Incidence Of Urinary Incontinence Research Articles

Effects of pelvic-abdominal mechanics exercises during pregnancy on improving perinatal pelvic floor function in primiparous women

Objective: To explore the effects of pelvic-abdominal mechanics exercises during pregnancy on improving pelvic floor function in primiparous women during the perinatal period. Methods: A single-center prospective study selected 200 primipara of singleton pregnancies with prenatal care and delivery established at Shanghai Tongren hospital from June 2022 to June 2023 as the study subjects. Participants were divided into two groups: the exercise group (100 cases) and the control group (100 cases) by using a random number table method, five participants dropped out of the study due to reasons such as follow-up failure. Ultimately, the exercise group consisted of 97 cases, while the control group consisted of 98 cases. Participants who engaged in pelvic-abdominal mechanics exercises for at least 3 months, exercising once a week, were included in the exercise group. Those who did not engage in exercise were included in control group. Comparing the two groups in terms of pregnancy discomfort symptoms, delivery outcomes, postpartum pelvic floor electromyography results, postpartum quality of life, and pelvic floor disease incidence. The statistical methods utilized included independent t-test, Pearson chi-square test, Fisher's exact test, and Mann-Whitney U test. Results: In the late stage of pregnancy, the VAS score for low back pain was 5.05±1.22 in the exercise group and 5.47±1.55 in the control group, with a statistically significant difference (t=2.090, P<0.05). The PFDI-20 score was 23.33±8.41 in the exercise group and 25.76±8.34 in the control group, with a statistically significant difference (t=2.026, P<0.05). The PFIQ-7 score was 19.21±7.69 in the exercise group and 26.66±6.19 in the control group, with a statistically significant difference (t=6.851, P<0.05). There was no statistically significant difference in sleep quality and incidence of urinary incontinence between the two groups in late pregnancy (t=1.252, P=0.396, P>0.05). In terms of childbirth outcomes, the exercise group had a vaginal delivery rate of 81.44% (79 cases), while the control group had a rate of 64.28% (63 cases), with a statistically significant difference (χ2=9.022, P<0.05). The duration of the second stage of labor was (42.68±21.38) minutes in the exercise group and (50.54±21.33) minutes in the control group, with a statistically significant difference (t=2.178, P<0.05). At 42 days postpartum, the evaluation of pelvic floor function showed that the vaginal pressure in the exercise group was 62.19±10.04, while in the control group it was 52.68±15.55, with a statistically significant difference (t=-5.074, P<0.05). The MOS grading in the exercise group was 3.82±1.26, whereas in the control group it was 2.34±1.55, with a statistically significant difference (t=-7.355, P<0.05). In terms of the incidence of postpartum pelvic floor disorders, the occurrence of pelvic organ prolapse was 7.22% in the exercise group and 12.24% in the control group, with no statistically significant difference (χ2=1.402, P>0.05). The occurrence rate of stress urinary incontinence was 13.4% in the exercise group and 30.61% in the control group, with a statistically significant difference (P=0.015, P<0.05). Conclusion: Pelvic-abdominal mechanics exercises may have some advantages in reducing symptoms related to perinatal pelvic floor dysfunction, enhancing pelvic floor function, and preventing the occurrence of pelvic floor disease.

Effect of Cox’s Interaction Model of Client Health Behavior Combined with Huangqi and Dangshen Decoction on Female Pelvic Floor Dysfunction

