Incidence Of Urinary Incontinence Research Articles

Systematic review of pelvic floor interventions during pregnancy.

Pelvic floor interventions during pregnancy could reduce the impact of pregnancy and delivery on the pelvic floor. To determine the effects of pelvic floor interventions during pregnancy on childbirth-related and pelvic floor parameters. PubMed, Embase, and LILACS were searched for reports published during between 1990 and 2016 in English, Spanish, or Portuguese. The search terms were "pregnancy," "pelvic floor muscle training," and related terms. Randomized controlled trials with healthy pregnant women were included. Baseline and outcome data (childbirth-related parameters, pelvic floor symptoms) were compared for three interventions: EPI-NO (Tecsana, Munich, Germany) perineal dilator, pelvic floor muscle training, and perineal massage. A total of 22 trials were included. Two of three papers assessing EPI-NO showed no benefit. The largest study investigating pelvic floor muscle training reported a significant reduction in the duration of the second stage of labor (P<0.01), and this intervention also reduced the incidence of urinary incontinence (evaluated in 10 trials). Two of six trials investigating perineal massage reported that a lower rate of perineal pain was associated with this intervention. Pelvic floor muscle training and perineal massage improved childbirth-related parameters and pelvic floor symptoms, whereas EPI-NO showed no benefit.

Effects of free-posture parturition on parturition outcomes and pelvic floor function in puerperae

Objective To observe the effects of free-posture parturition on the parturition outcomes and pelvic floor function of puerperae. Methods Totally 270 pregnant women who met the requirements were divided into an observation group (n=135) and a control group (n=135) by the prospective randomized controlled clinic trail. Pregnant women in the observation group adopted free-posture parturition, while pregnant women in the control group delivered in the frequently used supine position. The pregnant women in both groups were managed according to the existing labor standards, and the effects of free-posture parturition on their parturition outcomes and pelvic floor function were observed. Results Totally 133 pregnant women in the observation group delivered naturally and 2 transferred to cesarean parturition in the process, while 102 pregnant women in the control group delivered naturally and 33 transferred to cesarean parturition in the process (χ2=31.55, P 0.05) . The uniparae in the observation group were less likely to show reduced typeⅠand typeⅡ muscle fiber strength than the uniparae in the control group (P 0.05) . There was no statistically significant difference in the incidence of urinary incontinence between the puerparae in the two groups (P>0.05) . Conclusions The use of free-posture parturition can reduce the possibility of cesarean parturition substantially. The duration of labor stage in uniparae can be shortened significantly, and their pelvic floor muscle strength is better than that of the puerparea in the control group. Free-posture parturition does not contribute to negative outcomes of maternals and fetals. Key words: Parturition; Free-posture; Parturition outcome; Pelvic floor function

BLADDER TRAINING BERPENGARUH TERHADAP PENURUNAN KEJADIAN INKONTINENSIA URINE PADA PASIEN POST OPERASI BPH DI RUANG RAWAT INAP RSUD SOREANG

The incidence of benign prostate hyperplasia (BPH) in Indonesia is quite high, which is about 24-30% of urological cases treated in several central public hospitals. While the incidence of BPH in general hospital Soreang in 2014 shows a fairly high incidence rate (12.5 %) and the second number of the top ten surgery cases after fibro adenoma mamma. Open prostatectomy is an invasive treatment to help miction of the BPH patients and it can cause side effects especially urinary incontinence. According to the result of preliminarystudy indicated that 80 % patients who control to Soreang general hospital after open prostatectomy surgery have urinary incontinence. One kind of nursing interventions that can be given to overcome urinary incontinence is by doing bladder training. This study aims to determine the effect of bladder training with use of delay urination and scheduled urination technique to decrease the incidence of urinary incontinence in post operative BPH patients. The research used quasi experiment, with used pre and post test approach in two intervention groups without using control group to 60 samples who obtained by accidental sampling, so the total number of each group is 30 BPH patiens. The results showed that bladder training with both delay urination and scheduled urination techniques had a significant effect on decreasing incidence of urinary incontinence in postoperative BPH patients, but there was no significant difference in the results of the two bladder training techniques on decreasing incidence of urinary incontinence. Related to this result, to prevent urinary incontinence of the post operative BPH patients is suggested to the nurse to apply bladder training with delay urination and scheduled urination techniques and in its application need to considered the age and physical condition of the patient.

