g) than the sham electroacupuncture group (−2.6 g) with a mean difference of 7.4 g (95% CI, 4.8 to 10.0; P electroacupuncture than sham electroacupuncture with between-group differences of 1.0 episode in weeks 1 to 6 (95% CI, 0.2-1.7; P = .01), 2.0 episodes in weeks 15 to 18 (95% CI, 1.3-2.7; P electroacupuncture group and 2.0% in the sham electroacupuncture group, and all events were classified as mild. Conclusions and Relevance Among women with stress urinary incontinence, treatment with electroacupuncture involving the

  14. Effect of Electroacupuncture on Urinary Leakage Among Women With Stress Urinary Incontinence: A Randomized Clinical Trial.

    Science.gov (United States)

    Liu, Zhishun; Liu, Yan; Xu, Huanfang; He, Liyun; Chen, Yuelai; Fu, Lixin; Li, Ning; Lu, Yonghui; Su, Tongsheng; Sun, Jianhua; Wang, Jie; Yue, Zenghui; Zhang, Wei; Zhao, Jiping; Zhou, Zhongyu; Wu, Jiani; Zhou, Kehua; Ai, Yanke; Zhou, Jing; Pang, Ran; Wang, Yang; Qin, Zongshi; Yan, Shiyan; Li, Hongjiao; Luo, Lin; Liu, Baoyan

    2017-06-27

    Electroacupuncture involving the lumbosacral region may be effective for women with stress urinary incontinence (SUI), but evidence is limited. To assess the effect of electroacupuncture vs sham electroacupuncture for women with SUI. Multicenter, randomized clinical trial conducted at 12 hospitals in China and enrolling 504 women with SUI between October 2013 and May 2015, with data collection completed in December 2015. Participants were randomly assigned (1:1) to receive 18 sessions (over 6 weeks) of electroacupuncture involving the lumbosacral region (n = 252) or sham electroacupuncture (n = 252) with no skin penetration on sham acupoints. The primary outcome was change from baseline to week 6 in the amount of urine leakage, measured by the 1-hour pad test. Secondary outcomes included mean 72-hour urinary incontinence episodes measured by a 72-hour bladder diary (72-hour incontinence episodes). Among the 504 randomized participants (mean [SD] age, 55.3 [8.4] years), 482 completed the study. Mean urine leakage at baseline was 18.4 g for the electroacupuncture group and 19.1 g for the sham electroacupuncture group. Mean 72-hour incontinence episodes were 7.9 for the electroacupuncture group and 7.7 for the sham electroacupuncture group. At week 6, the electroacupuncture group had greater decrease in mean urine leakage (-9.9 g) than the sham electroacupuncture group (-2.6 g) with a mean difference of 7.4 g (95% CI, 4.8 to 10.0; P electroacupuncture than sham electroacupuncture with between-group differences of 1.0 episode in weeks 1 to 6 (95% CI, 0.2-1.7; P = .01), 2.0 episodes in weeks 15 to 18 (95% CI, 1.3-2.7; P electroacupuncture group and 2.0% in the sham electroacupuncture group, and all events were classified as mild. Among women with stress urinary incontinence, treatment with electroacupuncture involving the lumbosacral region, compared with sham electroacupuncture, resulted in less urine leakage after 6 weeks. Further research is needed to

  15. 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.

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

    Science.gov (United States)

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

    2015-01-01

    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 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. Result: 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 (Pself-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. PMID:25716389

  17. Managing therapeutic competition in patients with heart failure, lower urinary tract symptoms and incontinence.

    Science.gov (United States)

    Tannenbaum, Cara; Johnell, Kristina

    2014-02-01

    Up to 50% of heart failure patients suffer from lower urinary tract symptoms. Urinary incontinence has been associated with worse functional status in patients with heart failure, occurring three times more frequently in patients with New York Heart Association Class III and IV symptoms compared with those with milder disease. The association between heart failure and urinary symptoms may be directly attributable to worsening heart failure pathophysiology; however, medications used to treat heart failure may also indirectly provoke or exacerbate urinary symptoms. This type of drug-disease interaction, in which the treatment for heart failure precipitates incontinence, and removal of medications to relieve incontinence worsens heart failure, can be termed therapeutic competition. The mechanisms by which heart failure medication such as diuretics, angiotensin-converting enzyme (ACE) inhibitors and β-blockers aggravate lower urinary tract symptoms are discussed. Initiation of a prescribing cascade, whereby antimuscarinic agents or β3-agonists are added to treat symptoms of urinary urgency and incontinence, is best avoided. Recommendations and practical tips are provided that outline more judicious management of heart failure patients with lower urinary tract symptoms. Compelling strategies to improve urinary outcomes include titrating diuretics, switching ACE inhibitors, treating lower urinary tract infections, appropriate fluid management, daily weighing, and uptake of pelvic floor muscle exercises.

  18. The impact of urinary incontinence on self-efficacy and quality of life

    Directory of Open Access Journals (Sweden)

    Broome Barbara

    2003-08-01

    Full Text Available Abstract Urinary incontinence impacts 15 to 35% of the adult ambulatory population. Men after the removal of the prostate for cancer can experience incontinence for several weeks to years after the surgery. Women experience incontinence related to many factors including childbirth, menopause and surgery. It is important that incontinence be treated since it impacts not only the physiological, but also the psychological realms of a person's life. Depression and decreed quality of life have been found to co-occur in the person struggling with incontinence. Interventions include pharmacological, surgical as well as behavioral interventions. Effective treatment of incontinence should include the use of clinical guidelines and research to promote treatment efficacy.

  19. [Urinary incontinence in pregnancy and in puerperium: 3 months follow-up after delivery].

    Science.gov (United States)

    Granese, R; Adile, B

    2008-02-01

    The aim of this clinic prospective study was to point out the predisposing risk factors for the development of urinary incontinence during pregnancy and postpartum and to understand how to prevent the symptomatology. Sixty seven primipara women at 32 weeks of pregnancy and 3 months after the delivery, were studied through an urogynecological work-up and a questionnaire on the main urinary symptoms. At 32 weeks of pregnancy, 27 patients (40.29%) were affected by stress urinary incontinence (SUI) of type I and 22 (32.83%) by urge incontinence. Three months after delivery, it was observed SUI of type I in 8 patients (15.68%), SUI of type II in 9 patients (17.64%), SUI of type II and II degree cystouretrocele in 3 patients (5.8%) and urge incontinence in 14 patients (27.45%). The most frequent risk factors that were tracked down were: a vaginal delivery, with a prolonged labour, and the episiotomy. We didn't find either substantial changes in the weight between patients continent and incontinent or correlations with the patients' age or with the weight of the foetus and the symptomatology reported. It is important to understand the beginning of the urinary symptoms in the pregnant women, to prevent the worsening of it. It is required, however, a long term follow-up on our patients to verify if the urinary incontinence persists or disappears by the time is needed.

  20. Differences in pelvic floor morphology between continent, stress urinary incontinent, and mixed urinary incontinent elderly women: An MRI study.

    Science.gov (United States)

    Pontbriand-Drolet, Stéphanie; Tang, An; Madill, Stephanie J; Tannenbaum, Cara; Lemieux, Marie-Claude; Corcos, Jacques; Dumoulin, Chantale

    2016-04-01

    To compare magnetic resonance imaging (MRI) of the pelvic floor musculature (PFM), bladder neck and urethral sphincter morphology under three conditions (rest, PFM maximal voluntary contraction (MVC), and straining) in older women with symptoms of stress (SUI) or mixed urinary incontinence (MUI) or without incontinence. This 2008-2012 exploratory observational cohort study was conducted with community-dwelling women aged 60 and over. Sixty six women (22 per group), mean age of 67.7 ± 5.2 years, participated in the study. A 3 T MRI examination was conducted under three conditions: rest, PFM MVC, and straining. ANOVA or Kruskal-Wallis tests (data not normally distributed) were conducted, with Bonferroni correction, to compare anatomical measurements between groups. Women with MUI symptoms had a lower PFM resting position (M-Line P = 0.010 and PC/H-line angle P = 0.026) and lower pelvic organ support (urethrovesical junction height P = 0.013) than both continent and SUI women. Women with SUI symptoms were more likely to exhibit bladder neck funneling and a larger posterior urethrovesical angle at rest than both continent and MUI women (P = 0.026 and P = 0.008, respectively). There were no significant differences between groups on PFM MVC or straining. Women with SUI and MUI symptoms present different morphological defects at rest. These observations emphasize the need to tailor UI interventions to specific pelvic floor defects and UI type in older women. Older women with UI demonstrate different problems with their pelvic organ support structures depending on the type of UI. These new findings should be taken into consideration for future research into developing new treatment strategies for UI in older women. Neurourol. Urodynam. 35:515-521, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  1. Does the Urinary Microbiome Play a Role in Urgency Urinary Incontinence and Its Severity?

    Science.gov (United States)

    Karstens, Lisa; Asquith, Mark; Davin, Sean; Stauffer, Patrick; Fair, Damien; Gregory, W. Thomas; Rosenbaum, James T.; McWeeney, Shannon K.; Nardos, Rahel

    2016-01-01

    Objectives: Traditionally, the urinary tract has been thought to be sterile in the absence of a clinically identifiable infection. However, recent evidence suggests that the urinary tract harbors a variety of bacterial species, known collectively as the urinary microbiome, even when clinical cultures are negative. Whether these bacteria promote urinary health or contribute to urinary tract disease remains unknown. Emerging evidence indicates that a shift in the urinary microbiome may play an important role in urgency urinary incontinence (UUI). The goal of this prospective pilot study was to determine how the urinary microbiome is different between women with and without UUI. We also sought to identify if characteristics of the urinary microbiome are associated with UUI severity. Methods: We collected urine from clinically well-characterized women with UUI (n = 10) and normal bladder function (n = 10) using a transurethral catheter to avoid bacterial contamination from external tissue. To characterize the resident microbial community, we amplified the bacterial 16S rRNA gene by PCR and performed sequencing using Illumina MiSeq. Sequences were processed using the workflow package QIIME. We identified bacteria that had differential relative abundance between UUI and controls using DESeq2 to fit generalized linear models based on the negative binomial distribution. We also identified relationships between the diversity of the urinary microbiome and severity of UUI symptoms with Pearson's correlation coefficient. Results: We successfully extracted and sequenced bacterial DNA from 95% of the urine samples and identified that there is a polymicrobial community in the female bladder in both healthy controls and women with UUI. We found the relative abundance of 14 bacteria significantly differed between control and UUI samples. Furthermore, we established that an increase in UUI symptom severity is associated with a decrease in microbial diversity in women with UUI

  2. Urodynamic assessment of bladder and urethral function among men with lower urinary tract symptoms after radical prostatectomy: A comparison between men with and without urinary incontinence.

    Science.gov (United States)

    Lee, Hansol; Kim, Ki Bom; Lee, Sangchul; Lee, Sang Wook; Kim, Myong; Cho, Sung Yong; Oh, Seung-June; Jeong, Seong Jin

    2015-12-01

    We compared bladder and urethral functions following radical prostatectomy (RP) between men with and without urinary incontinence (UI), using a large-scale database from SNU-experts-of-urodynamics-leading (SEOUL) Study Group. Since July 2004, we have prospectively collected data on urodynamics from 303 patients with lower urinary tract symptoms (LUTS) following RP at three affiliated hospitals of SEOUL Study Group. After excluding 35 patients with neurogenic abnormality, pelvic irradiation after surgery, or a history of surgery on the lower urinary tract, 268 men were evaluated. We compared the urodynamic findings between men who had LUTS with UI (postprostatectomy incontinence [PPI] group) and those who had LUTS without UI (non-PPI group). The mean age at an urodynamic study was 68.2 years. Overall, a reduced bladder compliance (≤20 mL/cmH2O) was shown in 27.2% of patients; and 31.3% patients had idiopathic detrusor overactivity. The patients in the PPI group were older (p=0.001) at an urodynamic study and had a lower maximum urethral closure pressure (MUCP) (p<0.001), as compared with those in the non-PPI group. Bladder capacity and detrusor pressure during voiding were also significantly lower in the PPI group. In the logistic regression, only MUCP and maximum cystometric capacity were identified as the related factor with the presence of PPI. In our study, significant number of patients with LUTS following RP showed a reduced bladder compliance and detrusor overactivity. PPI is associated with both impairment of the urethral closuring mechanism and bladder storage dysfunction.

  3. Urinary tract infection: a cohort of older people with urinary incontinence.

    Science.gov (United States)

    Melo, Laís Samara de; Ercole, Flávia Falci; Oliveira, Danilo Ulisses de; Pinto, Tatiana Saraiva; Victoriano, Mariana Avendanha; Alcoforado, Carla Lúcia Goulart Constant

    2017-01-01

    To evaluate epidemiological aspects of urinary tract infection in older patients with urinary incontinence living in long-term care institutions in Belo Horizonte. Method: Concurrent cohort held from April 1st to October 1st, 2015. The study was conducted in two long-term care institutions in the city of Belo Horizonte, Minas Gerais, with 84 incontinent older people. Cumulative incidence of urinary tract infection was 19% (95% CI: 7.83-23.19) and the incidence density was 3.6 cases/100 people-month of follow-up period. The variables Bacteriuria and Institution presented statistical association with the occurrence of urinary tract infection. It is observed that the incidence of urinary tract infection in the study was smaller than in other similar international and national studies, however this is an important world health problem for the older population, with impact on mortality of these individuals. Avaliar aspectos epidemiológicos da infecção do trato urinário em pacientes idosos com incontinência urinária, residentes em instituições de longa permanência, de Belo Horizonte. Coorte concorrente realizada no período de 01 de abril a 01 de outubro de 2015. O estudo foi realizado em duas instituições de longa permanência, na cidade de Belo Horizonte, MG, com 84 idosos incontinentes. A incidência acumulada de infecção do trato urinário foi de 19% (IC 95%: 7,83-23,19) e a densidade de incidência foi de 3,6 casos/100 pessoas-mês de seguimento. As variáveis Bacteriúria e Instituição apresentaram associação estatística com a ocorrência de infecção do trato urinário. Observa-se que a incidência de infecção do trato urinário no estudo foi menor que em outros estudos nacionais e internacionais semelhantes, no entanto trata-se de um importante problema de saúde mundial para os idosos, com impacto na mortalidade desses indivíduos.

  4. Urodynamics Before Surgery for Stress Urinary Incontinence: The Urodynamic Examination Is Still One of the Best Friends of the Surgeon and of Patients with Stress Urinary Incontinence.

    Science.gov (United States)

    Serati, Maurizio; Agrò, Enrico Finazzi

    2016-08-01

    In the large majority of patients with stress urinary incontinence, urodynamics could provide new information, in comparison to simple clinical examination, and change subsequent management in a relevant percentage of cases. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  5. Prospective analyses of female urinary incontinence symptoms following total hip arthroplasty.

    Science.gov (United States)

    Okumura, Keiko; Yamaguchi, Kumiko; Tamaki, Tatsuya; Oinuma, Kazuhiro; Tomoe, Hikaru; Akita, Keiichi

    2017-04-01

    Some patients with hip osteoarthritis report that urinary incontinence (UI) is improved following total hip arthroplasty (THA). However, the type and severity of UI remain unclear. In this study, we hypothesize that both stress urinary incontinence (SUI) and urge urinary incontinence (UUI) are improved after THA. We assess the characteristics of UI and discuss the anatomical factors related to UI and THA for improved treatment outcome. Fifty patients with UI who underwent direct anterior-approach THA were evaluated. Type of UI was assessed using four questionnaires: Core Lower Urinary Tract Symptom Score (CLSS), Urogenital Distress Inventory Short Form (UDI-6), International Prostate Symptom Score (IPSS), and Overactive Bladder Symptom Score (OABSS). Uroflowmetry and postvoid residual urine were measured using ultrasound technology. Hip-joint function was evaluated using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and range of motion (ROM). Of the 50 patients, 21 had SUI, 16 had mixed urinary incontinence (MUI), and eight had urgency urinary incontinence (UUI). In total, 36 patients were better than improved (72 %). The rate of cured and improved was 76 % for SUI, 100 % MUI, and 50 % UUI. The improvement of ROM was more significant in cured or improved patients than in stable or worse patients. Improvement in mild UI may be an added benefit for those undergoing THA for hip-joint disorders. These data suggest that for patients with hip-joint disorder, hip-joint treatment could prove to also be a useful treatment for UI.

  6. Outcomes of Surgery for Stress Urinary Incontinence in the Older Woman

    Science.gov (United States)

    Ellington, David R.; Erekson, Elisabeth A.; Richter, Holly E.

    2015-01-01

    Synopsis As population demographics continue to evolve, specifics on age-related outcomes of stress urinary incontinence interventions will be critical to patient counseling and management planning. Understanding medical factors unique to older woman and their lower urinary tract condition will allow caregivers to optimize surgical outcomes, both physical and functional, and minimize complications within this population. PMID:26476111

  7. Systematic screening for urinary incontinence in older women : Who could benefit from it?

    NARCIS (Netherlands)

    Visser, E.; de Bock, G.H.; Kollen, B.J.; Meijerink, M.; Berger, M.Y.; Dekker, J.H.

    Objective. To identify women who are suffering from urinary incontinence but do not consult a physician and to identify reasons for this. Design. Survey study as part of a randomized controlled trial that investigates the effects of a standardized assessment and evidence-based treatment on urinary

  8. 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.

  9. Preventing urinary incontinence during pregnancy and postpartum: a review.

    Science.gov (United States)

    Wesnes, Stian Langeland; Lose, Gunnar

    2013-06-01

    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 focus is on pelvic floor muscle training to prevent UI. However, several other modifiable risk factors are likely to contribute to prevention of UI during pregnancy and postpartum. This review investigated modifiable risk factors for UI during pregnancy and postpartum and also reviewed randomized controlled trials on prevention of UI in association with pregnancy. Systematic searches for publications until September 2012 on prevention of UI during pregnancy and postpartum were performed. Based on available evidence, the following recommendations to prevent UI during pregnancy and postpartum were made: 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 (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 are addressed in association with pregnancy, incidence of UI during pregnancy and postpartum is likely to decrease.

  10. 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

  11. 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.

  12. 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.

  13. Longitudinal comparison study of pelvic floor function between women with and without stress urinary incontinence after vaginal delivery.

    Science.gov (United States)

    Yoshida, Mikako; Murayama, Ryoko; Haruna, Megumi; Matsuzaki, Masayo; Yoshimura, Kenichi; Murashima, Sachiyo; Kozuma, Shiro

    2013-04-01

    To compare the pelvic floor function between women with and without stress urinary incontinence after vaginal delivery. Seventeen women (age 35.5 ± 3.5) were prospectively studied at about 6 weeks, 3 months, and 6 months after vaginal delivery. Urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire - Short Form. Pelvic floor function was assessed by antero-posterior diameter of the levator hiatus using transperineal ultrasound. Five of 17 women experienced postpartum stress urinary incontinence. The antero-posterior diameter of the levator hiatus at rest was significantly longer in stress urinary incontinent women than in continent women until 3 months after delivery (p continent women and stress urinary incontinent women. Regardless of urinary incontinence, the antero-posterior diameter of the levator hiatus at rest shortened at 6 months postpartum, compared to 6 weeks postpartum (p continent women by 6 months postpartum (p = 0.02). The extended pelvic floor may be a cause of stress urinary incontinence in the postpartum period. Therefore, treatment to improve the extended pelvic floor should be developed for the prevention of stress urinary incontinence.

  14. Noctural Enuresis as a Risk Factor for Falls in Older Community Dwelling Women with Urinary Incontinence.

    Science.gov (United States)

    Pahwa, Avita K; Andy, Uduak U; Newman, Diane K; Stambakio, Hanna; Schmitz, Kathryn H; Arya, Lily A

    2016-05-01

    We determined the association of urinary symptoms with fall risk and physical limitations in older community dwelling women with urinary incontinence. We performed an in-depth assessment of daytime and nighttime urinary symptoms, fall risk, physical function, physical performance tests and mental function in older community dwelling women with urinary incontinence who had not sought care for urinary symptoms. All assessments were performed in participant homes. We used univariable and multivariable linear regression to examine the relationship of urinary symptoms to fall risk, physical function and physical performance. Of 37 women with a mean ± SD age of 74 ± 8.4 years who had urinary incontinence 48% were at high risk for falls. Nocturnal enuresis was reported by 50% of the women. Increased fall risk was associated with increasing frequency of nocturnal enuresis (p = 0.04), worse lower limb function (p Women with nocturnal enuresis had significantly lower physical performance test scores than women without nocturnal enuresis (median 7, range 0 to 11 vs 9, range 1 to 12, p = 0.04). In a multivariable regression model including age, nocturnal enuresis episodes and physical function only physical function was associated with an increased fall risk (p women with urinary incontinence. It may serve as a marker of fall risk even in women who do not seek care for urinary symptoms. Interventions targeting upper and lower body physical function could potentially decrease the risk of falls in older women with urinary incontinence. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  15. Minimal care--a new concept for the management of urinary incontinence in an open access, interdisciplinary incontinence clinic. The way ahead?

    DEFF Research Database (Denmark)

    Andersen, J T; Sander, P

    1996-01-01

    A new concept for assessment and treatment of urinary incontinence in an open access, interdisciplinary clinic is evaluated prospectively. Based on the patients needs and expectations, a minimal relevant investigative programme was planned. The patients were primarily offered conservative, non...... of the patients were managed by conservative treatment modalities whereas only 10% of the patients were referred to in-hospital treatment with invasive treatment modalities, mainly surgical procedures for urinary incontinence. Subjectively, 68% felt cured or very much improved, 23% experienced improvement and 9...... and treatment of urinary incontinence....

  16. 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

  17. Effect of Stress Urinary Incontinence on the Sexual Function of Couples and the Quality of Life of Patients.

    Science.gov (United States)

    Lim, Renly; Liong, Men Long; Leong, Wing Seng; Khan, Nurzalina Abdul Karim; Yuen, Kah Hay

    2016-07-01

    Studies of the effects of stress urinary incontinence on the sexual function of couples are scarce. We prospectively evaluated couple sexual function and the relationship between sexual function and quality of life. We also compared quality of life in females with vs without stress urinary incontinence. Sexually active females at least 21 years old with or without stress urinary incontinence and their partners were recruited for study. To assess sexual function the couples completed GRISS (Golombok Rust Inventory of Sexual Satisfaction) and a 1-item question on overall sexual experience, "Over the past 4 weeks, how satisfied have you been with your overall sexual life?" Additionally, females completed ICIQ-LUTSqol (International Consultation on Incontinence Questionnaire-Lower Urinary Tract Symptoms Quality of Life) to assess quality of life. For sexual function assessment 66 of 134 couples with (49.3%) and 95 of 176 without (54.0%) stress urinary incontinence were recruited. Females with stress urinary incontinence had lower overall sexual function, lower frequency of sexual intercourse, less satisfaction (each p stress urinary incontinence had more problems with erectile dysfunction (p = 0.027), less satisfaction (p = 0.006) and lower frequency of sexual intercourse (p = 0.001) but no difference in overall GRISS score (p = 0.093). Couples with stress urinary incontinence had poorer overall sexual experience (p stress urinary incontinence had poorer quality of life than those without stress urinary incontinence (120 of 134, response rate 89.6% vs 145 of 176, response rate 82.4%, p life did not significantly correlate (r = 0.001, p = 0.997). Stress urinary incontinence in females is negatively associated not only with female quality of life and sexual function but also with partner sexual function. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  18. Evaluation of urinary incontinence and quality of life in married women aged between 20 and 49 years (Sakarya, Turkey)

    Science.gov (United States)

    Özdemir, Kevser; Şahin, Sevil; Özerdoğan, Nebahat; Ünsal, Alaattin

    2018-02-23

    Background/aim: This study aimed to determine the prevalence of urinary incontinence and to evaluate the relationship between urinary incontinence and quality of life in married women. Materials and methods: This is a cross-sectional study conducted among married women aged 20-49 years living in the vicinity of the Çökekler Community Clinic (Family Health Center) in Sakarya, Turkey, from 1 November 2011 to 15 April 2012. The study group consisted of 1161 women. Results: The frequency of urinary incontinence was 71.5% (n = 830). Out of a total of 830 patients with symptoms of urinary incontinence, mixed was the most frequently determined type (60.4%), followed by urge (33.9%) and then stress urinary incontinence (5.8%). The mean scores obtained by women with urinary incontinence from the general health perceptions and social functioning domains of the SF-36 survey were lower (P Urinary incontinence was found to be a common problem among women, and it affects quality of life adversely. Recurrent urinary tract infection and advancing age were the key risk factors in the development of urinary incontinence.

  19. A prospective, randomized, controlled study of a suspension positioning system used with elderly bedridden patients with neurogenic fecal incontinence.

    Science.gov (United States)

    Su, Mei-Yin; Lin, Shi-Quan; zhou, Ye-Wen; Zhou, Ye-Wen; Liu, Si-Ya; Lin, Ai; Lin, Xi-Rong

    2015-01-01

    Elderly patients with acute neurological impairment are prone to severe disability, fecal incontinence (FI), and resultant complications. A suspension positioning system (SPS), based on the orthopedic suspension traction system commonly used for conservative treatment of pediatric femoral fracture and uncomplicated adult pelvic fracture, was developed to facilitate FI management in patients immobilized secondary to an acute neurological condition. To evaluate the effectiveness and safety of the system, a prospective, randomized, controlled study was conducted between October 2009 and July 2012. Two hundred (200) elderly, bedridden, hospitalized patients with acute, nonchronic neurological impairment were randomly assigned to receive routine FI nursing care (ie, individualized dietary modification, psychological support, health education, and social support for caregivers and family members [control group]) or routine incontinence care plus the SPS (experimental group) during the day. Rates of perianal fecal contamination, skin breakdown, incontinence associated dermatitis, pressure ulcer development, and lower urinary tract infection (LUTI) were significantly lower in the SPS than in the control group (P <0.05). Length of hospitalization and costs of care were also lower in the SPS group (P <0.05). Patient quality-of-life (QoL) and FI QoL scores were similar at baseline but significantly higher (better) at the 6-month follow-up interview in the SPS than in the control group (P <0.05). In this study, the rate of FI-associated morbidities was lower and 6-month patient QoL scores were higher in the SPS than in the control group. No adverse events were observed, and all patients completed the study. Further clinical studies are needed to examine the long-term effects of SPS use among neurologically impaired FI patients.

  20. Risk Factors for Urinary Incontinence in Taiwanese Women Aged 20-59 Years

    Directory of Open Access Journals (Sweden)

    Ching-Hung Hsieh

    2008-06-01

    Conclusion: There is a high prevalence of urinary incontinence among women who suffer from diabetes o hypertension, or who have undergone a gynecologic operation, in particular hysterectomy. From a public healt viewpoint, it is important to promote better health education in order to improve understanding of urinar incontinence and its risk factors and to increase the awareness of the availability of mainstream treatment; [Taiwan J Obstet Cynecol 2008;47(2:1 97-202

  1. [Postpartum stress urinary incontinence and associated obstetric factors].

    Science.gov (United States)

    Wang, Xiao-rong; Shi, Jun-xia; Zhai, Gui-rong; Zhang, Wei-yuan

    2010-02-01

    To evaluate the effect of cesarean section (CS) and vaginal delivery (VD) on postpartum stress urinary incontinence (SUI) and pelvic floor muscles strength and to find out the correlated obstetric factors and prevention for postpartum SUI. Totally, 788 women, who visited the antenatal clinics, delivered and had the follow-up at 6-8 weeks after delivery in Beijing Obstetrics and Gynecology Hospital in the year of 2008, were enrolled in this study and were divided into 3 groups: CS group (n = 212); normal vaginal delivery (NVD) group (n = 534) and forceps delivery (FD) group (n = 42). Women in the NVD and FD group were merged into one VD group and then divided into SUI and non-SUI group. Information of delivery mode and the correlated obstetric factors were obtained through questionnaires and medical records. Femiscan pelvic floor muscle examine system was applied to measure the pelvic floor muscle strength to understand the relationship between postpartum SUI and pelvic floor muscle strength. (1) Incidence of SUI: the overall proportion of women who complained of urinary incontinence (UI) during pregnancy was 15.4% (121/788), and it was 15.9% (85/534), 11.9% (5/42) and 14.6% (31/212) in the NVD, FD and CS group, respectively (P > 0.05). The overall incidence of postpartum SUI was 17.1% (135/788), and it was 19.1% (102/534), 26.2% (11/42) and 10.4% (22/212) in the NVD, FD and CS group, respectively, with significant difference between the NVD and FD group, and between the CS and NVD group (all P factors of postpartum SUI: among the VD group, 113 women were in the postpartum SUI group and 463 in the non-SUI group. Univariate analysis and logistic multivariate analysis showed that delivery mode, neonatal birth weight and UI during pregnancy were risk factors of postpartum SUI. CS decreased and higher neonatal birth weight and UI during pregnancy increased the risk of postpartum SUI. In the VD group, neonatal birth weight, forceps delivery and UI during pregnancy

  2. 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 (r s  = .40-.75, p < .01) and with relationship satisfaction (r s  = .35-.71, p < .05). Preliminary exploration of the contribution of study factors to relationship satisfaction through exploratory regression analysis showed unique contributions from sexual quality of life (18.7%, p < .001) and 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.

  3. EFFICACY OF PELVIC FLOOR THERAPY IN TREATING URINARY INCONTINENCE AMONG FEMALE COPD PATIENTS

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    Mohankumar Thekkinkattil

    2016-08-01

    Full Text Available Background: Chronic obstructive pulmonary disease (COPD is a leading cause of morbidity and mortality worldwide. The major manifestation of COPD includes dyspnea, decreased oxygenation and reduced exercise tolerance. The other manifestations such as urinary incontinence are less noted and treated inadequately. The prevalence of urinary incontinence in Indian COPD population has not been well documented. The treatment of urinary incontinence includes pelvic floor exercises (Kegel’s exercises, biofeedback, and acupuncture etc. Methods: Forty female moderate COPD patients diagnosed according to American Thoracic Criteria with a complaint of urinary incontinence were selected for the study. Pelvic floor therapy exercises were given daily 5 sets per day (1 set =1-3 counts for seven days. Baseline evaluation was done using International Consultation on Incontinence Short Form (ICIQ-SF on the day of referral for physiotherapy and the post study measurements were taken on 7th day of hospital stay. Wilcoxon Signed Rank calculator was used to assess the data collected. Results: The z value of ICIQ-SF questionnaire was 5.5109 ( p≤ 0.05 based on Wilcoxon Sign rank test and it was significant when we compared the pre and post test mean difference. The pre test mean score of ICIQ-SF was 14.175 and post test mean score was 4.4.Based on the findings, the results showed significant improvement in patient symptoms and reduced stress incontinence post pelvic floor therapy exercises. Conclusion: The study emphasizes the importance of pelvic floor therapy in treating stress urinary incontinence among COPD patients and it should also be included in a comprehensive pulmonary rehabilitation program.

  4. Use of urodynamics prior to surgery for urinary incontinence: How helpful is preoperative testing?

    Directory of Open Access Journals (Sweden)

    Gary E Lemack

    2007-01-01

    Full Text Available It has not yet been definitively demonstrated that preoperative evaluation of women with stress urinary incontinence with urodynamic testing enhances presurgical counseling, more effectively models patients′ expectations or improves postoperative outcome. Nonetheless, urodynamic testing is frequently utilized in the assessment of women with stress urinary incontinence and clearly accomplishes a number of goals when utilized for this purpose. For example, there are data to suggest that the risk of voiding dysfunction can be mitigated by utilizing data obtained from urodynamic testing to identify women more likely to void ineffectively after conventional stress incontinence procedures. Furthermore, it has been suggested though not proven, that patients with more severe forms of stress incontinence as identified by urodynamic testing, might be less likely to improve after surgery compared to others with more modest degrees of incontinence. Since urodynamic testing is invasive, costly and not always available, it is imperative that the usefulness of such testing be carefully explored and its utility appropriately defined. In this review, we discuss urodynamic techniques to assess stress urinary incontinence, particularly focusing on the ability of leak point pressure testing and urethral pressure profilometry to predict which patients would most likely benefit from surgery and which might be more likely to experience adverse events following surgery.

  5. Parameters of two-dimensional perineal ultrasonography for evaluation of urinary incontinence after Radical Prostatectomy.

    Science.gov (United States)

    Costa Cruz, Danilo Souza Lima da; D'Ancona, Carlos Arturo Levi; Baracat, Jamal; Alves, Marco Antonio Dionisio; Cartapatti, Marcelo; Damião, Ronaldo

    2014-01-01

    Urinary incontinence remains a major concern for patients undergoing radical prostatectomy. Its prevalence can reach 20% in the late postoperative period. This clinical study investigated the differences of a dynamic evaluation of the urethra and pelvic floor contraction using perineal ultrasound in men without prostate surgery and in men submitted to radical prostatectomy with and without stress urinary incontinence. Ninety two male patients were included, which 70% of them underwent radical prostatectomy (RP) for more than one year. Thirty one men with clinically post prostatectomy incontinence were compared by two-dimensional (2D) perineal ultrasound to 34 patients without post prostatectomy incontinence and to 27 men without surgery in two centers in Brazil. Our results showed that the continent group presented the urethral angle at rest significantly lower than the prostate group (p = 0.0002). We also observed that the incontinent group showed the displacement of the anterior bladder neck during contraction significantly lower than the continent group (p = 0.008). We found that the continent group presented the urethral angle at rest significantly lower than the prostate group. The incontinent group also showed the anterior bladder neck displacement during contraction significantly lower than the continent group. It was more evident when the severe incontinent group and the continent group were compared.

  6. Parameters of two-dimensional perineal ultrasonography for evaluation of urinary incontinence after Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    Danilo Souza Lima da Costa Cruz

    2014-10-01

    Full Text Available Introduction Urinary incontinence remains a major concern for patients undergoing radical prostatectomy. Its prevalence can reach 20% in the late postoperative period. Materials and Methods This clinical study investigated the differences of a dynamic evaluation of the urethra and pelvic floor contraction using perineal ultrasound in men without prostate surgery and in men submitted to radical prostatectomy with and without stress urinary incontinence. Ninety two male patients were included, which 70% of them underwent radical prostatectomy (RP for more than one year. Thirty one men with clinically post prostatectomy incontinence were compared by two-dimensional (2D perineal ultrasound to 34 patients without post prostatectomy incontinence and to 27 men without surgery in two centers in Brazil. Results Our results showed that the continent group presented the urethral angle at rest significantly lower than the prostate group (p = 0.0002. We also observed that the incontinent group showed the displacement of the anterior bladder neck during contraction significantly lower than the continent group (p = 0.008. Conclusions We found that the continent group presented the urethral angle at rest significantly lower than the prostate group. The incontinent group also showed the anterior bladder neck displacement during contraction significantly lower than the continent group. It was more evident when the severe incontinent group and the continent group were compared.

  7. The Impact of Midurethral Sling Surgery on Sexual Activity and Function in Women With Stress Urinary Incontinence

    NARCIS (Netherlands)

    Mengerink, Bianca B.; van Leijsen, Sanne A. L.; Vierhout, Mark E.; IntHout, Joanna; Mol, Ben W. J.; Milani, Alfredo L.; Roovers, Jan-Paul W. R.; van Eijndhoven, Hugo W. F.; van der Vaart, Carl H.; van Gestel, Iris; Hartog, Francis E.; Heesakkers, John F. A.; Kluivers, Kirsten B.

    2016-01-01

    Introduction: Stress urinary incontinence has a negative impact on sexual function. Aim: To assess the effect of midurethral sling surgery on sexual activity and function in women with stress urinary incontinence. Methods: This is a secondary analysis of the Value of Urodynamics Prior to Stress

  8. 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....

