Incidence Of Stress Urinary Incontinence Research Articles

The association between triglyceride -glucose index and stress urinary incontinence in adult American women: A population-based study.

This investigation seeks to determine the triglyceride glucose (TyG) index's link to stress urinary incontinence (SUI) in American females of adult age. The investigation relied on data acquired via the National Health and Nutrition Examination Survey (NHANES) conducted over the period from 2011 to 2018. The independent relationship between TyG index and SUI was tested using multivariate logistic regression analysis. We applied a smooth curve fitting approach to analyze the interrelation of them. In addition, subgroup analysis was conducted and interaction experiments were conducted. Among 4459 female participants aged 20 and above, TyG index and SUI demonstrated a favorable correlation. Model 3 indicated that with every single-unit rise in the TyG index, the incidence of SUI increases by 18% [1.18 (1.01, 1.38)]. In contrast to individuals in the lowest tertile, subjects within the highest tertile of the TyG index exhibited a 68% increase in SUI incidence [1.68 (95% CI: 1.26, 2.23), 0.0004]. By using smooth curve fitting, a nonlinear positive evidence of an interconnection of the TyG index to SUI was identified. Women exhibiting increased TyG index levels are at a heightened risk of SUI. TyG index displays a stronger correlation than that observed with BMI. According to our findings, the TyG index is viewed as a potential tool for identifying SUI in women, and monitoring the value of TyG index may be helpful for predicting the occurrence of SUI.

Evaluation of the quality of life and the incidence of stress urinary incontinence in nulliparous women training selected sports: a cross-sectional survey pilot study

IntroductionThe number of women suffering from urinary incontinence is increasing every year. The most common type of this condition is stress urinary incontinence. Involuntary leakage of urine occurs when sneezing, coughing, laughing, and standing up, as well as during physical activity. The problem of urinary incontinence is very embarrassing for athletes and affects their sports performance. The aim of the study was to assess the occurrence of urinary incontinence symptoms in women regularly training in selected sports.Methods64 women athletes were selected for the study. This pilot study involved women training in athletics (short-distance running, long-distance running, hurdles and jumping (high jump, long jump, triple jump, pole vault), basketball, volleyball, or strength sports). Women were selected based on sample size calculation from those training in specified clubs. Women who had given birth were excluded from the study. The subjects completed a proprietary questionnaire consisting of 8 questions. They also completed the Urinary Distress Inventory, Short Form (UDI-6SF) questionnaire and the Incontinence Impact Questionnaire, Short Form (IIQ-7).ResultsIn this study, 43% of women who trained had symptoms of urinary incontinence. Regression analysis results with UDI-6SF and IIQ-7 total scores as dependent variables and age as an independent variable showed that the slopes of regression were not statistically significantly different (<i>p</i>-value > 0.05). The results of the analysis of the correlation between SUI (stress urinary incontinence) and age (<i>p</i> = 0.0247) and practiced sport (<i>p</i> = 0.0476) turned out to be statistically significant.ConclusionsThe type of sport practiced affects the occurrence of UI (urinary incontinence) symptoms in women. In this study, female athletes practicing strength sports had the greatest predisposition to the occurrence of UI symptoms. The occurrence of UI symptoms has little impact on the deterioration of the quality of life among women practicing selected sports.

Antepartum pelvic floor muscle training (PFMT) plus perineal massage vs. postpartum PFMT alone: analysis of pelvic floor disorders, Quality of Life and sexual function.

The aim of this study was to analyze how antepartum pelvic floor muscle training (PFMT) plus perineal massage associated with postpartum PFMT have a significant impact on pelvic floor health during pregnancy and after delivery. One thousand two hundred thirty-three women were enrolled from January 2019 to December 2021. They were divided into two groups: 786 women underwent postpartum PFMT only, 447 women experienced both prepartum perineal massage and PFMT and postpartum PFMT. The primary endpoint was to evaluate prepartum perineal massage and PFMT's impact on delivery. The second endpoint was the evaluation of Quality of Life and sexual function at 3- and 12-months follow-up after delivery. Women who underwent prepartum PFMT experienced significantly lower percentage of episiotomy, high-grade obstetric tear or instrumental delivery and higher percentage of intact perineum. Furthermore, prepartum PFMT appeared to improve sexual function at 3 months follow-up, and it was associated with an earlier first sexual intercourse after childbirth. The incidence of stress urinary incontinence was significantly higher in women who experienced PFMT only in postpartum, both at 3- and 12-months follow-up, while the other examined clinical parameters did not show a significant difference. Prepartum PFMT has a role in preventing obstetric traumas and on improving Sexual Function and Quality of Live in the immediate postpartum. Moreover, prepartum PFMT in association with postpartum PFMT reduces the incidence of stress urinary incontinence in a higher percentage than postpartum PFMT only.