Weight loss in the prevention and treatment of diabetes.

The American Diabetes Association nutrition and lifestyle recommendations for prediabetes and type 2 diabetes focus on losing 7% of body weight and increasing physical activity to at least 150minperweek. This emphasis is largely based on results of the Diabetes Prevention Program (DPP) and Look AHEAD (Action for Health in Diabetes) clinical trials. DPP demonstrated that a lifestyle intervention aimed at 7% weight loss and 150min of activity per week reduced diabetes incidence by 58% after 2.8years of follow-up and resulted in sustained improvements in hemoglobinA1c, blood pressure and lipid levels. After 15years of follow-up, DPP's lifestyle intervention sustained a 27% risk reduction in progression to diabetes. Look AHEAD's lifestyle intervention significantly reduced hemoglobinA1c, blood pressure, triglycerides, and the amount and costs of medications needed to treat these conditions when compared with diabetes support and education. Other clinical and psychological benefits achieved with lifestyle intervention were greater reductions in c-reactive protein, less self-reported retinopathy, reduced risk of nephropathy, less sexual dysfunction, decreased incidence of urinary incontinence and fatty liver, remission of sleep apnea, better physical functioning, less knee pain, more remission of diabetes, reduced incidence of depression, less body image dissatisfaction and improved quality-of-life. A number of DPP translation studies have demonstrated weight losses of 4 to 7% at 6month and 1year follow-up which has led to Medicare coverage for CDC recognized DPP lifestyle programs starting in April 2018. Translation studies of Look AHEAD using a variety of delivery formats are underway.

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

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

A populational-based survey on the prevalence, incidence, and risk factors of urinary incontinence in older adults-results from the "SABE STUDY".

To estimate the prevalence and incidence of urinary incontinence (UI) and identify the associated risk factors in a cohort of elderly individuals in Brazil. In 2006, individuals aged ≥60 years were selected from the SABE Study (Health, Well-being, and Aging). The dependent variable was reported UI in 2009. UI was assessed using the International Consultation on Incontinence Questionnaire Urinary Incontinence-Short Form (ICIQ-UI SF). Incidence was measured in units of 1000 person-years, and Cox regression was applied for data analysis. Multivariate analysis was used to assess risk factors for UI. Incidence risk ratio (IRR) was used for comparison. This is the first study to examine the incidence of UI in Brazilian elderly individuals. In total, 1413 individuals were included; the mean age was 74.5 years, and 864 (61.8%) participants were female. The risk of UI was greater among women with cancer (other than skin) and among those with diabetes. In men, the risk of UI was greater for those in Instrumental Activities of Daily Living (IADL) category "5-8" and those who self-reported a "fair" health status. The prevalence of UI was 14.2% and 28.2% for men and women, respectively. The incidence rate of UI was 25.6 and 39.3 (×1000 person-years) for men and women, respectively. The incidence rate of UI among older adults in the Brazilian community was high for elderly individuals. The identified risk factors were diabetes and IADL category 5-8 (women) as well as cancer (other than skin) and self-reported health status (male).

Risk of complications and urinary incontinence following cytoreductive prostatectomy: a multi-institutional study.