  9. Urinary incontinence in prostate cancer patients treated with external beam radiotherapy

    International Nuclear Information System (INIS)

    Liu, Mitchell; Pickles, Tom; Berthelet, Eric; Agranovich, Alexander; Kwan, Winkle; Tyldesley, Scott; McKenzie, Michael; Keyes, Mira; Morris, James; Pai, Howard

    2005-01-01

    Background and purpose: To describe the incidence of urinary incontinence among prostate cancer patients treated with external beam radiotherapy (RT) and to investigate associated risk factors. Patients and methods: One thousand and hundred ninety-two patients with ≥24 months follow-up were the subjects of this series. All patients received between 50 and 72 Gy in 20-37 fractions (median 66 Gy/33). Post-RT urinary incontinence was scored by direct patient interviewing according to the modified RTOG/SOMA scale: Grade 1-occasional use of incontinence pads, Grade 2-intermittent use of incontinence pads, Grade 3-persistent use of incontinence pads, and Grade 4-permanent catheter. Risk-factors investigated were: age, diabetes, TURP prior to RT, elapsed time from TURP to RT, clinical stage, RT dose and presence of Grade ≥2 acute GU and GI toxicity. Non-parametric, actuarial univariate (Kaplan-Meier) and multivariate tests (MVA, Cox regression) were performed. Results: Median follow-up for the group is 52 months (24-109). Thirty-four patients (2.9%) had incontinence prior to RT, which was more common in TURP patients (7.8% vs 1.6% P<0.001). These are excluded from further analysis. Fifty-seven patients (4.9%) developed Grade 1 incontinence, 7 (0.6%) Grade 2, and 7 (0.6%) Grade 3. There was no Grade 4 incontinence. Actuarial rates for Grade ≥1 and ≥2 incontinence at 5 years are 7 and 1.7%, respectively. Risk factors on MVA associated with the development of Grade 1 or worse incontinence are pre-RT TURP (5-year rates 10% vs 6%, P=0.026), presence of Grade ≥2 acute GU toxicity (5-year rates 11% vs 5%, P=0.002). Age, diabetes, clinical stage, elapsed time from TURP to RT, RT dose or fraction size, acute GI toxicity were not significant. Patients who underwent post-RT TURP or dilatation for obstructive symptoms (4.3%), were more likely to develop Grade 2-3 incontinence (5-year rate 8 vs 1.5%, P=0.0015). Conclusions: Grade 2 or greater urinary incontinence is rare

  10. Etiopathogenesis, diagnostics and history of surgical treatment of stress urinary incontinence.

    Science.gov (United States)

    Jovan, Hadži-Djokić; Uroš, Babić; Aleksandar, Argirović; Miodrag, Aćimović; Milan, Radovanović; Bogomir, Milojević; Tomisla, Pejčić; Zoran, Džamić

    2014-01-01

    Urinary incontinence represents involuntary urine leakage into the urethra. This pathological condition represents a major medical, social and hygienic problem. The paper presents risk factors for development of the disorder, as well as diagnostic methods applied in evaluation of the female patients. Chronological review of diverse surgical techniques used in treatment of stress urinary incontinence reported in the published scientific papers is also presented. Review of the literature data was also performed. Sling procedures with application of suburethral loops have been used since the beginning of the last century in treatment of this disorder. Surgical treatment of stress urinary incontinence is applied when conservative treatment fails to give any effects according to strictly defined indications. During the last 100 years, surgical techniques have undergone different improvements and the results have also been significantly improved.

  11. Delayed Diagnosis of Vesicouterine Fistula After Treatment for Mixed Urinary Incontinence: Menstrual Cup Management and Diagnosis.

    Science.gov (United States)

    Goldberg, Leah; Elsamra, Sammy; Hutchinson-Colas, Juana; Segal, Saya

    2016-01-01

    A vesicouterine fistula is a rare form of urogenital fistula, yet there is increasing prevalence in the United States because of the rising rate of cesarean deliveries. Vesicouterine fistulas have various presentations including menouria, hematuria, or urinary incontinence. A 39-year-old multiparous woman presented with urine leakage after her third cesarean delivery. She had been treated for mixed urinary incontinence with overactive bladder medications and a midurethral sling with continued complaints of urine leakage. The patient noticed her symptoms of urine leakage improved during menses when she used a menstrual cup. After confirmation of vesicouterine fistula, the patient underwent robotic-assisted surgery and her symptoms of insensible urine leakage resolved. When evaluating women with urinary incontinence and a history of cesarean deliveries, use of menstrual cup may aid in the diagnosis of vesicouterine fistula. Robotic-assisted laparoscopic repair with tissue interposition flap is an efficacious minimally invasive method for treatment of vesicouterine fistula.

  12. Cough urethrocystography: The best radiological evaluation of female stress urinary incontinence?

    International Nuclear Information System (INIS)

    Varpula, M.; Maekinen, J.; Kiilholma, P.

    1989-01-01

    Urethrocystography and simultaneous urethrocystometry were performed on 40 women with primary urinary incontinence. The posterior urethrovesical angle, inclination angle, urethropelvic angle, and an orifice descent angle, not earlier described, were measured on radiographs obtained at rest, during coughing and during straining. The orifice descent angle was used to describe the descent of the internal urethral orifice in the cough radiographs, and was the only measurement that provided a significant correlation with urethrocystometry. The other angles measured, and radiographs obtained at rest or during straining were not useful in the evaluation of female stress urinary incontinence. The authors conclude that the best imaging method for the evaluation of female stress urinary incontinence is urethrocystography employing a single lateral view taken during coughing, with measurement of the orifice descent angle. (orig.)

  13. Objective comparison of subtotal vs. total abdominal hysterectomy regarding pelvic organ prolapse and urinary incontinence

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Møller, Lars Alling; Gimbel, Helga Margrethe Elisabeth

    2015-01-01

    OBJECTIVE: To compare subtotal and total abdominal hysterectomy regarding objective assessment of pelvic organ prolapse, urinary incontinence and voiding function 14 years after hysterectomy for benign diseases. STUDY DESIGN: Long-term follow-up of a randomized clinical trial of subtotal vs. total......, total: 100), the PFDI-20 questionnaire was answered by 140 (46.1%) (subtotal: 68, total: 72). We found no difference between subtotal and total abdominal hysterectomy in the PFDI-20 scores or regarding objectively assessed urinary incontinence or pelvic organ prolapse. In the subtotal hysterectomy group...... (443ml) (P=0.0147) according to the voiding diary. CONCLUSION: Subtotal and total abdominal hysterectomy are comparable regarding long-term objective pelvic organ prolapse and urinary incontinence. The subtotal hysterectomy group had a higher Qmax and voided volume....

  14. Effects of carrying a pregnancy and of method of delivery on urinary incontinence: a prospective cohort study

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    Mondor Myrto

    2004-02-01

    Full Text Available Abstract Background This study was carried out to identify risk factors associated with urinary incontinence in women three months after giving birth. Methods Urinary incontinence before and during pregnancy was assessed at study enrolment early in the third trimester. Incontinence was re-assessed three months postpartum. Logistic regression analysis was used to assess the role of maternal and obstetric factors in causing postpartum urinary incontinence. This prospective cohort study in 949 pregnant women in Quebec, Canada was nested within a randomised controlled trial of prenatal perineal massage. Results Postpartum urinary incontinence was increased with prepregnancy incontinence (adjusted odds ratio [adj0R] 6.44, 95% CI 4.15, 9.98, incontinence beginning during pregnancy (adjOR 1.93, 95% CI 1.32, 2.83, and higher prepregnancy body mass index (adjOR 1.07/unit of BMI, 95% CI 1.03,1.11. Caesarean section was highly protective (adjOR 0.27, 95% CI 0.14, 0.50. While there was a trend towards increasing incontinence with forceps delivery (adjOR 1.73, 95% CI 0.96, 3.13 this was not statistically significant. The weight of the baby, episiotomy, the length of the second stage of labour, and epidural analgesia were not predictive of urinary incontinence. Nor was prenatal perineal massage, the randomised controlled trial intervention. When the analysis was limited to women having their first vaginal birth, the same risk factors were important, with similar adjusted odds ratios. Conclusions Urinary incontinence during pregnancy is extremely common, affecting over half of pregnant women. Urinary incontinence beginning during pregnancy roughly doubles the likelihood of urinary incontinence at 3 months postpartum, regardless whether delivery is vaginal or by Caesarean section.

  15. Delivery parameters, neonatal parameters and incidence of urinary incontinence six months postpartum: a cohort study.

    Science.gov (United States)

    Wesnes, Stian Langeland; Hannestad, Yngvild; Rortveit, Guri

    2017-10-01

    Contradictory results have been reported regarding most delivery parameters as risk factors for urinary incontinence. We investigated the association between the incidence of urinary incontinence six months postpartum and single obstetric risk factors as well as combinations of risk factors. This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health during 1998-2008. This substudy was based on 7561 primiparous women who were continent before and during pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and six months postpartum. Data were linked to the Medical Birth Registry of Norway. Single and combined delivery- and neonatal parameters were analyzed by logistic regression analyses. Birthweight was associated with significantly higher risk of urinary incontinence six months postpartum [3541-4180 g: odds ratio (OR) 1.4, 95% confidence interval (CI) 1.2-1.6; >4180 g: OR 1.6, 95% CI 1.2-2.0]. Fetal presentation, obstetric anal sphincter injuries, episiotomy and epidural analgesia were not significantly associated with increased risk of urinary incontinence. The following combinations of risk factors among women delivering by spontaneous vaginal delivery increased the risk of urinary incontinence six months postpartum; birthweight ≥3540 g and ≥36 cm head circumference; birthweight ≥3540 g and forceps, birthweight ≥3540 g and episiotomy; and ≥36 cm head circumference and episiotomy. Some combinations of delivery parameters and neonatal parameters seem to act together and may increase the risk of incidence of urinary incontinence six months postpartum in a synergetic way. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  16. Urinary Incontinence due to Overactive Detrusor Muscle: A Rare Side Effect of Venlafaxine

    Directory of Open Access Journals (Sweden)

    Vithyalakshmi Selvaraj

    2015-01-01

    Full Text Available We report a case of reemergence of urinary incontinence (UI in a patient with benign prostatic hyperplasia (BPH after starting treatment with venlafaxine who was stabilized on tamsulosin and finasteride for about 6 years. A 66-year-old Caucasian male with prior history of major depressive disorder developed UI within a week of starting venlafaxine 75 mg per day. He described symptoms in the form of involuntary leakage of urine both during the day and at night. His symptoms of UI resolved after stopping the venlafaxine. To the best of our knowledge, there are only four case reports of venlafaxine induced urinary incontinence which have been published.

  17. 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.

  18. Frequency, severity and risk factors for urinary and faecal incontinence at 4 years postpartum: a prospective cohort.

    Science.gov (United States)

    Gartland, D; MacArthur, C; Woolhouse, H; McDonald, E; Brown, S J

    2016-06-01

    To investigate frequency, severity and risk factors for urinary incontinence and faecal incontinence 4 years after a first birth. Prospective pregnancy cohort study. Melbourne, Australia. A total of 1011 nulliparous women recruited in early pregnancy. Participants were followed up at 32 weeks of gestation; then at 3, 6, 9 and 12 months and 4 years postpartum. Frequency and severity of urinary and faecal incontinence. At 4 years, 29.6% of women reported urinary incontinence and 7.1% reported faecal incontinence. Compared with women having only spontaneous vaginal births, women who delivered exclusively by caesarean section were less likely to have urinary incontinence at 4 years postpartum (adjusted odds ratio 0.4, 95% confidence interval 0.3-0.6). Women who reported urinary incontinence before or during the index pregnancy, and those experiencing symptoms in the first year postpartum had increased odds of incontinence at 4 years, with the highest odds (6-12 times higher) among women who had previously reported moderate or severe symptoms. The odds of reporting faecal incontinence at 4 years were two to six times higher for women experiencing symptoms in pregnancy, and around four to eight times higher for those with symptoms in the first year postpartum. Urinary and faecal incontinence are prevalent conditions 4 years after a first birth. Women reporting urinary or faecal incontinence during pregnancy had markedly higher odds of reporting symptoms at 4 years postpartum, suggesting a need for further investigation and elucidation of aetiological pathways involving nonbirth-related risk factors. Moderate/severe incontinence prevalent 4 years after first birth in population cohort. Prior symptoms are biggest predictor. © 2015 Royal College of Obstetricians and Gynaecologists.

  19. Management of urinary tract infections in patients with neurogenic bladder: challenges and solutions.

    Science.gov (United States)

    Pannek, Jürgen; Wöllner, Jens

    2017-01-01

    Urinary tract infections (UTIs) are one of the most common morbidities in persons with neurogenic lower urinary tract dysfunction (NLUTD). They are associated with a significant morbidity and mortality, and they affect the quality of life of the affected patients. Diagnosis and treatment of UTI in this group of patients are challenging. In this review, the current strategies regarding diagnosis, treatment, and prevention are summarized. it is important to correctly diagnose a UTI, as treatment of bacteriuria should strictly be avoided. A UTI is defined as a combination of laboratory findings (leukocyturia and bacteriuria) and symptoms. Laboratory findings without symptoms are classified as asymptomatic bacteriuria. Routine urine screening is not advised. Only UTI should be treated; treatment of asymptomatic bacteriuria is not indicated. Prior to treatment, urine for a urine culture should be obtained. Antibiotic treatment for ~7 days is advised. In recurrent UTI, bladder management should be optimized and morphologic causes for UTI should be excluded. If UTIs persist, medical prophylaxis should be considered. Currently, no prophylactic measure with evidence-based efficacy exists. Long-term antibiotic prophylaxis should be used merely as an ultimate measure. Among the various mentioned innovative approaches for UTI prevention, bacteriophages, intravesical instillations, complementary and alternative medicine techniques, and probiotics seem to be most promising. Recently, several promising innovative options for UTI prophylaxis have been developed which may help overcome the current therapeutic dilemma. However, further well designed studies are necessary to evaluate the safety and efficacy of these approaches.

  20. [Study on reductive surgery for pelvic organ prolapse concomitant with anti-incontinence sling for treatment of occult stress urinary incontinence].

    Science.gov (United States)

    Zhang, Xiaolong; Lu, Yongxian; Shen, Wenjie; Liu, Jingxia; Ge, Jing; Liu, Xin; Zhao, Ying; Niu, Ke; Zhang, Yinghui; Wang, Wenying; Qiu, Chengli

    2014-06-01

    To evaluate the clinical outcome of anti-incontinence sling in the treatment of occult stress urinary incontinence (OSUI) during reductive surgery for advanced pelvic organ prolapse (POP). From Jun. 2003 to Dec. 2012, 78 patients with OSUI underwent reductive surgery for advanced POP such as high uterosacral ligament suspension, sacrospinous ligament suspension and sacral colpopexy in the First Affiliated Hospital, General Hospital of People's Liberation Army. Among them, 41 patients received reductive surgery alone was enrolled in non-concomitant anti-incontinence group and the other 37 patients who underwent same surgery with tension-free vaginal tape (TVT) or tension-free vaginal tape-obturator technique (TVT-O) was in anti-incontinence group. The patient's demography, objective and subjective outcomes, as well as complications and injures were compared between the two groups. The pelvic organ prolapse quantitation (POP-Q) was used to evaluate the objective outcomes of POP. Urinary distress inventory (UDI-6) and incontinence impact questionnaire short form (IIQ-7) were used to evaluate the subjective outcomes of stress urinary incontinence (SUI). Compared with the non-concomitant anti-incontinence group, the objective outcomes of reductive surgery exhibited no significant differences (100%, 78/78), and only the operation time of anti-incontinence group slightly increased 16 minutes. The occurrence rate of postoperative SUI was 12% (5/41), 15% (6/41), 17% (7/41) respectively after the operation at 2-month, 6-month and 12-month follow up in the non-concomitant anti-incontinence group; and the occurrence rate of the anti-incontinence group was 3% (1/37), 3% (1/37), 3% (1/37); but none of patients in the two groups require further surgery for stress urinary incontinence. Mean score of UDI-6 and IIQ-7 in all the patients decreased significantly after operation at 2-month, 6-month and 12-month follow up (all P statistic difference between the two groups (P > 0.05). It

  1. The effect of outpatient physical therapy intervention on pelvic floor muscles in women with urinary incontinence

    Directory of Open Access Journals (Sweden)

    Mara R. Knorst

    2013-10-01

    Full Text Available OBJECTIVE: To assess the effect of a weekly, short-term physical therapy intervention on the pelvic floor muscles and urinary incontinence (UI among patients of the public health system. METHOD: Quasi-experimental before-and-after study. Clinical history and function evaluation were performed using perineal bidigital maneuvers and perineometry. The intervention consisted of transvaginal electrical stimulation and pelvic floor kinesiotherapy. Data were analyzed using the paired t test or Wilcoxon signed-rank test, Pearson product-moment correlation coefficient or Spearman's rank correlation coefficient. A value of P<0.05 was considered significant. RESULTS: Eight-two women 55.1±10.9 years-old were evaluated. Mixed urinary incontinence (MUI, stress urinary incontinence (SUI and urge urinary incontinence (UUI were observed in 52.4%, 36.6% and 11%, respectively. The length of UI was 6.0 years (3.0-10. Approximately 13.64 physical therapy sessions were held on average. There was no difference in perineometry measurements following the intervention (40.6±24.1 versus 41.7±25.4, P=0.098. Muscle function significantly increased (P<0.01 in the bidigital maneuver. The patients reported being continent or satisfied with the treatment in 88.9% of cases. CONCLUSIONS: The results demonstrated an increase in muscle function and the attainment of urinary continence or treatment satisfaction in most cases.

  2. TVT versus TVT-O for minimally invasive surgical correction of stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Vicente Sola

    2007-04-01

    Full Text Available OBJECTIVE: The present work describes our experience in surgical correction of stress urinary incontinence, comparing both the TVT and the TVT-O techniques. METHOD: Between October 2001 and March 2004, 76 patients underwent the TVT procedure. Between January 2004 and January 2005, 98 surgical corrections of urinary incontinence were carried out using the TVT-O technique. RESULTS: Median operative time was 28 minutes for TVT and 7 minutes for TVT-O. Intraoperative complications for TVT occurred in 4 patients (6.6%: urinary bladder perforation in 3 patients (5%, p = 0.0228 and parietal peritoneum perforation in 1 case (1.6%. No intraoperative complications took place during TVT-O. Immediate postoperative complications: transient urinary retention in TVT, 2 cases (2.6% and overcorrection in TVT-O (1% which was readjusted within 24 hours. There were no late complications after TVT. There were 2 cases (2.04% with late complications in TVT-O. TVT and TVT-O resulted in correction of incontinence in 100% of the patients. CONCLUSION: TVT and TVT-O are two effective techniques for the correction of stress urinary incontinence. TVT-O would seem to be a technique much easier to perform resulting in less intraoperative complications.

  3. Urethro-cystography for female urinary stress incontinence

    International Nuclear Information System (INIS)

    Voigt, R.; Starker, K.; Friedrich-Schiller-Universitaet, Jena

    1985-01-01

    The normal parameters of urethro-cystography were evaluated in 324 examinations. There were definite differences between continent and pressure-incontinent women on the one hand, and stress-incontinent patients on the other, as regards the pubo-urethral angle, but not as regards the posterior vesico-urethral angle. Preoperative and post-operative urethro-cystograms showed statistically significant differences. (orig.) [de

  4. 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

    influence on lower urinary tract function. More than half of the patients had urge or mixed incontinence. Most of the patients were managed with conservative treatment. Fifteen percent were referred to in-hospital treatment, with 5% to incontinence surgery. In total 44% felt cured or very much improved......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 treatment with a limited consumption of resources ("minimal care"). This was a prospective observational study of 408 consecutive women examined and treated in the clinic. The main characteristics of the women were a high median age and a high prevalence of severe concomitant diseases with possible...

  5. Physical therapy in the treatment of stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Parezanović-Ilić Katarina

    2011-01-01

    Full Text Available Introduction. Stress urinary incontinence (SUI is an involuntary release of urine through the urethra during the increase of abdominal pressure in the absence of m. detrusor contraction. The exercise of pelvic floor muscles is recommended as the first line of cure. It is the least invasive and the only method without any undesirable side effects, which leads to either improvement or complete cure of SUI in 80-85% of cases. Objective. The aim of this study was to establish whether the strengthening of pelvic floor muscles using proprioceptive neural facilitation (PNF spiral dynamic technique was more efficient in comparison to classical Kegel exercise. Methods. The research was carried out at the Centre for Physical Medicine and Rehabilitation, Clinical Centre Kragujevac. Sixty-six female patients with the symptoms of SUI were monitored in the period of two years. Thirty-four patients did pelvic floor muscle exercises twice a day, in the morning and in the evening, with 15-20 contractions. Thirty-two patients used PNF spiral dynamic technique for strengthening pelvic floor muscles. The patients who used the spiral dynamic technique also did some exercises from the program; they exercised twice a day, in the morning and in the evening, following the prescribed schedule. Treatment outcome was assessed by measuring the pelvic floor muscles by a vaginal dynamometer. Results. The values of the pelvic floor muscle force that were measured using the vaginal dynamometer in both examined groups (PNF spiral dynamic technique or Kegel exercise were statistically significantly higher after the implemented exercise program (t-test; p=0.000. No statistically significant difference in pelvic floor muscle values was found between the patients who applied PNF spiral dynamic technique and those who did Kegel exercise either before or after the exercise (two-factor analysis of variance with repeated measurements, factor of exercise type; p=0.899. Conclusion

  6. Pelvic Floor Morphometric Differences in Elderly Women with or without Urinary Incontinence.

    Science.gov (United States)

    Fradet, Sarah; Morin, Mélanie; Kruger, Jennifer; Dumoulin, Chantale

    2018-01-01

    Purpose: Urinary incontinence (UI) affects as many as 50% of women aged 60 years and older, but UI pathophysiology, specifically in elderly women, remains unclear. A better understanding of morphometric differences between continent and urinary incontinent elderly women is needed to improve the effectiveness of conservative treatment approaches. We hypothesized that morphometric differences in the pelvic floor muscles (PFM) among elderly women with and without UI could be observed using three- and four-dimensional (3D/4D) transperineal ultrasound (TPU) imaging. Method: A total of 40 elderly women (20 women with and 20 women without UI), with a mean age of 67.10 (SD 4.94) years, participated in the study. This was a case-control study in which TPU images were taken under three conditions: rest, maximal voluntary contraction (MVC), and Valsalva. Independent t -tests were conducted to compare measurements between the groups. Results: The study revealed statistically significant differences between the groups. At rest, the levator hiatal area and transverse diameter were bigger, and the PFM position was lower in the incontinent group. During MVC, all axial plane parameters were bigger in the incontinent group. In the sagittal plane, PFM position was again lower in the incontinent group. During Valsalva, the anorectal angle was wider in the women with incontinence. Conclusion: PFM morphometric differences were present and were observed using 3D/4D TPU imaging in elderly women with and without UI.

  7. Prevalence of urinary incontinence and other urological problems during pregnancy: a questionnaire based study.

    Science.gov (United States)

    Sharma, J B; Aggarwal, Shena; Singhal, Saurabh; Kumar, S; Roy, K K

    2009-06-01

    To find out the prevalence of various urological symptoms in pregnant women, the status before pregnancy, and their perceived impact. A questionnaire incorporating various urological problems was prepared and used over 240 pregnant women to know their prevalence in different trimesters of pregnancy and compare them with prevalence before pregnancy. Increased urinary frequency (>10/day) (40.8 vs. 3.8%), nocturia (72.9 vs. 50.6%), burning micturition (21.3 vs. 3.8%), UTI (4.6 vs. 1.6%), urinary hesitancy (14.6 vs. 1.6%), urinary incontinence (25.8 vs. 8.2%) and botheration (22.1 vs. 2.7%) were seen during and before pregnancy, respectively. These also show an increment with advancement of gestation. Urinary incontinence was seen more often with advancing age and parity. There is a very high prevalence of urological symptoms during pregnancy as compared to before pregnancy.

  8. Female urinary incontinence, from pregnancy to menopause: a review of epidemiological and pathophysiological findings.

    Science.gov (United States)

    Fritel, Xavier; Ringa, Virginie; Quiboeuf, Emeline; Fauconnier, Arnaud

    2012-08-01

    Hypotheses that might explain urinary incontinence during pregnancy and after childbirth have been examined. The prevalence of urinary incontinence reaches a maximum during pregnancy and decreases after childbirth. Cesarean delivery is associated with lower rates of stress incontinence than vaginal delivery. Women delivered by cesarean section differ from women who had a vaginal delivery through pre-existing characteristics associated with the incontinence risk, producing a selection bias. The only randomized trial (intention of vaginal delivery vs. elective caesarean section) was not conclusive. The suspected etiological factors consist of congenital elements, obesity, aging, pregnancy and vaginal delivery. They are likely to have an effect at different times and on different portions of the urethral sphincter complex. Unfortunately, there exist no cohorts facilitating description of the natural history of female urinary incontinence. Given the small amount of usable data available, it is not possible to draw any conclusions concerning the possible long-term protective effects of cesarean section. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  9. Transobturator tapes are preferable over transvaginal tapes for the management of female stress urinary incontinence: Against

    Directory of Open Access Journals (Sweden)

    Arun Chawla

    2009-01-01

    Full Text Available Midurethral placement of tension-free vaginal tapes with a transvaginal route for stress urinary incontinence achieves higher and better long-term success rates than the transobturator route. Bladder perforations are reported more in transvaginal tape (TVT but incidences of vaginal erosions, extrusion, and groin pain are exceedingly more in TOT groups. There is no clear evidence that transobturator tape (TOT is associated with less post-operative voiding problems than TVT. Major complications such as bowel injuries and significant vascular injuries with TVT are rare. TVT has been found to be superior to TOT and preferable in technically demanding conditions such as prior anti-incontinence operation failures, obese women, and very elevated and scarred lateral cul-de sac. TVT is always preferred in severe grades of stress urinary incontinence and with patients of intrinsic sphincter deficiency (ISD with little or no urethral mobility.

  10. Factors associated with fecal incontinence in women with lower urinary tract symptoms.

    Science.gov (United States)

    Chang, Ting-Chen; Chang, Shiow-Ru; Hsiao, Sheng-Mou; Hsiao, Chin-Fen; Chen, Chi-Hau; Lin, Ho-Hsiung

    2013-01-01

    The aim of this study was to identify the factors associated with fecal incontinence in female patients with lower urinary tract symptoms.   Data regarding clinical and urodynamic parameters and history of fecal incontinence of 1334 women with lower urinary tract symptoms who had previously undergone urodynamic evaluation were collected and subjected to univariate, multivariate, and receiver-operator characteristic curve analysis to identify significant associations between these parameters and fecal incontinence.   Multivariate analysis identified age (odds ratio [OR]=1.03, 95% confidence interval [CI]=1.01-1.05, P=0.005), presence of diabetes (OR=2.10, 95%CI=1.22-3.61, P=0.007), presence of urodynamic stress incontinence (OR=1.90, 95%CI=1.24-2.91, P=0.003), pad weight (OR=1.01, 95%CI=1.00-1.01, P=0.04), and detrusor pressure at maximum flow (OR=1.02, 95%CI=1.01-1.03, P=0.003) as independent risk factors for fecal incontinence. Receiver-operator characteristic curve analysis identified age≥55years, detrusor pressure at maximum flow≥35 cmH(2) O, and pad weight≥15g as having positive predictive values of 11.4%, 11.5%, and 12.4%, respectively, thus indicating that they are the most predictive values in concomitant fecal incontinence.   Detrusor pressure at maximum flow and pad weight may be associated with fecal incontinence in female patients with lower urinary tract symptoms, but require confirmation as indicators by further study before their use as screening tools. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  11. Pelvic floor muscle training for female urinary incontinence: Does it work?

    Science.gov (United States)

    Singh, Nilanjana; Rashid, Mumtaz; Bayliss, Lorna; Graham, Penny

    2016-06-01

    Supervised pelvic floor muscle training in patients of stress and mixed urinary incontinence has been recommended. Our aim was to assess the utilisation and effectiveness of our supervised pelvic floor muscle training service and assess the impact of incontinence scores before physiotherapy on the subsequent results of physiotherapy. All 271 patients referred to physiotherapy for symptoms of incontinence filled out the International Consultation on Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptoms before starting treatment. Depending on pelvic floor muscle assessment, plans for exercises and follow up were made. If the strength of pelvic floor muscles was poor, electrical stimulation was offered. If awareness of the pelvic floor muscle contraction was poor, bio feedback was offered. Group sessions and vaginal cones were also used. Depending on the response to the treatment; patients were either discharged, referred to Urogynaecology clinic or continued physiotherapy. All patients who were discharged or referred for surgery were given a post treatment questionnaire to fill out. 79 (56 %) of 132 women with stress, 49 (51 %) of 98 with mixed and 27 (66 %) of 41 with urge incontinence reported successful control of symptoms (overall success 54 %). However, 65 % of women with incontinence scores of 0-5 before physiotherapy, 64 % with 6-10, 42 % with 11-15 and mere 28 % with 16-20 achieved success with physiotherapy. 27 (10 %) were lost to follow up. 1 in 2 women referred to physiotherapy for incontinence, achieved successful control of symptoms without the need for invasive investigations or surgery. However, poor incontinence scores before the start of physiotherapy is a poor prognostic indicator for success. 90 % women utilised the service.

  12. Treatment with rivastigmine or galantamine and risk of urinary incontinence : results from a Dutch database study

    NARCIS (Netherlands)

    Kroger, Edeltraut; Van Marum, Rob; Souverein, Patrick; Carmichael, Pierre Hugues; Egberts, Toine

    2015-01-01

    Treatment of Alzheimer disease (AD) with cholinesterase inhibitors (ChEIs) may increase the risk of urinary incontinence (UI). Objective: To assess whether ChEI use was associated with the risk of UI among older patients with AD. Methods: A crossover cohort study using the PHARMO Record Linkage

  13. The contribution of hysterectomy to the occurrence of urge and stress urinary incontinence symptoms

    NARCIS (Netherlands)

    van der Vaart, C. H.; van der Bom, J. G.; de Leeuw, J. R. J.; Roovers, J. P. W.; Heintz, A. P. M.

    2002-01-01

    OBJECTIVE: To study the contribution of hysterectomy to the occurrence of urge-or stress urinary incontinence symptoms. DESIGN: A population-based, cross-sectional cohort study conducted in 1999. SETTING: A university medical centre in The Netherlands. POPULATION: Random sample of 2322 women,

  14. Treatment with rivastigmine or galantamine and risk of urinary incontinence : Results from a Dutch database study

    NARCIS (Netherlands)

    Kroger, Edeltraut; Van Marum, Rob; Souverein, Patrick; Carmichael, Pierre Hugues; Egberts, Toine

    2015-01-01

    Treatment of Alzheimer disease (AD) with cholinesterase inhibitors (ChEIs) may increase the risk of urinary incontinence (UI). Objective: To assess whether ChEI use was associated with the risk of UI among older patients with AD. Methods: A crossover cohort study using the PHARMO Record Linkage

  15. Predicting the development of stress urinary incontinence 3 years after hysterectomy

    NARCIS (Netherlands)

    Lakeman, M.M.E.; van der Vaart, C.H.; van der Steeg, J.W.; Roovers, J.P.W.R.

    2011-01-01

    We aimed to develop a prediction rule to predict the individual risk to develop stress urinary incontinence (SUI) after hysterectomy. Prospective observational study with 3-year follow-up among women who underwent abdominal or vaginal hysterectomy for benign conditions, excluding vaginal prolapse,

  16. Nursing home staff members' attitudes and knowledge about urinary incontinence: the impact of technology and training.

    Science.gov (United States)

    Ehlman, Katie; Wilson, Amy; Dugger, Renee; Eggleston, Brandon; Coudret, Nadine; Mathis, Sherri

    2012-01-01

    Urinary incontinence (UI) poses challenges for nursing home personnel. The authors of this study explored differences in attitude and knowledge about UI among registered nurses, licensed practical nurses, and certified nursing assistants working in skilled nursing homes before and after study interventions.

  17. Biofeedback and physiotherapy versus physiotherapy alone in the treatment of genuine stress urinary incontinence

    DEFF Research Database (Denmark)

    Glavind, K; Nøhr, S B; Walter, S

    1996-01-01

    Biofeedback is a method of pelvic floor rehabilitation using a surface electrode inserted into the vagina and a catheter in the rectum. Forty women with genuine urinary stress incontinence were randomized to compare the efficacy of physiotherapy and physiotherapy in combination with biofeedback...

  18. [Surgery or physiotherapy for urinary stress incontinence; what is the preferred treatment in women?

    NARCIS (Netherlands)

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

    2014-01-01

    OBJECTIVE: To compare midurethral sling surgery and pelvic floor physiotherapy as initial treatment in women with moderate to severe urinary stress incontinence. DESIGN: Multicentre randomised trial. METHOD: The study population was made up of women aged 35 to 80 years with moderate to severe stress

  19. Predicting the development of stress urinary incontinence 3 years after hysterectomy

    NARCIS (Netherlands)

    Lakeman, Marielle M. E.; Van Der Vaart, C. Huub; Van Der Steeg, Jan Willem; Roovers, Jan-Paul W. R.

    Introduction and hypothesis We aimed to develop a prediction rule to predict the individual risk to develop stress urinary incontinence (SUI) after hysterectomy. Methods Prospective observational study with 3-year follow-up among women who underwent abdominal or vaginal hysterectomy for benign

  20. Urinary incontinence in the Netherlands : Prevalence and associated risk factors in adults

    NARCIS (Netherlands)

    Linde, J. Marleen; Nijman, Rien J. M.; Trzpis, Monika; Broens, Paul M. A.

    AimsTo determine the prevalence and risk factors associated with urinary incontinence (UI) among adults in the Netherlands. MethodsIn this cross-sectional study, we included 1257 respondents aged18 years, who completed the validated Groningen Defecation and Fecal Continence Checklist. UI was defined

  1. The prevalence of urinary incontinence in community-dwelling married women : a matter of definition

    NARCIS (Netherlands)

    Vandoninck, [No Value; Bemelmans, BLH; Mazzetta, C; Robertson, C; Keech, M; Boyle, P; Kiemeney, LA

    2004-01-01

    OBJECTIVE To determine the prevalence of female urinary incontinence (Ul) and its impact on quality of life. SUBJECTS AND METHODS In a Dutch national postal questionnaire survey, 1460 spouses of 1771 men in the town of Boxmeer, age-stratified and randomly selected, were asked to participate. The

  2. Risk of postpartum urinary incontinence associated with pregnancy and mode of delivery

    DEFF Research Database (Denmark)

    Foldspang, Anders; Hvidman, Lone; Mommsen, Søren

    2004-01-01

    Aim.  The aim was to estimate the postpartum urinary incontinence (PP UI) impact of precursory UI during pregnancy (PR UI) and delivery performed by cesarean section (CS) vs. vaginal childbirth (VC). Methods.  Among the members of two population samples, in total 8610 women aged 20–59 years, 1232...

  3. Prevalence of urinary incontinence among women and analysis of potential risk factors in Germany and Denmark

    DEFF Research Database (Denmark)

    Schreiber Pedersen, Louise; Lose, Gunnar; Høybye, Mette Terp

    2017-01-01

    INTRODUCTION: Urinary incontinence (UI) is a prevalent condition that interferes with women's health-related quality of life. Prevalence rates from earlier studies are wide-ranging, due to heterogeneity in methodology, definition of UI and the populations included. We aimed to determine the preva...

  4. Treating urinary incontinence in the elderly--conservative therapies that work: a systematic review.

    NARCIS (Netherlands)

    Teunissen, T.A.M.; Jonge, A. de; Weel, C. van; Lagro-Janssen, A.L.M.

    2004-01-01

    OBJECTIVE: To evaluate the effectiveness of conservative treatment in the community-based elderly (aged > or = 55 years) with stress, urge, and mixed urinary incontinence. DESIGN: Systematic review of before-after studies or randomized controlled trials on the effect of exercise and drug therapy in

  5. Results of primary versus recurrent surgery to treat stress urinary incontinence in women

    NARCIS (Netherlands)

    van der Doelen, Maarten J; Withagen, Mariëlla I J; Vierhout, Mark E; Heesakkers, John P F A

    INTRODUCTION AND HYPOTHESIS: We compared cure rates and complication rates in patients who had undergone primary or recurrent (secondary) surgery for stress urinary incontinence (SUI). METHODS: A retrospective cohort study that included patients who underwent surgery to treat SUI in a tertiary

  6. Results of primary versus recurrent surgery to treat stress urinary incontinence in women

    NARCIS (Netherlands)

    Doelen, M.J. van der; Withagen, M.I.J.; Vierhout, M.E.; Heesakkers, J.P.F.A.

