Diagnosis Of Urinary Incontinence Research Articles

Validation and cultural translation for the Brazilian Portuguese version of the Questionnaire for Urinary Incontinence Diagnosis.

Short questionnaires are important for validating the clinical diagnosis of urinary incontinence (UI). We sought to validate and culturally translate the Questionnaire for Urinary Incontinence Diagnosis (QUID) for the Brazilian Portuguese language. A cross-sectional study with 457 women (330 with urinary incontinence and 127 controls) was performed in a Southeastern Brazilian outpatient clinic. Patients answered a pilot-tested, notarized, six-item questionnaire (QUID) for internal consistency as well as a control questionnaire (ICIQ-SF and ICIQ-OAB) for construct validity. In both groups, floor and ceiling effects were calculated. Within UI women, test-retest (n=41) and responsiveness to conservative treatment (n=74) were also analyzed. Internal consistency (Cronbach's alpha) from the QUID was adequate between the UI (0.845-0.850) and control (0.724-0.775) groups. Mean QUID scores were statistically different between UI and control groups (p<0.05). No ceiling or floor effects were observed in incontinent patients. Test-retest reliability after 4 weeks (intraclass correlation coefficient [ICC]: 0.780-0.814) and responsiveness (0.867-0.889) were also adequate within UI women. Construct validity was adequate at all correlations between QUID and ICIQ-SF and ICIQ-OAB (r: 0.19-0.58; p<0.05). Responsiveness was demonstrated by a statistically significant difference in questions/subscale sores after physical therapy. The QUID presented adequate cultural translation, reliability, and good responsiveness to treatment in the Brazilian Portuguese language.

PD06-02 CAN OVERNIGHT AMBULATORY URODYNAMICS CHANGE PATIENT MANAGEMENT AND RESOLVE SYMPTOMS OF NOCTURIA AND/OR NOCTURNAL ENURESIS?

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Incontinence: Evaluation (Urodynamic Testing) (PD06)1 Apr 2020PD06-02 CAN OVERNIGHT AMBULATORY URODYNAMICS CHANGE PATIENT MANAGEMENT AND RESOLVE SYMPTOMS OF NOCTURIA AND/OR NOCTURNAL ENURESIS? Richard Axell*, Habiba Yasmin, Aleksejeva Kristina, Eskinder Solomon, Bogdan Toia, Pakzad Mahreen, Hamid Rizwan, Jeremy Ockrim, and Tamsin Greenwell Richard Axell*Richard Axell* More articles by this author , Habiba YasminHabiba Yasmin More articles by this author , Aleksejeva KristinaAleksejeva Kristina More articles by this author , Eskinder SolomonEskinder Solomon More articles by this author , Bogdan ToiaBogdan Toia More articles by this author , Pakzad MahreenPakzad Mahreen More articles by this author , Hamid RizwanHamid Rizwan More articles by this author , Jeremy OckrimJeremy Ockrim More articles by this author , and Tamsin GreenwellTamsin Greenwell More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000833.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Overnight ambulatory urodynamics (aUDS) is performed in patients with isolated nocturnal symptoms in whom conventional urodynamics have been non-diagnostic. We aimed to determine if a urodynamic diagnosis of detrusor overactivity (DO) or urge urinary incontinence (UUI) on overnight ambulatory urodynamics resulted in a change in patient management and in urinary symptoms. METHODS: We reviewed the overnight ambulatory studies of 25 patients of median age 38 years (28% Male) whose most bothersome urinary symptoms were nocturia and/or nocturnal enuresis following non-diagnostic conventional urodynamics between November 1998 and August 2018. We determined if DO and UUI was demonstrated and assessed their urinary symptoms before ambulatory urodynamics and again after urological treatment following any changes in urodynamics diagnosis and subsequent treatment. Five patients were excluded from the symptomatic follow-up as this data was not available. Statistical analysis was performed using Fisher Exact test for non-parametric data. RESULTS: DO was demonstrated in 19 (76%) out of the 24 patients who presented with nocturia (mean pressure 69.1 ± 53.3 cmH2O). UUI was demonstrated in 16 (80%) out of the 20 patients who also complained of nocturnal enuresis. Following overnight ambulatory urodynamics a change in urodynamic diagnosis was made in 15 (79%) patients. 16 (84%) patients also had their clinical diagnosis and subsequent management changed. 15 (79%) out of 19 patients reported an improvement in their urinary symptoms following these changes in diagnosis and treatment; 11 (61%) out of 18 had resolution of their nocturia and 11 (73%) out of 15 had resolution of their nocturnal enuresis (table 1). CONCLUSIONS: Overnight ambulatory studies demonstrated DO in 76% of patients presenting with nocturia, and UUI in 80% of patients presenting with nocturnal enuresis. Following subsequent treatment changes 61% of patients had resolution of their nocturia and 73% had resolution of their nocturnal enuresis symptoms. Source of Funding: none. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e154-e155 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Richard Axell* More articles by this author Habiba Yasmin More articles by this author Aleksejeva Kristina More articles by this author Eskinder Solomon More articles by this author Bogdan Toia More articles by this author Pakzad Mahreen More articles by this author Hamid Rizwan More articles by this author Jeremy Ockrim More articles by this author Tamsin Greenwell More articles by this author Expand All Advertisement PDF downloadLoading ...