Emerging evidence has suggested that cytoreductive prostatectomy (CRP) allows superior oncologic control when compared to current standard of care androgen deprivation therapy alone. However, the safety and benefit of cytoreduction in metastatic prostate cancer (mPCa) has not been proven. Therefore, we evaluated the incidence of complications following CRP in men newly diagnosed with mPCa. A total of 68 patients who underwent CRP from 2006 to 2014 at four tertiary surgical centers were compared to 598 men who underwent radical prostatectomy for clinically localized prostate cancer (PCa). Urinary incontinence was defined as the use of any pad. CRP had longer operative times (200 min vs 140 min, P < 0.0001) and higher estimated blood loss (250 ml vs 125 ml, P < 0.0001) compared to the control group. However, both overall (8.82% vs 5.85%) and major complication rates (4.41% vs 2.17%) were comparable between the two groups. Importantly, urinary incontinence rate at 1-year after surgery was significantly higher in the CRP group (57.4% vs 90.8%, P < 0.0001). Univariate logistic analysis showed that the estimated blood loss was the only independent predictor of perioperative complications both in the unadjusted model (OR: 1.18; 95% CI: 1.02–1.37; P = 0.025) and surgery type-adjusted model (OR: 1.17; 95% CI: 1.01–1.36; P = 0.034). In conclusion, CRP is more challenging than radical prostatectomy and associated with a notably higher incidence of urinary incontinence. Nevertheless, CRP is a technically feasible and safe surgery for selecting PCa patients who present with node-positive or bony metastasis when performed by experienced surgeons. A prospective, multi-institutional clinical trial is currently underway to verify this concept.

160 - Frontal lobe function correlates with one-year incidence of urinary incontinence in elderly with Alzheimer disease

160 - Frontal lobe function correlates with one-year incidence of urinary incontinence in elderly with Alzheimer disease

Moderate Hypofractionated Postprostatectomy Volumetric Modulated Arc Therapy With Daily Image Guidance (VMAT-IGRT): AMono-institutional Report on Feasibility and Acute Toxicity.

The aim of this study was to evaluate the acute toxicity profiles of a moderate hypofractionated regimen with volumetric modulated arc therapy (VMAT) in patients with prostate cancer (PC) who underwent radical prostatectomy. From December 2012 to February 2016, 125 patients, previously having undergone radical prostatectomy, received adjuvant (64 patients) or salvage (61 patients) radiotherapy (RT) inside an institutional protocol of moderate hypofractionation schedule using the VMAT technique (Varian RapidArc, Palo Alto, CA). Eligible patients were< 85 years old, with an Eastern Cooperative Oncology Group performance status of 0 to 2, histologically proven adenocarcinoma of the prostate without distant metastases, and pathologic stage pT2-4 N0-1, with at least 1 of the following risk factors: capsular perforation, positive surgical margins, seminal vesicle invasion, and/or postoperative prostate-specific antigen > 0.2 ng/mL. Patients were stratified into low (1%), intermediate (9%), and high-risk (90%) groups. The median age was 68 years. The median doses were 66 Gy (range, 65.5-71.4 Gy) to the prostatic bed and 52.5 Gy (range, 50.4-54 Gy) to the pelvic lymph nodes, in 28 or 30 fractions. The acute genitourinary (GU) and gastrointestinal (GI) toxicities were scored according to the Common Terminology Criteria for Adverse Events, v4. All 125 patients completed the planned treatment, with good tolerance. After RT, the median follow-up was 18 months. Acute toxicities were recorded for the GU (G0, 45/125 [36%]; G1, 63/125 [50.4%]; G2, 16/125 [12.8%]; G3, 1/125 [0.8%]) and the GI (G0, 42/125 [33.6%]; G1, 72/125 [57.6%]; G2, 11/125 [8.8%]; no G3). Analyzing data according to RT intent, a higher rate of GU toxicity≥ 2 was found in the adjuvant setting (17.1%) with respect to the salvage group (9.8%); P= .01 with the Fisher exact text. Furthermore, at statistical analysis, no difference was found between the type of surgery (robotic, laparoscopic, or open) and incidence of urinary incontinence (P= .8). The actuarial Kaplan-Meier rates for biochemical disease-free survival were 94% and 77% for adjuvant and salvage RT, at 36 months. Moderate hypofractionated postoperative RT with VMAT was feasible and safe with acceptable acute GU and GI toxicities. Longer follow-up is needed to assess late toxicity and clinical outcomes.