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: We compared cure rates and complication rates in patients who had undergone primary or recurrent (secondary) surgery for stress urinary incontinence (SUI). METHODS: A retrospective cohort study that included patients who underwent surgery to treat SUI in a tertiary

  7. The use of synthetic materials in the treatment of stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Robert Stanek

    2016-07-01

    Full Text Available Stress urinary incontinence is a very serious problem which has been noticed by the WHO. This difficult medical condition poses a serious problem as it affects c.a. 20% of the female population and it increases up to 35% in the group of females over 60 years of age. Since there is no single standard surgical procedure which could solve this problem, numerous synthetic materials are used for the operations. It seems that the materials are effective as they improve the condition of women suffering from stress urinary incontinence. Unfortunately these materials have their shortcomings which might lead to certain post-operative complications. Stress urinary incontinence is a disease which affects the social life of the patients. It has a high percentage of recurrence and causes the patient substantial difficulties with keeping high standards of personal hygiene which is consequence makes it impossible to fulfill their social roles. The etiology of this disease is complex and calls for a cross-disciplinary approach to the problem. As there are no standardized or unanimous treatment methods of stress urinary incontinence, numerous sources based on the clinical experience of many medical centers suggest performing TVT and TOT procedures as the most effective treatment methods. The efficacy of the TOT procedure is about 90.8%.

  8. Practice pattern variation in surgical management of pelvic organ prolapse and urinary incontinence in The Netherlands

    NARCIS (Netherlands)

    Ijsselmuiden, M.N.; Detollenaere, R.J.; Kampen, M.Y.; Engberts, M.K.; Eijndhoven, H.W. van

    2015-01-01

    INTRODUCTION: Practice pattern variation (PPV) is the difference in care that cannot be explained by the underlying medical condition. The aim of this study was to describe PPV among Dutch gynecologists regarding treatment of pelvic organ prolapse (POP) and urinary incontinence (UI). MATERIALS AND

  9. Behavioral Intervention to Eliminate Socially Mediated Urinary Incontinence in a Child with Autism

    Science.gov (United States)

    Ricciardi, Joseph N.; Luiselli, James K.

    2003-01-01

    We report the case of an 11-year-old boy with autism who demonstrated urinary incontinence that appeared to be maintained by social contingencies (adult attention and escape from activity "demands"). Although he wet himself frequently, he also used the bathroom appropriately and made many self-initiated toileting requests. Intervention was…

  10. The clinical relevance of cell-based therapy for the treatment of stress urinary incontinence

    DEFF Research Database (Denmark)

    Gräs, Søren; Lose, Gunnar

    2011-01-01

    Stress urinary incontinence is a common disorder affecting the quality of life for millions of women worldwide. Effective surgical procedures involving synthetic permanent meshes exist, but significant short- and long-term complications occur. Cell-based therapy using autologous stem cells...

  11. School Nurse Interventions in Managing Functional Urinary Incontinence in School-Age Children

    Science.gov (United States)

    Rivers, Charisse L.

    2010-01-01

    Uncomplicated urinary incontinence (UI) in school-age children is a prevalent yet underrecognized problem that has remained in the shadow of other concerns commonly perceived as more prominent or urgent. There is good evidence that functional UI in children can be treated and managed effectively. When there is no structural or neurologic…

  12. Education on Adult Urinary Incontinence in Nursing School Curricula: Can It Be Done in Two Hours?

    Science.gov (United States)

    Morishita, Lynne; And Others

    1994-01-01

    Responses from 339 undergraduate nursing programs (74%) showed that 98% included urinary incontinence content in their curricula. Although most agreed the subject was important and felt their teaching was effective, the didactic component averaged two hours, and clinical experience was not systematic; few faculty are prepared to teach this…

  13. Orgasm-associated urinary incontinence and sexual life after radical prostatectomy.

    Science.gov (United States)

    Nilsson, Andreas E; Carlsson, Stefan; Johansson, Eva; Jonsson, Martin N; Adding, Christofer; Nyberg, Tommy; Steineck, Gunnar; Wiklund, N Peter

    2011-09-01

    Involuntary release of urine during sexual climax, orgasm-associated urinary incontinence, occurs frequently after radical prostatectomy. We know little about its prevalence and its effect on sexual satisfaction. To determine the prevalence of orgasm-associated incontinence after radical prostatectomy and its effect on sexual satisfaction. Consecutive series, follow-up at one point in calendar time of men having undergone radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital, Stockholm, Sweden, 2002-2006. Of the 1,411 eligible men, 1,288 (91%) men completed a study-specific questionnaire. Prevalence rate of orgasm-associated incontinence. Of the 1,288 men providing information, 691 were sexually active. Altogether, 268 men reported orgasm-associated urinary incontinence, of whom 230 (86%) were otherwise continent. When comparing them with the 422 not reporting the symptom but being sexually active, we found a prevalence ratio (with 95% confidence interval) of 1.5 (1.2-1.8) for not being able to satisfy the partner, 2.1 (1.1-3.5) for avoiding sexual activity because of fear of failing, 1.5 (1.1-2.1) for low orgasmic satisfaction, and 1.4 (1.2-1.7) for having sexual intercourse infrequently. Prevalence ratios increase in prostate-cancer survivors with a higher frequency of orgasm-associated urinary incontinence. We found orgasm-associated urinary incontinence to occur among a fifth of prostate cancer survivors having undergone radical prostatectomy, most of whom are continent when not engaged in sexual activity. The symptom was associated with several aspects of sexual life. © 2011 International Society for Sexual Medicine.

  14. Assessment of symptoms of urinary incontinence in women with polycystic ovary syndrome.

    Science.gov (United States)

    Montezuma, Thais; Antônio, Flávia Ignácio; Rosa e Silva, Ana Carolina Japur de Sá; Sá, Marcos Felipe Silva de; Ferriani, Rui Alberto; Ferreira, Cristine Homsi Jorge

    2011-01-01

    The pelvic floor muscles are sensitive to androgens, and due to hyperandrogenism, women with polycystic ovary syndrome can have increased mass in these muscles compared to controls. The aim of this study is to compare reports of urine leakage and quality of life between women with and without polycystic ovary syndrome. One hundred thirteen 18-to 40-year-old nulliparous women with polycystic ovary syndrome or without the disease (controls) were recruited at the University Hospital of School Medicine of São Paulo University at Ribeirão Preto City, Brazil. The subjects were not taking any hormonal medication, had not undergone previous pelvic surgery and did not exercise their pelvic floor muscles. The women were divided into the following four groups: I-polycystic ovary syndrome with normal body mass index (n = 18), II-polycystic ovary syndrome with body mass index >25 (n = 32), III-controls with normal body mass index (n = 29), and IV-controls with Body Mass Index >25 (n = 34). Quality of life was evaluated using the SF-36 questionnaire, and the subjects with urinary complaints also completed the International Consultation on Incontinence Questionnaire Short Form to evaluate the severity of their urinary incontinence. The replies to the International Consultation on Incontinence Questionnaire Short Form revealed a significant difference in urinary function between groups, with 24% of the subjects in group IV reporting urinary incontinence. The mean scores for the SF-36 questionnaire revealed that group II had the lowest quality of life. The control obese group (IV) reported a higher prevalence of urinary incontinence. There was no difference in the reported frequency of urine loss between the polycystic ovary syndrome and control groups with normal body mass index or between the polycystic ovary syndrome and control groups with body mass index >25.

  15. Assessment of symptoms of urinary incontinence in women with polycystic ovary syndrome

    Directory of Open Access Journals (Sweden)

    Thais Montezuma

    2011-01-01

    Full Text Available OBJECTIVES: The pelvic floor muscles are sensitive to androgens, and due to hyperandrogenism, women with polycystic ovary syndrome can have increased mass in these muscles compared to controls. The aim of this study is to compare reports of urine leakage and quality of life between women with and without polycystic ovary syndrome. METHODS: One hundred thirteen 18-to 40-year-old nulliparous women with polycystic ovary syndrome or without the disease (controls were recruited at the University Hospital of School Medicine of São Paulo University at Ribeirão Preto City, Brazil. The subjects were not taking any hormonal medication, had not undergone previous pelvic surgery and did not exercise their pelvic floor muscles. The women were divided into the following four groups: I-polycystic ovary syndrome with normal body mass index (n = 18, II-polycystic ovary syndrome with body mass index >25 (n = 32, III-controls with normal body mass index (n = 29, and IV-controls with Body Mass Index >25 (n = 34. Quality of life was evaluated using the SF-36 questionnaire, and the subjects with urinary complaints also completed the International Consultation on Incontinence Questionnaire Short Form to evaluate the severity of their urinary incontinence. RESULTS: The replies to the International Consultation on Incontinence Questionnaire Short Form revealed a significant difference in urinary function between groups, with 24% of the subjects in group IV reporting urinary incontinence. The mean scores for the SF-36 questionnaire revealed that group II had the lowest quality of life. CONCLUSIONS: The control obese group (IV reported a higher prevalence of urinary incontinence. There was no difference in the reported frequency of urine loss between the polycystic ovary syndrome and control groups with normal body mass index or between the polycystic ovary syndrome and control groups with body mass index >25.

  16. PATHOPHYSIOLOGY AND PRINCIPLES OF THERAPY OF A NEUROGENIC HYPERACTIVE URINARY BLADDER IN PATIENTS AFTER CEREBROVASCULAR ACCIDENT

    Directory of Open Access Journals (Sweden)

    P. G. Shchvartz

    2017-01-01

    Full Text Available Neurogenic hyperactiv e bladder in different clinical variations is a characteristic com plication of restorativ e and residual periods of ischemic stroke and an important diagnostic criterion in vascular dementia. Mechanisms of formation of individual symptoms included in this syndrome is due to ischemic damage to cortical, subcortical and brainstem (the nucleus of Barrington centres of urination and associative areas of the brain, and the functional dissociation of these structures due to demyelination of the Central conductors of the afferent and efferent impulses. As a result of deficit of cerebral effects (such as brake and activating, is a violation of the implementation of the reflexes of urination (including carrying out continence, ongoing spinal (sympathetic, parasympathetic and somatic. The article presents a new concept of formation of the syndrome of hyperactive bladder on the basis of violations of the implementation of the 4 reflexes of urination, which provides the normal retention of urine and are responsible for the accumulation function of the bladder. First we analyzed the main point of application of drugs of anticholinergic and sympathomimetic actions in the reflexes of urination and mechanisms of restoration of function of the lower urinary tract in patients with acute and chronic v ascular diseases of the brain.

  17. [Characteristic Features of Urinary Incontinence--Diagnostic Investigation in Geriatric Patients].

    Science.gov (United States)

    Kirschner-Hermanns, R; Anding, R

    2016-02-01

    Urinary incontinence is a common medical and social problem in elderly people. It leads to a massive reduction in the quality of life of affected persons and their dependants and causes an enormous socio-economic burden, which will increase significantly within the next years and decades as the age structure of the German population changes. Successful treatment of urinary incontinence in the elderly requires a good pathophysiological understanding of the underlying problem as well as individually tailored diagnostic procedures, which must be oriented at the patient's wishes, the social environment and the resulting therapeutic consequences. This especially applies to persons with symptoms of dementia. Comorbidities such as diabetes mellitus, reduced mobility and a medication-induced decrease in cognitive function play a major role in the severity of urgency and urinary incontinence in the elderly. Also the frequently described concomitant diagnosis of urinary tract infection must be exactly evaluated. Before antibiotic treatment is given, it should be clarified if the patient suffers from "harmless" bacteriuria or a urinary tract infection requiring treatment. Patients with an age-associated decrease in brain power must be diagnosed quite carefully, because these patients may potentially be harmed by pharmacological treatment for overactive bladder syndrome. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Vaginal position and length in the bitch: relationship to spaying and urinary incontinence

    International Nuclear Information System (INIS)

    Gregory, S.P.; Holt, P.E.; Parkinson, T.J.; Wathes, C.M.

    1999-01-01

    A study was undertaken to determine if the vagina might be a suitable site for the measurement of intra-abdominal pressure during cystometry in the bitch, The position of the cranial vagina and vaginal length were measured radiographically and the effects of spaying and urinary Incontinence on these variables were evaluated in 30 continent and 30 incontinent bitches. The study used retrograde vaginourethrograms which had been obtained from animals used in a previous study, The cranial vagina was intra-abdominal on 36 of the vaginourethrograms, being least commonly intra-abdominal in incontinent bitches (11/30), Vaginal position was related linearly to vaginal length and continence status (P<0.01), while its length was related to bodyweight(P<0.01). Allowing for bodyweight, neutered animals had significantly shorter vaginas than entire bitches (P<0.01). Measurement of intra-abdominal pressure with concomitant measurement of intravesical pressure is essential if accurate assessment of detrusor pressure is to be determined during cystometry, The vagina is unlikely to be a useful location from which to measure intra-abdominal pressure since any pressure-measuring catheter inserted into it may fall outside the abdominal pressure zone. This is particularly true of neutered and/or incontinent bitches, the groups in which urodynamic investigations of urinary incontinence are most frequently indicated

  19. Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial.

    Science.gov (United States)

    Low, Lisa Kane; Miller, Janis M; Guo, Ying; Ashton-Miller, James A; DeLancey, John O L; Sampselle, Carolyn M

    2013-03-01

    The risk for urinary incontinence can be 2.6-fold greater in women after pregnancy and childbirth compared with their never-pregnant counterparts, with the incidence increasing with parity. We tested the hypothesis that the incidence of de novo postpartum urinary incontinence in primiparous women is reduced with the use of spontaneous pushing alone or in combination with perineal massage compared with women who experienced traditional directed pushing for second-stage management. This was a prospective clinical trial enrolling and randomizing 249 women into a four-group design: (1) routine care with coached or directed pushing, (2) spontaneous self-directed pushing, (3) prenatal perineal massage initiated in the third trimester, and (4) the combination of spontaneous pushing plus perineal massage. Self-report of incontinence was assessed using analysis of variance (ANOVA) and covariance (ANCOVA) models in 145 remaining women at 12 months postpartum using the Leakage Index, which is sensitive to minor leakage. No statistical difference in the incidence of de novo postpartum incontinence was found based on method of pushing (spontaneous/directed) (P value = 0.57) or in combination with prenatal perineal massage (P value = 0.57). Fidelity to pushing treatment of type was assessed and between-groups crossover detected. Spontaneous pushing did not reduce the incidence of postpartum incontinence experienced by women 1 year after their first birth due to high cross-over between randomization groups.

  20. Association of Urinary Tract Infection in Married Women Presenting with Urinary Incontinence in a Hospital based Population.

    Science.gov (United States)

    Subramaniam, Jayakumar; Eswara, Shilpalakshmiprasad; Yesudhason, Bineshlal

    2016-03-01

    Urinary incontinence (UI) is increasingly recognized as a significant health problem, which remains a hygienic as well as social problem. Women have higher risk of developing incontinence in their lifetime compared with men. Urinary tract infection can increase the incidence of incontinence. Present study was undertaken to assess the association of UTI in married women who presented with UI. The present study was aimed to identify the patients (married women) with complaints of UI and determining its association with UTI; and to identify the causative organism for the UTI along with its antimicrobial susceptibility pattern. This is a cross-sectional, non-randomized study of 107 married women with UI, who attended outpatient department in our hospital. Mid-stream urine (MSU) samples were collected from these patients with positive history of incontinence. Screening of urine for significant bacteriuria and culture to identify the etiological agents were performed followed by evaluation of their antimicrobial susceptibility profiles using Kirby Bauer disc diffusion method. Overall 25.2% of patients with incontinence had a positive urine culture. History of UTI was elicited in around 38.3% of patients, among which 15% had positive urine culture and 10.3% of the patients who did not have a history had positive culture. Escherichia coli was the commonest causative organism (66.6) causing UTI, followed by Enterococcus spp. (22.3%), Klebsiella pneumoniae (7.4%) and Proteus mirabilis (3.7%). The antimicrobial susceptibility pattern for Escherichia coli showed high sensitivity to Nitrofurantoin (94.4%) and high resistance to Ampicillin (94.4%). Our study revealed one in every four incontinent patients had UTI and almost half of them suffered from previous episodes of UTI. Thus appropriate correction of the existing UTI can help in the treatment of UI.

  1. Adjustable Perineal Male Sling for the Treatment of Urinary Incontinence: Long-term Results.

    Science.gov (United States)

    Altan, Mesut; Asi, Tariq; Bilen, Cenk Yucel; Ergen, Ali

    2017-08-01

    To present the long-term results in patients with urinary incontinence who were treated with adjustable perineal male sling. An adjustable male sling procedure was performed in 45 patients with a mean age of 67.6 ± 7.8 years who had urinary incontinence. The mean period between primary prostatic surgery and the sling procedure was 36.7 months. The difference between the classical sling and the adjustable one is a 10 cm tissue expander between the 2 layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via this port, in case of recurrence or persistence of incontinence. Mean follow-up was 48 ± 29 months. Average operative time was 101.1 ± 25.5 minutes (45-150). Median daily pad use in these patients decreased from 8(2-12) to 1(0-10) (P dry rate was higher in patients with nonsevere incontinence compared to the others with severe incontinence (57.9% vs 23.1%, P = .029). Nevertheless, there was no significant difference in the case of total success rate (78.9% vs 57.7%, respectively; P = .135). Age was significantly greater in both complete dry group (71.1 ± 4.8 vs 65.4 ± 8.7) and total success group (70.1 ± 5.2 vs 62.4 ± 5.2) (P = .017 and P < .001, respectively). Adjustable male sling is an acceptable procedure with low complication rates especially in patients with mild and moderate incontinence. At the same time, this procedure may be offered to patients with previous incontinence surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, type, and risk factors.

    Science.gov (United States)

    Daly, Deirdre; Clarke, Mike; Begley, Cecily

    2018-03-01

    While many women report urinary incontinence (UI) during pregnancy, associations with pre-pregnancy urinary leakage remain under-explained. We performed a multi-strand prospective cohort study with 860 nulliparous women recruited during pregnancy. Prevalence of any urinary leakage was 34.8% before and 38.7% during pregnancy. Prevalence of UI, leaking urine at least once per month, was 7.2% and 17.7% respectively. Mixed urinary incontinence (MUI) was reported by 59.7% of women before and 58.8% during pregnancy, stress urinary incontinence (SUI) by 22.6% and 37.2%, and urge urinary incontinence (UUI) by 17.7% and 4.0%, respectively. SUI accounted for half (50.0%), MUI for less than half (44.2%), and UUI for 5.8% of new-onset UI in pregnancy. Pre-pregnancy UI was significantly associated with childhood enuresis [adjusted odds ratio (AOR) 2.9, 95% confidence interval (CI) 1.5-5.6, p = 0.001) and a body mass index (BMI) ≥30 kg/m 2 (AOR 4.2, 95% CI 1.9-9.4, p pregnancy BMI was 25-29.99 kg/m 2 (AOR 2.0, 95% CI 1.2-3.5, p = 0.01), and women who leaked urine less than once per month (AOR 2.6, 95% CI 1.6-4.1, p  pregnancy. Considerable proportions of nulliparous women leak urine before and during pregnancy, and most ignore symptoms. Healthcare professionals have several opportunities for promoting continence in all pregnant women, particularly in women with identifiable risk factors. If enquiry about UI, and offering advice on effective preventative and curative treatments, became routine in clinical practice, it is likely that some of these women could become or stay continent.

  3. PELVIC FLOOR MUSCLE TRAINING IN THE TREATMENT OF URINARY INCONTINENCE AFTER RADICAL PROSTATECTOMY

    Directory of Open Access Journals (Sweden)

    Yu. L. Demidko

    2014-07-01

    Full Text Available The incidence of urinary incontinence after radical prostatectomy is 0.8 to 87%. This category of patients has pelvic floor muscle weakness and reduced perineal reflex. The treatment of these patients uses a pelvic floor exercise system that is to enhance muscle tone and to develop strong reflex contraction in response to a sudden rise in intraabdominal pressure. Pelvic floor muscle training belongs to first-line therapy for urinary incontinence occurring within 6 to 12 months after prostatectomy. The ability to control pelvic floor muscle knowingly and to train them allows one not only to increase the closing capability of sphincter mechanisms, but also to suppress involuntary detrusor contractions. We used this method in 9 patients who had undergone radical prostatectomy. The duration of pelvic floor muscle training under control was up to 25 weeks. During this period, the symptoms of incontinence were relieved. No contraindications or adverse reactions have put this method in first-line therapy for post-prostatectomy urinary incontinence.

  4. PELVIC FLOOR MUSCLE TRAINING IN THE TREATMENT OF URINARY INCONTINENCE AFTER RADICAL PROSTATECTOMY

    Directory of Open Access Journals (Sweden)

    Yu. L. Demidko

    2010-01-01

    Full Text Available The incidence of urinary incontinence after radical prostatectomy is 0.8 to 87%. This category of patients has pelvic floor muscle weakness and reduced perineal reflex. The treatment of these patients uses a pelvic floor exercise system that is to enhance muscle tone and to develop strong reflex contraction in response to a sudden rise in intraabdominal pressure. Pelvic floor muscle training belongs to first-line therapy for urinary incontinence occurring within 6 to 12 months after prostatectomy. The ability to control pelvic floor muscle knowingly and to train them allows one not only to increase the closing capability of sphincter mechanisms, but also to suppress involuntary detrusor contractions. We used this method in 9 patients who had undergone radical prostatectomy. The duration of pelvic floor muscle training under control was up to 25 weeks. During this period, the symptoms of incontinence were relieved. No contraindications or adverse reactions have put this method in first-line therapy for post-prostatectomy urinary incontinence.

  5. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    OpenAIRE

    Barbosa, Angélica Mércia Pascon; Dias, Adriano; Marini, Gabriela; Calderon, Iracema Mattos Paranhos; Witkin, Steven; Rudge, Marilza Vieira Cunha

    2011-01-01

    OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes ...

  6. Discrepancies between patient-reported outcome measures when assessing urinary incontinence or pelvic-prolapse surgery

    DEFF Research Database (Denmark)

    Larsen, Michael Due; Lose, Gunnar; Guldberg, Rikke

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: In order to assess the outcome following surgery for urinary incontinence (UI) and pelvic organ prolapse (POP) the importance of patient-reported outcome measures, in addition to the clinical objective measures, has been recognised. The International Consultation...... on Incontinence has initiated the development and evaluation of disease-specific questionnaires (ICIQ) to compare the patient's degree of improvement. Alternatively, the Patient's Global Impression of Improvement (PGI-I score) with an inherent before-after assessment has been widely accepted in recent studies...

  7. Expanding our understanding of lower urinary tract symptoms and incontinence in adults with pompe disease.

    Science.gov (United States)

    McNamara, Erin R; Austin, Stephanie; Case, Laura; Wiener, John S; Peterson, Andrew C; Kishnani, Priya S

    2015-01-01

    To study the prevalence of lower urinary tract symptoms (LUTS) and incontinence in late-onset Pompe disease (LOPD) Methods: Adult LOPD patients seen at the Duke Pompe Clinic were prospectively recruited and asked to complete validated questionnaires on LUTS and incontinence as part of an IRB-approved study. Patient demographics as well as previous urologic history were reviewed. 35 patients with LOPD were included in the study (17 males and 18 females). The median age was 51.8 (range 18-72 years of age). Of these patients, 27/35 were receiving enzyme replacement therapy (ERT) with median duration of 54 months (range 5-88 months). In the male patients, 9/17 (53%) described their stream as dribbling, weak, or intermittent, and 9/17 (53%) complained of post-void dribbling. In addition 38% of the men were unable to stop their urination midstream. In the female patients, the most common complaint was urinary incontinence, reported in 14/18 (78%). In addition, 7/18 (39%) complained of post-void dribbling, and 47% were unable to stop their urination midstream. Bowel incontinence was reported in 45% of patients. There was a significant association between urinary symptoms and lower extremity function scores and duration of ERT (p = 0.005 and p = 0.04, respectively) This is the first study in a large cohort of LOPD patients that demonstrates LUTS and incontinence occur at a high rate. This study emphasizes the spectrum of LOPD is beyond isolated gross motor and pulmonary involvement and has a significant effect on the lower urinary tract.

  8. The impact of gestational diabetes mellitus on postpartum urinary incontinence: a longitudinal cohort study on singleton pregnancies.

    Science.gov (United States)

    Chuang, C-M; Lin, I-F; Horng, H-C; Hsiao, Y-H; Shyu, I-L; Chou, P

    2012-10-01

    To determine whether gestational diabetes mellitus (GDM) is an independent risk factor for postpartum urinary incontinence in singleton pregnancies. A longitudinal cohort study. A single tertiary-care hospital in Taiwan. Pregnant women with term deliveries between 2002 and 2007 (n = 6653) were consecutively recruited. Logistic regression models were fitted based on generalised estimating equation methods to derive odds ratios for occurrences of type-specific urinary incontinence in the third trimester and at four time-points over 2 years during the postpartum period. Evaluation of whether GDM is an independent risk factor for postpartum urinary incontinence. The full model analysis revealed that GDM was an independent risk factor for all type-specific urinary incontinence (odds ratio [95% confidence interval]: 1.97 [1.56-2.51], 3.11 [2.18-4.43] and 2.73 [1.70-4.40] for stress, urge and mixed incontinence, respectively]. Compared with women without GDM, women with GDM tended to exhibit more severe symptoms of stress incontinence for up to 2 years postpartum, whereas for urge or mixed incontinence, more severe symptoms were found only for 6 months postpartum. Evaluation of quality of life using the Incontinence Impact Questionnaire 7 suggested that women with GDM requiring insulin treatment had a higher likelihood of functional impairment than women with GDM requiring conservative treatment only or women without GDM (P risk factor for postpartum urinary incontinence and had a significant impact on quality of life. Women with GDM should be provided with timely consultation and support once urinary incontinence occurs. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

  9. Investigation of evidence–based tests which were used to evaluate and diagnose process of urinary incontinence

    Directory of Open Access Journals (Sweden)

    Sema Dereli Yılmaz

    2011-09-01

    Full Text Available Investigation of evidence–based tests which were used to evaluate and diagnose process of urinary incontinence In this review we aimed to investigate the evidence-based clinical tests which were used to evaluate and diagnose the urinary incontinence. Urinary incontinence can be diagnosed in two ways. Two types of diagnosis can be made: symptomatic diagnosis and condition specific diagnosis. In general, symptomatic diagnoses are made in primary care using clinical history-taking, urinary diaries, pad tests and validated symptom scales. Condition-specific diagnoses are made by using urodynamic techniques. • A large proportion of women with urinary stress incontinence can be correctly diagnosed in primary care from clinical history alone. • On the basis of diagnosis the diary appears to be the most cost-effective of the three primary care tests (diary, pad test and validated scales used in addition to clinical history. • Ultrasound imaging may offer a valuable information about urinary incontinence • The clinical stress test is effective in the diagnosis of urinary stress incontinence. Adaptation of such a test so that it could be performed in primary care with a naturally filled bladder may prove clinically useful. • If a patient is to undergo an invasive urodynamic procedure, multichannel urodynamics is likely to give the most accurate result in a secondary care setting.

  10. Prevalence and knowledge of urinary incontinence and possibilities of treatment among low-income working women

    Directory of Open Access Journals (Sweden)

    Amabily Carolline Zago

    Full Text Available Abstract Introduction: Urinary incontinence (UI can affect women's lives in all areas, including in the occupational context, due to an uncomfortable workplace, incorrect positions for long periods of time and the handling of heavy items. Another worrying aspect is that the knowledge about urinary incontinence, in the health area, and its forms of treatment is still small among the low-income population. Objective: To verify the prevalence and knowledge about urinary incontinence and treatment possibilities among low-income working women. Methods: A cross-sectional study carried out on working women of a poultry processing plant. Results: The study included 136 women with an average age of 33.7 ± 9.7 years; body mass index of 26.6 ± 5.6 kg/m2; parity of 2.1 ± 1.1 children; monthly income of 2.3 ± 1 minimum wages. Of those interviewed, 63.9% were white; 44.8% had incomplete primary education; 52.9% were single; 53.6% underwent cesarean section delivery; and of those who underwent normal labor delivery, 86.6% underwent episiotomy. The prevalence of urinary incontinence was found to be 2.9%, and among the women affected, two reported that UI led to sexual, social, water and occupational restriction, and one of them believes that UI interferes with her concentration and productivity in the workplace. Regarding health knowledge, 46.3% had never heard of urinary incontinence before, and more than half (66.1% did not know about the existence of medical treatment. All women interviewed (100% were unaware of the existence of physiotherapeutic treatment. Conclusion: The prevalence of urinary incontinence was among those interviewed was small, however, the knowledge about the symptoms and possibilities of medical, and mainly physiotherapeutic treatment. is scarce among these women. This study allows to alert and to guide the health professionals and the society about the importance of actions that promote health education in the low income population

  11. Comparison of the functional profile of elderly women with urinary continence and incontinence

    Directory of Open Access Journals (Sweden)

    Gabriele Regiane Winter

    2014-10-01

    Full Text Available Urinary incontinence (UI, more prevalent in women and influencing their functional decline, increases with age. Current longitudinal study with two data collection in 2005-2006 and 2011 compares the functional profile of urinary continence and incontinence in elderly women. Sixty-eight women were divided into females with urinary continence (CG; n = 62 and females with urinary incontinence (IG; n = 6. Dependent variables measured were obesity and body adiposity indexes and functional fitness. Data were given in means with standard deviation (± and analyzed by the independent t-test (p < 0.05. There were six cases of UI. In the first evaluation group differences occurred for waist circumference (CG: 85.3±9.7 cm; IG: 91.2 ± 12.4cm; t=-2.267; p < 0.05 and cardiorespiratory fitness (CG: 517.9 ± 67.3 m; IG: 463.0±85.9 m; t = 2.571; p < 0.05. CG had a better functional profile, excepting flexibility and lower limbs strength, in the second evaluation. Women with UI had higher waist circumference and lower cardiorespiratory fitness. This may be due to the relationship between the variables and greater abdominal compression and functional decline. Results show that future public health strategies should focus on these factors to decrease the risk of people developing UI and to improve physical-functional and psycho-social benefits to elderly women.

  12. Effects of physical therapy in older women with urinary incontinence: a systematic review

    Directory of Open Access Journals (Sweden)

    Vanessa S. Pereira

    Full Text Available BACKGROUND: Urinary incontinence (UI is one of the most common public health problems among older women. Despite conservative treatment being recommended as the first treatment option, the effects of physical therapy in older women with UI is unclear. OBJECTIVE: This study aimed to systematically review the evidence about the effects of physical therapy on urinary symptoms in older women with UI. METHOD: The literature search for studies evaluating conservative treatment for incontinent in elderly women was conducted on Pubmed/Medline, Lilacs, Scielo, ISI Web of Knowledge and PEDro. We selected clinical trials published in English and Portuguese after the year 2000. The methodological quality of the studies was assessed using the PEDro scale. The results were analyzed using a critical review method. RESULTS: Six studies were reviewed in full revealing that pelvic floor muscle training was the treatment option in most studies. Five of the six selected studies were classified as having high methodological quality. There was significant improvement in urinary symptoms after treatment in five of the six selected studies. CONCLUSIONS: It was concluded that physical therapy treatment seems to be effective to decrease urinary incontinence symptoms in older women. However, the small number of studies and the use of concurrent interventions limit the conclusions on this issue.

  13. Research concepts use in the diagnosis and treatment of urinary incontinence

    Directory of Open Access Journals (Sweden)

    Gabriela Bidzińska

    2017-12-01

    Full Text Available Urinary incontinence is a significant social problem that affects both women and men regardless of age, ethnic or cultural differences. It is estimated that in Poland about 5 million people suffer from this disorder and it affects twice as many women than men. In addition, it has been shown that the frequency of disease and the severity of symptoms increases with age. Recent reports indicate that over 50% of all cases are stress urinary incontinence (WNM, which using appropriate diagnostic and therapeutic methods, is reversible and can be cured. The cause of stress urinary incontinence is the reduction of muscle tone of the crotch, pelvic floor, fascia and relaxation of connective tissue. Diagnosis of the lower urinary tract should be based on the interview, analysis of the micturition diary, physical and urodynamic examination. In recent years, imaging diagnostics, mainly including ultrasound, have also begun to be used. The cheapest and safest method for the patient is conservative treatment and the patient should be qualified for this form of therapy at the very beginning. Surgical treatment should be used when conservative treatment does not bring positive effects.

  14. Considerations in the modern management of stress urinary incontinence resulting from intrinsic sphincter deficiency.

    Science.gov (United States)

    Hillary, Christopher James; Osman, Nadir; Chapple, Christopher

    2015-09-01

    Intrinsic sphincter deficiency (ISD) is a common cause of stress urinary incontinence and is associated with more severe symptoms, often being associated with failed previous surgery. Due to the impaired sphincteric function, alternative surgical approaches are often required. The purpose of this review is to appraise the contemporary literature on the diagnosis and management of ISD. A PubMed search was performed to identify articles published between 1990 and 2014 using the following terms: ISD, stress urinary incontinence and type III stress urinary incontinence. Publications were screened for relevance, and full manuscripts were retrieved. Most studies base the diagnosis of ISD upon urodynamic appearances using recognized criteria (Valsalva leak point pressure <60 cm H2O or a maximum urethral closure pressure <20 cm H2O) in addition to clinical features. A range of non-surgical and surgical treatment options are available for the patient. Pubovaginal slings are more effective than retropubic colposuspensions with outcomes comparable to those reported with midurethral slings. The artificial urinary sphincter provides long-term cure rates; however, it is associated with specific morbidity including device erosion, mechanical failure and revision. The benefits of bulking agents, however, are not sustained beyond 1 year. There are few randomized controlled trials that compare accepted treatments specifically for patients with ISD. The lack of standardization in the definition and diagnostic criteria used limits inter-study comparisons. An assessment of urethral pressure profile when combined with the clinical features may help predict outcomes of surgical intervention.

  15. Age and prostate volume are risk factors for transient urinary incontinence after transurethral enucleation with bipolar for benign prostatic hyperplasia.

    Science.gov (United States)

    Hirasawa, Yosuke; Kato, Yuji; Fujita, Kiichiro

    2018-01-01

    To investigate the predictive factors for transient urinary incontinence after transurethral enucleation with bipolar. We retrospectively analyzed the data of 584 patients who underwent transurethral enucleation with bipolar between December 2011 and September 2016 operated by a single surgeon. Urinary incontinence after transurethral enucleation with bipolar was defined as involuntary leakage of urine that required the use of pads. It was evaluated at 1 week, and 1, 3, 6, 12 and 24 months after transurethral enucleation with bipolar. We defined transient urinary incontinence as urinary incontinence persisting up to 1 month after transurethral enucleation with bipolar. Based on independent risk factors identified by a multivariate stepwise logistic regression analysis, a nomogram to predict transient urinary incontinence was developed. Of the 584 patients, 17.3%, 13.5%, 3.1%, 0.41%, and 0% patients had urinary incontinence at 1 week, 1, 3, 6 and 12 months after transurethral enucleation with bipolar, respectively. The mean (±standard error) age was 69.6 ± 0.26 years, estimated prostate volume was 54.7 ± 0.91 cm 3 , operative time was 58.0 ± 1.1 min and the prostate specimen weight was 30.6 ± 0.69 g. On univariate analysis, age, prostate volume estimated by transrectal ultrasonography, prostate-specific antigen, prostate specimen weight, operative time, prostate specimen weight/prostate volume and prostate specimen weight/operative time were significant predictive factors for transient urinary incontinence after transurethral enucleation with bipolar. On multivariate analysis, age (hazard ratio 1.07, P-value = 0.0034) and prostate volume (hazard ratio 1.03, P-value bipolar. Age and prostate volume estimated by transrectal ultrasonography seem to represent significant independent risk factors for transient urinary incontinence after transurethral enucleation with bipolar. This should be well discussed with the patient before surgery. © 2017 The Japanese

  16. An open multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and mixed urinary incontinence

    DEFF Research Database (Denmark)

    Lose, Gunnar; Sørensen, Helle Christina; Axelsen, Susanne Maigaard

    2010-01-01

    Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This multicenter study was carried out to evaluate safety and efficacy of Bulkamid® for female stress and mixed urinary incontinence.......Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This multicenter study was carried out to evaluate safety and efficacy of Bulkamid® for female stress and mixed urinary incontinence....