Pretreatment of the urethral mucosa at the tip of the prostate: a retrospective review in preventing stress urinary incontinence after thulium laser enucleation of the prostate.

Explore the clinical application value of urethral mucosal pretreatment at the tip of the prostate in preventing stress urinary incontinence (SUI) after thulium laser enucleation of the prostate (ThuLEP). Eighty-seven patients with benign prostatic hyperplasia (BPH) treated with ThuLEP from June 2021 to December 2022 were divided into two groups. Of these, 42 patients (group A) underwent conventional ThuLEP and 45 patients (group B) were enucleated after pretreatment of the urethral mucosa. At the tip of the prostate, pretreatment of the urethral mucosa consisted of pushing the gland separately on both sides at the level of the verumontanum and cutting off the mucosa near the external urethral sphincter clockwise and counterclockwise. The perioperative and postoperative follow-up indicators [operation time, hemoglobin reduction, complications, Qmax, International Prostate Symptom Score (IPSS), quality of life (QoL), and post-void residual (PVR) volume] of the two groups of patients were collected and compared. All patients were followed up 1 month after surgery. All 87 procedures were successfully completed. There was no significant difference in age and gland size between the two groups (P > 0.05). There was no significant difference between operating time and hemoglobin reduction in the two groups (P > 0.05). The Qmax, IPSS, QOL, and PVR volume were significantly improved postoperatively in both groups (P < 0.05). Temporary SUI occurred in both groups [12 cases (28.5%) in group A and 3 cases (6.7%) in group B (P < 0.05)]. There was no significant difference in the incidence of infection and urethral stricture between the two groups (P > 0.05). Pretreatment of the urethral mucosa before ThuLEP for BPH significantly reduces the incidence of SUI after surgery. This technique, which preconditions the apical urethral mucosa of the prostate, is safe and effective, has few complications, and is worthy of clinical application.

Efficacy of Mid-Urethral Sling and Urethral Dilation for Stress Urinary Incontinence Combined with Urethral Stricture in Women.

To investigate the potential clinical benefits of mid-urethral sling (MUS) and urethral dilatation (UD) operations for the treatment of stress urinary incontinence (SUI) combined with urethral stricture. Descriptive study. Place and Duration of the Study: Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, from January 2017 to 2022. Patients with Qmax <15ml/s or PVR >50ml, and video urodynamic study (VUDS) capable of confirming the presence and position of urethral stricture were included. The clinical efficacy was evaluated by International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire, maximum flow rate (Qmax), and postvoid residual (PVR) urine. ICIQ-SF, Qmax, and PVR were measured presurgery, on postoperative 2-week, and 1-month postsurgery. There were total 19 patients with an average age of 61.37 ± 11.28 years (range 39-84) with SUI and urethral stricture. ICIQ-SF scores were decreased significantly at one month postoperatively compared with the preoperative [5.0 (0.0, 7.0) vs. 14.0 (13.0, 15.0), p <0.001]. Qmax was increased dramatically compared with the preoperative [21.3 (14.0, 28.4) vs. 13.0 (8.7,18.0), p <0.001], and PVR was decreased remarkably than the preoperative [0.0 (0.0,0.0) vs. 0.0 (0.0,60.0), p = 0.018]. Of 19 patients primarily managed with MUS and UD, two patients experienced recurrence requiring repetitive dilation till sling excision surgery was conducted, and improvement was evident in one patient after repeating UD. The overall incidence of SUI combined with urethral stricture in women is low. With a success rate of 89.5%, MUS and UD were effective therapies for the co-existence of SUI with urethral stricture, and repeated UD can be performed safely if necessary in long-term follow-up. Stress urinary incontinence, Urethral stricture, Mid-urethral sling, Urethral dilatation.

Comparison of Postoperative Stress Urinary Incontinence between Anteroposterior Dissection and Modified Gilling Method in Holmium Laser Enucleation of the Prostate.