Huangqi and Dangshen have significant medicinal and medical value as natural bio-based materials, but there are few studies on female pelvic floor dysfunction. We aimed to explore the effect of the Cox’s interaction model of client health behavior (Cox-IMCHB) combined with Huangqi and Dangshen decoction on female pelvic floor dysfunction. 166 postpartum patients with Qi-deficiency syndrome of pelvic floor dysfunction were selected from Tongren Hospital of Wuhan University hospital and divided into two groups, Group A and Group B, each consisting of 83 cases. The allocation was done using the random number table method. Patients in Group A received routine nursing and biofeedback electrical stimulation treatment, while patients in Group B received Cox-IMCHB combined with Huangqi and Dangshen decoction based on Group A. We compared the clinical efficacy, syndrome efficacy, pelvic floor muscle strength scores, sexual life quality scores, VAS score, pelvic floor functional exercise compliance score, and the incidence of urinary incontinence and pelvic organ prolapse between the two groups. The results showed that Group B had better clinical efficacy and syndrome efficacy, as well as a higher total effective rate (clinical efficacy: 91.57% vs. 72.29%; syndrome efficacy: 95.18% vs. 74.70%). Moreover, compared to Group A, Group B had higher scores of pelvic floor muscle strength and sexual life quality, a lower proportion of mild pain (85.54% vs. 71.08%), and higher scores of pelvic floor functional exercise compliance. The scores of pelvic floor functional exercise compliance in both groups tended to increase with time, and there was an interactive effect between groups and time (intergroup effect: F = 322.900, time effect: F = 186.200, interaction effect: F = 27.410). The incidence of urinary incontinence (2.41% vs. 14.46%, ϰ2 = 6.319) and pelvic organ prolapse (3.61% vs. 16.87%, ϰ2 = 9.608) in group B was lower (all P &gt; 0.05). The combination of Cox-IMCHB with Huangqi and Dangshen decoction can improve the pelvic function and exercise compliance of patients with pelvic floor dysfunction, relieve pain, and have significant clinical effects, which are worthy of promotion and application.

A study to untangle the puzzle of urinary incontinence and frailty co-occurrence among older adults: The roles of depression and activity engagement.

To explore the co-occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways. A secondary analysis of a 1-year three-wave panel data collected from older nursing home residents in China. Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co-occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism. A total of 348 older adults were included in this study, and 55.7% were women. The co-occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1-year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant. The co-occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co-occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement. The phenomenon of urinary incontinence and frailty co-occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co-occurrence. What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence. What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant. Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers' understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co-occurrence. The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines. No patient or public contribution.

Commentary on "Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques: a multicenter, real-world experience of 5068 patients".

Commentary on "Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques: a multicenter, real-world experience of 5068 patients".

Comparison of urinary incontinence following three different prostate apex disconnection techniques in transurethral thulium laser prostatectomy.

This study investigates the incidence of urinary incontinence following transurethral thulium laser prostatectomy with three different prostate apex disconnection techniques: semi-separation, pre-separation, and post-separation. The findings aim to provide references for clinical treatment. A retrospective analysis was conducted on 74 patients treated with transurethral thulium laser prostatectomy for prostatic hyperplasia from April 2022 to March 2023. Complete clinical and follow-up data were available for 52 patients. Clinical and follow-up data were collected for these patients. A comparison was made of urinary incontinence following the three different types of prostate apex disconnection in transurethral thulium laser prostatectomy. In this study, the immediate postoperative urinary incontinence rate for transurethral thulium laser prostatectomy was 9.62% (5/52), the short-term incontinence rate was 11.54% (5/52), and the long-term incontinence rate was 9.62% (5/52). The immediate postoperative incontinence rates for semi-separation, pre-separation, and post- separation were 8.33% (1/12), 8.33% (2/24), and 12.5% (2/16), respectively. The short-term incontinence rates for semi-separation, pre-separation, and post-separation were 8.33% (1/12), 8.33% (2/24), and 18.75% (3/16), respectively. The long-term incontinence rates for semi-separation, pre-separation, and post-separation were 8.33% (1/12), 8.33% (2/24), and 12.5% (2/16), respectively. The incidence of urinary incontinence following transurethral thulium laser prostatectomy was lower with semi-separation and pre-separation compared to post-separation.