  17. Quality of life after periurethral injection with polyacrylamide hydrogel for stress urinary incontinence.

    Science.gov (United States)

    Trutnovsky, Gerda; Tamussino, Karl; Greimel, Elfriede; Bjelic-Radisic, Vesna

    2011-03-01

    The purpose of this observational study was to examine the effect of periurethral injections with polyacrylamide hydrogel (PAHG) on quality of life (QoL) in selected patients with stress urinary incontinence (SUI). Fifty-four women with comorbidities or other reasons precluding other surgery received PAHG for SUI. Patient-reported outcomes were assessed with the "Incontinence Outcome Questionnaire" (IOQ) 9 months postoperatively. The IOQ is a 27-item, condition-specific instrument that assesses patient-reported outcomes after incontinence surgery. Forty-two women (78%) completed the questionnaire. Responses ranged from considerable (40%) and slight improvement (21%) to no change (29%) and worsening of symptoms (10%). Periurethral injections with PAHG are likely to provide relief of symptoms and improvement in QoL.

  18. Clinical profile of motor neuron disease patients with lower urinary tract symptoms and neurogenic bladder.

    Science.gov (United States)

    Vázquez-Costa, Juan Francisco; Arlandis, Salvador; Hervas, David; Martínez-Cuenca, Esther; Cardona, Fernando; Pérez-Tur, Jordi; Broseta, Enrique; Sevilla, Teresa

    2017-07-15

    Lower urinary tract symptoms (LUTS) are frequent in motor neuron disease (MND) patients, but clinical factors related to them are unknown. We describe differences in LUTS among MND phenotypes and their relationship with other clinical characteristics, including prognosis. For this study, we collected clinical data of a previously published cohort of patients diagnosed with classical amyotrophic lateral sclerosis (cALS), progressive muscular atrophy (PMA) or primary lateral sclerosis (PLS) with and without LUTS. Familial history was recorded and the C9ORF72 expansion was analysed in the entire cohort. Patients were followed-up for survival until August 2016. Fifty-five ALS patients (37 cALS, 10 PMA and 8 PLS) were recruited. Twenty-four reported LUTS and neurogenic bladder (NB) could be demonstrated in nine of them. LUTS were not influenced by age, phenotype, disability, cognitive or behavioural impairment, or disease progression, but female sex appeared to be a protective factor (OR=0.39, p=0.06). Neither family history nor the C9ORF72 expansion was linked to LUTS or NB. In the multivariate analysis, patients reporting LUTS early in the disease course tended to show poorer survival. In this study, LUTS appear to be more frequent in male MND patients, but are not related to age, clinical or genetic characteristics. When reported early, LUTS could be a sign of rapid disease spread and poor prognosis. Further prospective longitudinal and neuroimaging studies are warranted to confirm this hypothesis. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. "Stain in life": The meaning of urinary incontinence in the context of Muslim postmenopausal women through hermeneutic phenomenology.

    Science.gov (United States)

    Hamid, Tengku Aizan; Pakgohar, Minoo; Ibrahim, Rahimah; Dastjerdi, Marzieh Vahid

    2015-01-01

    UI is a worldwide chronic condition among postmenopausal women. Little is known about the meaning of lived experiences of urinary incontinence of these women's viewpoints in their context. The aim of this study was to illuminate the experience of Muslim community-dwelling postmenopausal women who were living with urinary incontinence (UI). Seventeen women with UI (range: 52-68 years) who had experienced it for more than ten years were interviewed. A phenomenological hermeneutic method was used to analyze and interpret the interview texts. The women's experiences of living with urinary incontinence have been presented in terms of three main themes: disruption of normal functioning, self-imposed restriction, and feelings of despair. Disruption of normal functioning meant emotional, spiritual, physical, and daily life disruption. Self-imposed restriction meant suppression of delights and needs and avoidance of social interactions. Feelings of despair referred to predictions of a bad and dark future of living with urinary incontinence, ambiguity, and hopelessness. The meaning of living with UI has been considered a 'stain in life'. Health care providers should be familiar with the different manifestations of urinary incontinence for early diagnosis and prevention of the negative effects of this condition to improve quality of life. In addition, symbolic interactionism theory can help health care providers to understand the meaning of urinary incontinence for women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. [Sonographic evaluation of the levator ani muscle in women with stress urinary incontinence].

    Science.gov (United States)

    Stachowicz, Norbert; Stachowicz, Sylwia; Smoleń, Agata; Morawska, Dorota; Kotarski, Jan

    2012-09-01

    Three-dimensional sonography has been used for about 15 years, not only to examine the female genital organs, but also the lower urinary tract and pelvic floor. Three-dimensional sonography offers more information than traditional two-dimensional sonography allowing for a dynamic representation of the examined structures and observation at any angle necessary. Translabial sonography is the best way of a sonographic examination of the lower urinary tract, because it does not affect the mutual relationship of any parts in the lower pelvic area, contrary to the transrectal or transvaginal probes. In order to establish proper treatment of the urinary incontinence symptoms, not only a functional examination of the lower urinary tract, but also a very accurate assessment of the statics of the female genital organs and pelvic floor need to be performed. The aim of the study was to rate the area and diameters of the limbs of the levator ani muscle using a three-dimensional (3D) translabial sonography in women with stress urinary incontinence without the female genital tract prolapse. The study group included 100 patients who were examined with the GE Kretz Voluson 730 (GE, Austria), equipped with 6-9 MHz translabial probe. The first group with stress urinary incontinence consisted of 50 women (mean age 56.22 (+/- 10.43) years) and the second group included 50 women without symptoms (mean age 49.40 (+/- 13.22) years). All cases of urinary stress incontinence in the first group were confirm by means of a urodynamic examination. Women in both groups had similar body weight (kilograms), mean (+/- SD): 26.88 (+/- 2.02) and 26.20 (+/- 4,14), respectively. Menopausal status in both groups was not statistically significant and amounted to 7.21 (+/- 8.71) in the group of women with stress urinary incontinence and 4.70 (+/- 6.32) in the group without symptoms. Mean (+/- SD) number of deliveries was significantly higher in the group of women with stress urinary incontinence than in

  1. Urinary incontinence and voiding dysfunction after radical retropubic prostatectomy (prospective urodynamic study).

    Science.gov (United States)

    Majoros, Attila; Bach, Dietmar; Keszthelyi, Attila; Hamvas, Antal; Romics, Imre

    2006-01-01

    During this prospective study we analyzed the effects of radical retropubic prostatectomy (RRP) on bladder and sphincter function by comparing preoperative and postoperative urodynamic data. The aim of the study was to determine the reason for urinary incontinence after RRP and explain why one group of patients will be immediately continent after catheter removal, while others need some time to reach complete continence. Urodynamic examination was performed in 63 patients 3-7 days before and 2 months after surgery. Forty-three (68.2%) and 53 (84.1%) patients regained continence at 2 and 9 months following RRP, respectively. Ten patients (15.9%) were immediately continent after catheter removal. Urodynamic stress incontinence was detected in 18 (28.6%), and detrusor overactivity incontinence in 2 (3.2%) patients 2 months after surgery. The amplitude of preoperative maximal voluntary sphincteric contractions was significantly higher in the postoperative continent group (125 vs. 96.5 cmH(2)O, P continent following catheter removal had no lower urinary tract symptoms (LUTS) and urodynamic abnormality preoperatively, and they had significantly higher preoperative and postoperative maximum urethral closure pressure (at rest and during voluntary sphincter contraction) than those who became continent later on. These data suggest that the main cause of incontinence after RRP is sphincteric weakness. In the continent group, those who became immediately continent had significantly higher maximum urethral closure pressure values at rest and at voluntary sphincteric contraction even before the surgery. Neurourol. Urodynam. (c) 2005 Wiley-Liss, Inc.

  2. The prevalence of urinary incontinence in community-dwelling married women: a matter of definition.

    Science.gov (United States)

    Vandoninck, Vera; Bemelmans, Bart L H; Mazzetta, Chiara; Robertson, Chris; Keech, Martin; Boyle, Peter; Kiemeney, Lambertus A

    2004-12-01

    To determine the prevalence of female urinary incontinence (UI) and its impact on quality of life. In a Dutch national postal questionnaire survey, 1460 spouses of 1771 men in the town of Boxmeer, age-stratified and randomly selected, were asked to participate. The prevalence of UI in the women was assessed in two ways. First, a total score on a short UI-specific questionnaire differentiated them into three groups, i.e. no symptoms (score 0-2), minimally (3-6) or severely incontinent (7-14). Second, a self-reported UI prevalence was calculated by asking respondents if they ever had urine loss. To conform to the International Continence Society standard definition, spouses were also asked to complete a general (Short Form-12) and lower urinary tract disease-specific quality-of-life questionnaire, and were asked about their need to seek help. The questionnaires were returned by 1071 women (mean age 57 years, range 29-79; response rate 73%); 34% were regarded as minimally and 12% as severely incontinent. The self-reported UI rate was 40%. Disease-specific and general quality of life was significantly lower for women with UI than for those with minimal or no urine loss; 38% of incontinent respondents had consulted a physician for their UI, and among respondents with minimal complaints this was 28%. Up to 46% of the married female population had some degree of UI, and severe UI significantly compromised their quality of life.

  3. Comparison of TOT and TVT in Treatment of Female Stress Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    Taylan Mit

    2014-03-01

    Full Text Available Aim: To compare the continence results and complications of the tension-free vaginal tape (TVT and transobturator tape (TOT procedures. Material and Method: Sixty two urinary incontinence patients; (37 were stress urinary incontinence and 25 were mixed incontinence underwent TVT or TOT. The clinic-pathologic parameters of the patients, perioperative and postoperative complications and outcome in terms of continence and quality of life were compared. Results: TOT and TVT were performed on % 50 of the patients respectively. An objective cure rate in patients who underwent TOT was observed in 74% of cases, an objective improvement in 26% of cases. 11 of the patients had dysuria, 10 of them had suprapubic pain. An objective cure rate in patients who underwent TVT was observed in 90% of cases, an objective improvement in 8% of cases. A de novo urge incontinence presented in 2 patients. The quality of life improved in 93,5% of cases. In terms of continence results and quality of life, there was no significant difference between the procedures. The complication rate was higher with the TVT procedure when compared to that of the TOT procedure. Discussion: TOT procedure in short terms, performs similar operational success with the TVT procedure. Operational time; in consideration of the cystoscopy time, can be an advantage compared to the TVT procedure. If the operation includes anterior colporrhaphy, the success of both procedures reduces.

  4. [Treatment of Urinary incontinence associated with genital prolapse: Clinical practrice guidelines].

    Science.gov (United States)

    Cortesse, A; Cardot, V; Basset, V; Le Normand, L; Donon, L

    2016-07-01

    Prolapse and urinary incontinence are frequently associated. Patente (or proven) stress urinary incontinence (SUI) is defined by a leakage of urine that occurs with coughing or Valsalva, in the absence of any prolapse reduction manipulation. Masked urinary incontinence results in leakage of urine occurring during reduction of prolapse during the clinical examination in a patient who does not describe incontinence symptoms at baseline. The purpose of this chapter is to consider on the issue of systematic support or not of urinary incontinence, patent or hidden, during the cure of pelvic organs prolapse by abdominal or vaginal approach. This work is based on an systematic review of the literature (PubMed, Medline, Cochrane Library, Cochrane database of systematic reviews, EMBASE) for meta-analyzes, randomized trials, registries, literature reviews, controlled studies and major not controlled studies, published on the subject. Its implementation has followed the methodology of the HAS on the recommendations for clinical practice, with a scientific argument (with the level of evidence, NP) and a recommendation grade (A, B, C, and professional agreement). In case of patent IUE, concomitant treatment of prolapse and SUI reduces the risk of postoperative SUI. However, the isolated treatment of prolapse can treat up to 30% of preoperative SUI. Concomitant treatment of SUI exposed to a specific overactive bladder and dysuria morbidity. The presence of a hidden IUE represents a risk of postoperative SUI, but there is no clinical or urodynamic test to predict individually the risk of postoperative SUI. Moreover, the isolated treatment of prolapse can treat up to 60% of the masked SUI. Concomitant treatment of the hidden IUE therefore exposes again to overtreatment and a specific overactive bladder and dysuria morbidity. In case of overt or hidden urinary incontinence, concomitant treatment of SUI and prolapse reduces the risk of postoperative SUI but exposes to a specific

  5. Low risk of urinary incontinence following prostate brachytherapy in patients with a prior transurethral prostate resection

    International Nuclear Information System (INIS)

    Wallner, Kent; Lee, Henry; Wasserman, Stuart; Dattoli, Michael

    1997-01-01

    Purpose: To review post implant morbidity in patients with prior transurethral prostate resection (TURP). Methods and Materials: Nineteen patients with stage T1-T2 prostatic carcinoma and prior TURP were treated with I-125 or Pd-103 implantation from 1991 through 1994. Follow-up ranged from 1 to 6 years (median: 3 years). The time from TURP to implantation ranged from 2 months to 15 years (median: 3 years). Results: Only one patient developed mild urinary stress incontinence, 6 months following his I-125 implant. The actuarial freedom from permanent urinary incontinence at 3 years after implantation was 94%. No patient required urethral dilatation for urethral stricture. Eleven patients were sexually potent prior to implantation. At 3 years after treatment, all patients had maintained potency. Conclusion: In our experience, there has been remarkably little adverse sequelae following I-125 or Pd-103 implantation in patients with a prior history of TURP

  6. The treatment of female stress urinary incontinence: an evidenced-based review.

    Science.gov (United States)

    Cameron, Anne P; Haraway, Allen McNeil

    2011-06-17

    To review the literature on the surgical and nonsurgical treatment options for stress urinary incontinence in women, focusing exclusively on randomized clinical trials and high quality meta-analyses. A computer-aided and manual search for published randomized controlled trials and high quality meta-analyses investigating both conservative and surgical treatment options for stress urinary incontinence. In the case of a treatment that is not studied in these formats large case series have been used. Articles were reviewed and the results summarized on pelvic floor physical therapy, pharmacotherapy, bulking agents, and surgery (open and minimally invasive). There are numerous high quality studies in the literature. It can be difficult to make definitive conclusions on the most appropriate treatment options due to the variability in the outcomes used to define success in these articles. There is also a dire lack of studies evaluating and comparing the surgical options for patients with intrinsic sphincter deficiency.

  7. Urinary incontinence a first presentation of central pontine myelinolysis: a case report.

    Science.gov (United States)

    Syed, Asmah Hassan; Shak, Joanna; Alsawaf, Ali

    2015-09-01

    An 84-year-old lady was treated for hyperosmolar hyperglycaemia with IV insulin, fluids and catheterisation for fluid balance monitoring. Trial without catheter failed as the patient complained of new-onset urinary incontinence and lack of awareness of bladder filling. In light of her breast cancer history, we excluded cauda equina. Ultrasound KUB showed an enlarged bladder. Whole-body MRI revealed a lesion in the pons which was highly suggestive of central pontine myelinolysis (CPM). Her electrolytes were normal throughout her admission; thus, the rapid fluctuation in osmolality, secondary to her hyperglycaemic state, was the likely cause of CPM. CPM has been reported secondary to hyperglycaemia; however, this is the first reported case of CPM presenting as urinary incontinence and loss of bladder sensation. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. 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.

  9. Urinary incontinence in Emirati women with diabetes mellitus type 2: prevalence, risk factors and impact on life.

    Science.gov (United States)

    Bani-issa, Wegdan; Fakhry, Randa; Al Momani, Fida

    2013-11-01

    To evaluate prevalence, risk factors for urinary incontinence and its impact on lives of Emirati women with diabetes mellitus type 2 (DM2). Risk factors examined were age, parity, history of urinary tract infections, body mass index (BMI) and DM2 duration. Incontinence is a known complication of DM2 with impact on women's lives. Less is known about incontinence problem among Emirati women with DM2. A cross-sectional survey design using probability sampling approach was employed to assess urinary incontinence in Emirati women with DM2. A total of 300 women with DM2, aged 20-65 years, were recruited from six healthcare centres. Data were collected over an 18-month period. A standardised incontinence questionnaire was used to assess type and frequency of incontinence within the past 12 months. Presence of weekly incontinence was the main outcome. Of the 300 women, 188 (63%) reported any incontinence, of which 48% had at least weekly episode. Both stress (n = 154, 51·3%) and urge (n = 181, 60·3%) were reported by participants, with 48 (31·1%) reporting at least weekly stress and 85 (46·9%) expressing at least weekly urge incontinence. Diabetes duration was a significant risk factor for any, stress and urge incontinence followed by age for only any and stress incontinence. BMI was a risk factor for urge incontinence. Women perceived incontinence as bothersome, disturbing their social activities and daily prayers. The prevalence of incontinence in Emirati women with DM2 is higher than that reported by women in other cultures. Risk factors identified were DM2 duration, age and obesity. Emirati women found incontinence to be a bothersome problem influencing their daily lives and prayers. Nurses in general practice should be alert to the incontinence problem by considering it as part of the routine diabetes evaluation of women, especially of those with longer duration of diabetes, obese and older. Cultural knowledge, sensitivity and individualised treatment plans need

  10. Value of MRI in the diagnosis of stress urinary incontinence in the absence of organ descent

    International Nuclear Information System (INIS)

    Beyersdorff, D.; Taupitz, M.; Fischer, T.; Hamm, B.; Tunn, R.; Rieprich, M.

    2001-01-01

    To detect pathomorphological changes of the pelvic floor, the vagina, and the urethra by MR imaging in patients with stress urinary incontinence in the absence of organ descent compared with findings in 10 healthy controls. Materials and Methods: The study included 10 healthy controls and 38 patients with stage II urinary incontinence showing no urge symptoms but a pathological stress profile on urodynamic testing. The subjects underwent MR imaging with a phased-array coil at 1.5 T in addition to urodynamic testing and gynecological examination. The following sequences were used: axial and coronal PD-weighted TSE sequences with a FOV of 20 cm and a section thickness of 4 mm; axial STIR sequence. Sagittal T 2 -weighted HASTE sequences were acquired during pelvic floor contraction, relaxation, and straining maneuvers. Results: In 22/38 cases pathomorphological changes were found by MR imaging. The pathomorphological changes were classified as lateral defects (n = 14) if the musculofascial connection between the levator muscle and the lateral vaginal wall or the butterfly shape of the vagina was absent and as central (n = 16) if changes were detected in the urethral wall. Defects of the pelvic floor muscles were detected in 8 cases. No underlying changes were identified in 16/38 cases. Conclusion: In cases of female urinary incontinence, MR imaging of the pelvic floor can detect pathomorphological changes, which are difficult to identify by clinical examination. MR imaging currently does not allow the detection of morphological changes in all forms of female urinary stress incontinence. (orig.) [de

  11. Incidence and risk factors of urinary incontinence in women visiting Family Health Centers

    OpenAIRE

    K?l??, Meral

    2016-01-01

    Background The objective of this study is to determine the incidence and the risk factors of the urinary incontinence in women visiting the Health Family Center. Methods 430 women, who visited three Family Health Centers in the city center of Erzurum for any reason between 25 November and 20 January 2016, were included in this study without any sampling. The data were collected by using the face-to-face interview method. Percentage distribution, Chi square test, and logistic regression analys...

  12. Pelvic Static Magnetic Stimulation to Control Urinary Incontinence in Older Women: A Randomized Controlled Trial

    Science.gov (United States)

    Wallis, Marianne C.; Davies, Elizabeth A.; Thalib, Lukman; Griffiths, Susan

    2012-01-01

    Objectives To determine the efficacy of non-invasive static magnetic stimulation (SMS) of the pelvic floor compared to placebo in the treatment of women aged 60 years and over with urinary incontinence for 6 months or more. Subjects and Methods A single-blinded randomized, placebo-controlled, parallel-group trial. Subjects were excluded if they had an implanted electronic device, had experienced a symptomatic urinary tract infection, or had commenced pharmacotherapy for the same in the previous 4 weeks, or if they were booked for pelvic floor or gynecological surgery within the next 3 months. Once written consent was obtained, subjects were randomly assigned to the active SMS group (n=50) or the placebo group (n=51). Treatment was an undergarment incorporating 15 static magnets of 800–1200 Gauss anterior, posterior, and inferior to the pelvis for at least 12 hours a day for 3 months. Placebo was the same protocol with inert metal disks replacing the magnets. Primary outcome measure was cessation of incontinence as measured by a 24-hour pad test. Secondary outcomes were frequency and severity of symptoms as measured by the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS-SF), the Incontinence Severity Index, a Bothersomeness Visual Analog scale, and a 24-hour bladder diary. Data were collected at baseline and 12 weeks later. Results There were no statistically significant differences between groups in any of the outcome measures from baseline to 12 weeks. Initial evidence of subjective improvement in the treatment group compared to the placebo group was not sustained with sensitivity analysis. Conclusion This study found no evidence that static magnets cure or decrease the symptoms of urinary incontinence. Additional work into the basic physics of the product and garment design is recommended prior to further clinical trials research. PMID:21817123

  13. The treatment of female stress urinary incontinence: an evidenced-based review

    OpenAIRE

    Cameron, Anne P; Haraway, Allen McNeil

    2011-01-01

    Anne P Cameron, Allen McNeil HarawayDepartment of Urology, Division of Neurourology and Pelvic Floor Reconstruction, University of Michigan Health System, Ann Arbor, MI, USAObjective: To review the literature on the surgical and nonsurgical treatment options for stress urinary incontinence in women, focusing exclusively on randomized clinical trials and high quality meta-analyses.Materials and methods: A computer-aided and manual search for published randomized controlled trials and high qual...

  14. Vaginal Calculus in a Woman With Mixed Urinary Incontinence and Vaginal Mesh Exposure.

    Science.gov (United States)

    Winkelman, William D; Rabban, Joseph T; Korn, Abner P

    2016-01-01

    Vaginal calculi are extremely rare and are most commonly encountered in the setting of an urethrovaginal or vesicovaginal fistula. We present a case of a 72-year-old woman with mixed urinary incontinence and vaginal mesh exposure incidentally found to have a large vaginal calculus. We removed the calculus surgically and analyzed the components. Results demonstrated the presence of ammonium-magnesium phosphate hexahydrate and carbonate apatite.

  15. A Study of Clinical Predictors Associated With Intrinsic Sphincter Deficiency in Women With Stress Urinary Incontinence

    Directory of Open Access Journals (Sweden)

    Kyung Kgi Park

    2017-06-01

    Full Text Available Purpose Recently, intrinsic sphincter deficiency (ISD has been identified as one important factor in the outcome of stress urinary incontinence (SUI related surgery. Clinical factors that can predict ISD are uncommon. The aim of this study was to determine predictive clinical factors for ISD in female patients with SUI. Methods The patients were classified into 3 groups according to the value of Valsalva leak point pressure (VLPP>90 cm H2O (anatomical incontinence, AI, between 61 and 90 cm H2O (equivocal, EV, and <60 cm H2O (ISD. All groups underwent a full examination, history evaluation, physical examination, uroflowmetry, and complete urodynamic study. Univariate analysis was performed by chi-square or t-test for categorical variables, respectively. A multivariate study was performed by Pearson correlation analysis in order to get clinical predictors of VLPP<60 cm H2O. Statistical significance was set at P<0.05. Results There were 3 groups with a total of 189 patients: 56 patients (AI, 29.7%, 64 patients (EV, 33.8%, and 69 patients (ISD, 36.5%. The univariate analysis revealed a significant difference associated with maximal urethral closing pressure (P=0.03 and Stamey classification (P=0.006 between ISD and AI. The more severe the urinary symptom grade, the higher the frequency of ISD. However, the multivariate analysis showed the independent predictor of ISD is only present in grades II and III symptoms in the Stamey classification (P=0.001. Conclusions It was found that the more severe the symptoms of urinary incontinence, the higher the possibility of ISD. In other words, the degree of urinary incontinence was found to be one relevant clinical factor in predicting ISD. This finding may help in evaluating and identifying the appropriate surgical technique for EV. Currently, absolute cutoff value to diagnose ISD has not yet been determined. More research is needed to identify clinical factors that can predict ISD.

  16. Training in exercises for pelvic floor muscles of patients with an urinary incontinence after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    P. V. Glybochko

    2014-11-01

    Full Text Available Training of muscles of a pelvic bottom under control of biofeedback is applied at 87 patients with an urinary incontinence after a radical prostatectomy. Biofeedback increases management and control of a pelvic floor. At good ability of management of muscles of a pelvic floor the median of restoration was 4 months. Without opportunity of management of muscles of pelvic floor restoration was 9.4 months.

  17. Training in exercises for pelvic floor muscles of patients with an urinary incontinence after radical prostatectomy

    Directory of Open Access Journals (Sweden)

    P. V. Glybochko

    2013-01-01

    Full Text Available Training of muscles of a pelvic bottom under control of biofeedback is applied at 87 patients with an urinary incontinence after a radical prostatectomy. Biofeedback increases management and control of a pelvic floor. At good ability of management of muscles of a pelvic floor the median of restoration was 4 months. Without opportunity of management of muscles of pelvic floor restoration was 9.4 months.

  18. Tension-free vaginal taping in pakistani women with stress urinary incontinence

    International Nuclear Information System (INIS)

    Saleem, A.

    2017-01-01

    To evaluate the effectiveness and determine the peroperative and postoperative complications of tension-free vaginal tape (TVT) sling for urinary stress incontinence (USI) and contributing factors to complications. Study Design: Descriptive study. Place and Duration of Study: Kidney Centre Postgraduate Institute, Karachi, from January 2009 to December 2010. Methodology: One hundred consecutive patients underwent TVT as per Ulmsten Technique for urinary stress incontinence and patients were followed for 3 years. The subjective cure rate and improvement rate was based on the international consultation on incontinence questionnaire for evaluating female lower urinary tract symptoms (ICIQ - FLUS). The subjective cure was defined as the statement of the woman not experiencing any loss of urine upon physical stress and improvement rate was defined as occasional leakage during stress. Results: Patients at 1- and 3-year up follow-up showed subjective cure rate and improvement rate of 98% and 2%, and 95% and 5%, respectively. Mean operative time was 32 minutes. UTI was the commonest complication observed in 7 (7%) patients. Women with voiding dysfunction preoperatively had 9-fold odds of difficulty postoperatively (0<0.001). There was a significant association of preoperative symptoms of overactive bladder (OAB) with the same postoperative symptoms (p<0.0001). Preoperative hysterectomy had a significant (p< 0.005) 15.63 fold odds of intraoperative bladder perforation. Conclusion: Tension-free vaginal tape sling is an efficacious and secure surgical procedure for the treatment of urinary stress incontinence. Bladder perforation, voiding dysfunction, supra-pubic discomfort and UTI are the commonest complications. Risk factors for perforation include preoperative hysterectomy. Pre-existing voiding dysfunction and UTI lead to persistent similar postoperative problems. (author)

  19. Validity and reliability of parental report of frequency, severity and risk factors of urinary tract infection and urinary incontinence in children.

    Science.gov (United States)

    Sureshkumar, Premala; Cumming, Robert G; Craig, Jonathan C

    2006-06-01

    We describe the validity and reliability of a questionnaire designed to determine frequency, severity and risk factors of urinary tract infection and daytime urinary incontinence in primary school-age children. Based on published validated questionnaires and advice from content experts, a questionnaire was developed and piloted in children attending outpatient clinics. Construct validity for parent report of frequency and severity of daytime urinary incontinence was tested by comparison with a daily accident diary in 52 primary school children, and criterion validity of parent report for UTI was verified by comparison with the reference standard (urine culture) in 100 primary school children. Test-retest reliability of the questionnaire was assessed in 106 children from primary schools. There was excellent agreement between the questionnaire and accident diary in severity (weighted kappa 0.94, 95% confidence intervals 0.85 to 1.03) and frequency of daytime urinary incontinence (0.88, 0.7 to 1.0). Parents reported urinary tract infection in 15% of children, compared to a positive urine culture in 8% (sensitivity 100% and specificity 68.5%). Test-retest reliability of the questionnaire was excellent (mean k 0.78, range 0.61 to 1.00). Parents overreport UTI by about 2-fold but can recall frequency and severity of daytime urinary incontinence well during a 3-month period. The developed questionnaire is a valid tool to estimate frequency, severity and risk factors of daytime urinary incontinence and UTI in primary school children.

  20. Electrostimulation, response of the pelvic floor muscles, and urinary incontinence in elderly patients post prostatectomy

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    Patrícia Zaidan

    Full Text Available Objective to investigate the response of the pelvic floor muscles (PFM, and urinary incontinence (UI, in patients having undergone a prostatectomy, after treatment using electrical stimulation. Materials and methods this observational study was conducted in an outpatient urogynecologic physical therapy clinic of Hospital dos Servidores in Rio de Janeiro, Brazil from August to September 2012. Ten patients (aged, 64 ± 7 years with urinary incontinence resulting from radical prostatectomy, having received surgery within six months of study entry, without urinary infection, and without metallic implants underwent electrical stimulation of the PFM, while in lateral decubitus position with knees and hips flexed. The parameters used were 65 Hz frequency, pulse width of 500 µs, biphasic current, intensity according to the tolerance level reported by the patient, perineal contraction time of four seconds, and rest time of eight seconds for 20 minutes twice a week, totaling 16 sessions of electrical stimulation with active-assisted contraction. Patients were evaluated before and after electrical stimulation through physical therapy evaluation of urinary incontinence, by being asked about the number of disposable guards used daily, using a visual analogue scale (VAS to measure how the UI interfered with activities of daily living, and by electromyographic biofeedback to measure the work of the PFM. Data were analyzed using Student’s paired t-tests and a significance level of 0.05. Results after 16 sessions of electrical stimulation, the electromyographic biofeedback evaluation showed a significant increase in muscle strength of 10.73 ± 8.64 to 17.16 ± 9.00 µV (t = -3.39, P = 0.008, a significant decrease in the number of diapers used before and after treatment (3.9 ± 1.2 to 1.8 ± 1.5, respectively; t = 5.16, P = 0.0006, and a significant decrease in the interference of urinary incontinence on daily activities of 9.6 ± 0.5 to 4.0 ± 3.8 (t = 5

  1. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.

    Science.gov (United States)

    Woodley, Stephanie J; Boyle, Rhianon; Cody, June D; Mørkved, Siv; Hay-Smith, E Jean C

    2017-12-22

    About one-third of women have urinary incontinence and up to one-tenth have faecal incontinence after childbirth. Pelvic floor muscle training (PFMT) is commonly recommended during pregnancy and after birth for both prevention and treatment of incontinence.This is an update of a review previously published in 2012. To determine the effectiveness of pelvic floor muscle training (PFMT) in the prevention or treatment of urinary and faecal incontinence in pregnant or postnatal women. We searched the Cochrane Incontinence Specialised Register (16 February 2017) and reference lists of retrieved studies. Randomised or quasi-randomised trials in pregnant or postnatal women. One arm of the trial included PFMT. Another arm was no PFMT, usual antenatal or postnatal care, another control condition, or an alternative PFMT intervention. Review authors independently assessed trials for inclusion and risk of bias. We extracted data and checked them for accuracy. Populations included: women who were continent (PFMT for prevention), women who were incontinent (PFMT for treatment) at randomisation and a mixed population of women who were one or the other (PFMT for prevention or treatment). We assessed quality of evidence using the GRADE approach. The review included 38 trials (17 of which were new for this update) involving 9892 women from 20 countries. Overall, trials were small to moderate sized, and the PFMT programmes and control conditions varied considerably and were often poorly described. Many trials were at moderate to high risk of bias. Other than two reports of pelvic floor pain, trials reported no harmful effects of PFMT.Prevention of urinary incontinence: compared with usual care, continent pregnant women performing antenatal PFMT may have had a lower risk of reporting urinary incontinence in late pregnancy (62% less; risk ratio (RR) for incontinence 0.38, 95% confidence interval (CI) 0.20 to 0.72; 6 trials, 624 women; low-quality evidence). Similarly, antenatal PFMT

  2. Treatment of Stress Urinary Incontinence in Neurological Patients With an Injectable Elastomer Prosthesis: Preliminary Results

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    Julien Renard

    2017-03-01

    Full Text Available Many treatment options for stress urinary incontinence are difficult to apply to neurological patients. Urolastic is a new agent that is primarily indicated for women with mild stress urinary incontinence or men after prostate surgery. In this report, we present a series of 5 cases describing the first use of Urolastic to treat neurological patients. All patients were evaluated with a voiding diary and the use of auxiliary devices as the main indicators of continence. The median operative time was 30.8 minutes, and no complications were observed. Of the 5 patients, 4 reported improved incontinence: 2 switched from diapers to small pads, while the other 2 patients were able to discontinue urinary condom use. The only instance of treatment failure occurred in a patient with a low-compliance bladder. The advantages of this procedure appear to include a soft-cuff effect, reversibility, and minimal invasiveness. However, a future randomized study would be necessary to validate this treatment option.

  3. The treatment of female stress urinary incontinence: an evidenced-based review

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    Cameron AP

    2011-06-01

    Full Text Available Anne P Cameron, Allen McNeil HarawayDepartment of Urology, Division of Neurourology and Pelvic Floor Reconstruction, University of Michigan Health System, Ann Arbor, MI, USAObjective: To review the literature on the surgical and nonsurgical treatment options for stress urinary incontinence in women, focusing exclusively on randomized clinical trials and high quality meta-analyses.Materials and methods: A computer-aided and manual search for published randomized controlled trials and high quality meta-analyses investigating both conservative and surgical treatment options for stress urinary incontinence. In the case of a treatment that is not studied in these formats large case series have been used.Results: Articles were reviewed and the results summarized on pelvic floor physical therapy, pharmacotherapy, bulking agents, and surgery (open and minimally invasive.Conclusion: There are numerous high quality studies in the literature. It can be difficult to make definitive conclusions on the most appropriate treatment options due to the variability in the outcomes used to define success in these articles. There is also a dire lack of studies evaluating and comparing the surgical options for patients with intrinsic sphincter deficiency.Keywords: stress urinary incontinence, conservative and surgical treatment

  4. Surgical Treatment of Female Stress Urinary Incontinence: AUA/SUFU Guideline.

    Science.gov (United States)

    Kobashi, Kathleen C; Albo, Michael E; Dmochowski, Roger R; Ginsberg, David A; Goldman, Howard B; Gomelsky, Alexander; Kraus, Stephen R; Sandhu, Jaspreet S; Shepler, Tracy; Treadwell, Jonathan R; Vasavada, Sandip; Lemack, Gary E

    2017-10-01

    Stress urinary incontinence is a common problem experienced by many women that can have a significant negative impact on the quality of life of those who suffer from the condition and potentially those friends and family members whose lives and activities may also be limited. A comprehensive search of the literature was performed by ECRI Institute. This search included articles published between January 2005 and December 2015 with an updated abstract search conducted through September 2016. When sufficient evidence existed, the body of evidence for a particular treatment was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions. The AUA (American Urological Association) and SUFU (Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction) have formulated an evidence-based guideline focused on the surgical treatment of female stress urinary incontinence in both index and non-index patients. The surgical options for the treatment of stress urinary incontinence continue to evolve; as such, this guideline and the associated algorithm aim to outline the currently available treatment techniques as well as the data associated with each treatment. Indeed, the Panel recognizes that this guideline will require continued literature review and updating as further knowledge regarding current and future options continues to grow. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  5. What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

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    Anderson Adriano Leal Freitas da Costa

    Full Text Available ABSTRACT BACKGROUND: Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP. METHODS: A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy. The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. CONCLUSIONS: This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.