Trends in inpatient female urinary incontinence surgery and costs in Taiwan, 1997–2011

ObjectiveTo explore the factors influencing the trends in incidence and cost for female inpatient urinary incontinence (UI) surgery from 1997 to 2011. Materials and methodsA dataset of one million individuals was randomly drawn from the nationwide National Health Insurance claim database covering Taiwan's population from 1997 to 2011. The participants consisted of women aged ≥20 years who underwent UI surgery. We evaluated the trends of inpatient UI incidence, the medical cost of UI surgery, and the number of UI surgeries performed from 1997 to 2011. ResultsA total of 1517 women underwent inpatient UI surgery from 1997 to 2011. Among these patients, the age-standardized incidence of UI surgery gradually trended upward from 1997 to 2010 but decreased in 2011. The trends were similar for medical costs, including annual inpatient cost, total medical service cost, and surgery fees. The annual inpatient cost had doubled in 2011 compared with that in 1997. However, physician visit fees, ward fees, and anesthesia fees started decreasing from 2005. The length of hospital stay and medication fees decreased during the 15-year study period. Surgeries by doctor specialty, hospital accreditation level, and patient age were stable for the study period. ConclusionThe trends of age-standardized incidence of UI surgery, annual inpatient cost, total inpatient cost, and surgery fees increased significantly from 1997 to 2009, and abruptly decreased from 2010 to 2011. Long-term observation evaluating the impact of Diagnosis-Related Group payment system in Taiwan is warranted to verify in the future.

Frontal Lobe Function Correlates withOne-Year Incidence of Urinary Incontinence in Elderly with Alzheimer Disease.

Urinary incontinence (UI) is frequently observed in patients with Alzheimer's disease (AD). Although previous works highlight the association between frontal lobe-related function and UI, causal relationship is unclear. To clarify the longitudinal association between frontal lobe function and the incidence of UI at 1 year in patients with AD. The subjects were 215 continent AD patients who attended the Memory Clinic of the National Center for Geriatrics and Gerontology of Japan during the period from March 2011 to December 2014. The absence or presence of UI was operationally assigned by the dementia behavior disturbance scale subscale, which was completed by the patients' caregivers. Frontal lobe function was assessed using the Frontal Assessment Battery (FAB). Other confounding factors including demographic data, cognitive status, vitality, mood, physical performance, and use of medication (cholinesterase inhibitors, calcium channel blockers [CCBs], diuretics, alpha blockers and anticholinergic drugs) were assessed. During 1-year follow up (mean: 377.4±83.7 days), the incidence of UI was 12.1% (n = 26). Patients with UI had significantly lower FAB performance at baseline (no UI versus UI = 9.3±2.8 versus 7.8±2.7). In multivariate analysis, stepwise logistic regression analysis demonstrated that FAB (odds ratio [OR] = 0.79, 95% confidence interval [CI] = 0.66-0.94) and the use of CCB (OR = 2.72, 95% CI = 1.09-6.77) were significantly associated with UI at 1 year. The results of study indicate that frontal lobe dysfunction is predictor for UI in patients with AD.

Urinary quality of life outcomes in men who were treated with image-guided intensity-modulated radiation therapy for prostate cancer

PurposeQuality of life (QoL) outcomes play a major role in the treatment selection for prostate cancer (CaP). We evaluated the urinary QoL outcomes in men who were treated with image-guided intensity-modulated radiation therapy (IG-IMRT) for CaP. Methods and materialsWe enrolled men who were diagnosed with CaP and underwent IG-IMRT in a large urological group practice into a prospectively maintained database. The typical radiation treatment dosage to prostates and seminal vesicles was 8100 cGy in 45 fractions. Urinary QoL was self-assessed using the standardized incontinence grade and International Prostate Symptom Score (IPSS) at baseline and at each follow-up visit. We evaluated the cumulative incidence of urinary incontinence and changes in both continence and IPSS over time. ResultsOf the 3602 men who were eligible for analysis, 3086 (85.7%) had no urinary incontinence; 479 (13.3 %) had minimal incontinence (no requirement for pads), and 37 (1.0 %) had significant urinary incontinence that required the use of pads or interfered with activities of daily living, at baseline. After a median follow-up of 24 months (range: 12.0-41.0 months), these numbers were 80.6%, 17.4%, and 2.0%, respectively. Radiation therapy appeared to have a beneficial effect on some men: 54.1% of men with minimal incontinence became completely continent of urine during follow-up. Of those with significant urinary incontinence, 29.7% reported resolution and 27.0% reported improved symptoms with no requirement for pads. Of the 1276 men with moderate IPSS, the mean IPSS decreased from 12 to 9.8 at the time of the last follow-up (P < .001). Similarly, of the 233 men with severe IPSS, the mean IPSS decreased from 24 to 13 at the time of the last follow-up (P < .001). ConclusionIG-IMRT for clinically localized CaP is associated with a relatively low incidence of urinary incontinence. Although unexplained, IG-IMRT seems to improve symptoms in some men with baseline urinary incontinence and moderate-to-severe IPSS.