КОМПЛЕКСНАЯ ДИАГНОСТИКА И ЛЕЧЕНИЕ НЕДЕРЖАНИЯ МОЧИ У ДЕТЕЙ

The article discusses the diagnosis and treatment of urinary incontinence in children. The etiological factors of urinary incontinence in children are considered in detail. Practical recommendations are given to doctors on the choice of approaches to diagnosis and effective medications for treatment and pharmacological methods of therapy. As one of the effective medications for the treatment of monosymptomatic nocturnal urinary incontinence, the drug Driptan (oxybutynin hydrochloride) is recommended.

The Effect of Incontinence Severity on Symptom Distress, Quality of Life, and Pelvic Floor Muscle Function in Turkish Women with Urinary Incontinence

Objective: The aim of the present study was to compare the differences in symptom distress, quality of life, and pelvic floor muscle function among Turkish women with mild, moderate, or severe urinary incontinence.Study design: One hundred and twenty women with a diagnosis of urinary incontinence (54.2% stress urinary incontinence and 45.8% mixed-urinary incontinence) participated in the present study. The severity of the urinary incontinence was stratified by the Incontinence Severity Index. The Turkish versions of the Urinary Distress Inventory-6 and the Incontinence Impact Questionnaire-7 were used to assess symptom distress and quality of life, respectively. Pelvic floor muscle strength and endurance were measured using a non-invasive vaginal perineometer.Results: Symptom distress and quality of life significantly differed among the mild, moderate, and severe urinary incontinence groups (p&lt;0.001). Patients with severe stress urinary incontinence displayed a higher decrease in quality of life than those with mild stress urinary incontinence (p&lt;0.001). Furthermore, severe mixed urinary incontinence had a greater impact on symptom distress and quality of life compared to mild and moderate mixed urinary incontinence (p&lt;0.05). The Incontinence Severity Index score was significantly associated with the Urinary Distress Inventory-6 and Incontinence Impact Questionnaire-7 scores (p&lt;0.001).Conclusion: Urinary incontinence affected the symptom distress and quality of life of patients in proportion to the severity of the symptoms. Therefore, the relationship between the severity of urinary incontinence and patients’ quality of life should be evaluated in clinical settings. To prevent the greater influence of incontinence on the quality of life of women with urinary incontinence, early detection of urinary incontinence and early management strategies are essential.

Evaluation of transperineal ultrasound in diagnosis and grading of female genuine urinary stress incontinence