  6. Comorbidity of functional urinary incontinence and encopresis: somatic and behavioral associations.

    Science.gov (United States)

    Von Gontard, Alexander; Hollmann, Elke

    2004-06-01

    Functional urinary incontinence and encopresis are common comorbid disorders in childhood. We analyze the specific somatic and behavioral symptoms associated with functional enuresis/urinary incontinence and encopresis when they occur together. A total of 167 consecutive children 5 to 10 year olds, with day and/or night wetting were examined prospectively with ultrasound, uroflowmetry, electroencephalography, the Child Behavior Checklist, Culture Fair Intelligence Test and ICD-10 child psychiatric diagnoses. The main findings for the comorbid group (20 patients) with wetting and soiling were a significantly higher rate of daytime incontinence and micturition problems, thickened bladder walls and pathological electroencephalography. There were higher, although not significant, rates of previous urinary tract infections, antibiotic prophylaxis, residual volume and abnormal uroflow curves in this group. Behaviorally, hyperkinetic syndromes, and emotional and conduct disorders (according to ICD-10) were more common. Of the 20 patients 65% had a Child Behavior Checklist total score (greater than 90th percentile) in the clinical range. The externalizing, internalizing, delinquent and anxious/depressed problem scales were also significantly higher. This risk group requires detailed assessment and specific treatment. In addition to the symptomatic treatment of the wetting and soiling, many of these children are in need of specific behavioral, psychotherapeutic and pharmacological treatment.

  7. What do Cochrane systematic reviews say about non-surgical interventions for urinary incontinence in women?

    Science.gov (United States)

    Costa, Anderson Adriano Leal Freitas da; Vasconcellos, Igor Martins; Pacheco, Rafael Leite; Bella, Zsuzsanna Ilona Katalin de Jármy Di; Riera, Rachel

    2018-01-01

    Urinary incontinence is a highly prevalent condition that impacts self-esteem and overall quality of life. Many non-surgical treatment options are available, ranging from pharmacological approaches to pelvic exercises. We aimed to summarize the available evidence regarding these non-surgical interventions. Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM-UNIFESP). A sensitive search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. We included 20 Cochrane systematic reviews: 4 assessing methods of vesical training, 3 evaluating pharmacological interventions, 4 studying pelvic floor muscle training approaches and 9 aimed at other alternatives (such as urethral injections, weighted vaginal cone use, acupuncture, biostimulation and radiofrequency therapy). The reviews found that the evidence regarding the benefits of these diverse interventions ranged in quality from low to high. This review included 20 Cochrane systematic reviews that provided evidence (of diverse quality) for non-pharmacological interventions for patients with urinary incontinence. Moderate to high quality of evidence was found favoring the use of pelvic floor muscle training among women with urinary incontinence. To establish solid conclusions for all the other comparisons, further studies of good methodological quality are needed.

  8. Lower Urinary Tract Urological Abnormalities and Urodynamic Findings of Physiological Urinary Incontinence Versus Non-mono Symptomatic Nocturnal Enuresis in Children.

    Science.gov (United States)

    Naseri, Mitra

    2014-03-01

    Although 98% of children attain daytime bladder control by three years of age, urinary incontinence is regarded physiological up to the fifth year of life. This study aimed to assess whether lower urinary tract urological abnormalities and abnormal urodynamic findings are infrequent in children with physiological urinary incontinence in contrast to those with non-monosymptomatic nocturnal enuresis (NMNE). During a three-year period (2007-2009), 66 neurologically normal children including 51 children (34 girls, 17 boys) older than five years of age with NMNE and intermittent daytime incontinence, and 15 children with physiological urinary incontinence (eight girls and seven boys) aged four to five years of age without any known urological abnormalities were enrolled in the study. Patients with neurologic deficits or known urological anomalies were excluded from the study. Kidney-bladder ultrasonography, voiding cystourethrography (VCUG), and urodynamic studies were performed to evaluate the anatomy of urinary tract and bladder function. Urinary tract infection was found in 23 (34.8%) children, 17 (33.3%) and 6 (40%) patients with NMNE and physiological urinary incontinence, respectively. Out of 48 patients who underwent VCUG, vesicoureteral reflux (VUR) was found in seven and eight children younger and older than five years of age, respectively. Abnormal urodynamic findings were reported in 5 (62.5%) of eight children younger than five-year-old, and 14 (63.6%) of 22 patients older than 5-year-old. VUR might be more frequent in children with physiological urinary incontinence than the normal population, and might be as common as NMNE with intermittent daytime incontinence.

  9. A review of the anatomy of the male continence mechanism and the cause of urinary incontinence after prostatectomy.

    Science.gov (United States)

    Moore, K N

    1999-03-01

    Radical prostatectomy was first described by Dr. Hugh Hampton Young in 1905 as a treatment for prostate cancer. Since that time, urinary incontinence has been reported as a significant postsurgical problem. With the expanding interest in continence therapy and an increase in the number of men undergoing prostate cancer surgery, there is a concomitant need for detailed consideration of the cause of postprostatectomy incontinence. Urinary leakage after radical prostatectomy is not, as traditionally thought, a simple case of stress urinary incontinence. Instead, it represents a complex, multifactorial problem that continues to challenge practitioners and researchers alike. An overview of the anatomy of the male continence mechanism is provided, followed by a discussion of the cause and risk factors implicated in postprostatectomy incontinence and suggestions for further research.

  10. Considering benefits and harms of duloxetine for treatment of stress urinary incontinence: a meta-analysis of clinical study reports

    DEFF Research Database (Denmark)

    Maund, Emma; Guski, Louise Schow; Gøtzsche, Peter C.

    2017-01-01

    BACKGROUND: The European Medicines Agency makes clinical study reports publicly available and publishes reasons for not approving applications for marketing authorization. Duloxetine has been approved in Europe for the treatment of stress urinary incontinence in women. The reported adverse effects...... of duloxetine include mental health problems and suicidality. We obtained clinical study reports from the European Medicines Agency concerning use of this drug for stress urinary incontinence. METHODS: We performed a meta-analysis of 4 randomized placebo-controlled trials of duloxetine (involving a total...... of 1913 patients) submitted to the European Medicines Agency for marketing approval for the indication of stress urinary incontinence in women. We used data from the clinical study reports (totalling 6870 pages and including individual patient data) to assess benefits (including frequency of incontinence...

  11. The effect of pelvic floor muscle training in urinary incontinent elderly women: a sistematic review

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    Raquel Henriques Jácomo

    Full Text Available Introduction The International Continence Society (ICS determines that the pelvic floor muscles training (PFMT is the first-choice treatment of urinary symptoms in women. Objective The aim of this study was to systematize randomized controlled clinical trials that address the effects of PFMT in the treatment of urinary symptoms in older women using objective outcome measures. Method Systematic review search was performed eletronic the following databases: Medline, Pubmed, Lilacs, PEDro and manual research conducted in the references of the studies. Were considered eligible women aged over 60 years who performed PFMT in isolation, without the involvement of another technique. The PFMT performed in clinic or at home, with or without the supervision of a therapist and with or without the use of biofeedback as an adjunct. Considered as outcome measures urodynamic studies, voiding diary that assesses daytime urinary frequency, nocturnal urinary frequency, urinary incontinence and exchange absorbent, and, finally, the absorbent test that quantifies loss urinary grams. The assessment of methodological quality of the studies was conducted by PEDro scale. Results Three studies were reviewed in full. Only one trial was rated high methodological quality. There was significant improvement in urinary symptoms after treatment proposed in the three selected studies. Conclusion Considering the studies available so far are weak the evidence for the use of PFMT in the treatment of urinary symptoms in elderly women.

  12. Comparison of Tension-free Vaginal Tape Versus Transobturator Tape in Women with Stress Urinary Incontinence

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    Zinat Ghanbari

    2007-06-01

    Full Text Available Objective: This study compared the Tension-free vaginal tape (TVT and Transobturator tape (TOT procedures for surgical treatment of stress urinary incontinence in women.Materials and methods: This prospective non randomized clinical trial was conducted in Vali-e-asr hospital from March 2001 to March 2005. A total of 71 patients with clinical and urodynamic diagnosis of Stress urinary incontinence (SUI were enrolled in the study. Patients were divided into two groups and underwent TVT or TOT procedures. Mean operation time, cure rate, post operative urinary retention, bleeding and infection were compared between two groups. SPSS software was used for statistical analysis. Chi square and fisher exact test calculated the effects of the nominal variables. Mean difference of quantitative variables were compared by student's T- test. P ≤0.05 was considered statistically significant. Results: There was no significant difference in mean time of operation and peri-operative complications among groups. Urinary retention was 13.8% (n=5 in the TVT group versus 2.8% (n=1 in TOT group (NS. The rates of cure (91.6% vs 91.4%, improvement (5.6% vs 8.6% and failure (2.8% vs 0 were similar for the TVT and TOT groups. The rate of hemorrhagic complications was 5.5% in TVT and 2.8% in TOT group (NS.Conclusion: TOT appears to be equally efficient to TVT for surgical treatment of stress urinary incontinence after 30 months follow-up.

  13. Diagnosis and management of urinary incontinence and functional fecal incontinence (encopresis) in children

    NARCIS (Netherlands)

    Nijman, Rien J. M.

    The ability to maintain normal continence for urine and stools is not achievable in all children by a certain age. Gaining control of urinary and fecal continence is a complex process, and not all steps and factors involved are fully understood. While normal development of anatomy and physiology are

  14. Protocol for the value of urodynamics prior to stress incontinence surgery (VUSIS) study: a multicenter randomized controlled trial to assess the cost effectiveness of urodynamics in women with symptoms of stress urinary incontinence in whom surgical treatment is considered

    NARCIS (Netherlands)

    van Leijsen, Sanne A. L.; Kluivers, Kirsten B.; Mol, Ben Willem J.; Broekhuis, Suzan R.; Milani, Fred L.; van der Vaart, C. Huub; Roovers, Jan-Paul W. R.; Bongers, Marlies Y.; den Boon, Jan; Spaans, Wilbert A.; de Leeuw, Jan Willem; Dietz, Viviane; Kleinjan, Jan H.; Brölmann, Hans A. M.; Roos, Eveline J.; Schaafstra, Judith; Heesakkers, John P. F. A.; Vierhout, Mark E.

    2009-01-01

    BACKGROUND: Stress urinary incontinence (SUI) is a common problem. In the Netherlands, yearly 64.000 new patients, of whom 96% are women, consult their general practitioner because of urinary incontinence. Approximately 7500 urodynamic evaluations and approximately 5000 operations for SUI are

  15. Protocol for the value of urodynamics prior to stress incontinence surgery (VUSIS) study: a multicenter randomized controlled trial to assess the cost effectiveness of urodynamics in women with symptoms of stress urinary incontinence in whom surgical treatment is considered.

    NARCIS (Netherlands)

    Leijsen, S.A.L. van; Kluivers, K.B.; Mol, B.W.; Broekhuis-Smallegoor, S.R.; Milani, F.L.; Vaart, C.H. van der; Roovers, J.P.; Bongers, M.Y.; Boon, J. den; Spaans, W.A.; Leeuw, J.W. de; Dietz, V.; Kleinjan, J.H.; Brolmann, H.A.M.; Roos, E.J.; Schaafstra, J.; Heesakkers, J.P.F.A.; Vierhout, M.E.

    2009-01-01

    BACKGROUND: Stress urinary incontinence (SUI) is a common problem. In the Netherlands, yearly 64.000 new patients, of whom 96% are women, consult their general practitioner because of urinary incontinence. Approximately 7500 urodynamic evaluations and approximately 5000 operations for SUI are

  16. Mean echogenicity and area of puborectalis muscle in women with stress urinary incontinence during pregnancy and after delivery

    NARCIS (Netherlands)

    van de Waarsenburg, Maria K; Withagen, Mariëlla I J; Grob, Anique T M; Schweitzer, Karlijn J; van Veelen, Greetje A; van der Vaart, Carl H

    2016-01-01

    INTRODUCTION AND HYPOTHESIS: Pregnancy and childbirth are risk factors for the development of stress urinary incontinence (SUI). Urinary continence depends on normal urethral support, which is provided by normal levator ani muscle function. Our objective was to compare mean echogenicity and the area

  17. Patient Characteristics Impacting Health State Index Scores, Measured by the EQ-5D of Females with Stress Urinary Incontinence Symptoms

    NARCIS (Netherlands)

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

    2010-01-01

    Objective: To describe the characteristics of women seeking treatment for symptoms of stress urinary incontinence (SUI) and to investigate the association of SUI symptoms with generic health-related quality of life (HRQoL) as measured by the EuroQol (EQ-5D) instrument. Methods: The Stress Urinary

  18. [Early versus delayed physiotherapy in the treatment of post-prostatectomy male urinary incontinence].

    Science.gov (United States)

    Tarcía Kahihara, Carina; Ferreira, Ubirajora; Nardi Pedro, Renato; Matheus, Wagner Eduardo; Rodrigues Netto, Nelson

    2006-10-01

    To analyze the importance of the starting time for pelvic floor physiotherapy in patients with post radical prostatectomy urinary incontinence. Between May 2003 and February 2004 18 patients with the diagnosis of post radical prostatectomy urinary incontinence underwent physiotherapy of the pelvic floor. Each patient received 12 sessions using kinesotherapy and electric stimulation on a weekly basis. Patients were divided into two groups: Group 1 included eight patients that started therapy within the first six months after surgery; Group 2 included 10 patients starting therapy after the sixth post operative month. All patients were evaluated by the pad test and number of incontinence pads per day. Evaluating pad tests before and after treatment, six patients in group 1 had a reduction of the amount of urine leak in comparison to seven patients in group 2. The statistical analysis showed significant differences before and after treatment for both groups (group 1: p = 0.028; group 2: p = 0.018). The evaluation of the number of pads showed: Group 1: all eight patients using pods had a reduction in the number of pads. Group 2: 5 of the eight patients using pads had a reduction and the other three continued using the same number. Statistical analysis comparing the number of pads per day before and after treatment showed a significant difference in group 1 (p = 0.004). There was no statistically significant difference in the number of pads per day before and after physiotherapy in group 2, although half of the patients showed a diminishment in the number of pads required after treatment. Results demonstrate that early indication of physiotherapy for the treatment of post radical prostatectomy urinary incontinence is better than delayed treatment. New works may be developed in the future to confirm our results.

  19. Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence

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    Míriam Raquel Diniz Zanetti

    Full Text Available CONTEXT AND OBJECTIVE: Urinary incontinence is a public health problem that affects more than 200 million people worldwide. Stress incontinence is the most prevalent type. Pelvic floor muscle exercises have been used for treating it, although there is no consensus regarding their application. The aim of this study was to compare the results from treating female stress urinary incontinence with pelvic floor muscle exercises with or without physiotherapist supervision. DESIGN AND SETTING: This was a randomized, prospective, controlled trial in the Urogynecology and Vaginal Surgery Sector, Universidade Federal de São Paulo. METHODS: Forty-four women were randomized to be treated for stress urinary incontinence with pelvic floor exercises for three consecutive months, into two groups: one with and the other without physiotherapist supervision. They were evaluated before and after treatment using a quality-of-life questionnaire, pad test, micturition diary and subjective evaluation. Descriptive analysis was used to evaluate the population. The homogeneity of the two groups was evaluated using the Kruskal-Wallis and Chi-squared tests. The success of the two groups after treatment was evaluated using the Wilcoxon test. RESULTS: The supervised group showed statistically greater improvement in the pad test, micturition diary and quality of life than did the control group. In the subjective evaluation, only 23.8% of the control group patients were satised with their treatment. In the supervised group, 66.8% of patients did not want any other treatment. CONCLUSION: Supervised pelvic floor muscle exercises presented better results in objective and subjective evaluations than did unsupervised exercises.

  20. The Impact of Stress Urinary Incontinence on Individual Components of Quality of Life in Malaysian Women.

    Science.gov (United States)

    Lim, Renly; Liong, Men Long; Leong, Wing Seng; Lau, Yong Khee; Khan, Nurzalina Abdul Karim; Yuen, Kah Hay

    2018-02-01

    To assess the impact of stress urinary incontinence (SUI) on individual components of quality of life (QoL) using both condition-specific and generic questionnaires, and to compare the results of the 2 instruments with a control group. Women with or without SUI aged ≥21 years old were recruited. Subjects completed the International Consultation of Incontinence-Urinary Incontinence Short Form (ICIQ-UI-SF), International Consultation of Incontinence-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol), and EQ-5D questionnaires. A total of 120 women with SUI and 145 controls participated. The ICIQ-LUTSqol total score (mean ± standard deviation) was significantly higher in the SUI group (38.96 ± 10.28) compared with the control group (20.78 ± 2.73) (P women with SUI affected "moderately" or "a lot." When measured using the EQ-5D questionnaire, there were significantly higher percentages of patients with SUI who had problems with usual activities, pain or discomfort, and anxiety or depression (P Women suffering from SUI have significantly poorer QoL compared with continent women when measured using both condition-specific and generic QoL measures. Clinicians should pay closer attention to the impact of SUI on individual components of QoL, particularly limitations on physical activities and jobs, which were the 2 most impairing and frequently reported components of QoL. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Urinary Incontinency in Elderly Women and the Potential Risk Factors: A Cohort Study among the Elderly Women of Amirkola

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    E Moudi

    2017-02-01

    Full Text Available BACKGROUND AND OBJECTIVE: Urinary incontinence is a common health problem among elderly population, particularly elderly women, and it is necessary to identify the different risk factors that cause urinary incontinence. The present study was designed to assess this problem among elderly women in Babol and the risk factors associated with it. METHODS: In this cross-sectional study, 590 elderly women over 60 years old in Amirkola were studied using census method. The required data were collected using standard checklists and questionnaires. Any form of involuntary withdrawal of urine, wetting the pad or underwear was considered urinary incontinence. FINDINGS: In this study, the mean age of subjects was 68.2 ± 6.8 years and 194 out of 590 women (32.9% had urinary incontinence. The marital status (OR: 0.64 (CI-95% =0.42-0.98, p=0.04, constipation history (OR: 1.63 (CI-95% =0.11-2.39, p=0.01 and use of corticosteroid drugs (OR: 1.7 (CI-95% =1.01-2.95, p=0.05 were directly related to urinary incontinence after matching with other risk factors. However, urinary incontinence in elderly women was not related to factors such as age, obesity, education, number of children, chronic diseases like diabetes, blood pressure and respiratory disorders. CONCLUSION: According to the results of this study, one third of elderly women in Babol suffer from urinary incontinence and unmarriedness, constipation history, and use of corticosteroid drugs increase the possibility of this condition, which necessitates the need for more attention to this problem and its risk factors that have significant emotional effects on elderly women.

  2. Urinary incontinence and quality of life of women living in nursing homes in the Mediterranean region of Turkey.

    Science.gov (United States)

    Göral Türkcü, Sinem; Kukulu, Kamile

    2017-11-01

    This study was conducted to determine the effect of urinary incontinence (UI) on the quality of life of women living in nursing homes in the Mediterranean region of Turkey. The study was conducted on 95 women living in nursing homes in the Mediterranean region. Data were collected from a questionnaire on sociodemographic characteristics, the Urinary Incontinence Quality of Life Scale, the Index of Activities of Daily Living, and the International Consultation on Incontinence Questionnaire Short Form. The quality of life of women who did not consider UI a health problem was significantly higher than that of those who considered otherwise. Mixed UI was the most common UI type among the women living in nursing homes, with a rate of 31.7%. According to the overall mean scores on the Urinary Incontinence Quality of Life Scale, quality of life was the most affected among women who had nocturnal incontinence. Quality of life was affected from most to least by the mixed type, stress type, and urge type of incontinence. Early diagnosis and treatment of UI could be improved if health professionals, who have a unique role in changing the perception of society, offered training to women experiencing incontinence. Identifying this problem and determining and preventing the risk factors are important for enhancing women's quality of life. © 2017 Japanese Psychogeriatric Society.

  3. 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

  4. Three-dimensional translabial ultrasound assessment of urethral supports and the urethral sphincter complex in stress urinary incontinence.

    Science.gov (United States)

    Cassadó Garriga, Jordi; Pessarrodona Isern, Antoni; Rodríguez Carballeira, Monica; Pallarols Badia, Mar; Moya Del Corral, Manuela; Valls Esteve, Marta; Huguet Galofré, Eva

    2017-09-01

    The pathophysiological mechanism of incontinence is multifactorial. We evaluated the role of 3D-4D ultrasound in the assessment of the fascial supports of the urethra and the urethral sphincter complex (USC) for diagnosing stress urinary incontinence. Observational case-control study in women with and without stress urinary incontinence attending a urogynecology service and a general gynecology service. All women were interviewed, examined, and classified according to the Pelvic Organ Prolapse Quantification (POP-Q) and underwent a 3D-4D translabial ultrasound. Fascial supports of the urethra were assessed by tomographic ultrasound and were considered to be intact or absent if it was possible to identify them at eight levels on each side, urethral mobility was assessed on maximal Valsalva in sagittal section and the length and volume of the USC at rest and on maximal Valsalva were determined using the Virtual Organ Computer-aided Analysis (VOCAL) program. Variables were compared between continent and incontinent women. A total of 173 women were examined, 78 continent and 95 incontinent. There was a significant difference in urethral mobility between continent and incontinent women (12.82 mm vs. 21.85 mm, P rest was significantly shorter (P continent and incontinent women. However, the length of the USC at rest was shorter and urethral mobility was higher in incontinent women. Neurourol. Urodynam. 9999:XX-XX, 2016. © 2016 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  5. Adynamic Graciloplasty With a Pedicled Gracilis Muscle Flap Wrapped Around Bulbar Urethra for Treatment of Male Acquired Urinary Incontinence.

    Science.gov (United States)

    Guo, Hailin; Sa, Yinglong; Xu, Yuemin; Wang, Lin; Fei, Xiaofang

    2016-05-01

    To evaluate the efficacy of adynamic gracilis urethral myoplasty with a pedicled gracilis muscle flap wrapped around bulbar urethra for treatment of male acquired urinary incontinence. Twenty-four patients with acquired urinary incontinence (8 after radical prostatectomy, 7 after transurethral resection of the prostate, and 9 after posterior urethroplasty) were included in our study. Eighteen of these patients (75.0%) had mild to moderate urinary incontinence, and 6 (25.0%) had severe urinary incontinence. All patients received adynamic gracilis urethral myoplasty with a pedicled gracilis muscle flap wrapped around bulbar urethra and had a close follow-up. The mean postoperative maximum urethral pressure after the gracilis muscle wrapped around bulbar urethra was significantly higher than that of the preoperative measurements (P urethra can raise the urethral pressure. Adynamic graciloplasty with a pedicled gracilis muscle flap wrapped around bulbar urethra is a safe and effective surgical option in the treatment of male patients with mild to moderate incontinence, but is not suitable for severe incontinence. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Factors involved in the persistence of stress urinary incontinence from pregnancy to 2 years post partum.

    Science.gov (United States)

    Arrue, Miren; Diez-Itza, Irene; Ibañez, Larraitz; Paredes, Jone; Murgiondo, Arantzazu; Sarasqueta, Cristina

    2011-12-01

    To identify factors involved in the persistence of stress urinary incontinence (SUI) from pregnancy to 2 years post partum. In a longitudinal study at Donostia Hospital, San Sebastián, Spain, 458 primigravid women were recruited from April to October 2007. SUI was diagnosed via the 2002 International Continence Society definition. Severity was assessed via the Incontinence Severity Index, and impact on quality of life via the International Consultation on Incontinence Questionnaire. Means (Student t test and analysis of variance) and percentages (χ(2) and Fisher exact tests) were compared, and multiple logistic regression analysis was performed with variables that were significant or close to significant in a univariate analysis (Ppregnancy. Incontinence severity was slight or moderate in most cases and the impact on quality of life was low. A higher body mass index (BMI) in pregnant women at term was the only factor found to be associated with persistent SUI (odds ratio 1.19; 95% confidence interval 1.08-1.32). Higher BMI in pregnant women at term was an independent risk factor for the persistence of SUI from pregnancy to 2 years post partum. Copyright © 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors.

    Science.gov (United States)

    Brown, Stephanie J; Donath, Susan; MacArthur, Christine; McDonald, Ellie A; Krastev, Ann H

    2010-02-01

    Few studies have examined associations of prepregnancy urinary incontinence (UI). Multicentre prospective pregnancy cohort study (n = 1,507) using standardised measures to assess frequency and severity of UI. Prevalence of UI increased from 10.8% in the 12 months before the index pregnancy to 55.9% in the third trimester. Stress incontinence (36.9%) and mixed incontinence (13.1%) were more common during pregnancy than urge incontinence alone (5.9%). UI before pregnancy was associated with childhood enuresis (adjusted odds ratio (AdjOR) = 2.4, 95% confidence interval (CI) 1.6-3.4), higher maternal body mass index (AdjOR = 2.3, 95% CI 1.4-3.8), and previous miscarriages or terminations (AdjOR = 1.6, 95% CI 1.1-2.3). The strongest predictor of incident UI in pregnancy was occasional leakage (less than once a month) before pregnancy (AdjOR = 3.6, 95% CI 2.8-4.7). Further research is needed to elucidate the complex interplay of prepregnancy and pregnancy-related factors in the aetiology of UI in nulliparous women.

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

    Science.gov (United States)

    Bernards, Arnold T M; Berghmans, Bary C M; Slieker-Ten Hove, Marijke C Ph; Staal, J Bart; de Bie, Rob A; Hendriks, Erik J M

    2014-02-01

    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 practice guidelines (CPGs) for physiotherapy management of patients with stress urinary incontinence (SUI) in order to support physiotherapists in decision making and improving efficacy and uniformity of care. A computerized literature search of relevant databases was performed to search for information regarding etiology, prognosis, and physiotherapy assessment and management in patients with SUI. Where no evidence was available, recommendations were based on consensus. Clinical application of CPGs and feasibility were reviewed. The diagnostic process consists of systematic history taking and physical examination supported by reliable and valid assessment tools to determine physiological potential for recovery. Therapy is related to different problem categories. SUI treatment is generally based on pelvic floor muscle exercises combined with patient education and counseling. An important strategy is to reduce prevalent SUI by reducing influencing risk factors. Scientific evidence supporting assessment and management of SUI is strong. The CPGs reflect the current state of knowledge of effective and tailor-made intervention in SUI patients.

  9. Reconstructive surgery for male stress urinary incontinence: Experiences using the ATOMS system at a single center

    Directory of Open Access Journals (Sweden)

    Krause, Jens

    2014-12-01

    Full Text Available Objective: To propose possible success-driven solutions for problem and complication rates encountered with the ATOMS sling system, based on first-hand experience; and to provide possible actual alternative scenarios for the treatment of male . Patients and methods: During the defined period (between 4/2010 and 04/2014, 36 patients received ATOMS system implants at our clinic. We collected pre- and post-operative evaluation data using the International Consultation on Incontinence Questionnaire Short Form (ICIQ SF. As an expansion of the questionnaire, we added questions about post-operative perineal pain, the general satisfaction with the results of the intervention and willingness to recommend the operation to a best friend. Results: Our data shows a relatively high explantation rate, but a surprisingly high patient satisfaction rate. Explantation was required mainly due to late onset infections or other symptomatic factors. Compared to other studies early onset infections were rare. Conclusion: A non-invasive, uncomplicated adjustable system to alleviate male stress urinary incontinence remains a challenge. Although there are various systems available for the treatment of male stress urinary incontinence, it seems that despite the advantages of the ATOMS system, an artificial sphincter system may pose more advantages based on our experience, understanding and knowledge of its well-documented long-term solutions and problems.

  10. Urodynamic changes associated with successful stress urinary incontinence surgery: is a little tension a good thing?

    Science.gov (United States)

    Kraus, Stephen R; Lemack, Gary E; Sirls, Larry T; Chai, Toby C; Brubaker, Linda; Albo, Michael; Leng, Wendy W; Lloyd, L Keith; Norton, Peggy; Litman, Heather J

    2011-12-01

    To identify urodynamic changes that correlate with successful outcomes after stress urinary incontinence (SUI) surgery. Six-hundred fifty-five women were randomized to Burch colposuspension or autologous fascial sling as part of the multicenter Stress Incontinence Surgical Treatment Efficacy Trial. Preoperatively and 24 months after surgery, participants underwent standardized urodynamic testing that included noninvasive uroflowmetry, cystometrogram, and pressure flow studies. Changes in urodynamic parameters were correlated to a successful outcome, defined a priori as (1) negative pad test; (2) no urinary incontinence on 3-day diary; (3) negative cough and Valsalva stress test; (4) no self-reported SUI symptoms on the Medical, Epidemiologic and Social Aspects of Aging Questionnaire; and (5) no re-treatment for SUI. Subjects who met criteria for surgical success showed a greater relative increase in mean Pdet@Qmax (baseline vs 24 months) than women who were considered surgical failures (P = .008). Although a trend suggested an association between greater increases in bladder outlet obstruction index and outcome success, this was not statistically significant. Other urodynamic variables, such as maximum uroflow, bladder compliance, and the presence of preoperative or de novo detrusor overactivity did not differ with respect to outcome status. Successful outcomes in both surgical groups (Burch and sling) were associated with higher voiding pressures relative to preoperative baseline values. However, concomitant changes in other urodynamic voiding parameters were not significantly associated with outcome. Copyright © 2011 Elsevier Inc. All rights reserved.

  11. Surgical treatment of female stress urinary incontinence with the Gynecare TVT Secur™ System – preliminary report

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    Włodzimierz Baranowski

    2010-02-01

    Full Text Available Introduction: Sling procedures were first introduced over 100 years ago in the treatment of stress urinaryincontinence. Since then they have evolved to become less invasive and safer. The sling procedure using theGynecare TVT Secur™ system is a new therapeutic option for women with stress urinary incontinence.Objectives: To evaluate the efficacy and safety of Gynecare TVT Secur™ in the surgical treatment of stressurinary incontinence in women. Material and methods: The study comprised consecutive female patients admitted to the Department ofGynaecology and Gynaecological Oncology of the Military Institute of Health Services in Warsaw, Poland, whohad been qualified for surgical treatment of stress urinary incontinence on the basis of physical signs and symptomsand the findings of a urodynamic study. The procedure was performed using the Gynecare TVT Secur™system with tapes introduced in an H- or U-shape mode. Results: Between October 2006 and September 2009, 77 sling procedures using the Gynecare TVT Secur™system were performed in women with stress urinary incontinence. Their mean age was 55.1 (30-76 years, meanBMI 28.5 (20.2-43.8 kg/m2. Sixty-nine implants were positioned in H-shape mode, 8 in U-shape mode. Fortyninewomen (63.6% were menopausal, 14 (18.2% previously had three or more natural deliveries, 13 (16.8%had a history of gynaecological surgeries. Thirty-one procedures were performed under general anaesthesia and46 under local anaesthesia. The mean duration of the surgery was 9 (4-42 minutes. It was possible to dischargefifty-seven (74% women on the day of the surgery. Urine retention was observed only in 1 (1.7% woman. Noother complications were recorded. Conclusions: The surgical treatment of urinary incontinence with sling procedures using the Gynecare TVTSecur™ system shows good immediate efficacy and safety. Considering this as well as the short duration ofthe procedure and its good tolerability under local anaesthesia, use

  12. Prevalence and risk factors of urinary incontinence among Chinese women in Shanghai.

    Science.gov (United States)

    Liu, Bo; Wang, Lei; Huang, Sheng-Song; Wu, Qiang; Wu, Deng-Long

    2014-01-01

    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. 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, menstruation, and several demographic variables was also collected. Data were subsequently analyzed using McNemar's test, univariate analysis, multinomial logistic regression models, and binary logistic regression models. The prevalence rate of UI was estimated to be 23.3%. The rate of stress UI (SUI) was 14.0% (761/5433), which was more prevalent than the rate of urgency UI (UUI) and mixed UI (MUI), which were 3.0% (164/5433) and 6.3% (341/5433), respectively. The risk factors associated with developing UI included aging, lack of education, poor living environment (specifically in the rural area), intense manual labor, the absence of physical exercise, hyperlipemia, diabetes, nocturia, consumption of greasy food, divorce or widowing, chronic pelvic pain (CPP), pelvic organ prolapse (POP), frequent urinary tract infection, and vaginal delivery without episiotomy. We also observed that most Chinese women were not aware of UI, which prevented them from seeking early treatment. Urinary incontinence is a common disorder among Chinese women in Shanghai, and many risk factors contribute to the development of UI. Most Chinese women were not aware of UI, which prevented them from seeking early treatment.

  13. Pelvic floor muscle training for urgency urinary incontinence in women: a systematic review.

    Science.gov (United States)

    Greer, Joy A; Smith, Ariana L; Arya, Lily A

    2012-06-01

    The objective of this study is to evaluate the effectiveness of existing physiotherapy modalities for the treatment of urge urinary incontinence (UUI). A systematic review was performed for primary studies of physiotherapy techniques for UUI published in English between 1996 and August 2010 in major electronic databases. Only randomized clinical trials that reported outcomes separately for women with UUI were included. Outcomes assessed were reduction in UUI, urinary frequency, and nocturia. Data from 13 full-text trials including the modalities of pelvic floor muscles exercises with or without biofeedback, vaginal electrical stimulation, magnetic stimulation, and vaginal cones were analyzed. The methodologic quality of these trials was fair. Significant improvement in UUI was reported for all physiotherapy techniques except vaginal cone therapy. There are insufficient data to determine if pelvic physiotherapy improves urinary frequency or nocturia. Evidence suggests that physiotherapy techniques may be beneficial for the treatment of UUI.

  14. A pilot randomized control trial to evaluate pelvic floor muscle training for urinary incontinence among gynecologic cancer survivors.

    Science.gov (United States)

    Rutledge, Teresa L; Rogers, Rebecca; Lee, Sang-Joon; Muller, Carolyn Y

    2014-01-01

    We previously reported high rates of urinary incontinence among gynecologic cancer survivors and aimed to evaluate the effectiveness of a simple intervention for treatment of urinary incontinence in this population. We recruited 40 gynecologic cancer survivors who reported urinary incontinence on a validated questionnaire. Women were randomized to either pelvic floor muscle training/behavioral therapy (treatment group) or usual care (control group). The primary outcome measure, assessed at 12 weeks post intervention, was a 40% difference in the validated Patient Global Impression of Improvement (PGI-I) score. Fisher's exact test was used to identify differences between groups for frequency data; two-sample t-test was conducted for continuous measurements. Mean age of this cohort was 57 (range: 37-79). The majority of the survivors had uterine cancer (60%), 18% had received radiation therapy, 95% had received surgical therapy, and 35% had received chemotherapy. At three months, 80% of the treatment and 40% of the control group reported that their urinary incontinence was "much better" or "very much better" as evaluated by the Patient Global Impression of Improvement scale (p=0.02). Brink's scores were significantly improved in the treatment group as compared to those of the controls (pgynecologic cancer survivors, it is often under-assessed and undertreated. We found a simple intervention that included pelvic floor muscle training and behavioral therapy, which significantly improved cancer survivor's urinary incontinence. © 2013.

  15. Adjustable mini-sling compared to conventional mid-urethral slings in women with urinary incontinence

    DEFF Research Database (Denmark)

    Rudnicki, Martin; von Bothmer-Ostling, Katarina; Holstad, Anja

    2017-01-01

    INTRODUCTION: The primary aim was to compare the objective and subjective outcomes and short-term complication rates of an adjustable single-incision mini-sling (SIMS) versus standard mid-urethral slings (SMUS). The secondary aim was reporting pain perception and complications at one-year follow......-up. MATERIAL AND METHODS: The study was designed as a multicenter prospective randomized trial where women were included by eight centers in Denmark, Norway and Sweden. The trial was registered at ClinicalTrials. gov: NCT01754558. A total of 305 women less than 60 years old with verified stress urinary...... incontinence were included. All women were randomized to SIMS (Ajust(®) ; N=155) or SMUS (TVT, TVT-O or TOT; N=150) and were evaluated by stress test and bladder diary before and after surgery and symptoms related to incontinence using ICIQ-SF, PISQ-12 and PGI-S and PGI-I. Objective cure was defined...