Clinical Outcomes of Anteroposterior Dissection Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia

Holmium laser enucleation of the prostate (HoLEP) is a standard surgical procedure for treatment of benign prostatic hyperplasia (BPH). A low incidence of postoperative urinary incontinence in association with anteroposterior dissection HoLEP was recently reported. We evaluated 66 patients with BPH who underwent anteroposterior dissection HoLEP from March 2013 to November 2014. The International Prostate Symptom Score (IPSS), quality of life (QOL) index, maximum flow rate (Qmax), and post-void residual urine volume (PVR) were assessed preoperatively and at 1 and 3 months after treatment. The incidence of postoperative urinary incontinence, which was defined as the requirement of more than one pad per day, was compared between the first and second half of the patient population. Postoperative urination parameters (IPSS, QOL index, Qmax, and PVR) were significantly improved. The incidence of urinary incontinence at 3 months was significantly lower in the second half (4%) than first half (28%) of the patient population (p＝0.020). In conclusion, anteroposterior dissection HoLEP is an effective procedure for the treatment of BPH and can reduce the rate of postoperative urinary incontinence, even in low-volume institutes.

Ten-Year Prevalence and Incidence of Urinary Incontinence in Older Women: A Longitudinal Analysis of the Health and Retirement Study.

To measure the incidence of urinary incontinence (UI) over 10years in older women who did not report UI at baseline in 1998, to estimate the prevalence of female UI according to severity and type, and to explore potential risk factors for development of UI. Secondary analysis of a prospective cohort. Health and Retirement Study. Women participating in the Health and Retirement Study between 1998 and 2008 who did not have UI at baseline (1998). UI was defined as an answer of "yes" to the question, "During the last 12months, have you lost any amount of urine beyond your control?" UI was characterized according to severity (according to the Sandvik Severity Index) and type (according to International Continence Society definitions) at each biennial follow-up between 1998 and 2008. In 1998, 5,552 women aged 51 to 74 reported no UI. The cumulative incidence of UI in older women was 37.2% (95% confidence interval (CI)=36.0-38.5%). The most common incontinence type at the first report of leakage was mixed UI (49.1%, 95% CI=46.5-51.7%), and women commonly reported their symptoms at first leakage as moderate to severe (46.4%, 95% CI=43.8-49.0%). Development of UI in older women was common and tended to result in mixed type and moderate to severe symptoms.

Investigation and analysis of urinary incontinence in elderly hospitalized patients

Objective To investigate the incidence and influencing factors of urinary incontinence in elderly patients with ambulatory care, and to provide basis for further improving the nursing of elderly patients with urinary incontinence. Methods A questionnaire survey was conducted among 970 elderly hospitalized patients aged over 60 years in 24 hospitals of 10 cities in Southwest China by the international advisory committee on urinary incontinence (ICI-Q-SF). According to the questionnaires we had known the incidence about urinary incontinence of the elderly ambulatory inpatients and analyzed the relationship between some factors (age, sex, marriage, self-perception of health assessment, toilet capacity and so on) and urinary incontinence. Results This investigation shows that the incidence about urinary incontinence of the elderly ambulatory inpatients was 20.5%.The severity of symptom was divided into 3 grades: mild, moderate and severe, the incidence were 58.2%, 30.2% and 11.6%. Regression analysis showed that the high incidence of urinary incontinence occurred in these inpatients who was older, mateless, poor self-evaluation and poor toilet capacity (P<0.05). Conclusions Elderly ambulatory inpatients are the people at high risks of urinary incontinence. This is affected by many factors, so we should strengthen the nursing intervention for this kind of patients. Key words: Urinary incontinence; Elderly; Inpatients