Few studies have evaluated the usefulness of anteroposterior dissection holmium laser enucleation of the prostate (HoLEP). Thus, this study investigated the incidence of stress urinary incontinence (SUI) after HoLEP and usefulness of anteroposterior dissection HoLEP in preventing postoperative SUI. In total, 288 patients who underwent HoLEP performed by a single experienced surgeon between May 2014 and September 2021 were enrolled. Furthermore, 134 patients underwent retrograde dissection using the modified Gilling method (surgery 1) and 154 patients underwent anteroposterior dissection HoLEP (surgery 2). The risk factors for SUI, as well as the rates of SUI improvement for the two surgical procedures, were evaluated. Postoperative SUI was observed in 58 (20.1%) of 288 patients, of whom, 48 (82.8%) recovered continence within 6 months. Ten patients (17.2%) required more than 6 months to recover continence. SUI incidence 1 month after HoLEP was 29.9% (40/134 patients) for surgery 1 and 11.7% (18/154 patients) for surgery 2; a statistically significant difference was observed between the two groups (odds ratio [OR], 0.311; 95% confidence interval [CI], 0.168-0.575; p < 0.001). In addition, surgery 2 was significantly associated with early recovery from SUI compared with surgery 1 (stratified hazard ratio, 0.782; 95% CI, 0.615------0.995; p < 0.001). The multivariable analysis demonstrated that only surgical procedure (OR, 0.350; 95%CI, 0.168-0.732; p=0.005) was an independent predictor of SUI.- Conclusion: We reaffirmed that anteroposterior dissection HoLEP is a useful procedure for reducing the risk of postoperative SUI and early recovery of urinary continence.

(362) Stress Urinary Incontinence Rates in Men Undergoing Optilume Balloon Dilation for Radiation-Induced Posterior Urethral Stenosis: A Single Center Experience

Abstract Introduction While radiation can be a viable treatment option for prostate cancer, development of radiation-induced urethral stenosis occurs in approximately 2% of patients. Optilume, a paclitaxel-coated urethral dilation balloon was FDA approved in 2021 and has shown improved urethral patency and reduced rates of reintervention for anterior urethral strictures relative to standard endoscopic procedures. As the utility of Optilume expands into posterior urethral stenosis, it is important to identify the associated potential complications. Incidence of stress urinary incontinence (SUI) has been reported to be as high as 33% following urethroplasty for patients with radiation-induced urethral stenoses. Rates of SUI following Optilume balloon dilation have yet to be evaluated in this high-risk population. Objective To evaluate rates of SUI in patients undergoing Optilume balloon dilation for radiation-induced posterior urethral stenosis. Methods From March 2022 to February 2023, select men with radiation-induced posterior urethral stenoses underwent Optilume balloon dilation. Initial evaluation included retrograde urethrogram and/or diagnostic cystoscopy. Dilation was performed with a 30-French Optilume and left inflated for five minutes per standard protocol. A 16-French catheter was inserted and left in place for three to five days. Patients were scheduled for a three-month post-dilation cystoscopy. Pre- and post-dilation continence rates were compared. Results A total of 16 men with confirmed radiation-induced posterior urethral stenoses underwent Optilume balloon dilation. Of the 16 patients, 12 patients had documentation regarding their pre- and post-treatment continence status. No patients developed de novo SUI. Baseline pre-treatment SUI was noted in one patient (8.3%) requiring an average of 4 Depends per day. This patient noted no change in his degree of SUI following Optilume dilation and the dilation site was found to be widely patent on his follow up cystoscopy. He is scheduled for artificial urinary sphincter in the near future. Mean follow up was 77 days (range 30-180 days). Repeat intervention was required in three patients (18.8%) for repeat stenosis. Conclusions Optilume balloon dilation for radiation-induced posterior urethral stenosis does not appear to lead to de novo SUI in short to intermediate term follow up. Further prospective studies with a larger group of patients and longer follow up duration are warranted in this complex population. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Laborie.

Persistent and De Novo Stress Urinary Incontinence After Minimally Invasive Sacrocolpopexy.