  16. Clarifying the Role of Urodynamics in the Preoperative Evaluation of Stress Urinary Incontinence

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    Sophie G. Fletcher

    2008-01-01

    Full Text Available It has not yet been definitively demonstrated that preoperative evaluation of women with stress urinary incontinence (SUI with urodynamic testing (UDS enhances surgical outcomes. Nonetheless, UDS is frequently utilized in the assessment of women with SUI in the hopes that results will shed light on preoperative risk factors for failure or postoperative voiding dysfunction. Poorer outcomes for stress incontinence surgery are primarily attributed to intrinsic sphincter deficiency (ISD, detrusor overactivity (DO, and voiding dysfunction. The ability of UDS to identify and characterize those parameters reliably remains under investigation. Furthermore, debate continues regarding the association of each of those factors with postoperative success for various SUI procedures. Since UDS is invasive, costly, and not always available, it is imperative that its benefit be carefully explored. In this review, we discuss the value of UDS in identifying risk factors for poor outcome and how those risk factors are associated with surgical failure.

  17. Injectable bulking agents for urinary incontinence after radical prostaectomy, mimicking local recurrence: A case report

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    Yoon, Je Hong; Ahn, Sung Eun; Moon, Sung Kyoung; Park, Seong Jin; Lim, Joo Won; Lee, Sun Ju [Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul (Korea, Republic of)

    2017-02-15

    Periurethral bulking agent injection (or transurethral submucosal injection) is a comparatively less invasive procedure for the treatment of stress urinary incontinence in patients who develop incontinence after radical prostatectomy, and who are more frequently being treated with transurethral submucosal injection. However, as the radiologic findings of bulking agents are not very well known, they can be mistaken for local recurrence in prostate cancer patients who have undergone prostatectomy. Unlike some of the literatures, in which the radiologic features of collagen injections have been reported, the radiologic findings of silicone injections are yet to be determined. Thus, it is our intention to report this case along with the literature review as the authors have experienced an actual case of a silicone injection mistaken as local recurrence.

  18. TOT versus TVT – mesh surgical treatment in stress urinary incontinence

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    Ovidiu Bratu

    2015-12-01

    Full Text Available Introduction: Stress urinary incontinence is a highly debilitating condition, with an important impact over the quality of life. When the conservative treatment fails, the surgical treatment is a viable solution. Minimally invasive sling procedures have become the gold standard of surgical management for stress urinary incontinence (SUI in women. Material and methods: The study was conducted on 68 patients with stress urinary incontinence, 52 have undergone the retropubic tension-free vaginal tape and 16 patients were operated using the transobturator tape procedure. All the patients were evaluated before the operation and the indication of the surgical treatment was established on the basis of physical examination (all the patients had positive cough test, abdominal ultrasound (to determine postvoid residual urine volume, urinalysis and urine culture (the majority of the patients have had before the operation recurrent urinary tract infections. Results: The satisfaction was similar in both groups of patients, with an average satisfaction rate of 91% for TVT and 86% for the patients who have undergone TOT procedure. The patients were in a proportion of 78,9% at menopause, with an average number of natural births of 1.9 and a mean BMI of 28.2. Regarding the surgical duration, this has varied between 20 and 40 minutes, being higher in the TVT cases (up to 5-7 minutes longer than TOT, because cystoscopy was performed during the operation to verify if the bladder was perforated or not. The urethral catheter was removed immediately after the operation in the case of the TOT procedure and in the day after the operation for the patients who have undergone TVT procedures (all of these patients associated genital prolapse. The hospitalization time was 3 days. We haven’t encountered significant intraoperative and postoperative complications. Conclusions: The TOT and TVT procedures have proven to be highly effective and safe methods in the treatment of

  19. Use of antibiotics for urinary tract infection in women undergoing surgery for urinary incontinence - a cohort study

    DEFF Research Database (Denmark)

    Sørensen, Rikke Guldberg; Kesmodel, Ulrik Schiøler; Brostrøm, Søren

    2014-01-01

    OBJECTIVE: To describe the use of antibiotics for urinary tract infection (UTI) before and after surgery for urinary incontinence (UI); and for those with use of antibiotics before surgery, to estimate the risk of treatment for a postoperative UTI, relative to those without use of antibiotics...... from the date of surgery were extracted from a prescription database. MAIN OUTCOME MEASURES: Use of antibiotics for UTI in relation to UI surgery, and the risk of being a postoperative user of antibiotics for UTI among preoperative users. RESULTS: A total of 2151 women had a primary surgical procedure...... for UI; of these 496 (23.1%) were preoperative users of antibiotics for UTI. Among preoperative users, 129 (26%) and 215 (43.3%) also redeemed prescriptions of antibiotics for UTI within 0-60 and 61-365 days after surgery, respectively. Among preoperative non-users, 182 (11.0%) and 235 (14.2%) redeemed...

  20. The Adjustable Transobturator Male System in Stress Urinary Incontinence After Transurethral Resection of the Prostate.

    Science.gov (United States)

    Friedl, Alexander; Schneeweiss, Jenifer; Stangl, Kathrin; Mühlstädt, Sandra; Zachoval, Roman; Hruby, Stephan; Gründler, Therese; Kivaranovic, Danijel; Fornara, Paolo; Lusuardi, Lukas; Brössner, Clemens

    2017-11-01

    To investigate the efficacy and safety of the Adjustable Transobturator Male System (ATOMS) in men with stress urinary incontinence after transurethral resection of the prostate (TURP). From a large international prospectively administrated ATOMS register, we identified 49 patients with an ATOMS device as a result of persistent stress urinary incontinence after TURP. For evaluation, the men were divided into standard transurethral resection of the prostate (sTURP) and palliative transurethral resection of the prostate (pTURP) in radiated patients. Baseline and follow-up measurements included continence parameters, urodynamics, quality-of-life surveys (Patient Global Impression-Improvement and International Consultation on Incontinence Questionnaire-Short Form), and pain ratings. The dry rate (0-1 security pad/vs 10%, P = .0171) and infection was the most common side effect (50%) observed. Neither intraoperative nor Clavien-Dindo 4 and 5 adverse events were recorded. In sTURP and pTURP, the median daily pad count and the pad test improved significantly (all P <.001), and quality-of-life parameters shifted to a high satisfaction level (P <.001 and P = .001). Urodynamics remained unchanged and postoperative pain was not an issue. The ATOMS device shows promising treatment outcomes in patients after TURP and a similar efficacy as in postprostatectomy incontinence. There is no difference in continence outcome between sTURP and pTURP; however, a higher removal rate was found after pTURP, which may be important for patient counseling. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Specific obstetrical risk factors for urinary versus anal incontinence 4 years after first delivery.

    Science.gov (United States)

    Fritel, X; Khoshnood, B; Fauconnier, A

    2013-09-01

    Delivery can be complicated by urinary or anal incontinence (UI or AI). We hypothesized that the mechanisms of injury may differ for UI and AI. Hence, obstetrical risk factors may be specific for different types of incontinence. Data on maternal characteristics were collected at first delivery. Data on incontinence were obtained by a questionnaire completed by 627 women 4 years after first delivery. UI was defined by "Do you have involuntary loss of urine" and AI by "Do you have involuntary loss of flatus or stool". A multinomial logistic regression analysis was conducted to assess risk factors for UI only, AI only, and UI+AI. Twenty-two percent of women reported UI only, 6.5% AI only, and 6.5% both. Risk factors associated with UI only were age (at first delivery)≥ 30 (OR 2.27 [95% CI 1.47-3.49]), pre-existing UI (6.44 [2.19-19.0]) and pregnancy UI (3.64 [2.25-5.91]). Risk factors associated with AI only were length of the second active stage> 20minutes (2.86 [1.15-7.13]) and third degree perineal tear (20.9 [1.73-252]). Significant predictors of UI+AI were age ≥ 30 (2.65 [1.29-5.46]), no epidural (4.29 [1.65-11.1]), third degree perineal tear (20.0 [1.28-314]), and UI before pregnancy (32.9 [9.00-120]). Cesarean delivery was not significantly associated with UI, AI, or UI+AI, although for all three outcomes, the adjusted odds ratios were substantially less than one. We found specific associations between obstetrical risk factors and urinary versus anal incontinence 4 years after first delivery. Our results are consistent with the hypothesis that the underlying mechanisms of injury differ for UI and AI. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  2. Clinical impact of and contributing factors to urinary incontinence in women 5 years after first delivery.

    Science.gov (United States)

    Liang, Ching-Chung; Wu, Ming-Ping; Lin, Shu-Jen; Lin, Yu-Jr; Chang, Shuenn-Dhy; Wang, Hui-Hsuan

    2013-01-01

    This study was conducted to investigate the prevalence of and contributing factors to urinary incontinence (UI) in women 5 years after their first birth and to evaluate the associations of UI with delivery mode and quality of life. Between 2005 July and 2006 March, primiparous women who delivered at term in a tertiary hospital were recruited into this cohort study. Immediately postpartum, the women completed a structured urogynecological questionnaire regarding lower urinary tract symptoms. Then the same urogynecological questionnaire, the Incontinence Impact Questionnaire (IIQ-7), and the Urinary Distress Inventory (UDI-6) were mailed to them 5 years later to follow up on UI. Three hundred and twelve women responding to the mailed questionnaires were included in the analyses. The prevalence 5 years after first delivery of stress (SUI) and urge (UUI) UI were 43.6 % and 19.2 %, respectively. Women with UI during their first pregnancy were more likely to develop UI 5 years postpartum than those without it; women who delivered their first child vaginally had a greater incidence of UI than those having cesarean birth; UUI in women following cesarean delivery more negatively impacted emotional health than it did following vaginal birth, whereas the impact of SUI did not significantly differ between delivery groups. UI during the first pregnancy and vaginal delivery in primiparous women may predict an increased risk of having UI 5 years after delivery. UUI adversely affected women's emotional health, especially in those undergoing cesarean section.

  3. Periurethral constrictor: late results of the treatment of post prostatectomy urinary incontinence

    Directory of Open Access Journals (Sweden)

    Roberto S. Lima

    2011-08-01

    Full Text Available OBJECTIVES: We evaluated retrospectively, the long-term outcome of patients with post-prostatectomy urinary incontinence (PPUI after placement of the Periurethral Constrictor (PUC. MATERIALS AND METHODS: Fifty-six men with severe PPUI were studied, with a mean age of 68.5 years old. Fifty-one men had PPUI due to radical surgery having the device placed around the bulbous urethra, and five individuals with benign prostatic hypertrophy (BPH had placement around the bladder neck. The mean follow-up was 82.2 months. RESULTS: Twenty-two patients (39.28% became continent (0 to 1 pad a day and 34 (60.72% were incontinent. Complications were as follows: urethral erosion in 15 (26.78%; mechanical malfunction in 2 (3.5%; infection in 2 (3.5%; urinary fistula in 1 (1.7%; Urinary tract infection1 (1.7%. Twenty-three patients needed to have the device removed (41.07%. Success rate (continent me was 30.35%. CONCLUSION: In the present series the PUC was not effective for the treatment of severe PPUI in the long-term follow-up.

  4. Muscle-Derived Cells for Treatment of Iatrogenic Sphincter Damage and Urinary Incontinence in Men

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    H. Gerullis

    2012-01-01

    Full Text Available Introduction. Aim of this study was to assess the safety and efficacy of injection of autologous muscle-derived cells into the urinary sphincter for treatment of postprostatectomy urinary incontinence in men and to characterize the injected cells prior to transplantation. Methods. 222 male patients with stress urinary incontinence and sphincter damage after uroloical procedures were treated with transurethral injection of autologous muscle-derived cells. The transplanted cells were investigated after cultivation and prior to application by immunocytochemistry using different markers of myogenic differentiation. Feasibility and functionality assessment was achieved with a follow-up of at least 12 months. Results. Follow-up was at least 12 months. Of the 222 treated patients, 120 responded to therapy of whom 26 patients (12% were continent, and 94 patients (42% showed improvement. In 102 (46% patients, the therapy was ineffective. Clinical improvement was observed on average 4.7 months after transplantation and continued in all improved patients. The cells injected into the sphincter were at least ~50% of myogenic origin and representative for early stages of muscle cell differentiation. Conclusions. Transurethral injection of muscle-derived cells into the damaged urethral sphincter of male patients is a safe procedure. Transplanted cells represent different phases of myogenic differentiation.

  5. A 20-year study of persistence of lower urinary tract symptoms and urinary incontinence in young women treated in childhood.

    Science.gov (United States)

    Petrangeli, F; Capitanucci, M L; Marciano, A; Mosiello, G; Alvaro, R; Zaccara, A; Finazzi-Agro, E; De Gennaro, M

    2014-06-01

    To determine whether urinary incontinence (UI) and lower urinary tract symptoms (LUTS) persist over years, patients treated for UI and LUTS in childhood were re-evaluated in adulthood. Forty-seven women (cases) treated in childhood for daytime UI/LUTS (group A) and nocturnal enuresis (group B) self-completed (average age: 24.89 ± 3.5 years) the International Consultation on Incontinence Questionnaire for Female with LUTS (ICIQ-FLUTS). ICIQ-FLUTS was self-administered to 111 healthy women (average age: 23 ± 5.1 years) from a nursing school as a control group. Data obtained from ICIQ-FLUTS and quality of life (QoL) score (0-10) were compared (Fisher's exact test) between patients and controls, and between group A (n = 28) and group B (n = 19). Prevalence of LUTS was higher in patients than in controls. The difference between patients and controls was statistically significant (p = 0.0001) for UI (34% vs. 7%) and feeling of incomplete bladder emptying (49% vs. 28%). QoL score was >5 in 59% of patients and 1% of controls (p = 0.0001). No significant differences were found between groups A and B. UI and LUTS are confirmed in young women who suffered for the same condition in childhood. Longitudinal studies are needed to assess if these symptoms persist or are newly onset. Copyright © 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  6. A 10-Year Follow-Up of Urinary and Fecal Incontinence among the Oldest Old in the Community: The Canadian Study of Health and Aging

    Science.gov (United States)

    Ostbye,Truls; Seim, Arnfinn; Krause, Katrina M.; Feightner, John; Hachinski, Vladimir; Sykes, Elizabeth; Hunskaar, Steinar

    2004-01-01

    Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991-1992, 1996, and 2001. Using data from the CSHA, we report the…

  7. Skin care and incontinence

    Science.gov (United States)

    ... skin care; Incontinence - pressure sore; Incontinence - pressure ulcer Patient Instructions Preventing pressure ulcers Images Male urinary system References Holroyd S. Incontinence-associated dermatitis: identification, prevention and care. Br J Nurs . 2015;24( ...

  8. Perineal Ultrasound Findings of Stress Urinary Incontinence : Differentiation from Normal Findings

    International Nuclear Information System (INIS)

    Baek, Seung Yon; Chung, Eun Chul; Rhee, Chung Sik; Suh, Jeong Soo

    1995-01-01

    Perineal ultrasonography is a noninvasive method that is easier than chain cystoure-thrography in the diagnosis of stress urinary incontinence(SUI). We report the findings of stress urinary incontinence at peritoneal ultrasound and its differential points form normal control. Twenty-two patients with SUI and l6 normal controls were included in our study. Aloka SSD 650 with 3.5MHz convex transducer was used, and sagittal image through the bladder, bladder base, urethrovesical junction and pubis was obtained from the vulva area, We measured thepdsterior urethrovesical angle(PUVA) at rest and stress, and calculated the difference between the two angles. We also measured the distance of bladder neck descent during stress and the diameter of proximal urethra at rest. The data were analyzed with student t-test. At rest, PUVA was 135.3 .deg. in patients with SUI group and 134.5 .deg. in normal control group(P=0.8376). During streets, PUVA was 149.5 .deg. in SUI group and 142.1 .deg. in normal group(P=0.0135). The difference PUVAs at rest and during stress was 14.2 .deg. in SUI group and 7.6 .deg. in normal group(P=0.0173). The distance of bladder neck descent during stress was 14.5mm in SUI group and 9.8mm in normal group(P=0.0029). The diameter of proxiaml urethra at rest was 4.4mm in SUI group and 3.6mm in normal group(P=0.0385). In conclusion, ultrasound parameters that include the PUVA during stress, the difference between PUVAs at rest and during stress, the distance of bladder neck descent during stress and the diameter of proximal ureyhra at rest are useful in diagnosis of the stress urinary incontinence

  9. Vaginal cone use in passive and active phases in patients with stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Jorge Milhem Haddad

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate vaginal cone therapy in two phases, passive and active, in women with stress urinary incontinence. METHODS: A prospective study was conducted at the Department of Obstetrics and Gynecology, São Paulo University, Brazil. Twenty-four women with a clinical and urodynamic diagnosis of stress urinary incontinence were treated with vaginal cones in a passive phase (without voluntary contractions of the pelvic floor and an active phase (with voluntary contractions, each of which lasted three months. Clinical complaints, a functional evaluation of the pelvic floor, a pad test, and bladder neck mobility were analyzed before and after each phase. RESULTS: Twenty-one patients completed the treatment. The reduction in absolute risk with the pad test was 0.38 (p<0.034 at the end of the passive phase and 0.67 (p<0.0001 at the end of the active phase. The reduction in absolute risk with the pelvic floor evaluation was 0.62 (p<0.0001 at the end of the passive phase and 0.77 (p<0.0001 at the end of the active phase. The reduction in absolute risk of bladder neck mobility was 0.38 (p<0.0089 at the end of the passive phase and 0.52 (p<0.0005 at the end of the active phase. Complete reversal of symptomatology was observed in 12 (57.1% patients, and satisfaction was expressed by 19 (90.4%. CONCLUSION: Using vaginal cones in the passive phase, as other researchers did, was effective. Inclusion of the active phase led to additional improvement in all of the study parameters evaluated in women with stress urinary incontinence. Randomized studies are needed, however, to confirm these results.

  10. Coping with stress and quality of life in women with stress urinary incontinence

    Directory of Open Access Journals (Sweden)

    Jolanta Adamczuk

    2015-09-01

    Full Text Available Introduction: Urinary incontinence (UI involves uncontrolled leakage of urine through the urethra as a result of damage to its sphincter muscle and a disturbed function of the urogenital diaphragm within the pelvis minor. The symptoms of UI radically impair psychological, somatic, and social functioning. The aim of each disease stress coping process is to reduce the impact of harmful agents as well as the acquisition of necessary preventive measures in order to combat the disorder. Aim of the study was to assess the relationship between coping styles used when dealing with stress associated with disease and the quality of life. Material and methods: The study was carried out at an outpatients’ clinic located in the Lublin Province (eastern Poland, covering 150 women with diagnosed stress urinary incontinence, aged between 32 and 79. The following methods were used: (a Coping Inventory for Stressful Situations (Endler, Parker to assess coping styles, (b CASP-19 scale (Higgins, Hyde, Wiggins, Blade to measure the overall quality of life, and (c Urinary Incontinence Life Quality Scale (Szymona-Pałkowska, Kraczkowski. Results : The preferred style in the studied group of women was Task-Oriented Coping. This style is associated with a low score on the Independence from Symptoms scale and low Control, being simultaneously correlated with Autonomy and Self-Realisation. Emotion-Oriented Coping is associated with low psychological, physical and social well-being, as well as with little independence from the disease symptoms, little pleasure and self-realisation, but it gives a sense of internal control. Avoidance-Oriented Coping does not significantly correlate with any of the Overall Quality of Life dimensions. Conclusions : Women suffering from UI tend to try to solve their problem by means of cognitive transformation. In their situation, clinging to the problem turns out to be a depressing factor and entails a lower quality of their life.

  11. Risk of complications and urinary incontinence following cytoreductive prostatectomy: a multi-institutional study

    Directory of Open Access Journals (Sweden)

    Dae Keun Kim

    2018-01-01

    Full Text Available Emerging evidence has suggested that cytoreductive prostatectomy (CRP allows superior oncologic control when compared to current standard of care androgen deprivation therapy alone. However, the safety and benefit of cytoreduction in metastatic prostate cancer (mPCa has not been proven. Therefore, we evaluated the incidence of complications following CRP in men newly diagnosed with mPCa. A total of 68 patients who underwent CRP from 2006 to 2014 at four tertiary surgical centers were compared to 598 men who underwent radical prostatectomy for clinically localized prostate cancer (PCa. Urinary incontinence was defined as the use of any pad. CRP had longer operative times (200 min vs 140 min, P < 0.0001 and higher estimated blood loss (250 ml vs 125 ml, P < 0.0001 compared to the control group. However, both overall (8.82% vs 5.85% and major complication rates (4.41% vs 2.17% were comparable between the two groups. Importantly, urinary incontinence rate at 1-year after surgery was significantly higher in the CRP group (57.4% vs 90.8%, P < 0.0001. Univariate logistic analysis showed that the estimated blood loss was the only independent predictor of perioperative complications both in the unadjusted model (OR: 1.18; 95% CI: 1.02-1.37; P = 0.025 and surgery type-adjusted model (OR: 1.17; 95% CI: 1.01-1.36; P = 0.034. In conclusion, CRP is more challenging than radical prostatectomy and associated with a notably higher incidence of urinary incontinence. Nevertheless, CRP is a technically feasible and safe surgery for selecting PCa patients who present with node-positive or bony metastasis when performed by experienced surgeons. A prospective, multi-institutional clinical trial is currently underway to verify this concept.

  12. Perineal Ultrasound Findings of Stress Urinary Incontinence : Differentiation from Normal Findings

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Seung Yon; Chung, Eun Chul; Rhee, Chung Sik; Suh, Jeong Soo [Ewha Womans University Hospital, Seoul (Korea, Republic of)

    1995-06-15

    Perineal ultrasonography is a noninvasive method that is easier than chain cystoure-thrography in the diagnosis of stress urinary incontinence(SUI). We report the findings of stress urinary incontinence at peritoneal ultrasound and its differential points form normal control. Twenty-two patients with SUI and l6 normal controls were included in our study. Aloka SSD 650 with 3.5MHz convex transducer was used, and sagittal image through the bladder, bladder base, urethrovesical junction and pubis was obtained from the vulva area, We measured thepdsterior urethrovesical angle(PUVA) at rest and stress, and calculated the difference between the two angles. We also measured the distance of bladder neck descent during stress and the diameter of proximal urethra at rest. The data were analyzed with student t-test. At rest, PUVA was 135.3 .deg. in patients with SUI group and 134.5 .deg. in normal control group(P=0.8376). During streets, PUVA was 149.5 .deg. in SUI group and 142.1 .deg. in normal group(P=0.0135). The difference PUVAs at rest and during stress was 14.2 .deg. in SUI group and 7.6 .deg. in normal group(P=0.0173). The distance of bladder neck descent during stress was 14.5mm in SUI group and 9.8mm in normal group(P=0.0029). The diameter of proxiaml urethra at rest was 4.4mm in SUI group and 3.6mm in normal group(P=0.0385). In conclusion, ultrasound parameters that include the PUVA during stress, the difference between PUVAs at rest and during stress, the distance of bladder neck descent during stress and the diameter of proximal ureyhra at rest are useful in diagnosis of the stress urinary incontinence

  13. OnabotulinumtoxinA in urinary incontinence: Prospective Study of a Case Series.

    Science.gov (United States)

    Martín-Martínez, A; Fernández-Mederos, A; García-Hernández, J Á

    2017-09-01

    To assess the safety and efficacy of a single intravesical injection of onabotulinumtoxinA (OnaBTA) for treating urge urinary incontinence (UUI) in women. We performed a prospective case-series study of consecutive patients with refractory UUI treated with an intravesical injection of OnaBTA. The patients were administered 100 units of OnaBTA injected into the bladder wall following 4 weeks of flushing with anticholinergic agents or beta 3 agonists. The urodynamic and clinical endpoints were evaluated before and 6 months after the injection of OnaBTA. The primary study endpoint was the number of episodes of urinary leakage. A total of 204 of the 210 selected patients conducted a valid visit 6 months after the therapeutic application. At 6 months of treatment with OnaBTA, 110 (53.9%) patients remained continent and were considered a success. However, 57 (27.9%) patients experienced one episode of urinary leakage per day, and 37 (18.2%) had 2 or more. In terms of the urodynamic parameters, we observed the following changes: increase in maximum bladder capacity (P<.0001) and reduced maximum pressure of the detrusor (P<.0001). In terms of the safety profile, 8 (3.9%) patients had self-limiting haematuria during the procedure, which resolved spontaneously, and 9 (4.4%) patients had acute urinary retention that required intermittent catheterisation. This study supports the use of OnabotulinumtoxinA in patients with urge urinary incontinence that does not respond to medical treatment. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Effect of fesoterodine on urethral closure function in women with stress urinary incontinence assessed by urethral pressure reflectometry

    DEFF Research Database (Denmark)

    Klarskov, Niels; Darekar, Amanda; Scholfield, David

    2014-01-01

    INTRODUCTION AND HYPOTHESIS: The aim was to evaluate, using urethral pressure reflectometry (UPR), the effect of fesoterodine on urethral function in women with stress urinary incontinence (SUI). METHODS: Women aged 18 to 65 years were eligible for this randomised, double-blind, placebo...... significant differences were seen between fesoterodine 4 mg or fesoterodine 8 mg and placebo in opening urethral pressure (primary endpoint) or other UPR endpoints. No statistically significant differences were seen between either fesoterodine dose and placebo in the change from baseline in the bladder diary...... variables (total urinary incontinence, SUI, or urgency urinary incontinence episodes per 24 h). Adverse events were reported by 8 participants taking fesoterodine 4 mg, 17 taking fesoterodine 8 mg, and 8 taking placebo. CONCLUSIONS: Fesoterodine did not affect urethral pressure or significantly decrease...

  15. The value of urethro-cystography in the diagnosis of female urinary stress incontinence

    International Nuclear Information System (INIS)

    Goeller, W.; Koeller, M.; Tremmel, K.; Barth, V.; Staedtische Krankenanstalten Esslingen am Neckar

    1986-01-01

    Urethrocystography was performed in 72 women with stress urinary incontinence (SUI). The radiological findings were compared with the clinical diagnosis. 8 Patients with a normal radiological study had SUI grade I by clinical criteria. Explanations of this discrepancy are discussed. In 4 cases the interpretation interfered with a large cystocele. In 60 patients (83.5%) the radiological study confirmed the clinical diagnosis and supported the gynaecologist in the indication for operation on SUI. However this indication cannot be based on the radiological study by itself; it must in fact take into account all the other aspects of the disease. (orig.)

  16. Predictors and reasons for help-seeking behavior among women with urinary incontinence

    DEFF Research Database (Denmark)

    Pedersen, Louise Schreiber; Lose, Gunnar; Hoybye, Mette Terp

    2018-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of the study was to evaluate the predictors and reasons for help-seeking behavior among women with urinary incontinence (UI) in Germany and Denmark. METHODS: This international postal survey was conducted in 2014. In each country, 4,000 women of at least 18...... years of age were randomly selected. The questionnaires included validated items regarding help-seeking behavior and the ICIQ-UI SF. UI was defined as any involuntary loss of urine. Binary logistic regression analysis was used to assess factors predicting help-seeking behavior. Reasons for seeking...

  17. Which nonsurgical options are effective for the treatment of female urinary incontinence?

    DEFF Research Database (Denmark)

    Brostrøm, Søren

    2008-01-01

    In this study sponsored by the US federal government, Shamliyan et al. extracted data from 96 randomized controlled trials and 3 meta-analyses, and reviewed the evidence of nonsurgical treatment for female urinary incontinence (UI). Pelvic-floor muscle training alone, or in combination with bladder...... training, was found to be effective in improving UI compared with standard care. Generalizing the clinical relevance of these studies, however, was difficult because of heterogeneity between the trials. Anticholinergic agents were also moderately effective, but adverse effects were frequent. Additionally...

  18. Urethrotonography - a radiological and manometrical combination technique to diagnose urinary stress incontinance in comparison with urethral pressure profile recording

    International Nuclear Information System (INIS)

    Wess, H.

    1982-01-01

    The study described here was carried out in order to gain more insight into the pathogenesis of urinary stress incontinance and the related urethrovesical functions. The pathophysiological changes in the urogenital tract that are associated with urinary stress incontinance are described just as well as the clinical symptoms and signs differentiating the individual forms of incontinance from each other. Account is further taken of the various manometrical and radiological techniques used in the diagnosis of urinary stress incontinance. In this study, which included a total of 100 patients, comparative evaluations were made of the pressure behaviour of the bladder during the filling-up phase and the closing mechanism of the urethra both at rest and under stress using the following procedures: - Method developed by Brown and Wickham for urethral pressure profile recording; visualisation of the bladder and urethra with the aid of X-rays and a balloon catheter especially developed by us. The latter technique may help to solve the problems usually arising when given morphological factors are to be connected with certain medical views or theories concerning the vesical and urethral functions as well as the pathogenesis of urinary stress incontinance. It may thus enable more straightforward diagnosis to be made. (TRV) [de

  19. Evaluation of intra-individual test–re-test variability of uroflowmetry in healthy women and women suffering from stress, urge, and mixed urinary incontinence

    DEFF Research Database (Denmark)

    Lunacek, Libor; Gärtner, Marcel; Krhut, Jan

    2018-01-01

    Introduction and hypothesis: The objective was to evaluate the intra-individual variability of uroflowmetry (UFM) in healthy control subjects and women suffering from stress, urge, and mixed urinary incontinence. Methods: A total of 35 healthy controls (group A) and 105 women suffering from urinary...... incontinence were enrolled in the study. Thirty-five women suffered from stress urinary incontinence (group B), 35 women suffered from mixed urinary incontinence (group C), and 35 women with overactive bladder both dry and wet (group D). All participants were asked to perform UFM measurement three times......-individual difference in any of the recorded parameters was identified among the three UFM recordings in groups A, C, and D. The intra-individual variability of the following parameters reached statistical significance in patients suffering from stress urinary incontinence (group B): Qmax (p = 0.0016), Qave (p = 0...

  20. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.

    Science.gov (United States)

    Boyle, Rhianon; Hay-Smith, E Jean C; Cody, June D; Mørkved, Siv

    2012-10-17

    About a third of women have urinary incontinence and up to a 10th have faecal incontinence after childbirth. Pelvic floor muscle training is commonly recommended during pregnancy and after birth both for prevention and the treatment of incontinence. To determine the effect of pelvic floor muscle training compared to usual antenatal and postnatal care on incontinence. We searched the Cochrane Incontinence Group Specialised Register, which includes searches of CENTRAL, MEDLINE, MEDLINE in Process and handsearching (searched 7 February 2012) and the references of relevant articles. Randomised or quasi-randomised trials in pregnant or postnatal women. One arm of the trial needed to include pelvic floor muscle training (PFMT). Another arm was either no PFMT or usual antenatal or postnatal care. Trials were independently assessed for eligibility and methodological quality. Data were extracted then cross checked. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook for Systematic Reviews of Interventions. Three different populations of women were considered separately, women dry at randomisation (prevention); women wet at randomisation (treatment); and a mixed population of women who might be one or the other (prevention or treatment). Trials were further divided into those which started during pregnancy (antenatal); and those started after delivery (postnatal). Twenty-two trials involving 8485 women (4231 PFMT, 4254 controls) met the inclusion criteria and contributed to the analysis.Pregnant women without prior urinary incontinence (prevention) who were randomised to intensive antenatal PFMT were less likely than women randomised to no PFMT or usual antenatal care to report urinary incontinence up to six months after delivery (about 30% less; risk ratio (RR) 0.71, 95% CI 0.54 to 0.95, combined result of 5 trials).Postnatal women with persistent urinary incontinence (treatment) three months after delivery and who received

  1. Self-assessment of treatment compliance with antimuscarinic drugs and lower urinary tract condition among women with urinary incontinence.

    Science.gov (United States)

    Kosilov, Kirill; Loparev, Sergey; Kuzina, Irina; Shakirova, Olga; Zhuravskaya, Natalya; Lobodenko, Alexandra

    2017-11-01

    Our aim was to determine the efficiency of the Medication Compliance Self-Report Inventory (MASRI) in self-reporting antimuscarinic drug treatment compliance among women with urinary incontinence (UI). The study assessed 347 women aged 18-65 (averaging 49.7) years with more than one urinary incontinence (UI) episode per day. Treatment compliance was tested at the beginning and at weeks 4, 8, and 12 using the MASRI, the Brief Medication Questionnaire (BMQ), and visual pill counts. The MASRI's constructive, concurrent, and discriminate validity was studied in comparison with an external standard that uses the chi-square and Spearman coefficient. Receiver operating characteristic (ROC) analysis was performed to identify optimum MASRI cutoffs that would predict noncompliance. Furthermore, the functional condition of the lower urinary tract was tested using voiding diaries, uroflowmetry, and cystometry. The correlation between the percentage of noncompliant women according to the MASRI, and individuals with a belief barrier with respect to the BMQ screen was r = 0.81 (p ≤0.05), r = 0.84 (p ≤0.05), and r = 0.79 (p ≤0.05). The correlation between the percentage of noncompliant women according to the MASRI and of women who missed >20% of their doses according to the Regimen Screen of the BMQ was r = 0.79, p ≤0.05, r = 0.82, p ≤0.01, r = 0.77, and p ≤0.05 at the control points. Finally, the percentage of noncompliant patients who self-reported correctly according to the MASRI data compared with the BMQ was 95.6%, 95.7%, and 96.6% at the control points. The MASRI entails acceptable validity for accurately predicting treatment compliance with antimuscarinic drugs among women who have had UI for >3 months.

  2. Urinary incontinence and weight change during pregnancy and postpartum: a cohort study.

    Science.gov (United States)

    Wesnes, Stian Langeland; Hunskaar, Steinar; Bo, Kari; Rortveit, Guri

    2010-11-01

    Weight gain during pregnancy may contribute to increased urinary incontinence (UI) during and after pregnancy, but scientific support is lacking. The effect of weight loss on UI postpartum is unclear. From 1999 to 2006, investigators in the Norwegian Mother and Child Cohort Study recruited pregnant women during pregnancy. This study was based on 12,679 primiparous women who were continent before pregnancy. Data were obtained from questionnaires answered at weeks 15 and 30 of pregnancy and 6 months postpartum. Weight gain greater than the 50th percentile during weeks 0-15 of pregnancy was weakly associated with higher incidence of UI at week 30 compared with weight gain less than or equal to the 50th percentile. Weight gain greater than the 50th percentile during pregnancy was not associated with increased prevalence of UI 6 months postpartum. For each kilogram of weight loss from delivery to 6 months postpartum among women who were incontinent during pregnancy, the relative risk for UI decreased 2.1% (relative risk = 0.98, 95% confidence interval: 0.97, 0.99). Weight gain during pregnancy does not seem to be a risk factor for increased incidence or prevalence of UI during pregnancy or postpartum. However, weight loss postpartum may be important for avoiding incontinence and regaining continence 6 months postpartum.

  3. Urinary incontinence during pregnancy and postpartum. Associated risk factors and influence of pelvic floor exercises.

    Science.gov (United States)

    Martin-Martin, Sergio; Pascual-Fernandez, Angela; Alvarez-Colomo, Cristina; Calvo-Gonzalez, Raul; Muñoz-Moreno, Marife; Cortiñas-Gonzalez, Jose Ramon

    2014-05-01

    To determine the prevalence of urinary incontinence (UI) before pregnancy, in the third trimester and postpartum. To analyze its influence on quality of life and associated potential risk factors and the efficacy of pelvic floor exercises. Prospective study in 413 pregnant women. The modified ICIQ-SF incontinence questionnaire was given to the pregnant women at the end of the third quarter. This questionnaire was administered by telephone at 3 and 6 months postpartum. The influence of several risk factors for UI in pregnancy and postpartum were analyzed. Patients with persistent UI at 6 months postpartum were trained to do pelvic floor exercises. Patients with UI before pregnancy were excluded from the study. UI in the third trimester was 31%. Analyzed risk factors did not condition a higher percentage of UI. Prevalence of UI was 11.3% at 3 months postpartum and 6.9% at 6 months. 70% of the incontinent patients already had it during pregnancy and it appeared de novo post-delivery in 30% of the patients. Prevalence of UI after delivery was higher in women with UI in pregnancy and lower in caesarean cases. Most women improved with pelvic floor exercises. Analysed risk factors did not significantly increase UI in pregnancy. Prevalence of UI after delivery is higher in women with UI in pregnancy and lower in caesarean cases. Postpartum pelvic floor exercises for three months in patients with persistent stress UI at 6 months postpartum clearly improved the degree of continence.