Simple versus Radical Hysterectomy in Women with Low-Risk Cervical Cancer

BackgroundRetrospective data suggest that the incidence of parametrial infiltration is low in patients with early-stage low-risk cervical cancer, which raises questions regarding the need for radical hysterectomy in these patients. However, data from large, randomized trials comparing outcomes of radical and simple hysterectomy are lacking.MethodsWe conducted a multicenter, randomized, noninferiority trial comparing radical hysterectomy with simple hysterectomy including lymph-node assessment in patients with low-risk cervical cancer (lesions of ≤2 cm with limited stromal invasion). The primary outcome was cancer recurrence in the pelvic area (pelvic recurrence) at 3 years. The prespecified noninferiority margin for the between-group difference in pelvic recurrence at 3 years was 4 percentage points.ResultsAmong 700 patients who underwent randomization (350 in each group), the majority had tumors that were stage IB1 according to the 2009 International Federation of Gynecology and Obstetrics (FIGO) criteria (91.7%), that had squamous-cell histologic features (61.7%), and that were grade 1 or 2 (59.3%). With a median follow-up time of 4.5 years, the incidence of pelvic recurrence at 3 years was 2.17% in the radical hysterectomy group and 2.52% in the simple hysterectomy group (an absolute difference of 0.35 percentage points; 90% confidence interval, −1.62 to 2.32). Results were similar in a per-protocol analysis. The incidence of urinary incontinence was lower in the simple hysterectomy group than in the radical hysterectomy group within 4 weeks after surgery (2.4% vs. 5.5%; P=0.048) and beyond 4 weeks (4.7% vs. 11.0%; P=0.003). The incidence of urinary retention in the simple hysterectomy group was also lower than that in the radical hysterectomy group within 4 weeks after surgery (0.6% vs. 11.0%; P<0.001) and beyond 4 weeks (0.6% vs. 9.9%; P<0.001).ConclusionsIn patients with low-risk cervical cancer, simple hysterectomy was not inferior to radical hysterectomy with respect to the 3-year incidence of pelvic recurrence and was associated with a lower risk of urinary incontinence or retention. (Funded by the Canadian Cancer Society and others; ClinicalTrials.gov number, NCT01658930.)

Holmium Laser Enucleation of Prostate: Is novel En Bloc Enucleation Technique Better Than the Traditional 2-Lobe Technique-A Prospective Randomized Study.

To compare the safety and efficacy of the en bloc technique with the standard 2-lobe technique for holmium laser enucleation of the prostate (HoLEP). This prospective study included patients with benign prostatic hyperplasia (BPH) who underwent HoLEP from September 2020 to March 2022, by en bloc or 2-lobe technique. Patient demographics, prostate volume, enucleation, morcellation and operative time, and incidence of postoperative incontinence were compared between the 2 groups. We included 64 patients (30 en bloc and 34 2-lobe techniques) who underwent HoLEP in this study. The mean age, prostate volume, creatinine, and PSA of patients were comparable in both groups [(68.53 vs. 67.55 years; P=.62), (79.43 vs. 79.88 g, P=.92), (1.08 mg/dL vs. 1.20 mg/dL, P=.35), (3.78 vs. 4.63 ng/mL; P=.376), respectively]. The enucleation time was significantly shorter in the en bloc group than in the 2-lobe group (54.2 vs. 61.67; P=.03). Additionally, the mean operative time was also comparatively shorter in the en bloc group than the 2-lobe group (72.36 vs. 80.50; P=.057). The improvement in the quality-of-life (QoL) score was significantly better with en bloc than the 2-lobe group (3.80 vs. 2.11; P=.01). There was a significant difference in stress urinary incontinence on days 1, 7, and 30 (P .001) with en bloc compared to the two-lobe technique. Although the outcomes of en bloc and 2-lobe endoscopic enucleation of prostate techniques were comparable, the en bloc technique seems to be a better option in most patients undergoing HoLEP due to less enucleation and operative time and lowered stress urinary incontinence incidence.

A Retrospective Study Analyzing the Incidence of Urine Incontinence after Cesarean Section Delivery in Comparison with Vaginal Delivery