Stress urinary incontinence (SUI) has an observed prevalence of between 4%and 35%. Purpose: To determine the role of transperineal ultrasound in diagnosing stress incontinence, its degree and the possible cause by: Measuring the BN descent, urethral hypermobility, funneling of BN or proximal urethra, urethral diameter, posterior urethra vesical angle, associated cystocele Using color Doppler to detect escape of urine through the urethra. Methods: 52 female patients diagnosed to have genuine stress incontinence using 3 day voiding diary, simple questionnaire and confirmed by standard urodynamics. Classification of stress incontinence into mild, moderate and severe using Valsalva leak point pressure during urodynamic study. Transperineal ultrasound for evaluation of the anterior pelvic compartment regarding: bladder neck descent, urethralhy permobility, Funneling of the BN, posterior urethrovesical angle ,urethral diameter, associatedcystocele, and finally the Doppler detection of urinary escape both at rest and with Valsalva maneuvers. Results: 28/52 cases (53.8%) of SUI didn’t show clinical evidence of cystocele; 11 cases (21.2%) showed grade 1 cystocele and 13cases (25%) showed grade 2 cystocele. The presence or absence of cystocele and also the grade of cystocele did not show a statistically significant relation to the degree of SUI; p=0.089 and 0.086 respectively Conclusion: We came to conclusion that transperineal ultrasound can be used in accurate diagnosis and grading of female urinary stress incontinence with our given cutoff values for bladder displacement, α angle, β angle and urethral diameters and from this grading by transperineal ultrasound comes the novelity of our research.

Randomized controlled trial for the efficacy of electroacupuncture in the treatment of urge urinary incontinence: A clinical study protocol.

Background:Despite that the urge urinary incontinence (UUI) is a nonfatal disease, it can lead to anxiety, embarrassment and depression to the patient. UUI is a common public health problem that can significantly affect the quality of life of the patient. Several conservative treatments have been recommended for the treatment of UUI; however, their efficiency remains unclear, leaving the disease without a real effective treatment. The clinical application of acupuncture to treat UUI is currently considered an effective approach despite the limited evidence that support its efficiency. The aim of this study is to assess the efficacy and safety of electroacupuncture therapy in the treatment of UUI.Methods and analysis:A randomized, parallel, controlled study will be performed. Patients with UUI treated with electroacupuncture group (EA) will compare with the sham-treated sham EA (SA) patients. A total of 100 participants with UUI will be randomly allocated to either the EA or the SA group with a 1:1 ratio. The treatment of UUI patients will performed 3 times per week, for 8 weeks in 30-minute sessions. At the end of the treatment the patients will be followed-up until week 32. The primary outcomes include scores of incontinence questionnaire-short form, the average 24-hour urgency incontinence episodes, and the average 24-hour urge episodes responses from baseline until the 4th, 8th , 24th, and 32nd week. The secondary outcomes included the average 24-hour urine volume and the average 24-hour micturition frequency responses from baseline until the 8th and 32nd week, as well as the change in incontinence quality of life scores from baseline at the 8th and 32nd week. In addition, the degree of satisfaction of the participants undergoing acupuncture treatment will be measured at the 4th and 8th week. The participants’ clinical acupuncture expectations were evaluated at baseline, and the questionnaire for urinary incontinence diagnosis was used to identify stress incontinence, mixed urinary incontinence, and urge incontinence at baseline.Discussion:This is a randomized, controlled, observer-blinded trial of electroacupuncture treatment for UUI. The results of this trial will provide more evidence on whether electroacupuncture is efficacious for treating UUI.

Urinary and fecal incontinence in stroke survivors followed in general practice: A retrospective cohort study.

Investigating the short- and long-term health outcomes after stroke is a public health priority. We aimed to analyse the incidence of urinary and fecal incontinence within 10 years of stroke in individuals followed in general practice in Germany. Individuals who had received an initial stroke diagnosis at one of 1262 general practices in Germany between January 2006 and December 2015 were included (index date). Individuals without stroke were matched (1:1) to those with stroke based on propensity scores by using a "greedy" algorithm and logistic regression with sex, age, index year, and 17 comorbidities diagnosed in the 12 months before the index date. The main outcome of the study was the incidence of urinary and fecal incontinence within 10 years of stroke. This study analysed data for 16,181 individuals with stroke and 16,181 without stroke. Within 10 years of the index date, 22% and 11% of men with and without stroke received a diagnosis of urinary incontinence (log-rank P<0.001); the prevalence of urinary incontinence was 34% in female stroke survivors and 17% in females with no history of stroke (log-rank P<0.001). The respective proportions of fecal incontinence were 5% and 2% for men (log-rank P<0.001) and 6% and 3% for women (log-rank P<0.001). Overall, stroke was positively associated with both urinary incontinence (men: hazard ratio [HR] 2.34, 95% confidence interval [CI] 2.10-2.61; women: HR 2.36, 95% CI 2.14-2.61) and fecal incontinence (men: HR 2.43, 95% CI 1.88-3.13; women: HR 2.60, 95% CI 1.98-3.41). This study, using data from Germany, suggests that general practitioners should regularly screen for urinary and fecal incontinence in the decade following stroke.