  4. Prevalence and risk factors for urinary incontinence in healthy pregnant Brazilian women.

    Science.gov (United States)

    Martins, Gisele; Soler, Zaida A S G; Cordeiro, José Antônio; Amaro, João Luiz; Moore, Katherine N

    2010-10-01

    Physiological and anatomical changes of pregnancy are risk factors for lower urinary tract symptoms (LUTS). This study aimed to evaluate the prevalence and risk factors for urinary incontinence (UI) in healthy pregnant women. A cross-sectional study was conducted in pregnant Brazilian women who enrolled in the primary health-care system in Sao Jose do Rio Preto, Brazil. Face-to-face interview and completion of two-part questionnaire were administered and done which evaluated the presence of LUTS pre- and during pregnancy. The data were analyzed by logistic regression. Five hundred pregnant women were enrolled ranging from first to third trimester. LUTS present in 63.8% in these women; the main associated risk factors were multiparity and prepregnancy LUTS as well as smoking, constipation, and daily coffee intake. The prevalence of UI during pregnancy is high, highlighting the presence of the risk factors associated with UI during pregnancy.

  5. Hyperthyroidism and female urinary incontinence: a population-based cohort study.

    Science.gov (United States)

    Chung, Shiu-Dong; Chen, Yi-Kuang; Chen, Yi-Hua; Lin, Herng-Ching

    2011-11-01

    The imbalanced autonomic nervous system present in hyperthyroidism may cause lower urinary tract symptoms. Urinary incontinence (UI) is the most bothersome lower urinary tract symptom; however, in the literature, reports regarding urinary dysfunction and/or incontinence among hyperthyroid patients are scarce. This population-based cohort study aimed to examine the relationship between hyperthyroidism in women and the risk of developing UI in Taiwan. This study used data from the Longitudinal Health Insurance Database. For this study, 10,817 female patients diagnosed with hyperthyroidism from 2001 to 2005 were recruited together with a comparison cohort of 54,085 matched enrollees who did not have a history of hyperthyroidism. All patients were tracked for a 3-year period from their index date to identify those who had a subsequent UI. The stratified Cox proportional hazards models were used to compute the risk of UI between study and comparison cohorts. During the follow-up period, of 64,169 patients, 173 (1·60%) from the hyperthyroidism group and 560 (1·04%) from the comparison group, had a diagnosis of UI. The regression analysis showed that, after adjusting for monthly income, geographic region, urbanization level of the community in which the patient resided, obesity and hysterectomy, patients with hyperthyroidism were more likely to have UI during the 3-year follow-up period than the comparison patients (hazard ratio = 1·54; 95% CI = 1·30-1·83; P hyperthyroidism at the 3-year follow-up. © 2011 Blackwell Publishing Ltd.

  6. Predictors of urinary incontinence between abdominal obesity and non-obese male adults.

    Science.gov (United States)

    Li, Dongmei; Xu, Yi; Nie, Qingbin; Li, Yan; Mao, Gengsheng

    2017-09-01

    To investigate factors that may be associated with urinary incontinence (UI) in abdominal obese and non-obese adult males. Data were analyzed for 2671 men (≥40 years of age) who participated in the National Health and Nutrition Examination Survey (2005-2008). We define abdominal obesity as a waist circumference >102 cm. Men with Incontinence Severity Index ≥3 were defined as having UI. Logistic regression analyses were used to identify factors associated with stress and urge UI. Multivariate analysis found that in abdominal obese men, stress UI was associated with enlarged prostate (odds ratio [OR] = 2.20, 95% confidence interval [CI]: 1.16-4.16), chronic respiratory tract disease (OR = 2.78, 95% CI: 1.55-4.97), and major depression (OR = 4.79, 95% CI: 1.79-12.84). In non-obese men, arthritis was associated with stress UI (odds ratio = 3.37, 95% CI: 1.06-10.73). Urge UI in abdominally obese men was associated with age ≥65 years (OR = 1.67, 95% CI: 1.05-2.67), being non-Hispanic black (OR = 1.63, 95% CI: 1.06-2.52), and with enlarged prostate (OR = 2.30, 95% CI: 1.54-3.40), arthritis (OR = 1.39, 95% CI: 1.03-1.88), and major depression (OR = 2.96, 95% CI: 1.89-4.64). Urge UI in non-obese men was associated with current smoking (OR = 1.79, 95% CI: 1.01-3.17), major depression (OR = 2.60, 95% CI: 1.33-5.09) and vitamin D deficiency (OR = 1.61, 95% CI: 1.01-2.59). Factors associated with urinary incontinence varied with abdominal obesity status and type of UI. The findings identify important contributors to urinary incontinence that clinicians should consider to help manage and effectively treat the condition.

  7. Orthotopic ileal bladder substitution in women: factors influencing urinary incontinence and hypercontinence.

    Science.gov (United States)

    Gross, Tobias; Meierhans Ruf, Susan D; Meissner, Claudia; Ochsner, Katharina; Studer, Urs E

    2015-10-01

    Urinary incontinence or the inability to void spontaneously after ileal orthotopic bladder substitution is a frequent finding in female patients. To evaluate how hysterectomy and nerve sparing affect functional outcomes and whether these relate to pre- and postoperative urethral pressure profile (UPP) results. Prospectively performed pre- and postoperative UPPs of 73 female patients who had undergone cystectomy and bladder substitution were correlated with postoperative voiding and continence status. Outcome analyses were performed with the Kruskal-Wallis test, Wilcoxon-Mann-Whitney, or two-group post hoc testing with the Bonferroni correction. Chi-square or Fisher exact tests were applied for the categorical data. Of postoperatively continent or hypercontinent patients, 22 of 43 (51.2%) had the uterus preserved; of incontinent patients, only 4 of 30 (13.3%, pcontinent or hypercontinent patients, 27 of 43 patients (62.8%) had bilateral and 15 of 43 (34.9%) had unilateral attempted nerve sparing. In incontinent patients, 11 of 30 (36.7%) had bilateral and 16 of 30 (53.3%) had unilateral attempted nerve sparing (p=0.02). When compared with postoperatively incontinent patients, postoperatively continent patients had a longer functional urethral length (median: 32mm vs 24mm; prest (56cm H2O vs 35cm H2O; prest (74cm H2O vs 47.5cm H2O; p=0.01). The main limitation was the limited number of patients. In female patients undergoing radical cystectomy and bladder substitution, preservation of the uterus and attempted nerve sparing results in better functional outcomes. The preoperative UPPs correlate with postoperative voiding and continence status and may predict which patients are at a higher risk of functional failure after bladder substitution. If preservation of the urethra's innervation is not possible during cystectomy, poor functional results with bladder substitutes are likely. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights

  8. Comparative adequecy of colpocystourethrorectography and transrectal sonography in female urinary incontinence

    International Nuclear Information System (INIS)

    Braccini, G.; Pannocchia, P.; Alderigi, L.; Gigoni, R.; Calderazzi, A.

    1991-01-01

    In order to investigate the diagnostic reliability of transrectal US in the study of female urinary incontinence, the authors compared the static images obtained by means of colpocystourethrorectography with the ones obtained with transrectal US. The study population included 30 patients suffering from urinary incontinence. US images were obtained both at rest and during Valsalva's maneuver, some minutes before cystourethrography and employing part of its preparation (vesical filling with 250 cc of iodine contrast medium and positioning of a metallic bead chain in the urethra). On static images obtained with cystourethrography and transrectal US both at rest and during Valsalva, 4 parameters were evaluated: anterior and posterior vesical angles, urethral axis angle, and distance between symphysis pubis and urethral-vesical junction. As for posterior vesical angle, urethral axis angle, and symphysis-junction distance, the statistical comparison of the results did non demonstrate any significant differences. Anterior vesical angle was not included because it is too difficult to measure by transrectal US. In our experience, transrectal US was capable of yielding accurate information similar to that obtained with colpocystourethrorectography. 25 refs

  9. Life experiences of Brazilian men with urinary incontinence and erectile dysfunction following radical prostatectomy.

    Science.gov (United States)

    de Moraes Lopes, Maria Helena Baena; Higa, Rosângela; Cordeiro, Sílvia Nogueira; Rodrigues Estapê, Nuri Aparecida; Levi D'ancona, Carlos Arturo; Turato, Egberto Ribeiro

    2012-01-01

    The objective of this study was to explore the psychosocial meaning and repercussions on lifestyle associated with erectile dysfunction and urinary incontinence (UI) in men following radical prostatectomy. Ten men from Southeastern Brazil who underwent radical prostatectomy for prostate cancer were interviewed. All participants underwent treatment at a urology clinic during the period of September 2007 to February 2009. A clinical-qualitative study was conducted, using semi-structured interviews with open-ended questions. All interviews were recorded and transcribed verbatim. Each man was interviewed once. The average length of the interviews was 37 minutes (range: 16 to 81 minutes). Data from the interviews were subjected to content thematic analysis and development of categories based on psychodynamic references. Three themes were identified: (1) sexuality called into question; (2) a body without governance; and (3) experiencing loss. These men reported difficulties in dealing both with the physical and emotional impotence resulting from the treatment. Urinary incontinence and erectile dysfunction affected their body by accentuating conflicts related to masculinity, triggering subjective feelings of powerlessness, and psychological distress. Study respondents assigned multiple psychological meanings to issues related to feelings of powerlessness in general, leading to a narcissistic wound. The men experienced UI as a bodily deficiency, and erectile dysfunction was experienced as a feeling of being devitalized. These results suggest that UI from prostate cancer treatment affects sexuality and self-esteem.

  10. Urinary incontinence, mental health and loneliness among community-dwelling older adults in Ireland

    DEFF Research Database (Denmark)

    Stickley, Andrew; Santini, Ziggi Ivan; Koyanagi, Ai

    2017-01-01

    Background Urinary incontinence (UI) is associated with worse health among older adults. Little is known however, about its relation with loneliness or the role of mental health in this association. This study examined these factors among older adults in Ireland. Methods Data were analyzed from 6...... community-dwelling adults but this association is largely explained by comorbid mental health problems, in particular, depression.......Background Urinary incontinence (UI) is associated with worse health among older adults. Little is known however, about its relation with loneliness or the role of mental health in this association. This study examined these factors among older adults in Ireland. Methods Data were analyzed from...... 6903 community-dwelling adults aged ≥ 50 collected in the first wave of The Irish Longitudinal Study on Ageing (TILDA) in 2009–11. Information was obtained on the self-reported occurrence (yes/no) and severity (frequency/activity limitations) of UI in the past 12 months. Loneliness was measured using...

  11. Quantitative Sonographic Differences in Mid-Urethra between Postmenopausal Women with and without Stress Urinary Incontinence.

    Science.gov (United States)

    Olgan, Safak; Mantar, Ozge Piri; Okyay, Recep Emre; Gulekli, Bulent

    2016-01-01

    The aim of this study was to evaluate midurethral tissue characteristics in continent and stress urinary incontinent postmenopausal women by using transvaginal ultrasound gray-level histogram. Thirty-seven patients with stress urinary incontinence (SUI) and 77 patients without SUI were evaluated. Vaginal ultrasound gray-level histograms were performed by 2 gynecologists blinded to patients' SUI statuses. The mean gray-level (MGL) of ultrasound gray-level histogram, representing the echogenicity of a region of interest, was measured in the anterior and posterior midurethral wall along a vertical ultrasound beam. The difference in MGL between anterior and posterior (AP difference) midurethra was calculated. The MGL value of SUI patients was found to be lower in posterior (p = 0.008) and higher in anterior midurethral region (p = 0.001) when compared with control group. In addition, the difference in MGL between anterior and posterior midurethra (AP difference) was found to be higher in SUI group (p < 0.001). Multivariate analysis by logistic regression including confounding factors revealed that AP difference was independently associated with presence of SUI (adjusted OR 1.14, 95% CI 1.08-1.20, p < 0.001). Intra- and inter-observer reproducibility was found to be high with intraclass correlation coefficient of 0.83 and 0.78, respectively. Postmenopausal SUI patients might have a distinct midurethral echogenicity pattern with the quantitative ultrasonography. © 2016 S. Karger AG, Basel.

  12. Innovative treatment modalities for urinary incontinence: a European survey identifying experience and attitude of healthcare providers.

    Science.gov (United States)

    Kastelein, Arnoud W; Dicker, Maarten F A; Opmeer, Brent C; Angles, Sonia S; Raatikainen, Kaisa E; Alonso, Joan F; Tăut, Diana; Airaksinen, Olavi; Cardozo, Linda D; Roovers, Jan-Paul W R

    2017-11-01

    Urinary incontinence is a common condition in women, with a reported prevalence ranging from 25% to 51%. Of these women, an estimated 38% suffer from stress urinary incontinence (SUI). A European research consortium is investigating an innovative system based on information and communication technology for the conservative treatment of women with SUI. When introducing a new intervention, implementation barriers arise and need to be identified. Therefore, we investigated healthcare providers' experience with and attitude towards innovative care options. We performed an online survey to assess (1) the characteristics and practice of healthcare providers, (2) current protocols for SUI, (3) current use of biofeedback, and (4) knowledge about serious gaming. The survey was sent to members of professional societies in Europe (EUGA), UK (BSUG) and The Netherlands (DPFS). Of 341 questionnaires analyzed (response rate between 18% and 30%), 64% of the respondents had access to a protocol for the treatment of SUI, and 31% used biofeedback when treating patients with SUI. However, 92% considered that biofeedback has a clear or probable added value, and 97% of those who did not use biofeedback would change their practice if research evidence supported its use. Finally, 89% of respondents indicated that they had no experience of serious gaming, but 92% considered that it could be useful. Although inexperienced, European urogynecologists and physical therapists welcome innovative treatment options for the conservative treatment of SUI such as portable wireless biofeedback and serious gaming. Scientific evidence is considered a prerequisite to incorporate such innovations into clinical practice.

  13. STEM CELLS IN THE TREATMENT OF URINARY STRESS INCONTINENCE – A VISION OF FUTURE?

    Directory of Open Access Journals (Sweden)

    Adolf Lukanović

    2018-02-01

    Full Text Available Background. For one third of all women urinary incontinence is a health problem. Different strategies of treatment have been used, namely surgical, medical and physiotherapy. To this armamentarium a new method – adult stem cells therapy – has been added. Methods. The source of adult autologues multipotent stem cells consists of muscle-derived stem cells, adipose-derived stem cells and mesenchymed bone marrow cells. In facilities for stem cells with processing and in the presence of specific inducing factors, muscle derived stem cells can be differentiated to striated or smooth muscles. Clinical work is based on animal models that with immunohistochemical analysis demonstrated new skeletal-muscle fiber formation at the site of injection of stem cells. In stress urinary incontinence (SUI autologues bioptic material is obtained by using a musle needle biopsy device. From the biopsy speciment with dissociation muscle-derived stem cells are isolated and injected under local anaesthesia in the middle urethra and/or external urethral sphincter. Initial results of SUI treatment with adult muscle-derived stem cells suggest that perspectives of this method are encouraging. Conclusions. Stem cell therapy is promising to become minimally invasive method for reconstruction of the muscles and connective tissue of urethra and external urethral sphincter.

  14. Between suffering and hope: rehabilitation from urinary incontinence as an intervening component.

    Science.gov (United States)

    Delarmelindo, Rita de Cássia Altino; Parada, Cristina Maria Garcia de Lima; Rodrigues, Rosalina Aparecida Partezani; Bocchi, Silvia Cristina Mangini

    2013-07-01

    This is a qualitative study seeking to understand Brazilian women's experience of urinary incontinence (UI) and design a representative theoretical model for the experience. Theoretical saturation occurred after analysis of the 18th non-directive interview in accordance with Grounded Theory. Two phenomena emerged: living with the challenges of UI and experiencing the hope and disappointment of rehabilitation from UI. Upon re-alignment of the components, the core category emerged, namely: between suffering and hope--rehabilitation from urinary incontinence as an intervening component. From the analysis in light of symbolic interactionism, pregnancy and vaginal birth were observed to be symbols of women's vulnerability to the suffering from living with the moral and physio-psychosocial challenges of UI. It is also inferred that the lack of consideration of the Unified Health System (SUS) in investing in the process of rehabilitation from UI may be having a negative effect on the incentive programs for promoting vaginal birth. Most of all, it reveals the ongoing suffering of women with UI, most of whom do not have access to rehabilitation due to the lack of programs geared to the real needs of these users of the Unified Health System.

  15. Between suffering and hope: rehabilitation from urinary incontinence as an intervening component

    Directory of Open Access Journals (Sweden)

    Rita de Cássia Altino Delarmelindo

    2013-07-01

    Full Text Available This is a qualitative study seeking to understand Brazilian women's experience of urinary incontinence (UI and design a representative theoretical model for the experience. Theoretical saturation occurred after analysis of the 18th non-directive interview in accordance with Grounded Theory. Two phenomena emerged: living with the challenges of UI and experiencing the hope and disappointment of rehabilitation from UI. Upon re-alignment of the components, the core category emerged, namely: between suffering and hope - rehabilitation from urinary incontinence as an intervening component. From the analysis in light of symbolic interactionism, pregnancy and vaginal birth were observed to be symbols of women's vulnerability to the suffering from living with the moral and physio-psychosocial challenges of UI. It is also inferred that the lack of consideration of the Unified Health System (SUS in investing in the process of rehabilitation from UI may be having a negative effect on the incentive programs for promoting vaginal birth. Most of all, it reveals the ongoing suffering of women with UI, most of whom do not have access to rehabilitation due to the lack of programs geared to the real needs of these users of the Unified Health System.

  16. A prospective study of transobturator tape as treatment for stress urinary incontinence after transvaginal mesh repair.

    Science.gov (United States)

    Lau, Hui-Hsuan; Su, Tsung-Hsien; Huang, Wen-Chu; Hsieh, Ching-Hung; Su, Chin-Hui; Chang, Rhu-Chu

    2013-10-01

    The transobturator suburethral sling is a common surgical treatment for stress urinary incontinence (SUI). In patients with incontinence after trocar-guided transvaginal mesh repair (Prolift), data on outcome remain limited. In the present study, we hypothesized that transobturator tape in such cases is assumed to be as effective as surgery alone. This was a prospective analysis of outcomes of transobturator slings in women who had undergone transvaginal mesh repair and in those who underwent sling surgery alone (controls). Objective cure was defined as the absence of urinary leakage during the stress test at filling cystometry and a negative cough test during pelvic examination. The success rates were evaluated 3-6 months postoperatively. One hundred women were recruited for the study. Compared to the control group, women after transvaginal mesh repair had a significantly lower objective success rate (62 vs 86%, p = 0.005) and poorer bladder neck mobility (0.5 ± 0.8 vs 1.1 ± 0.5 cm, p = 0.001). The transobturator sling has lower objective success rate in women after transvaginal mesh that may be due to decreased bladder neck mobility. Patients with post-mesh repair SUI who opt for sling surgery should be informed of these less satisfactory outcomes during preoperative counseling.

  17. 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.

  18. A urinary incontinence continuing education online course for community health nurses in South Korea.

    Science.gov (United States)

    De Gagne, Jennie C; Park, Sunah; So, Aeyoung; Wu, Bei; Palmer, Mary H; McConnell, Eleanor S

    2015-04-01

    Although urinary incontinence is prevalent among older women living in rural Korea, a lack of awareness and education exists in this population and among health professionals. Geographic isolation and limited resources also contribute to having few educational offerings for rural nurses. The authors' aim was to develop an online continuing education course on continence care for community health nurses and to examine its effectiveness. A one-group, pretest-posttest design was used to detect changes in knowledge and attitudes after taking the online education course. Participant satisfaction was also measured at the end of the training. A significant improvement in knowledge and attitudes toward continence care was noted. More than 95% of participants responded that they would recommend the online program to other health care providers and indicated the program would be helpful regarding continence care in their practice. The continuing education online course is a feasible strategy to support rural community health nurses' learning to improve knowledge and attitudes toward urinary incontinence management and care. Copyright 2015, SLACK Incorporated.

  19. Management of recurrent stress urinary incontinence after burch and sling procedures.

    Science.gov (United States)

    Zimmern, Philippe E; Gormley, E Ann; Stoddard, Anne M; Lukacz, Emily S; Sirls, Larry; Brubaker, Linda; Norton, Peggy; Oliphant, Sallie S; Wilson, Tracey

    2016-03-01

    To examine treatment options selected for recurrent stress urinary incontinence (rSUI) in follow-up after Burch, autologous fascial and synthetic midurethral sling (MUS) procedures. We performed a secondary analysis of the SISTER and ToMUS trials of participants who underwent primary stress urinary incontinence (SUI) treatment (without prior SUI surgery or concomitant procedures). Using Kaplan-Meier analysis, retreatment-free survival rates by initial surgical procedure were compared. Mean MESA (Medical Epidemiologic and Social Aspects of Aging) stress index was also compared between those retreated for rSUI compared to those not retreated. Half of the women in the SISTEr trial met inclusion criteria for this analysis (329/655, 174 Burch and 155 fascial sling), as did 444/597 (74%) of subjects in ToMUS (221 transobturator midurethral sling (TMUS), and 223 retropubic midurethral sling (RMUS). Types of surgical retreatment included autologous fascial sling (19), synthetic sling (1), and bulking agent (18). Five-year retreatment free survival rates (and standard errors) were 87% (3%), 96% (2%), 97% (1%), and 99% (0.7%) for Burch, autologous fascial sling, TMUS, and RMUS groups respectively (P < 0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n = 23) was significantly higher than mean MESA stress index at last visit for those not retreated (n = 645) (P < 0.0001). In these cohorts, 6% of women after standard anti-incontinence procedures were retreated within 5 years, mostly with injection therapy or autologous fascial sling. Not all women with rSUI chose surgical retreatment. © 2015 Wiley Periodicals, Inc.

  20. Urinary Incontinence as a Predictor of Death: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Gregor John

    Full Text Available The association between urinary incontinence (UI and increased mortality remains controversial. The objective of our study was to evaluate if this association exists.We performed a systematic review and meta-analysis of observational studies comparing death rates among patients suffering from UI to those without incontinence. We searched in Medline, Embase and the Cochrane library using specific keywords. Studies exploring the post-stroke period were excluded. Hazard ratios (HR were pooled using models with random effects. We stratified UI by gender and by UI severity and pooled all models with adjustment for confounding variables.Thirty-eight studies were retrieved. When compared to non-urinary incontinent participants, UI was associated with an increase in mortality with pooled non adjusted HR of 2.22 (95%CI 1.77-2.78. The risk increased with UI severity: 1.24 (95%CI: 0.79-1.97 for light, 1.71 (95%CI: 1.26-2.31 for moderate, and 2.72 (95%CI: 1.90-3.87 for severe UI respectively. When pooling adjusted measures of association, the resulting HR was 1.27 (95%CI: 1.13-1.42 and increased progressively for light, moderate and severe UI: 1.07 (95%CI: 0.79-1.44, 1.25 (95%CI: 0.99-1.58, and 1.47 (95%CI: 1.03-2.10 respectively. There was no difference between genders.UI is a predictor of higher mortality in the general and particularly in the geriatric population. The association increases with the severity of UI and persists when pooling models adjusted for confounders. It is unclear if this association is causative or just reflects an impaired general health condition. As in most meta-analyses of observational studies, methodological issues should be considered when interpreting results.

  1. Preventing Urinary Incontinence With Supervised Prenatal Pelvic Floor Exercises: A Randomized Controlled Trial.

    Science.gov (United States)

    Fritel, Xavier; de Tayrac, Renaud; Bader, Georges; Savary, Denis; Gueye, Ameth; Deffieux, Xavier; Fernandez, Hervé; Richet, Claude; Guilhot, Joëlle; Fauconnier, Arnaud

    2015-08-01

    To compare, in an unselected population of nulliparous pregnant women, the postnatal effect of prenatal supervised pelvic floor muscle training with written instructions on postpartum urinary incontinence (UI). In a randomized controlled trial in two parallel groups, 282 women were recruited from five university teaching hospitals in France and randomized during the second trimester of pregnancy. The physiotherapy group received prenatal individually supervised exercises. Both groups received written instructions about how to perform exercises at home. Women were blindly assessed at baseline, end of pregnancy, and 2 and 12 months postpartum. The primary outcome measured was UI severity, assessed with an International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form score (range 0-21; 1-5 is slight UI) at 12 months postpartum; other outcomes were UI prevalence and pelvic floor troubles assessed using self-administered questionnaires. To give a 1-point difference in UI severity score, we needed 91 women in each group (standard deviation 2.4, α=0.05, β=0.20, and bilateral analysis). Between February 2008 and June 2010, 140 women were randomized in the physiotherapy group and 142 in the control group. No difference was observed between the two groups in UI severity, prevalence, or pelvic floor troubles at baseline, end of pregnancy, and at 2 and 12 months postpartum. At 12 months postpartum, the primary outcome was available for 190 women (67.4%); mean UI severity was 1.9 in the physiotherapy group compared with 2.1 in the control group (P=.38). Prenatal supervised pelvic floor training was not superior to written instructions in reducing postnatal UI. ClinicalTrials.gov; www.clinicaltrials.gov, NCT00551551. I.

  2. Conservative chiropractic management of urinary incontinence using applied kinesiology: a retrospective case-series report.

    Science.gov (United States)

    Cuthbert, Scott C; Rosner, Anthony L

    2012-03-01

    The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI). Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI. Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, low-amplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable. The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time.

  3. Development of a wearable microwave bladder monitor for the management and treatment of urinary incontinence

    Science.gov (United States)

    Krewer, F.; Morgan, F.; Jones, E.; Glavin, M.; O'Halloran, M.

    2014-05-01

    Urinary incontinence is defined as the inability to stop the flow of urine from the bladder. In the US alone, the annual societal cost of incontinence-related care is estimated at 12.6 billion dollars. Clinicians agree that those suffering from urinary incontinence would greatly benefit from a wearable system that could continually monitor the bladder, providing continuous feedback to the patient. While existing ultrasound-based solutions are highly accurate, they are severely limited by form-factor, battery size, cost and ease of use. In this study the authors propose an alternative bladder-state sensing system, based on Ultra Wideband (UWB) Radar. As part of an initial proof-of-concept, the authors developed one of the first dielectrically and anatomically-representative Finite Difference Time Domain models of the pelvis. These models (one male and one female) are derived from Magnetic Resonance images provided by the IT'IS Foundation. These IT'IS models provide the foundation upon which an anatomically-plausible bladder growth model was constructed. The authors employed accurate multi-pole Debye models to simulate the dielectric properties of each of the pelvic tissues. Two-dimensional Finite Difference Time Domain (FDTD) simulations were completed for a range of bladder volumes. Relevant features were extracted from the FDTD-derived signals using Principle Component Analysis (PCA) and then classified using a k-Nearest-Neighbour and Support Vector Machine algorithms (incorporating the Leave-one-out cross-validation approach). Additionally the authors investigated the effects of signal fidelity, noise and antenna movement relative to the target as potential sources of error. The results of this initial study provide strong motivation for further research into this timely application, particularly in the context of an ageing population.

  4. The Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12): validation of the Dutch version.

    Science.gov (United States)

    't Hoen, Lisette A; Utomo, Elaine; Steensma, Anneke B; Blok, Bertil F M; Korfage, Ida J

    2015-09-01

    To establish the reliability and validity of the Dutch version of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in women with pelvic floor dysfunction. The PISQ-12 was translated into Dutch following a standardized translation process. A group of 124 women involved in a heterosexual relationship who had had symptoms of urinary incontinence, fecal incontinence and/or pelvic organ prolapse for at least 3 months were eligible for inclusion. A reference group was used for assessment of discriminative ability. Data were analyzed for internal consistency, reproducibility, construct validity, responsiveness, and interpretability. An alteration was made to item 12 and was corrected for during the analysis. The patient group comprised 70 of the 124 eligible women, and the reference group comprised 208 women from a panel representative of the Dutch female population. The Dutch PISQ-12 showed an adequate internal consistency with a Cronbach's alpha of 0.57 - 0.69, increasing with correction for item 12 to 0.69 - 0.75, for the reference and patient group, respectively. Scores in the patient group were lower (32.6 ± 6.9) than in the reference group (36.3 ± 4.8; p = 0.0001), indicating a lower sexual function in the patient group and good discriminative ability. Reproducibility was excellent with an intraclass correlation coefficient for agreement of 0.93 (0.88 - 0.96). A positive correlation was found with the Short Form-12 Health Survey (SF-12) measure representing good criterion validity. Due to the small number of patients who had received treatment at the 6-month follow-up, no significant responsiveness could be established. This study showed that the Dutch version of the PISQ-12 has good validity and reliability. The PISQ-12 will enable Dutch physicians to evaluate sexual dysfunction in women with pelvic floor disorders.

  5. Obesity with Comorbid Stress Urinary Incontinence in Women: A Narrative Review to Inform Dietetics Practice.

    Science.gov (United States)

    Gordon, Barbara; Shorter, Barbara; Isoldi, Kathy Keenan; Moldwin, Robert M

    2017-06-01

    Stress urinary incontinence (SUI) is a common problem among women; clinical treatment guidelines include weight reduction as a strategy for controlling urinary leakage. The purpose of this review was to gather evidence on the association between obesity and SUI and to ascertain whether there are any special considerations for implementing medical nutrition therapy with community-dwelling, obese, adult females with comorbid SUI. Five key findings emerged: epidemiologic studies consistently report statistically significant associations between obesity and SUI, randomized control trials found that weight loss appears to ameliorate SUI symptoms, the SUI-activity link may affect weight management, there is a potential interplay between SUI and the obesity-sleep connection, and dietary components are associated with the exacerbation of urinary symptoms. The pathogenesis of SUI and obesity-related contributions to urinary leakage is included in the introductory discussion. Lastly, insights on special considerations for implementing nutrition interventions with this population are offered. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  6. Neurogenic bladder in spinal cord injury patients

    Directory of Open Access Journals (Sweden)

    Al Taweel W

    2015-06-01

    Full Text Available Waleed Al Taweel, Raouf SeyamDepartment of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaAbstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.Keywords: neurogenic bladder, spinal cord injury, urodynamics, intestine, intermittent catheterization

  7. Prevalence of lower urinary tract symptoms, overactive bladder and urinary incontinence in western Turkey: results of a population-based survey.

    Science.gov (United States)

    Zumrutbas, Ali E; Bozkurt, Ali I; Tas, Erdogan; Acar, Cenk I; Alkis, Okan; Coban, Kazim; Cetinel, Bulent; Aybek, Zafer

    2014-10-01

    To estimate the prevalence of lower urinary tract symptoms, urinary incontinence and overactive bladder in western Turkey. This cross-sectional, population-based survey was carried out between May and October 2012. A random sample of 2128 women and men aged ≥18 years was selected from the health registries. A questionnaire including sociodemographic data, comorbid conditions, lower urinary tract symptoms, overactive bladder and urinary incontinence symptoms, body mass index, vital signs, and dipstick urinalysis was developed. The questions were answered by the participants, and remaining data were provided by the site staff. International Continence Society definitions were used. A total of 1571 (74%) individuals agreed to participate, and analysis were carried out on 1555 people (636 men [40.9%] and 919 women [59.1%]) after 16 individuals with a nitrite-positive dipstick test were excluded. Lower urinary tract symptoms were reported by 71.0% of the study population. The prevalence of storage, voiding and post-micturition symptoms were 56.1% (44.2% men, 64.1% women), 39.3% (40.9% men, 37.8% women) and 30.7% (38.6% men, 28.7% women), respectively. The most prevalent storage symptom was urgency, which was reported by 29.3% of the study population (20.1% men, 35.6% women). The prevalence of urge, stress and mixed urinary incontinence were: 6.5% (3.9% men, 8.2% women), 14.1% (3.9% men, 21.2% women) and 5.6% (0.8% men, 9.0% women), respectively. The present study is the first and largest population-based survey evaluating the prevalence of lower urinary tract symptoms, urinary incontinence and overactive bladder in Turkey. Our findings show these symptoms are highly prevalent in western Turkey. © 2014 The Japanese Urological Association.

  8. Can quality of life be improved by pelvic floor muscle training in women with urinary incontinence after ischemic stroke?

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Jensen, Rigmor; Lindskov, Grethe

    2004-01-01

    The purpose of this study was to evaluate the effect of pelvic floor muscle training in women with urinary incontinence after ischemic stroke measured by quality of life (QoL) parameters. Three hundred thirty-nine medical records of stroke patients were searched. Twenty-six subjects were randomised...... to a Treatment Group or a Control Group in a single blinded, randomised study design. The intervention included 12 weeks of standardised pelvic floor muscle training. The outcome was measured by the Short Form 36 (SF-36) Health Survey Questionnaire and The Incontinence Impact Questionnaire (IIQ). Twenty....... Development of specific instruments for QoL in stroke patients with urinary incontinence can be recommended....

  9. 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

  10. Assesment of patients treated with Tension free vaginal tape (TVT for stres urinary incontinence with quality of life tests.

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    Özgür Özyüncü

    2009-03-01

    Full Text Available Objective: The aim of this study is to classify the patients with “Urinary incontinence score for females” test and than evaluation of the patients with quality of life tests before and after TVT procedure. Design: The history, physical examination, intraoperative complications, operation time and postoperative complications of patients were recorded. At the preoperative period “Urinary incontinence score for females” test were performed to all patients. To the patients in the stress, urge and mixed incontinence groups, UDI-6 (Urogenital Distress Inventory-6 and IIQ-7 (Incontinence Impact Questionairre-7 quality of life tests were performed preoperatively and at 6th week and 6th month postoperatively and results were then compared. Setting: Hacettepe University Hospital, Department of Obstetrics and Gynecology Patients: 94 patients in which TVT procedure was performed Interventions: TVT procedure was performed on 94 patients. The UDI-6 (Urogenital Distress Inventory-6 and IIQ-7 (Incontinence Impact Questionairre-7 quality of life tests were performed preoperatively postoperatively. Results: The mean age of the patients were 46,8 years. TVT procedure alone were performed in 8 patients. In addition to TVT, Anterior and posterior colporraphy is performed in 27, Vaginal hysterectomy and Unilateral/bilateral salphingoophorectomy is performed in 57 and manchester operation in 2 of the remaining patients. The most common intraoperative complication was bladder perforation (%15.9. When classified according to urinary incontinence score for females, the percentage of stress, urge and mixed incontinence groups were 36,2, 6,4 and 57,4 respectively and the success rate of TVT in these groups were 100%, 66.67% and 88.89% respectively. When preoperative and postoperatif IIQ-7 and UDI-6 scores were compared, the difference between scores were found to be statistically significant. Conclusions: When classification of patients were done with subjective

  11. A randomized, nonblinded extension study of single-incision versus transobturator midurethral sling in women with stress urinary incontinence

    NARCIS (Netherlands)

    Schellart, René P.; Zwolsman, Sandra E.; Lucot, Jean-Philippe; de Ridder, Dirk J. M. K.; Dijkgraaf, Marcel G. W.; Roovers, Jan-Paul W. R.

    2018-01-01

    Midurethral sling procedures are the first surgical option in women undergoing surgery for stress urinary incontinence (SUI). Single-incision midurethral-slings (SIMS) were designed to provide similar efficacy to traditional midurethral slings but with reduced morbidity. In this international trial

  12. Use of symptom-relieving drugs before and after surgery for urinary incontinence in women: a cohort study

    DEFF Research Database (Denmark)

    Sørensen, Guldberg; Brostrøm, Søren; Kesmodel, Ulrik Schiøler

    2013-01-01

    To describe the use of symptom-relieving drugs (antimuscarinic drugs or duloxetine) before and after surgery for urinary incontinence (UI); and for those with use of antimuscarinic drugs or duloxetine before surgery, to estimate the risk of being a postoperative user, relative to those without use...