Introduction: Urine incontinence is the involuntary leakage of urine. Its actual prevalence is underestimated. There is a general belief that vaginal delivery is a major risk. Elective cesarean delivery is increasing worldwide; one reason is to protect against pelvic floor disorders, including urine incontinence. Previous studies included small samples with controversial results. This study aimed to compare the risk of urine incontinence in women who had cesarean delivery with those who had vaginal delivery. Methods: It was a retrospective study on 1751 women delivered in a university hospital over a 5- year period. Data collected on number of deliveries, age at first and last delivery, mode of each delivery, gestational age, birth weight, indication of cesarean section, induction of labor, episiotomy, perineal tears, smoking, chronic cough, chronic constipation, presence and severity of urine incontinence using ICIQ score. Patients were categorized into 2 groups: all cesarean section deliveries and at least one vaginal delivery. Results: A total of 600 respondents delivered only by cesarean section, and 1151 had at least one vaginal delivery. Urine incontinence prevalence in the cesarean group was 5.8%, and 6.9% in the vaginal group. Age, perineal tear, chronic cough, and chronic constipation were found to be significantly associated with urinary incontinence. After adjusting for all other variables, vaginal delivery was not found to be significantly associated with incontinence compared to cesarean. Conclusion: Vaginal and cesarean deliveries have a comparable incidence of urinary incontinence. It is difficult to get a firm conclusion on whether cesarean is protective. Chronic constipation and cough are important factors regardless of delivery mode.

Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques: a multicenter, real-world experience of 5068 patients.

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate (EEP) comparing en-bloc (Group 1) versus 2-lobe/3-lobe techniques (Group 2). We performed a retrospective review of patients undergoing EEP for benign prostatic enlargement in 12 centers between January 2020 and January 2022. Data were presented as median and interquartile range (IQR). Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence (SUI) and mixed urinary incontinence (MUI). There were 1711 patients in Group 1 and 3357 patients in Group 2. Patients in Group 2 were significantly younger (68 [62-73] years vs 69 [63-74] years, P = 0.002). Median (interquartile range) prostate volume (PV) was similar between the groups (70 [52-92] ml in Group 1 vs 70 [54-90] ml in Group 2, P = 0.774). There was no difference in preoperative International Prostate Symptom Score, quality of life, or maximum flow rate. Enucleation, morcellation, and total surgical time were significantly shorter in Group 1. Within 1 month, overall incontinence rate was 6.3% in Group 1 versus 5.3% in Group 2 (P = 0.12), and urge incontinence was significantly higher in Group 1 (55.1% vs 37.3% in Group 2, P < 0.001). After 3 months, the overall rate of incontinence was 1.7% in Group 1 versus 2.3% in Group 2 (P = 0.06), and SUI was significantly higher in Group 2 (55.6% vs 24.1% in Group 1, P = 0.002). At multivariable analysis, PV and IPSS were factors significantly associated with higher odds of transient SUI/MUI. PV, surgical time, and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.

Incidence and influencing factors of urinary incontinence in stroke patients: A meta-analysis.

The incidence of stroke in China ranks first in the world and is the leading cause of death and disability in adults. Urinary incontinence is an independent risk factor leading to poor prognosis of stroke. However, studies on the incidence of urinary incontinence in stroke patients and its influencing factors are different, fluctuate greatly, and there is no unified basis. To quantitatively analyze the incidence of urinary incontinence in stroke patients and its related influencing factors, and further make public health strategic decisions to reduce the occurrence of adverse outcomes. Computer searches were conducted in PubMed, Medline, Web of Science, Cochrane Library, Embase, CLNAHL Complete, China National Knowledge Infrastructure (CNKI), Chinese Biomedical database(CBM), Wan Fang Database, VIP Database, observational studies such as cohort studies, case-control studies or cross-sectional studies on the incidence or influencing factors of urinary incontinence in stroke patients from the establishment of the database to the publication in August 2023. Studies selection, quality evaluation and data extraction were conducted independently by two researchers according to the established search strategy. Stata 14.0 statistical software was used for meta-analysis. A total of 21 manuscripts were included, with a cumulative sample size of 7327 cases, including 2887 patients with urinary incontinence. Meta-analysis results showed that the incidence of urinary incontinence in stroke patients was 38% [95% confidence interval (34%, 41%)], including married patients and lacunar infarction were the protective factors for urinary incontinence in stroke patients, while age, chaperone, low educational level, chronic cough, lesion sites (parietal lobe, frontal lobe, and temporal lobe), stroke type (cerebral hemorrhage, subarachnoid hemorrhage and cerebral hemorrhage complicated with subarachnoid hemorrhage), dysfunction (aphasia dyslexia, dysphagia, eye movement abnormalities, leg muscle disorders), post-stroke depression, the higher the NIHSS score, the lower the Bachmann index (BI) score, OCSP classification (total anterior circulation infarction) and other 11 items were risk factors for urinary incontinence in stroke patients. The incidence of urinary incontinence in stroke patients is 38%. Marriage and lacunar infarction are the protective factors of urinary incontinence. Age, carer, low educational level, chronic cough, lesion site (parietal, frontal and temporal lobes), stroke type (cerebral hemorrhage, subarachnoid hemorrhage, cerebral hemorrhage combined with subarachnoid hemorrhage), dysfunction (aphasia and dysarthria syndrome, dysphagia, eye movement abnormalities, leg muscle disorders), post-stroke depression, and higher NIHSS score, Lower BI score and OCSP classification (total anterior circulation infarction) were risk factors for urinary incontinence in stroke patients.