Data on stress urinary incontinence (SUI) after minimally invasive sacrocolpopexy (SCP) with or without midurethral sling placement are limited. The aim of the study was to determine the incidence of SUI after minimally invasive sacrocolpopexy. This was a secondary analysis of 2 randomized clinical trials of participants undergoing SCP. Participants completed symptom assessment and urodynamic testing. Participants underwent SCP with or without midurethral sling placement. Preoperatively, participants were defined as having symptomatic SUI, occult SUI, or no SUI. Participants completed the Pelvic Floor Distress Inventory-20 at 6 and 12 months postoperatively and were categorized as having persistent SUI in the setting of symptomatic or occult SUI or de novo SUI. Eighty-one participants were included. Sixty-one participants met inclusion criteria for the persistent SUI analysis: 42 participants with symptomatic SUI and 19 participants with occult SUI. There were 20 participants in the de novo SUI group. The overall incidence of persistent SUI was 26.2% (95% confidence interval [CI], 15.8%-39.1%) with 33.3% (95% CI, 19.6%-49.6%) of symptomatic and 10.5% (95% CI, 1.5%-33.1%) of occult participants. Bothersome symptoms were defined as "moderately" or "quite a bit" bothered postoperatively. Of participants with symptomatic SUI, 14.3% participants were bothered and no participants underwent retreatment. No patient with occult SUI was bothered; however, 1 patient underwent retreatment. The incidence of de novo SUI was 45% (95% CI, 23.1%-68.5%). No patient in the de novo SUI group was bothered or underwent SUI treatment. Approximately 1 in 4 participants reported persistent SUI. Almost 50% reported de novo SUI. However, few participants were bothered or underwent treatment.

Clinical outcomes of holmium laser enucleation of the prostate: A large prospective registry-based patient cohort study under regular follow-up protocol.

To evaluate the efficacy and safety of holmium laser enucleation of the prostate (HoLEP) in a large prospective cohort of patients with benign prostatic hyperplasia (BPH) through systematic follow-up at a single institution. Clinical outcomes were analyzed between August 2008 and June 2022. Patients were followed-up at 2 weeks, 3 months and 6 months postoperatively. A total of 3,000 patients (mean age, 69.6±7.7 years) underwent HoLEP. Baseline total International Prostate Symptom Score (IPSS) was 19.3±7.7 and maximum flow rate (Qmax) was 9.4±4.8 mL/s. Mean total prostate volume was 67.7±3.4 mL. Total operation time was 60.7±31.5 minutes, and catheterization time was 1.0 days (range, 1.0-1.0 days). At 6 months postoperatively, the total IPSS decreased to 6.6±5.8 and Qmax increased to 22.2±11.3 mL/s. Complications at 6 months postoperatively included stress urinary incontinence (SUI) in 36 patients (1.9%), urgency urinary incontinence (UUI) in 25 (1.3%), bladder neck contracture (BNC) requiring transurethral incision (TUI) in 16 (0.5%), and urethral stricture in 29 (1.0%). Eleven patients (0.4%) with prostatic fossa stones required stone removal. Sixty-one patients (2.0%) required secondary surgery (transurethral coagulation, 16 [0.5%]; TUI for BNC, 16 [0.5%]; stone removal for prostatic fossa stones, 11 [0.4%]; and endoscopic internal urethrotomy for urethral stricture, 18 [0.6%]). Mid-term follow-up results after HoLEP in BPH patients showed excellent efficacy and low complication rates. Unlike previous reports, the incidence of SUI and UUI after HoLEP was low, but the occurrence of de novo stone formation in prostatic fossa was notable.

Assessment of the Incidence and Risk Factors of Stress Urinary Incontinence in Women after Cervical Cancer Surgery: A Single-Centre Retrospective Study.

Stress urinary incontinence (SUI) is a common postoperative complication that significantly affects the quality of life in women who have undergone radical hysterectomy for cervical cancer. This study evaluates the incidence and risk factors associated with SUI in women after cervical cancer surgery. This case-control study included women diagnosed with cervical cancer who underwent radical hysterectomy at our hospital between May 2020 and May 2023. Participants were divided into two groups based on the presence of postoperative SUI, namely the SUI group and the SUI-free group. Inclusion criteria required the absence of preoperative urinary incontinence and stable vital signs. Data were collected on demographic characteristics, tumour histology and staging, urodynamic parameters, and intraoperative and postoperative factors. Ninety-seven patients with cervical cancer who underwent radical hysterectomy were divided into two groups: The SUI group (n = 27) and the SUI-free group (n = 70), with an SUI incidence of 27.8% in the study population. Significant differences between the SUI and SUI-free groups were observed in menopausal status (p = 0.026), chronic constipation (p = 0.011), and tumour diameter (p < 0.001). Urodynamic assessments revealed a higher maximum urinary flow rate (Qmax) in the SUI group compared to the SUI-free group (21.36 ± 6.41 vs. 17.38 ± 5.18 mL/s; p = 0.002). Logistic regression analysis identified menopause (odds ratio (OR) = 7.700, 95% confidence interval (CI) = 1.256-47.192), chronic constipation (OR = 9.918, 95% CI = 1.387-70.911), Qmax (OR = 1.302, 95% CI = 1.061-1.598), and surgery duration (OR = 1.040, 95% CI = 1.001-1.081) as independent protective factors. SUI is a significant postoperative complication in women undergoing cervical cancer surgery. Menopause, chronic constipation, tumour diameter, Qmax, and surgery duration were independent risk factors.