Prevalensi dan Faktor Risiko Inkontinensia Urin pada lansia di Panti Sosial Tuna Werdha (PSTW) Sabai Nan Aluih Sicincin Pariaman

The increased life expectancy of Indonesian people to 66.2 years old contributes to the increased number of elderly people (Aging Structured Population). Aging Process causes health problems among elderly people, including depression, immune deficiency, sleep disorder (insomnia) and urinary incontinence (1). Urinary incontinence is a defect of bladder sphincter or neurological dysfunction which causes loss of control of urinating (2). Urinary incontinence can cause physical, psychological, social and economic problem, thus affecting the quality of life of elderly people (3) (4). The purpose of this study was identifying the prevalence and risk factors of urinary incontinence among elderly people in PSTW Pariaman. This study was an observation analytical study with cross sectional approach. Here, the degree of urinary incontinence was determined using urinary incontinence diagnosis tool in the form of questionnaire based on Sandvix Severity Index (SSI) and The Three Incontinence ( 3 IQ ). This study used total sampling of ≥45 year-old elderly people. It was found that the number of elderly people with urinary incontinence was around 23.73% with higher number of male (85.71%). The most prevalent age was 65-75 years old and the complaint had lasted over 6 months (85.72%) and had low education level (64.28%). From blood pressure examination, half of the respondents had hypertension (50%). The degree of urinary incontinence based on SSI level showed that most elderly people had moderate incontinence of 85.71%. This was consistent with the theory that the common problem for elderly people is urinary incontinence with estimated incidents of 25-35% of the entire elderly population in their lifetime ( ONAT, 2014 ).

Is there a link between back pain and urinary symptoms?

To identify epidemiological studies of mechanical low back pain and urinary dysfunction, and to identify potential evidence supporting a mechanism for this relationship. A systematic online search was conducted of EmBASE, Medline, CINAHL, and PEDro databases. We excluded studies where an obvious link between low back pain and urinary dysfunction exists (such as cauda equina syndrome). Two reviewers used inclusion/exclusion criteria to screen the articles. Data were extracted and summarised with a narrative review, and study quality was assessed. We included 22/930 studies. Twelve studies addressed the epidemiological link between low back pain and urinary symptoms. The studies all found a statistically significant association between the diagnosis of urinary incontinence or urinary symptoms and low back pain, (aOR's 1.1 to 3.1). Results were consistent when stratified by sex, age, and when adjusted for confounders. The study quality was good in 4/12. Eight studies reported on an assessment/intervention related to pelvic floor function, urinary symptoms and low back pain. Pelvic floor dysfunction was common in women with low back pain, however randomized studies and pre-post studies reported mixed results for pelvic floor physiotherapy improving low back pain. The study quality was good in 3/8. Low back pain and urinary incontinence are associated in large epidemiological studies, and the presence of one condition seems to predispose the development of the other. There is limited evidence to suggest pelvic floor interventions are useful for low back pain in this patient population, therefore the mechanism for this relationship is still unclear.

Prevalence, dimensions, and predictor factors of sexual dysfunction in women of Iran Multiple Sclerosis Society: a cross-sectional study.