Incidence of urinary incontinence after hip fracture surgery and associated risk factors: a prospective study

BackgroundThe contribution of the postoperative process to developing or worsening urinary incontinence (UI) after hip fracture surgery (HFS) remains unclear. We aimed to evaluate UI incidence and worsening among older patients undergoing HFS, and explore associated risk factors.MethodsThis prospective cohort study included patients ≥ 75 years admitted between October 2019 and October 2021 to the Traumatology Service of three hospitals in the Consorci Sanitari de Alt-Penedès i Garraf (Barcelona, Spain) with hip fracture requiring surgical treatment. UI was assessed using the first two questions of the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) at baseline and at days 30 (± 3 days) and 90 (± 3 days) after HFS. Surgery-related data and post-surgical complications were recorded.ResultsA total of 248 patients with a mean (SD) age of 85.8 (6.78) years were included; 77.8% were female and 154 (62.1%) had UI at baseline. After HFS, 3.24% experienced urinary tract infections (UTIs), 3.64%, acute urinary retention (AUR), 8.57%, constipation, and 53.9%, prolonged catheterization (> 24 h). Fifty-eight patients without baseline UI developed UI at 30 days, resulting in a UI incidence of 61.7% (95% CI 51.1–71.54) between days 0 and 30. Of the 248 patients, 146 (59.1%) experienced worsening of UI. AUR and UTIs were identified as risk factors for UI development and worsening after HFS, respectively.ConclusionThe incidence of UI in older patients after HFS is significant. Patient management protocols should consider AUR and UTIs to reduce or eliminate the incidence of UI in older patients undergoing HFS.

Prevalence and incidence of urinary incontinence in pregnancy: a review

The uncontrolled flow of urine that happens when someone sneezes, coughs, or engages in physical activity is known as urinary incontinence (UI). The most common kind of urine incontinence that affects women is this one. Hence, this study aimed to examine the incidence, prevalence, and contributing factors of pregnancy-related UI. An electronic literature search was conducted in the MEDLINE database using the search phrases &amp;quot;Urinary Incontinence,&amp;quot; &amp;quot;UI,&amp;quot; &amp;quot;Pregnancy,&amp;quot; &amp;quot;Prevalence,&amp;quot; and &amp;quot;Risk Factors&amp;quot; to discover relevant papers between 2018 and 2024. On Google Scholar, relevant search terms were employed to search for academic publications. Several inclusion criteria served as a guide for the selection of articles. It was found that urinary incontinence is a condition that often increases in prevalence from 6 months to 12 years postpartum. Typically, it is of low to moderate severity and has little impact on the overall well-being of the majority of persons. Furthermore, the study highlighted the importance of pregnancy, rather than the act of giving birth, in the subsequent development of urine incontinence in the long term after delivery. Women who gave birth vaginally had a greater occurrence of persistent UI as compared to those who had cesarean deliveries. During pregnancy, more than 50% of women suffered from urine incontinence. Nevertheless, the majority saw a rapid recovery during the first year after childbirth.