  13. Pelvic floor muscle exercise therapy with myofeedback for women with stress urinary incontinence : A meta-analysis

    NARCIS (Netherlands)

    De Kruif, Yvette P.; Van Wegen, Erwin E.H.

    1996-01-01

    Involuntary urine loss can be a major social and hygienic problem for women suffering from stress urinary incontinence (SUI). A frequently applied treatment method for these women is pelvic floor muscle exercise therapy (PFE), either with or without EMG-biofeedback (myofeedback). This paper attempts

  14. Prevalence and risk of sport types to stress urinary incontinence in sportswomen: A cross-sectional study.

    Science.gov (United States)

    Hagovska, Magdaléna; Švihra, Ján; Buková, Alena; Dračková, Dana; Švihrová, Viera

    2018-02-21

    The objective of our study was to investigate the prevalence and risk of developing stress urinary incontinence (SUI) in each type of high-intensity sport, and the associated impact on quality of life in sportswomen. This cross-sectional study was conducted between March and November 2016. The study included 278 sportswomen. The basic inclusion criteria were being nulliparous and engaging in high-intensity physical activity. The exclusion criteria were childbirth, surgical treatment of gynecological and urological illnesses and urinary tract infection. For evaluation were used: The International Physical Activity Questionnaire (IPAQ), The International Consultation on Incontinence Questionnaire Urinary Incontinence (ICIQ-UISF), the Overactive Bladder Questionnaire (OAB-q), the Urinary Incontinence Quality of Life Scale (I-QOL). The highest percentage of SUI was found in athletes (23.8%), followed by volleyball players (19.6%). We found that cumulative metabolic equivalent (MET) did not affect SUI, but the type of sport did. The risk of SUI was highest in volleyball sportswomen (odds ratio[OR] = 2.16,95% confidence interval[CI] = 0.96-4.89, P physiotherapy for strengthening pelvic floor muscles. © 2018 Wiley Periodicals, Inc.

  15. Observational study on safety and tolerability of duloxetine in the treatment of female stress urinary incontinence in German routine practice

    NARCIS (Netherlands)

    Michel, Martin C.; Minarzyk, Anette; Schwerdtner, Inka; Quail, Deborah; Methfessel, Hans D.; Weber, Hans-Joachim

    2013-01-01

    To evaluate the safety and tolerability of duloxetine during routine clinical care in women with stress urinary incontinence (SUI) in Germany, and in particular, to identify previously unrecognized safety issues as uncommon adverse reactions, and the influence of confounding factors present in

  16. The Influence of Urinary Incontinence on Publicly Financed Home Care Services to Low-Income Elderly People.

    Science.gov (United States)

    Baker, Dorothy I.; Bice, Thomas W.

    1995-01-01

    A retrospective cohort design is used to estimate the effect of urinary incontinence (UI) on the public costs of home care services to elderly individuals. Multivariate analyses controlling for other individual, household, and supply characteristics demonstrate that those with UI generate significantly greater public costs for home care services.…

  17. Pelvic floor muscle training in the prevention and treatment of urinary incontinence in women - what is the evidence?

    DEFF Research Database (Denmark)

    Brostrøm, Søren; Lose, G.

    2008-01-01

    Many women suffer from urinary incontinence (UI). During and after pregnancy, women are advised to perform pelvic floor muscle training (PFMT) to prevent the development of UI. In established UI, PFMT is prescribed routinely as first-line treatment. Published studies are small, underpowered...

  18. Predictive Value of Urodynamics on Outcome After Midurethral Sling Surgery for Female Stress Urinary Incontinence EDITORIAL COMMENT

    NARCIS (Netherlands)

    Houwert, R. Marijn; Venema, Pieter L.; Aquarius, Annelies E.; Bruinse, Hein W.; Kil, Paul J. M.; Vervest, Harry A. M.

    2009-01-01

    Urodynamic investigation (UDI) is routinely performed before midurethral sling surgery (MUS) for female stress urinary incontinence to detect factors that may adversely affect the surgical outcome or confirm the diagnosis. A recent review, however, concluded that there was insufficient evidence to

  19. Stress urinary incontinence in patients treated for cervical cancer: is TVT-Secur a valuable treatment option?

    NARCIS (Netherlands)

    Hazewinkel, Menke H.; Schilthuis, Marten S.; Roovers, Jan-Paul

    2009-01-01

    We present two patients with bothersome stress urinary incontinence (SUI) following radical hysterectomy and pelvic lymphadenectomy for early stage cervical cancer. One patient underwent adjuvant radiotherapy. We selected, after extensive counseling, TVT-Secur in these two patients as we aimed to

  20. Patient reported outcome measures in women undergoing surgery for urinary incontinence and pelvic organ prolapse in Denmark, 2006-2011

    DEFF Research Database (Denmark)

    Sørensen, Rikke Guldberg; Kesmodel, Ulrik Schiøler; Hansen, Jesper Kjær

    2012-01-01

    surgery for urinary incontinence (UI) or pelvic organ prolapse (POP) from 2006 to 2011. Using frequency of symptoms and a visual analogue scale (VAS) both pre- and postoperatively, their severity of symptoms and quality of life were measured by questionnaires. RESULTS: During the study period, 20...

  1. Is prenatal urethral descent a risk factor for urinary incontinence during pregnancy and the postpartum period?

    Science.gov (United States)

    Pizzoferrato, Anne-Cécile; Fauconnier, Arnaud; Bader, Georges; de Tayrac, Renaud; Fort, Julie; Fritel, Xavier

    2016-07-01

    Obstetric trauma during childbirth is considered a major risk factor for postpartum urinary incontinence (UI), particularly stress urinary incontinence. Our aim was to investigate the relation between postpartum UI, mode of delivery, and urethral descent, and to define a group of women who are particularly at risk of postnatal UI. A total of 186 women were included their first pregnancy. Validated questionnaires about urinary symptoms during pregnancy, 2 and 12 months after delivery, were administered. Urethral descent was assessed clinically and by ultrasound at inclusion. Multivariate logistic regression analysis was used to determine the risk factors for UI during pregnancy, at 2 months and 1 year after first delivery. The prevalence of UI was 38.6, 46.5, 35.6, and 34.4 % at inclusion, late pregnancy, 2 months postpartum, and 1 year postpartum respectively. No significant association was found between UI at late pregnancy and urethral descent assessed clinically or by ultrasound. The only risk factor for UI at 2 months postpartum was UI at inclusion (OR 6.27 [95 % CI 2.70-14.6]). The risk factors for UI at 1 year postpartum were UI at inclusion (6.14 [2.22-16.9]), body mass index (BMI), and urethral descent at inclusion, assessed clinically (7.21 [2.20-23.7]) or by ultrasound. The mode of delivery was not associated with urethral descent. Prenatal urethral descent and UI during pregnancy are risk factors for UI at 1 year postpartum. These results indicate that postnatal UI is more strongly influenced by susceptibility factors existing before first delivery than by the mode of delivery.

  2. [Prevalence and risk factors for urinary incontinence in women living in the South Priaralye region].

    Science.gov (United States)

    Gaibullaev, A A; Iskandarova, G T; Abdurizaev, A A

    2016-04-01

    To estimate prevalence and types of urinary incontinence (UI) among women living in the South Priaralye region, and to analyze risk factors associated with UI. The population-based study was conducted by nested-typological method. Analysis was carried out on the data of 1487 women collected by a standard ICIQ-SF questionnaire, an assessment tool for female urinary incontinence recommended by the European Association of Urology. The study showed that the prevalence of UI among women aged 18 years and older in the South Priaralye region was 27%. The predominant type of the disease was stress UI since in 44.8% of women, the uncontrolled urine loss occurred during exercise. In 16.1% of women urgent type UI was observed, and in 38.6% mixed type of UI was found. The most significant risk factors for UI were recurrent urinary tract infection (odds ratio (OR) of 5.9 (95% confidence interval (CI) 4.12-8.38), gynecological disease (OR 2.7 (95% CI 1.99-3.59), enuresis in childhood (OR 2.4 (95% CI 1.21-4.88), constipation (OR = 2.1 (95% CI 1.45-2.93) the number of births (OR = 1.2 (95% CI 1,05-1.28), and occupation, namely work involving physical strain (odds ratio of 1.2 (95% CI 1.04-1.43). In the area of the South Priaralye, more than a fourth of adult females were found to have a UI. Understanding the nature and risk factors for UI will allow planning the resources required to provide treatment and preventive measures in the future.

  3. CONTEMPORARY APPROACHES TO MALE URINARY INCONTINENCE: A CONTROLLED RANDOMIZED COMPARATIVE STUDY

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    Hany M. I. Elgohary

    2015-12-01

    Full Text Available Background: Urinary incontinence UI is an involuntary leakage of urine due to loss of bladder control which is a common and often embarrassing problem that may cause tremendous emotional distress. Prevalence and risk factors depend on baseline physiological mechanisms, including weakness of pelvic floor muscles, hyperactive bladder that may result in urge UI, poor urethral sphincter function associated with stress UI, and impaired structural and functional integrity of pudendal nerve activity, associated with Pelvic floor muscle weakness plays an important role in UI etiology. Pelvic floor muscles work to support the bladder neck in the intra- abdominal cavity and maintain urinary continence. Weakness of these muscles leads the bladder to shift to the extra-abdominal cavity and thus a change in the urethra-vesicle angle occurs. Methods: Group (A twenty participants who received behavioral training (BT pelvic floor exercises (PFE and interferential current, group (B twenty participants who received BT, PFE and posterior tibial nerve stimulation, and group (C twenty participants who received BT, PFE and placebo interferential current. Urodynamic and cystometric measures including bladder volume at first desire to void, maximum cystometric capacity, and pressure at maximum flow rate were measured before and after intervention. Results: Results of this study revealed that there was a statistical significant difference in bladder volume at first desire to void, maximum cystometric capacity, and pressure at maximum flow rate in favor of participants who received a combination of BT, PFE and interferential current compared with those who received a combination of BH and PFE with either posterior tibial nerve stimulation or placebo interferential current. Conclusion: Interferential current is better than posterior tibial nerve stimulation in the rehabilitation of urinary incontinence.

  4. An International Continence Society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD).

    Science.gov (United States)

    Gajewski, Jerzy B; Schurch, Brigitte; Hamid, Rizwan; Averbeck, Márcio; Sakakibara, Ryuji; Agrò, Enrico F; Dickinson, Tamara; Payne, Christopher K; Drake, Marcus J; Haylen, Bernie T

    2018-03-01

    The terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD) should be defined and organized in a clinically based consensus Report. This Report has been created by a Working Group under the auspices and guidelines of the International Continence Society (ICS) Standardization Steering Committee (SSC) assisted at intervals by external referees. All relevant definitions for ANLUTD were updated on the basis of research over the last 14 years. An extensive process of 18 rounds of internal and external review was involved to exhaustively examine each definition, with decision-making by collective opinion (consensus). A Terminology Report for ANLUTD, encompassing 97 definitions (42 NEW and 8 CHANGED, has been developed. It is clinically based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different groups involved not only in lower urinary tract dysfunction but additionally in many other medical specialties. A consensus-based Terminology Report for ANLUTD has been produced to aid clinical practice and research. © 2017 Wiley Periodicals, Inc.

  5. Manometric Biofeedback Effectiveness on Urinary Incontinence and Quality of Life: A Non-Randomized Control Trial

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    Marcos E Fernandez-Cuadros

    2017-04-01

    Full Text Available Objectives This study aimed at examining if a 6-session protocol of tonic-phasic exercises using manometric biofeedback (BFB is capable of improving quality of life (QoL and muscular strength in patients with urinary incontinence (UI. Methods A prospective quasi-experimental before-after study was performed on 31 patients with Urinary Incontinence (UI referred to the rehabilitation department of Santa Cristina’s University hospital, Madrid, Spain. The study was performed from January to December 2016. At initial evaluation, affiliation of data, predisposing factors, and type of UI were recorded. Patients were given lifestyle recommendations and international consultation on incontinence questionnaire short form (ICIQ-SF/ incontinence quality-of-life measure (I-QOL questionnaires/scales to be fulfilled at the beginning/end of treatment. Manometric evaluation was recorded at initial/final evaluation by MYOMED ® 932. Manometric-BFB protocol consisted of a 30-minute session of tonic/phasic exercises (15 minutes each, 2 times a week for up to 6 sessions, supervised by a physiotherapist. Results Mean age was 52 ± 12.1 years. Overall, 96.7% (n = 31 of the participants were females. Maximum and mean strength of pelvic floor contraction was 24 ± 17.72 and 4.9 ± 4.1 mmHg, and increased significantly after treatment to 35 ± 20.85 and 7.45 ± 4.92 mmHg (P < 0.01. The mean ICIQ-SF score was 9.13 ± 5.18 and decreased significantly to 6.13 ± 4.75 (P = 0.003. The mean I-QoL score increased significantly from 70.33 ± 22.12 to 81.25 ± 16.72 (P = 0.0017. The I-QoL Limiting Behaviour (LB-subscale raised from 68.38 ± 23.33 to 80 ± 16.56 (P = 0.0015; I-QoL Psychosocial Impact (PI-subscale increased from 77.43 ± 24.51 to 80 ± 17.47 (p = 0.0152; and I-QoL social embarrassment (SE-subscale incremented from 60.72 ± 22.37 to 74.37 ± 20.86 (P = 0.0007. Conclusions Manometric-BFB protocol is capable of decreasing UI and to improve QoL and manometric values

  6. Relationships Among Use of Complementary and Alternative Interventions, Urinary Incontinence, Quality of Life, and Self-esteem in Women With Urinary Incontinence.

    Science.gov (United States)

    Öz, Özge; Altay, Birsen

    The purpose of this study was to examine associations among sociodemographic characteristics, urinary incontinence (UI) characteristics, UI-specific quality of life and self-esteem, and use of complementary and alternative medicine (CAM) interventions for UI. Correlational-descriptive research. This sample comprised 394 female patients 18 years or older cared for in the urology and gynecology outpatient clinics of a university hospital in Samsun, Turkey. Participants completed an investigator-developed questionnaire that included 2 validated instruments, King's Health Questionnaire (KHQ) and the Rosenberg Self-esteem Scale. Descriptive statistics were used for demographic data and use of CAM interventions. Variables associated with CAM use were assessed using χ analysis. The differences between using CAM and scales points of the KHQ and the Rosenberg Self-esteem Scale were assessed using the t test, and the relationship between the KHQ and the Rosenberg Self-esteem Scale was assessed using correlation analysis. Thirty-three percent (n = 130) of women indicated using CAM interventions to manage their UI. The most common CAM intervention, reported by 52.6% of respondents, was prayer. Women with lower UI-specific quality of life and self-esteem scores were more likely to report using CAM interventions (P self-esteem and condition-specific health-related quality of life than women who did not use these interventions.

  7. Validation of use of the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) for impairment rating: a transversal retrospective study of 120 patients.

    Science.gov (United States)

    Timmermans, Luc; Falez, Freddy; Mélot, Christian; Wespes, Eric

    2013-09-01

    A urinary incontinence impairment rating must be a highly accurate, non-invasive exploration of the condition using International Classification of Functioning (ICF)-based assessment tools. The objective of this study was to identify the best evaluation test and to determine an impairment rating model of urinary incontinence. In performing a cross-sectional study comparing successive urodynamic tests using both the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) and the 1-hr pad-weighing test in 120 patients, we performed statistical likelihood ratio analysis and used logistic regression to calculate the probability of urodynamic incontinence using the most significant independent predictors. Subsequently, we created a template that was based on the significant predictors and the probability of urodynamic incontinence. The mean ICIQ-UI-SF score was 13.5 ± 4.6, and the median pad test value was 8 g. The discrimination statistic (receiver operating characteristic) described how well the urodynamic observations matched the ICIQ-UI-SF scores (under curve area (UDA):0.689) and the pad test data (UDA: 0.693). Using logistic regression analysis, we demonstrated that the best independent predictors of urodynamic incontinence were the patient's age and the ICIQ-UI-SF score. The logistic regression model permitted us to construct an equation to determine the probability of urodynamic incontinence. Using these tools, we created a template to generate a probability index of urodynamic urinary incontinence. Using this probability index, relative to the patient and to the maximum impairment of the whole person (MIWP) relative to urinary incontinence, we were able to calculate a patient's permanent impairment. Copyright © 2012 Wiley Periodicals, Inc.

  8. Urinary incontinence and vaginal squeeze pressure two years post-cesarean delivery in primiparous women with previous gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Angélica Mércia Pascon Barbosa

    2011-01-01

    Full Text Available OBJECTIVE: To assess the prevalence of urinary incontinence and associated vaginal squeeze pressure in primiparous women with and without previous gestational diabetes mellitus two years post-cesarean delivery. METHODS: Primiparous women who delivered by cesarean two years previously were interviewed about the delivery and the occurrence of incontinence. Incontinence was reported by the women and vaginal pressure evaluated by a Perina perineometer. Sixty-three women with gestational diabetes and 98 women without the disease were screened for incontinence and vaginal pressure. Multiple logistic regression models were used to evaluate the independent effects of gestational diabetes. RESULTS: The prevalence of gestational incontinence was higher among women with gestational diabetes during their pregnancies (50.8% vs. 31.6% and two years after a cesarean (44.8% vs. 18.4%. Decreased vaginal pressure was also significantly higher among women with gestational diabetes (53.9% vs. 37.8%. Maternal weight gain and newborn weight were risk factors for decreased vaginal pressure. Maternal age, gestational incontinence and decreased vaginal pressure were risk factors for incontinence two years after a cesarean. In a multivariate logistic model, gestational diabetes was an independent risk factor for gestational incontinence. CONCLUSIONS: The prevalence of incontinence and decreased vaginal pressure two years post-cesarean were elevated among women with gestational diabetes compared to women who were normoglycemic during pregnancy. We confirmed an association between gestational diabetes mellitus and a subsequent decrease of vaginal pressure two years post-cesarean. These results may warrant more comprehensive prospective and translational studies.

  9. Effects of Biofeedback in Preventing Urinary Incontinence and Erectile Dysfunction after Radical Prostatectomy

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    Fabiana S. B. Perez

    2018-02-01

    Full Text Available In this study, we present a biofeedback method for the strengthening of perineal muscles during the preoperative procedures for radical prostatectomy, and we evaluate this technique as a prevention measure against complications such as urinary incontinence (UI and erectile dysfunction (ED, which affect prostatectomy patients after surgery. In the experimental protocol, the patients performed specific exercises with the help of a device that provided the patient with visual biofeedback, based on a plot of the anal pressure. For the experimental protocol, we selected 20 male patients, with an average age of 64.0 years, and submitted them to ten therapeutic sessions each. A control group consisting of 32 men with an average age of 66.3 years, who were treated with the same surgical procedure but not with the preoperative procedures, also took part in the experiment. To evaluate UI and ED after the surgery in both control and experimental groups, we used two validated questionnaires—to assess UI, we used the King’s Health Questionnaire (KHQ and, for ED, we used the International Index of Erectile Function (IIEF-5 Questionnaire. We compared the variables associated with UI and ED after the surgery for the control and experimental groups. The occurrence of UI after radical prostatectomy in the control group (100% of the patients was higher than that for the experimental group (5% of the patients, with p < 0.0001. Likewise, the occurrence of erectile dysfunction after prostatectomy in the control group (48.6% of the patients was higher than that for the experimental group (5% of the patients, with p < 0.0001. The number of nocturia events also decreased as a consequence of the intervention (p < 0.0001, as did the number of disposable underwear units for urinary incontinence (p < 0.0001. Furthermore, we compared, only for the experimental group, the anal pressure before the biofeedback intervention and after the surgery, and we

  10. Neurogenic Stuttering

    Science.gov (United States)

    ... Teachers Speech-Language Pathologists Physicians Employers Tweet Neurogenic Stuttering Parents of Preschoolers Parents of School-Age Children ... Pathologists Physicians Employers Download brochure What is neurogenic stuttering? Neurogenic stuttering is a type of fluency disorder ...

  11. Female urinary incontinence: quality of life comparison on reproductive age and postmenopausal period

    Directory of Open Access Journals (Sweden)

    Mariana Tirolli Rett

    Full Text Available Abstract Introduction: urinary incontinence (UI is defined as any involuntary leakage of urine and their symptoms can affect women's quality of life (QoL. Objectives: to compare incontinent women's QoLin reproductive age (G1 with those in post menopausal period(G2. Material and methods: a descriptive and retrospective study involved 86 women with UI complaints. Clinical, sociodemographic, obstetrical and gynecological antecedents were collected. Pelvic floor evaluation was conducted by digital palpation and QoL was evaluated by King's Health Questionnaire (KHQ. Mann-Whitney and t Student test were used to compare QoL domains. Results: 36 women in reproductive age (G1 42.9 (± 7,4 years and 50 women in postmenopausal period (G2 61,6 (± 9,3 years were assessed. The G2 showed significantly more nocturia (p = 0,0057, urge incontinence (p = 0,0061 and enuresis (0,0021 symptoms, whereas in G1 bladder pain and voiding difficulties were more significant. KHQ domains showed statistical differences in: general health perception (G1 26,4 ± 16,8 versus G2 38,0 ± 16.2; p = 0,0019 and emotions (G1 15,1 ± 31,3 versus G2 38,9 ± 37,5; p = 0,0051. Conclusion: UI affects negatively QoLin women. Women on postmenopausal period showed higher impact on the QoLdomains related to general health perception and emotions.

  12. Contemporary surgical devices for male stress urinary incontinence: a review of technological advances in current continence surgery.

    Science.gov (United States)

    Chung, Eric

    2017-07-01

    Male stress urinary incontinence (SUI) remains a debilitating condition that adversely impacts all domains of quality of life and is associated with significant social stigma and health economic burden. The incidence of post-prostatectomy urinary incontinence (PPI) depends on the definition of urinary incontinence and the length of patient follow up. In patients with persistent PPI following failure of conservative measures, surgical treatment is recommended although there is no published guideline on when surgery should be performed, and what the best surgical option is. Male slings (MS) can be divided into adjustable or non-adjustable types, and offers an attractive option for patients who wish to avoid mechanical handling during urinary voiding. Published intermediate data supports good safety and efficacy rate in men with mild to moderate degree of SUI. The AMS 800 artificial urinary sphincter (AUS) remains the standard of treatment for complete continence and has the longest efficacy and safety records. Other AUS-like devices are designed to address current AMS 800 limitations but themselves are fraught with their own issues.

  13. Effect of tension-free vaginal tape and TVT-obturator on lower urinary tract symptoms other than stress urinary incontinence.

    Science.gov (United States)

    Ballert, Katie N; Kanofsky, Jamie A; Nitti, Victor W

    2008-03-01

    Variable effects on lower urinary tract symptoms (LUTS) other than stress urinary incontinence (SUI) have been reported after tension-free vaginal tape (TVT). We measured the effect of TVT on LUTS using the American Urological Association Symptom Index (AUASI). Patients undergoing TVT completed the AUASI pre- and post-operatively. Total scores (TS), storage scores (SS), and voiding scores (VS) were compared overall and among patients with SUI vs mixed urinary incontinence (MUI) and those who underwent TVT vs TVT-obturator (TVT-O). The mean change in TS and SS was -3.6 and -3.0. Mean reductions in TS and SS were significant in all patient subsets with no change in VS. There was no significant difference in the mean changes in TS between patients with SUI vs MUI or those undergoing TVT vs TVT-O. LUTS are improved after TVT in most patients. In general, voiding symptoms were not adversely affected.

  14. The efficacy of electroacupuncture for the treatment of simple female stress urinary incontinence - comparison with pelvic floor muscle training: study protocol for a multicenter randomized controlled trial.

    Science.gov (United States)

    Su, Tongsheng; Zhou, Jing; Liu, Zhishun; Chen, Yuelai; Zhang, Wei; Chu, Haoran; Luo, Qiong; Lu, Jin; An, Junming; Liu, Baoyan

    2015-02-08

    Previous research has shown that electroacupuncture therapy has a potential therapeutic effect for simple female stress urinary incontinence. In this study, pelvic floor muscle training, the first-line treatment for stress urinary incontinence in women based on meta-analysis of numerous randomized control trials and recommended by international clinical practice, is used as a control group to demonstrate whether electroacupuncture therapy is a better method for female stress urinary incontinence. A randomized controlled trial has been designed to evaluate the therapeutic benefit of electroacupuncture for female stress urinary incontinence compared with pelvic floor muscle training. The safety of electroacupuncture and patient compliance will also be evaluated. Untoward reaction to the electroacupuncture, including a broken needle, fainting on acupuncture, or pain during acupuncture, will be recorded and the therapy will be stopped if an untoward reaction occurs. After we have received full ethical approval and patient consent, participants will be randomized to receive a series of 24 electroacupuncture or pelvic floor muscle training interventions. The frequency and amount of leakage will be measured as the primary outcome parameters. Secondary outcome parameters include the 1-hour pad test, the short-form of the International Consultation on Incontinence Questionnaire, patient subjective effectiveness evaluation, weekly usage of pad, and usage of specialty therapy for female stress urinary incontinence. This trial will help to determine whether electroacupuncture is a more effective treatment than pelvic floor muscle training for patients with female stress urinary incontinence. ClinicalTrials.gov NCT01940432 (12 September 2013).

  15. Prevalence and risk factors of urinary incontinence in Chinese women: a population-based study.

    Science.gov (United States)

    Ge, Jing; Yang, Peng; Zhang, Yi; Li, Xinyu; Wang, Quanyi; Lu, Yongxian

    2015-03-01

    To estimate the current prevalence rate of urinary incontinence (UI) and to identify risk factors in Chinese women, we conducted a population-based survey in 3058 women in Beijing, China, in 2009. The prevalence rate of UI was estimated to be 22.1%, with stress UI (12.9%) being more prevalent than urgency UI (1.7%) and mixed UI (7.5%). The prevalence rates of UI, urgency UI, and mixed UI increased with age, with the highest recorded in participants aged ≥70 years. However, stress UI was most commonly seen in participants aged 50 to 69 years. Risk factors for UI included aging, lower education background, older age of menarche, menstrual disorder, pregnancy history, episiotomy, chronic pelvic pain, gynecological disease, other chronic diseases, constipation, fecal incontinence, lower daily water intake, and frequency of high protein intake. UI is a common disorder in Chinese women, and many risk factors are able to affect the development of UI. © 2011 APJPH.

  16. Reliability of voiding colpo-cysto-urethrography in female urinary stress incontinence before and after treatment

    International Nuclear Information System (INIS)

    Klarskov, P.; Jepsen, P.V.; Dorph, S.

    1988-01-01

    Voiding colpo-cysto-urethrography was performed in 52 consecutive female patients with genuine urinary stress incontinence before treatment and in 50 of the patients after treatment. The patients were randomized to either pelvic floor training or surgery. Surgery included a colposuspension operation in patients with an anterior suspension defect and a vaginal repair in patients with a posterior suspension defect. All pre- and posttreatment examinations were reevaluated blindly by one observer 4 to 6 years later. The pretreatment radiologic reevaluation was in agreement with the original classification in 79% and not in agreement in 21%. Pelvic floor training did not change the degree of suspension defect systematically. The effect of squeezing was significantly improved following pelvic floor training. A colposuspension gave rise to a typical radiologic configuration of the bladder and urethra. A vaginal repair was not detectable radiologically and it did not correct a posterior descent. The degree of descent and the degree of incontinence were not correlated and it was not possible radiologically to distinguish treatment failures from treatment success. (orig.)

  17. Reliability of voiding colpo-cysto-urethrography in female urinary stress incontinence before and after treatment

    Energy Technology Data Exchange (ETDEWEB)

    Klarskov, P.; Jepsen, P.V.; Dorph, S.

    Voiding colpo-cysto-urethrography was performed in 52 consecutive female patients with genuine urinary stress incontinence before treatment and in 50 of the patients after treatment. The patients were randomized to either pelvic floor training or surgery. Surgery included a colposuspension operation in patients with an anterior suspension defect and a vaginal repair in patients with a posterior suspension defect. All pre- and posttreatment examinations were reevaluated blindly by one observer 4 to 6 years later. The pretreatment radiologic reevaluation was in agreement with the original classification in 79% and not in agreement in 21%. Pelvic floor training did not change the degree of suspension defect systematically. The effect of squeezing was significantly improved following pelvic floor training. A colposuspension gave rise to a typical radiologic configuration of the bladder and urethra. A vaginal repair was not detectable radiologically and it did not correct a posterior descent. The degree of descent and the degree of incontinence were not correlated and it was not possible radiologically to distinguish treatment failures from treatment success.

  18. Analytic model comparing the cost utility of TVT versus duloxetine in women with urinary stress incontinence.

    Science.gov (United States)

    Jacklin, Paul; Duckett, Jonathan; Renganathan, Arasee

    2010-08-01

    The purpose of this study was to assess cost utility of duloxetine versus tension-free vaginal tape (TVT) as a second-line treatment for urinary stress incontinence. A Markov model was used to compare the cost utility based on a 2-year follow-up period. Quality-adjusted life year (QALY) estimation was performed by assuming a disutility rate of 0.05. Under base-case assumptions, although duloxetine was a cheaper option, TVT gave a considerably higher QALY gain. When a longer follow-up period was considered, TVT had an incremental cost-effectiveness ratio (ICER) of pound 7,710 ($12,651) at 10 years. If the QALY gain from cure was 0.09, then the ICER for duloxetine and TVT would both fall within the indicative National Institute for Health and Clinical Excellence willingness to pay threshold at 2 years, but TVT would be the cost-effective option having extended dominance over duloxetine. This model suggests that TVT is a cost-effective treatment for stress incontinence.

  19. Multimodal vaginal toning for bladder symptoms and quality of life in stress urinary incontinence.

    Science.gov (United States)

    de la Torre, Sarah; Miller, Larry E

    2017-08-01

    Treatment options for women with stress urinary incontinence (SUI) have limitations. We hypothesized that multimodal vaginal toning therapy would improve bladder symptoms and quality of life in women with postpartum SUI and sexual function complaints. Patients self-administered 24 sessions of multimodal vaginal toning therapy lasting 10 min each over 50 days. Outcomes included 1-h pad weight test, Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), Female Sexual Distress Scale-Revised 2005 (FSDS-R), Female Sexual Function Index (FSFI), pelvic floor muscle strength, patient satisfaction, and adverse events. Of the 55 patients enrolled (safety population), 48 completed the study per-protocol (PP population). A total of 38 (79%) patients had a positive 1-h pad weight test at baseline. In this group, urine leakage was moderate or severe in 82% of patients at baseline, but in only 18% after treatment. Treatment success was 84%, defined as >50% improvement in pad weight relative to baseline. In the PP population, mean UDI-6 score improved by 50% (p life improved by 54% for FSDS-R and 15% for FSFI (both p life in women with SUI.

  20. The clinical relevance of cell-based therapy for the treatment of stress urinary incontinence

    DEFF Research Database (Denmark)

    Gräs, Søren; Lose, Gunnar

    2011-01-01

    or progenitor cells presents an alternative approach, which aims at repairing the anatomical components of the urethral continence mechanism. In vitro expanded progenitor cells isolated from muscle biopsies have been most intensely investigated, and both preclinical trials and a few clinical trials have......Stress urinary incontinence is a common disorder affecting the quality of life for millions of women worldwide. Effective surgical procedures involving synthetic permanent meshes exist, but significant short- and long-term complications occur. Cell-based therapy using autologous stem cells...... provided proof of concept for the idea. An initial enthusiasm caused by positive results from early clinical trials has been dampened by the recognition of scientific irregularities. At the same time, the safety issue for cell-based therapy has been highlighted by the appearance of new and comprehensive...

  1. Self-reported urinary incontinence in elderly and its associated factors

    Directory of Open Access Journals (Sweden)

    Alisson Fernandes Bolina

    2013-05-01

    Full Text Available Household survey, cross-sectional and observational study that aimed to verify the socio-demographic factors and self-reported morbidities associated with urinary incontinence (UI. The research was carried out between August and December 2008 with 2,142 elderly people. We used a semi-structured instrument, and performed a descriptive analysis and logistic regression (p<0.05. Most were female and with income of up to one minimum wage. UI prevailed among those aged 70├80 years, widowed and uneducated; for the group without UI: 60├70 years, married or living with partner and 4├8 years of study. The factors associated with increased chances of presenting UI were: 70├80 years and 80 years and older, no education and obesity. It is important to pay attention to the factors associated with UI in the development of effective actions on health prevention.

  2. High Prevalence of Stress Urinary Incontinence in Adult Patients with Bronchiectasis

    LENUS (Irish Health Repository)

    Duignan, N

    2016-07-01

    Stress urinary incontinence (SUI) is frequently under-reported in patients with chronic lung disease and may have negative psychosocial consequences. We conducted a prospective study to determine the prevalence, severity and treatment outcomes of SUI in female bronchiectasis patients referred for airway clearance techniques. Nineteen out of 40 (48%) patients reported SUI symptoms. Of these, 14 (74%) reported a reduced quality of life secondary to SUI. Following personalised intervention, symptom improvement was observed in 13\\/19 (68%). Five out of 19 (26%) required specialist referral for further continence care. No associations with lung disease severity and SUI were noted. SUI is common in adult female bronchiectasis patients and should be routinely screened for to improve patients’ overall quality of life.

  3. Periurethral injection of collagen in the treatment of urinary stress incontinence: ultrasonographic appearance

    Energy Technology Data Exchange (ETDEWEB)

    Leonhardt, C.; Krysl, J.; Arenson, A.M.; Herschorn, S. [Toronto Univ., ON (Canada). Faculty of Medicine

    1995-06-01

    Transvesical and transvaginal ultrasonography (US) was performed 26 times in 23 patients, 3 to 36 months after periurethral injection of collagen to treat symptomatic urinary stress incontinence. The appearance, location and volume of the collagen were recorded. In all the patients the injected collagen had the appearance of a well-circumscribed mass of variable size, located at the bladder base. Transvesical US demonstrated the collagen in only 17 of the patients, and allowed only limited visualization of the collagen in five of these 17 patients. However, transvaginal US demonstrated the collagen in all of them. The collagen collections showed various levels of echogenicity with both techniques. However, in patients with more than one deposit of collagen, the collections had similar echogenicity. The study indicated that US provides a rapid, noninvasive method of assessing collagen after periurethral injection, and that transvaginal US was the best method of visualizing such collections. 10 refs., 5 figs.

  4. Epidemiology and impact of urinary incontinence, overactive bladder, and other lower urinary tract symptoms: results of the EPIC survey in Russia, Czech Republic, and Turkey.

    Science.gov (United States)

    Kogan, Mikhail Iosifovich; Zachoval, Roman; Ozyurt, Ceyhun; Schäfer, Thomas; Christensen, Nicola

    2014-10-01

    To estimate the prevalence of urinary incontinence (UI), overactive bladder (OAB), and other lower urinary tract symptoms (LUTS) in the Czech Republic, Russia, and Turkey. Stage one of this population-based survey consisted of computer-assisted telephone interviews to obtain prevalence estimates of storage, voiding, and post-micturition LUTS. Stage two face-to-face interviews evaluated subjects with mixed urinary incontinence (MUI), stress urinary incontinence (SUI) or OAB (case group) and a control group (subjects with other incontinence or LUTS complaints, or no symptoms). Prevalence of LUTS categories were determined for each country based on International Continence Society (ICS) criteria. A total of 3130 individuals agreed to participate in the survey, which found high rates of LUTS (men 80%; women 84%) and OAB (men 18%; women 28%). Duration of urinary symptoms was relatively brief (approximately 60% ≤ 3 years) and was associated with relatively modest effects on quality of life and work performance in the majority of individuals. Forty percent had consulted with a healthcare provider about their urinary symptoms, of whom 37% had consulted with a physician and 34% with an urologist, and 12% had been treated with a prescription medication. Drug therapy, while uncommon, was associated with a high degree of self-reported improvement (96%). Because of between-country population differences, aggregate results may not always be representative of results for each of the three countries individually. Study limitations include reliance on patient self-report, and potential bias introduced by patients who declined to participate in the