Use of the anterior prostatic urethral mucosa preservation technique during holmium laser enucleation of the prostate can reduce postoperative stress urinary incontinence.

Holmium laser enucleation of the prostate (HoLEP) is an effective and safe surgery for patients with benign prostatic hyperplasia. However, some patients exhibit postoperative urinary incontinence. Here, we compared surgical outcomes and incidence of stress urinary incontinence between HoLEP with and without anterior prostatic urethral mucosa preservation (APUMP). All patients in this study underwent HoLEP with APUMP technique (APUMP group) and without APUMP technique (no-APUMP group). Enucleation weight, enucleation time, max flow rate increase at 3 months, and urinary incontinence rates immediately after catheter removal and at 1 month after surgery were compared between the groups. In the APUMP (n = 340) and no-APUMP (n = 75) groups, the median enucleation weights were 34.5 and 35.0 g, respectively (p = .982). The corresponding median enucleation times were 33.0 and 46.5 min (p < .01), and median max flow rate increases at 1 month were 10.5 and 9.9 mL/s (p = .89). The urinary incontinence rates immediately after catheter removal were 4.1% and 14.7% (p < .01), and were 3.8% and 12.0% (p < .01) at 1 month after surgery. HoLEP using the APUMP technique could be performed with a shorter operative time while maintaining efficacy. The incidence of postoperative urinary incontinence could be decreased by APUMP, indicating that such preservation facilitates the maintenance of urinary continence after surgery.

Impact of Stress Urinary Incontinence After Radical Prostatectomy on Time to Intervention, Quality of Life and Work Status

To characterize the incidence of stress urinary incontinence (SUI) after radical prostatectomy (RP), its treatment, and impact on quality of life (QoL) and work status 1year after RP. Prostate cancer patients treated by RP (1998-2016) were selected from CaPSURE. SUI was defined as any pads per day (ppd) 1 year after RP. SUI procedures were tracked by CPT codes (sling and artificial sphincter). Patients reported work status (full-time, part-time, unpaid), UCLA PCa Index urinary function (UF) and bother (UB) and SF36 Index physical function (PF). Associations of incontinence with UF, UB, and PF and work status changes were assessed (ANOVA). Lifetable estimates and Cox proportional hazards regression evaluated risk of undergoing SUI procedures. 664/2989 (22%) men treated with RP reported SUI at 1 year. More men with SUI had ≥GG2, intermediate to high-risk disease and non-nerve-sparing surgery (all P<.01). Cumulative incidence of SUI procedures was 1.4% at 10years after RP. Age (HR 2.68 per 10years, 95% CI 1.41-5.08) and number of ppd at 1 year (HR 3.20, 95% CI 2.27-4.50) were associated with undergoing SUI procedures. UF declined at 1year after RP, while UB and PF remained stable. UF, UB, and PF were inversely associated with number of ppd (all P<.01). Change in work status was not associated with incontinence or QoL scores. Incontinence affected QoL without impacting work status, suggesting that men with SUI after RP may continue working and go under-treated despite impact on QoL.