Prevalence and incidence of urinary incontinence in pregnancy: a review

The uncontrolled flow of urine that happens when someone sneezes, coughs, or engages in physical activity is known as urinary incontinence (UI). The most common kind of urine incontinence that affects women is this one. Hence, this study aimed to examine the incidence, prevalence, and contributing factors of pregnancy-related UI. An electronic literature search was conducted in the MEDLINE database using the search phrases &amp;quot;Urinary Incontinence,&amp;quot; &amp;quot;UI,&amp;quot; &amp;quot;Pregnancy,&amp;quot; &amp;quot;Prevalence,&amp;quot; and &amp;quot;Risk Factors&amp;quot; to discover relevant papers between 2018 and 2024. On Google Scholar, relevant search terms were employed to search for academic publications. Several inclusion criteria served as a guide for the selection of articles. It was found that urinary incontinence is a condition that often increases in prevalence from 6 months to 12 years postpartum. Typically, it is of low to moderate severity and has little impact on the overall well-being of the majority of persons. Furthermore, the study highlighted the importance of pregnancy, rather than the act of giving birth, in the subsequent development of urine incontinence in the long term after delivery. Women who gave birth vaginally had a greater occurrence of persistent UI as compared to those who had cesarean deliveries. During pregnancy, more than 50% of women suffered from urine incontinence. Nevertheless, the majority saw a rapid recovery during the first year after childbirth.

Application of Kegel Motion Combined With Warming Acupuncture at the Eight Acupuncture Points in Patients With Urinary Incontinence After Radical Prostatectomy

Purpose To study the effect of Kegel exercise combined with Baliao warming acupuncture in the treatment of urinary incontinence after radical prostatectomy. Methods A single-center, retrospective cohort study was conducted on patients with clinically localized prostate cancer. This study involved 200 patients through a specific exclusion criterion admitted to the Department of Urology of our hospital, including 100 cases in the control group (single Kegel Motion) and 100 cases in the experimental group (Kegel Motion combined with acupuncture) from July 2017 to November 2020. Time from catheter removal to full recovery of urinary continence was recorded by 1 month, 3 months, and 6 months after surgery. The International Consultation on Incontinence Questionnaire-Short Form, the “1-hour diaper test,” and the Quality of Life Incontinence Questionnaire were used to evaluate the frequency and severity of urinary incontinence, the efficacy of urinary incontinence and the patients’ qualities of life, respectively. An independent sample t test, rank sum test, and χ2 test were adopted for comparison between groups. Results None of the frequency, severity, and efficacy of urinary incontinence nor the patients’ qualities of life showed a difference between the experimental group and the control group at 1 month after surgery (P &amp;gt; 0.05) but showed significant differences at 3 months and 6 months postoperatively (P &amp;lt; 0.05). Conclusions The Kegel Motion combined with warming acupuncture at the 8 acupuncture points can reduce the incidence of urinary incontinence, improve urinary control ability, and improve the quality of life of patients with urinary incontinence after radical prostatectomy.

Comparative analysis of the safety and efficacy of 1470-nm diode laser enucleation of the prostate and plasmakinetic resection of prostate in the treatment of large volume benign prostatic hyperplasia (>80 ml)

Objective To compare the efficacy and safety of 1470-nm diode laser enucleation of the prostate (DiLEP) with that of plasmakinetic resection of the prostate (PKRP) in treating patients with large benign prostatic hyperplasia (BPH > 80ml). Methods The clinical data from 211 cases of BPH (>80 ml) were collected for analysis. The patients were divided into two groups: the PKRP group (n = 118) and the DiLEP group (n = 93), based on the surgical method used. Result The DiLEP group demonstrated significantly lower surgical time (p < 0.001), intraoperative bleeding (p < 0.001), bladder flushing time (p = 0.003), indwelling catheter time (p < 0.005), and length of hospital stay (p = 0.018) compared to the PKRP group. However, the quality of the prostatectomy was significantly higher in the DiLEP group (p = 0.005). The Qmax for the DiLEP group was significantly higher than that of the PKRP group (p < 0.05). Compared to the PKRP group, the incidence of urinary incontinence in the DiLEP group increased significantly 4 weeks post-surgery (p = 0.026), although the need for blood transfusion during surgery was significantly reduced (p = 0.037). Conclusion Both DiLEP and PKRP are safe and effective methods for treating large-volume BPH. However, DiLEP offers advantages such as more thorough glandular resection, shorter surgical time, reduced bleeding, quicker recovery, and fewer complications.