Sexual dysfunction (SD) is a stressful and common symptom in women with multiple sclerosis (MS) and affects different aspects of their life, seriously. The purpose of this study was to determine the prevalence, dimensions, and predictor factors of SD in Iranian women with MS. This cross-sectional study was conducted in Iran MS Society. Participants were 260 married women who had definite MS. Data were collected using self-report questionnaires, including Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19); Fatigue Severity Scale (FSS); Depression, Anxiety, and Stress Scale-21 (DASS-21); Questionnaire for Urinary Incontinence Diagnosis (QUID); ENRICH Marital Satisfaction Scale (EMS); Sexual Self-Efficacy Questionnaire; and socio-demographic and disease information questionnaire. Pearson correlation coefficients, independent sample t-test, one-way analysis of variance (ANOVA), and multiple linear regression model were used for data analysis. Majority (76.2%) of the participants had SD, and according to the dimensions of SD in MS, primary SD was found in 176 (67.7%), secondary SD in 158 (60.7%), and tertiary SD in 126 (48.5%) of the participants. The most important and common problem was delayed orgasm (60%). According to the results of multiple linear regression model, the predictor factors of SD were sexual self-efficacy (B = -0.721, P < 0.001), disability status (B = 2.714, P < 0.001), urge incontinence (B = 0.367, P = 0.029), depression (B = 0.446, P = 0.007), anxiety (B = 0.332, P = 0.037), fatigue (B = 0.177, P = 0.002), duration of disease (B = -0.463, P = 0.014), and duration of DMT use (B = 0.662, P = 0.002). According to the results of this cross-sectional study, SD was a very common and complex problem in women of Iran MS Society, and a number of physical, neurological, and psychological factors, such as sexual self-efficacy, disability status, urge incontinence, depression, anxiety, fatigue, duration of DMT use, and duration of disease, play a role in SD of these patients. So, in the treatment procedure of SD in MS women, adopting a multidisciplinary approach, as well as considering all contributory factors and their impact on sexual function, is recommended.

The Onset of Urinary Incontinence in Different Subgroups and its Relation to Menopausal Status: A Hospital-based Study.

Numerous risk factors have been reported to influence the development of urinary incontinence (UI). In this study, we took a closer look on the different forms of UI and tried to identify differences in regard to potential risk factors. Of special interest was the onset of UI symptoms and its relation to menopausal status. This was a hospital-based analysis of patients who presented with urinary incontinence in the outpatient ward of a tertiary hospital. The diagnosis of urinary incontinence was based on the subjective complaints of patients. Data concerning menopausal status, hormone replacement therapy, prior hysterectomy were assessed. The mean age was 53.8 years in the SUI group, 62.7 years in the MUI group and 66.1 years in the UUI group, respectively (p<0.001). The proportion of patients with UUI was higher in the postmenopausal group, whereas the proportion of SUI was higher in the premenopausal group (p<0.001). The mean age in which complaints occurred was significantly lower in the SUI group (45.4 years) compared to the MUI (51.0 years) and UUI groups (54.7 years) (p<0.001). There was no correlation between menopausal status and onset of urinary incontinence (p=0.143). Additional anamnestic information help further characterize the different types of urinary incontinence that can lead to an optimization of treatment options. Younger age and premenopausal status were accompanied by milder forms of UI while menopausal status itself had no influence on the onset of UI symptoms indicating that age-related changes may lead to different types of incontinence.

ROC Analysis and Significance of Transperineal Ultrasound in the Diagnosis of Stress Urinary Incontinence

ROC Analysis and Significance of Transperineal Ultrasound in the Diagnosis of Stress Urinary Incontinence

Mulabandha yoga therapy and its utility in cases of urinary incontinence in females: A randomized clinical trial

Background: Urinary incontinence (UI) is a common condition in women, with prevalence ranging from 8.5% to 38% depending on age, parity, and definition. This problem is more common in Asian countries, where women usually do not seek treatment for their reproductive health problems and do not vocalize their symptoms. Mulabandha yoga therapy (MYT) is said to be effective for the management of UI. Hence, it was tried to see the effects of this method in females. Aims and Objective: The aim and objective was to study the effect of yoga therapy in female patients for 3 months suffering from UI. Methods: An intervention of Mulabandha yoga therapy (Contraction of pelvic group muscles) for the period of three months has been done by interventional group. Design: Participants were allocated into two groups by generating random allocation sequence. Participants: Fifty female participants were divided into two groups, i.e., interventional and noninterventional (control) groups. The interventional group (n = 25) received an intensive supervised MYT protocol along with medication and the control group (n = 25) received only oral medicines. Outcome Measures: Improvement in UI symptoms was assessed using the Questionnaire for Urinary Incontinence Diagnosis (QUID). Both groups were evaluated at the beginning of the study and after 12 weeks. Results: At the completion of study, data received from all the fifty women were included in the analysis. Percentage improvement in the QUID mean change was 58.72 in the intervention group and 21.54 in the control group. Intergroup comparison (Mann–Whitney test) was found to be statistically significant in the intervention group (p &lt; 0.00), whereas it was nonsignificant in the control group (p = 0.14). Conclusion: MYT plays a significant role in the improvement of UI symptoms.