MP13-16 EXPERIENCE WITH 3,000 CASES OF HOLMIUM LASER ENUCLEATION OF PROSTATE IN A SINGLE INSTITUTION

You have accessJournal of UrologyCME1 Apr 2023MP13-16 EXPERIENCE WITH 3,000 CASES OF HOLMIUM LASER ENUCLEATION OF PROSTATE IN A SINGLE INSTITUTION Hyo Myoung Lee, Min Chul Cho, Sung Yong Cho, Jae-Seung Paick, and Seung-June Oh Hyo Myoung LeeHyo Myoung Lee More articles by this author , Min Chul ChoMin Chul Cho More articles by this author , Sung Yong ChoSung Yong Cho More articles by this author , Jae-Seung PaickJae-Seung Paick More articles by this author , and Seung-June OhSeung-June Oh More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003233.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of HoLEP in patients with benign prostatic hyperplasia (BPH) at a single institution. METHODS: From August 2008 to June 2022, the baseline demographics, and post-operative follow-up results were retrospectively analyzed through EMR review. Patients were followed up at 2 weeks (n=2,997), 3 months (n=2,199), and 6 months (n=1,853) postoperatively under a critical pathway. Then, they were on open follow-up. RESULTS: A total of 3,000 patients (mean age 69.6±7.7 years) underwent HoLEP. Mean total prostate volume was 67.9 (±34.2) ml and the baseline total IPSS score and the quality of life score were 19.3 (±7.7) and 3.9 (±1.1), respectively. The preoperative maximum flow rate (Qmax) was 9.4 (±4.8) ml/s, and the postvoid residual urine (PVR) volume was 77.8 (±97.6) ml. The total operation time was 60.7 (±31.6) minutes, and the catheter time was 1.3 (±1.2) day. Complications within 2 weeks postoperatively included re-catheterization in 110 patients (3.7%), blood transfusion in 19 patients (0.6%), transurethral coagulation (TUC) in 16 patients (0.5%), stress urinary incontinence (SUI) in 215 (mild 204; severe 11) patients (7.2%), urgency urinary incontinence (UUI) in 174 (mild 129; severe 45) patients (5.8%). Complications at 3 months postoperatively were SUI in 128 (mild 109; severe 19) patients (5.8%), UUI in 113 (mild 74; severe 39) patients (5.1%). Complications at 6 months postoperatively included SUI in 36 (mild 34; severe 2) patients (1.9%), UUI in 25 (mild 17; severe 8) patients (1.3%), bladder neck contracture in 15 patients (0.8%), de novo prostatic fossa stone in 11 patients (0.6%), and urethral stricture in 29 patients (1.5%). A total of 61 patients (2.0%) required secondary surgery (TUC 16, 0.5%; TUI for BNC 16, 0.5%; removal of prostatic fossa stones 11, 0.4%; EIU for urethral stricture 18, 0.6%). At 3 months postoperatively, the total IPSS score was 7.9 (±5.9), Qmax was 21.8 (±11.6) ml/s, and the PVR volume was 21.0 (±38.1) ml. At 6 months postoperatively, the total IPSS score was 6.6 (±5.8), Qmax was 22.2 (±11.3) ml/s, and the PVR volume was 19.7 (±36.8) ml. CONCLUSIONS: Our mid-term follow-up results after HoLEP in BPH patients showed excellent efficacy and low complications. Unlike other previous reports, the incidence of SUI and UUI after HoLEP was low, but the occurrence of de novo stone formation in the prostatic fossa was notable. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e179 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hyo Myoung Lee More articles by this author Min Chul Cho More articles by this author Sung Yong Cho More articles by this author Jae-Seung Paick More articles by this author Seung-June Oh More articles by this author Expand All Advertisement PDF downloadLoading ...

A 10- to 20-year follow-up after tension-free vaginal tape for stress urinary incontinence.

Midurethral slings (MUS) have become the gold standard in the treatment of stress urinary incontinence (SUI). Some information is already available on the outcome of tension-free vaginal tape (TVT) after 10 years or more. Our objective was to assess the current outcome (efficacy, adverse events) of women who had been successfully operated upon for SUI by means of a TVT procedure 10 to 20 years ago. We performed a retrospective cohort study including 291 women (mean age 69.4 years) who underwent a successful TVT procedure (retropubic bottom-to-top route) in a teaching hospital between January 2001 and December 2010. The main outcome measure was the incidence of SUI at 10-20 years' follow-up. Others were incidence of re-operation, tape exposure and de novo overactive bladder symptoms. We carried out a univariate logistic regression analysis to examine the relationship between outcomes and a set of clinical variables. After a median of 15 years, TVT remains highly effective: 272 women (94%) experienced either no leakage under any circumstance (214=74%) or leakage less than weekly (58=20%). Mesh exposure (8=2.7%; 1.8 events per 1,000 patient-years) and repeat surgery for SUI (11=3.8%; 2.5 events per 1,000 patient-years) were low. Three women (1%) needed to perform intermittent self-catheterisation. Bothersome overactive bladder symptoms (45=15%) were common and associated with polypharmacy, cardiovascular medication and obesity. The efficacy of TVT is demonstrated up to 20 years. The presence of bothersome OAB symptoms in the population may be an indicator of multimorbidity.

Association between vaginal or cesarean delivery and later development of stress urinary incontinence or pelvic organ prolapse: A retrospective population-based cohort study.