Association of Diastasis Recti Abdominis with Pelvic Floor Muscle Strenth and Urine Incontinence in Gynecological Population

Purpose: Diastasis recti abdominis (DRA) denotes an anomalous separation of the rectus muscles throughout their longitudinal axis, devoid of fascial irregularities. The current study sought to determine the prevalence of DRA and its potential association with pelvic floor muscular strength and urinary incontinence in the gynaecological population of Faisalabad. This was a cross-sectional study.&#x0D; Materials and Methods: A Convenient sampling technique was used for collecting data. A sample of 100 females from government hospitals of Faisalabad was taken. Study was conducted in Faisalabad from February 2018 to May 2018. Inclusion criteria of the research was, immediate postpartum ladies, females aged 18 to menopausal age, and females who had normal vaginal birth. Manometric techniques were employed to quantify the strength of the pelvic floor muscles (PFMS), with outcomes represented in cmH2O. The incidence of urinary incontinence (UI) was ascertained by querying patients regarding any manifestations postpartum. The extent of diastasis recti abdominis (DRA) was gauged utilizing fingerbreadth assessments of the rectus abdominis muscles. This particular measurement spanned a distance of 4.5 cm both superior and inferior to the umbilicus, aligned with the linea alba.&#x0D; Findings: Results were analyzed through SPSS version 26. Diastasis recti abdominis was found to be present in 57% of the females. 7% of the women had very weak pelvic floor muscle, 38% had weak, 50% had moderate strength and 5% had good strength of pelvic floor muscles. Out of 100, urine incontinence was found in 59% females. There was no statistically significant correlation observed between diastasis recti abdominis muscle and either urinary incontinence or pelvic floor muscle strength, with a p-value exceeding 0.05.&#x0D; Implications to Theory, Practice and Policy: Incorporate routine DRAM screening for postpartum gynecological patients. Educate women about DRAM, its risk factors, and prevention strategies. Promote postpartum exercises and physical therapy to strengthen abdominal muscles and pelvic floor. Provide nutritional counseling to address obesity, a risk factor for DRAM. Implement a multidisciplinary approach involving gynecologists, physiotherapists, and nutritionists. Conduct additional research on the long-term consequences of DRAM and effective interventions. Conduct awareness campaigns targeting both healthcare providers and the public to increase DRAM awareness.

Does Centralization of Radical Prostatectomy Reduce the Incidence of Postoperative Urinary Incontinence?

BackgroundOn the basis of previous analyses of the incidence of urinary incontinence (UI) after radical prostatectomy (RP), the hospital RP volume threshold in the Netherlands was gradually increased from 20 per year in 2017, to 50 in 2018 and 100 from 2019 onwards. ObjectiveTo evaluate the impact of hospital RP volumes on the incidence and risk of UI after RP (RP-UI). Design, setting, and participantsPatients who underwent RP during 2016–2020 were identified in the claims database of the largest health insurance company in the Netherlands. Incontinence was defined as an insurance claim for ≥1 pads/d. Outcome measurements and statistical analysisThe relationship between hospital RP volume (HV) and RP-UI was assessed via multivariable analysis adjusted for age, comorbidity, postoperative radiotherapy, and lymph node dissection. Results and limitationsRP-UI incidence nationwide and by RP volume category did not decrease significantly during the study period, and 5-yr RP-UI rates varied greatly among hospitals (19–85%). However, low-volume hospitals (≤120 RPs/yr) had a higher percentage of patients with RP-UI and higher variation in comparison to high-volume hospitals (>120 RPs/yr). In comparison to hospitals with low RP volumes throughout the study period, the risk of RP-UI was 29% lower in hospitals shifting from the low-volume to the high-volume category (>120 RPs/yr) and 52% lower in hospitals with a high RP volume throughout the study period (>120 RPs/yr for 5 yr). ConclusionsA focus on increasing hospital RP volumes alone does not seem to be sufficient to reduce the incidence of RP-UI, at least in the short term. Measurement of outcomes, preferably per surgeon, and the introduction of quality assurance programs are recommended. Patient summaryIn the Netherlands, centralization of surgery to remove the prostate (RP) because of cancer has not yet improved the occurrence of urinary incontinence (UI) after surgery. Hospitals performing more than 120 RP operations per year had better UI outcomes. However, there was a big difference in UI outcomes between hospitals.