The safety and efficacy of CO2 laser in the treatment of stress urinary incontinence.

Conservative treatment is recommended as first-line therapy for stress urinary incontinence (SUI). We hypothesized that CO2 laser treatment would demonstrate safety and efficacy for women with SUI. A prospective, open-label, cohort study of 33 women (mean age 43years) referred from a continence clinic after urologist/urogynecologist assessment, with a verified stress urinary incontinence diagnosis based on urodynamic testing. The participants completed three outpatient treatments with laser therapy and were subsequently evaluated at 1, 3 and 6months. The independent t and chi-square tests were used to assess changes in sanitary pad usage and SUI symptoms. Sanitary pad usage decreased from a median of 12 per day at baseline to 7 at 1-3months post-treatment (P < 0.0001) and returned to 12 at 6months post-treatment. Scores on the Urogenital Distress Inventory and the International Consultation of Incontinence Questionnaire decreased (improved) significantly at 1-3months post-treatment: from 45 ± 2 and 16 ± 4, respectively, to 29.3 ± 14.7 and 8.15 ± 3.1, respectively (P < 0.0001). The scores returned to levels similar to baseline at 6months after treatment. Participants reported mild and transient side effects, with significant improvement in quality of life. Laser therapy can be an optional conservative treatment for women who seek minimally invasive non-surgical treatment for the management of SUI. No serious adverse effects were reported though the sample size was not large, a possible limitation of the study. Further large randomized control trials are needed to appraise the efficacy and safety of laser therapy for stress urinary incontinence and to demonstrate the ultimate utility of this modality.

Особенности лечения стрессовой формы недержания мочи у пациенток с пролапсом передней стенки влагалища III–IV стадий

to improve treatment results of patients with stress urinary incontinence and severe cystocele by optimizing surgical tactics and rehabilitation methods. a total of 56 women aged 54 to 68 years with stages III-IV of the anterior vaginal wall prolapse (according to the POP-Q classification) and urethral sphincter insufficiency were evaluated. All patients underwent a transvaginal extraperitoneal anterior mesh repair without concomitant sling procedure. The severity of prolapse, a presence or absence of stress urinary incontinence, and ultrasound signs of sphincter insufficiency were re-evaluated two months after procedure. in all cases, the anterior wall prolapse was eliminated or reduced to subclinical stage. Two months after procedure, 48 patients (85,7%) noted the onset of stress urinary incontinence (moderate and severe) with progressive deterioration. In the remaining cases (14,3%), patients did not have any urinary incontinence. All patients underwent active rehabilitation for 6 months. In 6 cases (12,5%), there was a decrease in the severity of urinary incontinence to the level that had virtually didnt affect the quality of life; in remaining cases, conservative treatment was considered ineffective and sling procedure was recommended. A diagnosis of latent urinary incontinence remains to be controversial. To detect this form, a cough test with a prolapse reduction is usually performed. In addition, preoperative urodynamic testing can be used, since it has good sensitivity in identifying latent urinary incontinence, but it is an expensive procedure for the routine practice. A determination of the urethral sphincter insufficiency makes it possible to predict the development of the stress urinary incontinence with a high accuracy, but this method also has a number of limitations. patients with stages III-IV of the anterior vaginal wall prolapse and ultrasound signs of sphincter insufficiency have a risk of developing stress urinary incontinence after surgical treatment. In this group of patients, a simultaneous surgery can be recommended in order to correct prolapse and to prevent subsequent urinary incontinence.

Influence of the urethral pressure transducer in measuring Valsalva leak point pressure in women undergoing multichannel urodynamic testing.