Child delivery mode may be associated with pelvic floor disorders. We explored the association between different delivery modes and later development of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in Taiwanese women. This was a retrospective population-based cohort study. Women who delivered babies between January 1, 2000, and December 31, 2018, were selected for this study. The study used Taiwan's National Health Insurance (NHI) Research Database. After propensity score matching, 51,587 women who underwent cesarean section (C/S) and 51,587 women who underwent vaginal delivery (VD) were recruited. Primary outcomes were the presence of SUI and POP after delivery. The incidence of SUI (1.6/1000 person-years) and POP (1.5/1000 person-years) was higher in the VD group than in the C/S group (0.8 and 0.6 in 1000 person-years). VD was associated with an increased risk of SUI [hazard ratio (HR): 2.79, 95% confidence interval (CI): 2.45-3.17] and POP (HR: 1.96, 95% CI: 1.75-2.19) compared to C/S. We also found that age (HR: 1.06, 95% CI: 1.05-1.08 in SUI, HR: 1.08, 95% CI: 1.07-1.09 in POP) and Charlson Comorbidity Index (CCI) (HR: 1.28, 95% CI: 1.12-1.46 in SUI, HR: 1.27, 95% CI: 1.13-1.43 in POP) were associated with an increased risk of SUI and POP. The cumulative incidence of SUI and POP was higher in the VD group than in the C/S group (log-rank test, P < 0.05). The current study was the largest retrospective cohort study regarding the influence of delivery mode on SUI and POP so far. VD was found to be associated with an increased risk of SUI and POP compared with C/S. Postpartum care for pelvic physical therapy should be provided particularly to women undergoing VD.

Running Gait Retraining in the Management of a Multiparous Runner With Chronic Stress Urinary Incontinence: A Case Study

Background: Stress urinary incontinence (SUI) is highly prevalent in the postpartum population and can result from injury or capacity deficits of the pelvic floor musculature. Impact forces seen during running increase demand on the pelvic floor musculature, resulting in a higher incidence of SUI. Running gait retraining, with emphasis on reducing impact, may reduce symptoms of SUI. Case Description: A 43-year-old woman was evaluated for chronic SUI when coughing, sneezing, and running since the birth of her second child 8 years ago. Initial interventions focused on pelvic floor, hip, and abdominal muscle training, and after 3 visits over 4 weeks, her SUI symptoms with coughing and sneezing resolved. She continued to complain of SUI during running. After a 2-dimensional video running gait assessment, running gait retraining was initiated in the form of verbal feedback to reduce the sound intensity of the foot striking the ground. Outcomes: After 2 visits of gait retraining over 2 weeks, the patient's SUI symptoms with running resolved. Gait reassessment revealed decreased sound intensity with foot strike. Eight weeks post-treatment, the patient remained symptom-free, and their Pelvic Floor Distress Inventory-20 (PFDI-20) total score decreased from 51.04/300 to 4.16/300. Discussion: This patient experienced meaningful improvements in symptoms of SUI following standard pelvic physical therapy treatment of pelvic floor, abdominal, and hip muscle training but only achieved resolution of symptoms with running after individualized running gait modification. Running gait retraining to reduce sound intensity during foot strike may have resulted in a decrease in impact and improvements in SUI symptoms while running.

Factors Associated with the Incidence of Stress Urinary Incontinence in Uterine Prolapse Cases at RSUD Dr. Soetomo Surabaya

&lt;div class="WordSection1"&gt;&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Urinary incontinence (UI) is the involuntary leakage of urine, which can cause problems and have a negative impact on quality of life. Stress urinary incontinence is one of the subtypes of urinary incontinence which is defined as the involuntary expulsion of urine during exertion or physical activity, or sneezing, or coughing. The purpose of this study was to explain the relationship between age, type of delivery, parity, and body mass index with the incidence of stress urinary incontinence in cases of uterine prolapse at RSUD Dr Soetomo Surabaya.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method:&lt;/strong&gt; This type of research is a quantitative research using analytical observational method, with a cross sectional approach. The sampling technique in this study was total sampling that met all inclusion and exclusion criteria. The independent variables of this study were age, type of delivery, parity, and body mass index. The dependent variable of this study is stress urinary incontinence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result:&lt;/strong&gt; Fisher's Exact test results on age, type of delivery, parity, and body mass index obtained p-values of 0.004, 0.021, 0.021, 0.014, 0,014 respectively. Because the p value of the five variables &amp;gt; 0.05, it can be concluded that H1 is accepted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;There is a relationship between age, type of delivery, parity, body mass index, and degree of uterine prolapse. The results of the logistic regression test showed that most related variable to the incidence of stress urinary incontinence was age.&lt;/p&gt;&lt;/div&gt;&lt;div class="WordSection2"&gt; &lt;/div&gt;&lt;strong&gt;&lt;br clear="all" /&gt;&lt;/strong&gt;