Clinical and Aesthetic Review of Episiotomy Wound Closure Methods.

An episiotomy is a surgical incision in the perineum to facilitate the baby's head during delivery. Physicians or midwives may use this procedure if he/she finds out the tissue around the vaginal opening begins tearing or does not seem to be stretching enough to allow the baby to be delivered. With an increasing trend for hospital births and for physicians to get involved in the normal uncomplicated birth process, there was rise in the number of episiotomies. After the baby is delivered through the extended vaginal opening, the area is applied with local anesthetic agent and incision is repaired with sutures. Our study reviewed the development in the past twenty years regarding episiotomy wound closure methods, and discovered that continuous sutures for episiotomy or perineal repair have clinical advantages in term of faster and better wound healing, more favorable scarring, shorter post-procedural pain, more rapid resumption of sexual activity, lower incidence of urinary incontinence, compared to interrupted sutures. They were also beneficial in term of less consumption of suture materials. In determining suture materials, clinicians should strongly consider the tear severity, tissue characteristics, as well as the desired aesthetic outcome.

Prevalence of urınary ıncontınence ın women who applıed to a famıly health center ın the Van Provınce

Our aim of this study was to determine the incidence of urinary incontinence in women living in a family health center district in the province of Van, the effect of birth rate and type of delivery on urinary incontinence, the awareness level of women in this subject. This is a descriptive-cross-sectional study. The study was conducted by face to face survey method in women gave birth who applied to Family Health Center no.1 in Ipekyolu District. 227 women who agreed to participate in the study were included in the study. The mean number of pregnancies was 4.13 ± 0.71, 83 of the women (36.6%) stated that they had incontinent. 31 (37.3%) reported compression type, 25 (30.1%) stress type and 27 (32.6%) mixed type incontinence, 170 (74.9%) of the women see urinary incontinence as a health problem. The high number of children significantly increases urinary incontinence. Urinary incontinence is significantly higher in patients with diabetes mellitus. Women who have had their birth at home have higher urinary incontinence incidence than the women who have had all their births at hospital. Receiving education for 8 years and below increases to see urinary incontinence as a health problem. It is important in terms of women's health to educate women on reproductive health, to make full use of family planning services and to take all necessary measures to make all deliveries in hospital.

Sexual function in adolescents and young adults (AYA) with Bladder exstrophy-epispadias complex: Influence of the incontinence

BackgroundBladder exstrophy-epispadias complex (BEEC) is the most severe congenital anomaly involving the urinary tract. Currently, there is a growing interest in the long-term outcomes and their impact on quality of life (QoL). MethodsOur aim was to determine the incidence of urinary incontinence and whether it affects sexual function. The study population included BEEC patients >18 years treated at a specialized third-level hospital. We contacted them via telephone and emailed a voluntary online questionnaire which was anonymously self-completed. The online test included validated questionnaires to assess the following parameters: incontinence (ICIQ-SF), LUTS (ICIQ-FLUTS/IPSS) and sexual function (FSH/FSM2). Answers of the questionnaires were collected into a database for further evaluation. Statistical significance was defined by p < .05. ResultsAmong the thirteen patients (7 men and 6 women) who answered the questionnaire the median score on ICIQ-SF was 6/21. Based on that questionnaire only 4 patients (30.8 %) were classified as continent (ICIQ-SF = 0). However, when directly asked if they were able to stay dry in their day-to-day life, 61.5 % responded affirmatively, a number that doubled those who were considered continent according to the ICIQ-SF test. Incontinence was associated with an increased sexual dysfunction, having a correlation with low satisfaction in men and diminished libido and lubrication in women. ConclusionsIn the present study, we found a high incontinence rate, which is discrepant with the self-perception of day-to-day dryness. In addition, our data showed that incontinence is linked to a diminished sexual function.