To determine if the air-charged urethral sensor balloon currently used in urodynamic testing (UDS) significantly impacts Valsalva leak point pressure (VLPP) measurements. This is a prospective cohort study of women undergoing UDS at an academic institution. VLPPs were obtained at 150 mL and urodynamic capacity with and without the urethral pressure sensor in the urethra. VLPP measurements were analyzed using a Wilcoxon signed-rank test. Median and interquartile range are presented. Sixty-three patients were enrolled in the study, 53 were included in the primary analysis. The mean age of the subjects was 56.2 ± 12.1 years. Nine patients (16%) solely leaked when the balloon was not present in the urethra either with cough or during VLPP measurement. At both 150 mL and urodynamic capacity, when VLPP testing was performed, there was a significant difference (cmH2 O) between the control and intervention values, (76.2 [55.0, 97.0] vs 68.8 [46.3, 93.3], P = .0012; 79.3 [53, 96.5] vs 72.5 [50.8, 92.3], P = .04). There was also a statistically significant difference between the control and intervention values for the lowest leak value at 150 mL and capacity (70.5 [51, 94.5] vs 60.0 [40, 88] P = .002; 73.5 [49.5, 91.5] vs 61 [45, 88], P = .017). The higher VLPPs obtained with the urethral balloon in place indicate that the balloon may be the cause of falsely elevated VLPPs during urodynamic testing. Additionally, the balloon may mask a diagnosis of stress urinary incontinence in some patients.

Randomized controlled trial comparing mini-sling with transobturator sling for the treatment of stress urinary incontinence.

Stress urinary incontinence (SUI) is the involuntary loss of urine on effort and is a condition that negatively interferes with various aspects of a woman's life. This study aimed to demonstrate the non-inferiority of the less invasive single-incision mini-sling (SIMS) method in objective and subjective cures in relation to tension-free transobturator tape (TOT) in two analyses, per protocol and intention to treat, and secondarily to evaluate complications and quality of life. This study was a randomized controlled trial (RCT). Participants in this study included 105 women with a clinical diagnosis of stress predominant urinary incontinence and urodynamic results demonstrating SUI and absence of detrusor overactivity. Patients were evaluated pre- and postoperatively through anamnesis, physical examination, urinalysis, urine culture and susceptibility testing, simplified pad test, the Urinary Incontinence-Specific Quality of Life Instrument (I-QOL) and Urogenital Distress Inventory Short Form (UDI-6). Regarding the objective cure, SIMS was non-inferior to TOT (p < 0.05). However, the same was not found for the subjective cure (p > 0.05). There were no differences in the complication rates (p > 0.05). However, in the TOT group, bladder perforation (2.4%), tape exposure (2.4%) and urinary retention occurred, lasting > 7 days (2.4%). In both groups, there was improvement in quality of life after surgery, without significant differences (p > 0.05). The non-inferiority of SIMS in relation to TOT was only demonstrated in the objective cure. There were no significant differences between groups regarding complications and quality of life.

Effect of Pelvic Floor Muscle Exercises on Severity of Urinary Incontinence among Elderly Female Patients

Introduction: Prevention of urinary incontinence at primary level is a significant task for all health care workers. Current treatments include many behavioral modalities among which PFME is one of the effective strategies. In the present setting there is lack of practice of PFME as a preventive and curative strategy among elderly females. Objective: To compare the severity of urinary incontinence before and after pelvic floor muscle exercise, to determine the association of severity of urinary incontinence with selected baseline variables. Methodology: Quasi experimental one group pre-test post-test research design with purposive sampling technique was used to collect data from 35 elderly females with urinary incontinence in IPD, Senior Citizen OPD and OBG OPD of selected hospital, Bangalore. QUID (Questionnaire for Urinary Incontinence Diagnosis) was used to identify the type of urinary incontinence and ICIQ UI SF (International Consultation on Incontinence Questionnaire-Short Form) was used to assess the severity of urinary incontinence. Data was analysed using both descriptive and inferential statistics on the basis of objectives and hypothesis of the study. Frequency, percentage, mean, standard devation of the data was analysed in terms of descriptive statistics and paired t test, independent t-test and ANOVA test of inferential statistics were used to assess the level of significance. Result: There was a significant reduction of mean severity score of pre-test from 12.23±2.03 to 9.89±1.8 at p value&lt;0.001. Mean of three content areas of UI (frequency, amount and impact of urine leakage) reduced from 3.14±0.69 to 2.34±0.68, 3.26±1.09 to 2.49±0.85 and 5.83±1.01 to 5.06±0.93 at p-value &lt;0.001. There was no statistically significant association between any of the baseline variables with severity of urinary incontinence. Conclusion: The health professionals need to focus more on providing training and positive reinforcement to these patients as PFME is one of the most common mode of management for patients with urinary incontinence.