Association of Serum Triglyceride and Stress Urinary Incontinence in Women From the National Health and Nutrition Examination Survey: A Cross-Sectional Study

ObjectiveTo investigate the relationship between serum triglyceride levels and stress urinary incontinence (SUI) in women from the National Health and Nutrition Examination Survey. MethodsAdults who participated in the National Health and Nutrition Examination Survey from 2005 to 2018 were included in the study. Univariate and multivariate logistic regressions were used to assess the relationship between serum triglyceride levels and the incidence and severity of SUI. ResultsApproximately 7973 participants (mean, 49.9 years of age) were enrolled in the study. Of those, 3367 had SUI, and 4606 did not have SUI. An adjusted multivariate logistic regression analysis demonstrated a positive correlation between serum triglyceride levels and the incidence of SUI (ORs, 1.05; 95% CI, 1-1.11, P = .045). Besides, subgroup analyses indicated that the results were robust among women with different characteristics. Additionally, serum triglyceride levels were positively associated with the severity of SUI. ConclusionSerum triglyceride levels were closely related to the incidence and severity of SUI. Based on our findings, we suggest that serum triglycerides can be included as a risk indicator for screening high-risk groups of SUI.

Comparison of Kegel Exercises and Stabilization Exercises for Urinary Incontinence in Postpartum Females

Stress urinary incontinence (SUI) is the spontaneous urine loss upon any effort or physical activity, or coughing or sneezing. Objectives: This study aimed to investigate the effects of Kegel exercises and stabilization exercises on urinary incontinence along with the improvement in the strength of pelvic floor. Methods: This was a quasi-experimental study in which purposive sampling was done from postpartum females from Physiotherapy OPDs of Government hospitals of Faisalabad after meeting inclusion exclusion criteria. Thirty females with urinary incontinence were assigned into two groups: Group A and Group B. Group A received Kegel exercises for 4 weeks and group B received stabilization exercises for 4 weeks. Data was analyzed by SPSS version 16. Paired T test was used for inter-group analysis and independent T test was used for intra-group analysis. Results: The study concluded that the incidence of stress urinary incontinence increases with age as 36.7% participants of the study were from 51-60 years of age group. This study also proved that both kegel exercise and stabilization exercise were beneficial in treating stress urinary incontinence and showed significant difference with a p value of 0.012. Conclusions: It showed that stabilization exercises are a better approach in treating stress urinary incontinence by showing greater mean value of 2.533 ± 1.187. In the end, kegel exercises are primary treatment of stress urinary incontinence but when doing them alone, they showed lesser improvement with a mean value of 1.533 ± 0.833.

Effect of prolonged second stage of labor on pelvic floor function: A prospective cohort study.

To evaluate the effect of the second stage of labor (SSL) lasting > 2 h on pelvic floor function. This single-center prospective cohort study included primiparous women with SSL > 2 h treated at Tongji Hospital between January 2018 and December 2019 (case group). A matched group of women with similar newborn weight and SSL < 2 h were recruited simultaneously (control group). Stress urinary incontinence (SUI) and pelvic floor muscle (PFM) characteristics were measured at 6 weeks, 6 months, and finally 1 year postpartum. A total of 63 pairs of primiparous women completed 1-year follow-up. The incidence of SUI in the case group was significantly higher than that in the control group at 6 weeks postpartum (P = 0.020); however, the differences were not significant at 1 year postpartum (P=1.00). PFM endurance was significantly lower in the case group at 6 weeks (P = 0.000), 6 months (P = 0.000), and 1 year (P = 0.011) after childbirth. There was no difference in PFM strength between the two groups. The maximal voluntary contraction (MVC) of PFM was significantly lower in the case group at 6 weeks postpartum (P = 0.007), but the differences were not significant at 1 year postpartum (P = 0.197). PFM endurance and MVC were higher at 1 year than at 6 weeks postpartum in both groups. The SSL > 2 h increased the incidence of SUI at 6 weeks postpartum and decreased PFM endurance for 1 year.