Pharmacotherapy of urinary incontinence in the elderly

The prevalence and the incidence of Urinary Incontinence is growing. Women suffer predominantly from stress and mixed urinary incontinence and men from urge incontinence. In elderly people, the pathophysiological and the physiological change in the lower urinary tract system must be considered as well as an underlying multimorbidity. Stress urinary incontinence is among others caused by an insufficient urethral closure mechanism and urge incontinence is followed by unhibited detrusor contractions. Medical treatment is beside other important conservative options only one part of the treatment strategy in incontinence. Duloxetine, aserotonine-norepinephrine reuptake inhibitore can increase activity of the external urethral sphincter and is able to reduce incontinence episodes in up to 64 %. Antagonists of muscarinic receptors can reduce urgency, frequency and urge incontinence as well as increase bladder capacity significantly. In Germany, darifenacin, fesoterodin, oxybutynin, propiverine, solifenacin, tolterodine and trospium chloride are available to treat urge incontinence. The efficacy of these agents are almost comparable in the elderly with the exception of oxybutynin IR. However, tolerability is different and not well studied in the elderly population with the exception of fesoterodin. Side effects, especially dry mouth, dizziness and constipation often limit their use. None of the agents show ideal efficacy or tolerability in all patients. Last summer therefore aβ3-agonist mirabegron was also introduced in Germany but was withdrawn.

Differential effects of selective estrogen receptor modulators on the vagina and its supportive tissues.

Some selective estrogen receptor modulators (SERMs) have been associated with increased incidence of urinary incontinence and pelvic organ prolapse. This study explored the effects of five SERMs on the function and matrix components of the vagina and its supportive tissues. Fifty-six rats were administered SERMs by oral gavage for 8 weeks (n = 8 for each SERM): raloxifene, tamoxifen, idoxifene, bazedoxifene at three different doses, and bazedoxifene with conjugated estrogens. Thirty-two rats were used as controls (n = 8 per group): sham operation (no ovariectomy), ovariectomy only, ovariectomy with vehicle gavage, and 17β-estradiol (subcutaneous). Vaginal supportive tissue complex was tested by uniaxial tensile testing. Total collagen content (hydroxyproline) and glycosaminoglycan content (Blyscan) were measured. Ovariectomy significantly decreased the mechanical integrity of the vagina and its supportive tissue complex, with a decrease in ultimate load and stiffness (all P < 0.05). Although 17β-estradiol supplementation maintained these properties similarly to sham operation, none of the SERMs was as effective--particularly idoxifene, bazedoxifene at higher doses, and bazedoxifene with conjugated estrogens (all P < 0.05). In addition, idoxifene and bazedoxifene induced increased total collagen content compared with sham or 17β-estradiol treatment (all P < 0.05). Glycosaminoglycan content did not change significantly. Unlike 17β-estradiol, SERM supplementation does not fully prevent ovariectomy-induced deterioration in the biomechanical properties of the vagina and its supportive tissues, with the effects of idoxifene and bazedoxifene being the least. The paradoxically increased collagen content in these two groups may be related to increased formation of nonfunctional collagen.

Incidence and impact of urinary incontinence and health related quality of life for postpartum Bangladeshi women: comparison by birth mode