Three-Dimensional Transperineal Ultrasonography for Diagnosis of Female Occult Stress Urinary Incontinence.

BackgroundWe evaluated the utility of three-dimensional transperineal ultrasonography in detecting occult stress urinary incontinence in women undergoing anterior pelvic floor reconstruction surgery for severe cystocele.Material/MethodsWe enrolled 207 women with stage III–IV cystocele without urinary stress incontinence. One week before the operation, the patients underwent pelvic floor ultrasonography. We measured the vertical distance between the bladder neck and posterior margin of the pubic symphysis, the posterior vesicourethral angle, the urethral rotation angle, the formation of funnel shape, the hiatus area, and the length of the urethra and the funnel shape. Postoperatively, the patients were evaluated for symptoms of stress urinary incontinence and with the 20-minute pad test.ResultsThe posterior vesicourethral angle with Valsalva maneuver, the difference in the posterior vesicourethral angle between the resting state and with the Valsalva state, and the angle of the proximal urethra were larger in the incontinence-positive group than in the incontinence-negative group (P<0.05). Funnel shape urethra was longer in the incontinence-positive group than in the incontinence-negative group (P<0.05). The cutoff value was 137.5° for the posterior vesicourethral angle with Valsalva maneuver, 39.5° for the difference in the posterior vesicourethral angle, 44.5° for the angle of the proximal urethra, and 0.35 cm for the length of the funnel shape. Multivariate analysis revealed that the difference between the posterior vesicourethral angle in the resting state and with Valsalva, the angle of the proximal urethra, and the length of funnel shape were strongly correlated with occult stress urinary incontinence.ConclusionsUltrasonography is an effective method for identifying occult stress urinary incontinence.

Intraday and interday reliability of pelvic floor muscles electromyography in continent woman.

Vaginal surface electromyography (sEMG) is a tool used for the diagnosis and therapeutic intervention of urinary incontinence. Current sEMG systems differ in regard to electrode arrangement and data reproducibility. The aim of this study was to determine the intrasession, intraday, and interday reliabilities of sEMG parameters using a probe with circumferential electrode-position. The intrasession, intraday, and interday reliabilities of maximum isometric voluntary contractions (MVC) of the pelvic floor muscles were assessed for 19 healthy continent women. Three sEMG parameters that are used to describe muscle activity were verified: maximal EMG (EMGmax ), mean over 500 ms around EMGmax (EMGA0.5 ), and mean over 2 seconds during MVC plateau (EMGA2-4 ). Relative and absolute reliability parameters were calculated, and the statistical methods described by Bland and Altman were applied to the data. We observed substantial reliabilities for all obtained parameters (EMGmax , EMGA2-4 , and EMGA0.5 ) in regard to the intrasession measurements (ICC = 0.93-0.97; CI = 0.86-0.99). Overall, the intraday reliability has been moderate (ICC = 0.64-0.75; CI = 0.27-0.90). EMGmax (ICC = 0.75; CI = 0.45-0.90) and EMGA2-4 (ICC = 0.73, CI = 0.42-0.89) were higher than EMGA0.5 (ICC = 0.64; CI = 0.27-0.85). However, the interday reliability was only fair for EMGmax (ICC = 0.48; CI = 0.04-0.77) and EMGA0.5 (ICC = 0.51; CI = 0.07-0.78) but moderate for EMGA2-4 (ICC = 0.65; CI = 0.28-0.85). This intrasession, intraday, and interday reliability results are similar to the results reported in the literature using probes with longitudinally oriented bars. The mean sEMG signal over 2 seconds (EMGA2-4 ) exhibited the highest reliability and is recommended for further studies. The interday reliability might be enhanced by considering the menstruation cycle.