Purpose/Hypothesis: To investigate the incidence of urinary incontinence (UI) and relationship between UI, comorbidity, and health related quality of life (HRQOL) of postpartum Bangladeshi women. Comorbidity, and health related quality of life (HRQOL) of postpartum Bangladeshi women.Number of Subjects: n=94Materials/Methods: Prospective, correlational design (n=94) postpartum Bangladeshi women, ages 18-44, with history of one or more obstetrical deliveries within the last three years. This study was implemented at the Center for Rehabilitation of the Paralyzed (CRP) in Bangladesh after approval of CRP Ethics Board and IRB approval at Nova Southeastern University. Subjects who met the inclusion criteria for the study and signed the written consent were included in the study and completed the Bengali version of SF-36 and IIQ-7.Results: Six subjects were eliminated from the study because of co-morbidity exclusion factors. Eight subjects were excluded from main data analysis and utilized for comparison because of “mixed birth mode” (MBM). UI incidence was reported at 45.3% (n=86) total, 44% CS, and 46.6% for NVD (CS: n=41; NVD: n=45). IIQ-7 scores and UI presence showed strong correlations in both CS (rho=.729, 84, pConclusions: No significant difference between birth modes was found in UI and HRQOL measures. A significant decrease in HRQOL for women during postpartum period compared to age related norms was reported. Report of abdominal/pelvic pain and presence of UI were directly related to HRQOL in this study. Future research should focus on pelvic/abdominal pain in the postpartum period and “mixed birth mode” impact on QOL and UI.Clinical Relevance: There are no studies comparing HRQOL with incidence and impact of UI and comorbidities amongst Bangladeshi women by birth mode. Postpartum UI and co-morbidities are physical therapy related disorders that are commonly seen in the clinic and have a direct impact on health related quality of life for women.

Investigation of geriatric syndromes in very elderly people in Beijing community

Objective To investigate the geriatric syndromes in the very elderly people in Beijing community, in order to provide the basis for management of geriatric syndromes and rational use of medical resources. Methods All community-dwelling residents aged 95 years and over living in Haidian district and some residents aged 85 years and over living in Haidian, Chaoyang and Xicheng districts were investigated in household in Beijing. The survey included the general condition, functional status and geriatric syndromes such as falls, senile urinary incontinence, chronic pain syndrome, chronic constipation and malnutrition occurrence. Results 336 seniors with the mean age of (96.0±3.0) years were investigated. The percentage of people who had falls within 1 year, chronic pain, and chronic constipation was 27.2% (88/324), 37.3% (122/327) and 47.6% (160/336) respectively. The incidence of urinary incontinence was 37.1% (118/318), with 33.3% (46/138) in males and 40.0% (72/180) in females, and there was no significant gender difference in the incidence of urinary incontinence (P=0.220). The incidences of malnutrition and malnutrition risks was 10.4% (31/299) and 50.5% (151/299). 37.2% of subjects could walk outdoor with a better physical function. The self-rated health satisfaction was lower in elderly people with malnutrition and urinary incontinence than in subjects without those diseases (40.0% vs. 70.4%, 34.0% vs. 64.6%, χ2=25.20, 25.30, both P<0.001). 26% of them had never heard of geriatrics. Conclusions Geriatric syndromes are common in community-dwelling older seniors. It is urgent to spread the geriatric knowledge and set a reasonable goal for diagnosis and treatment in the seniors. Key words: Syndrome; Accidental falls; Urinary incontinence; Malnutrition

Quality of Life, Sexual Functions and Urinary Incontinence After Hysterectomy in Hungarian Women

Objectives: The aim of the current study is to examine changes in sexual function, incontinence and quality of life after hysterectomy, with particular regard to different surgical methods of hysterectomy. Material and methods: A total number of 210 women with hysterectomy were asked to answer the questionnaire between 2011 and 2013; 164 of them accepted to cooperate. Twenty-one women were excluded from the study because of depression, thus the final number of participants was 143. In our retrospective study, patients were randomized by the snowball sampling (or chain referral sampling) method into three groups: having had 1total abdominal hysterectomy; 2. vaginal hysterectomy; or 3. subtotal abdominal hysterectomy (according to Crobach). Three questionnaires were used to collect quality of life data: 1. our own questionnaire on general health status, 2. the Short Form 36 questionnaire, and 3. a combination of shortened versions of the Lemack and Female Sexual Function Index. For the statistical analysis, Student’s t-test and/or the Mann–Whitney U-test were used. The statistical analysis was performed by using SPSS 20.0.5 system. The significance level of p ≤ 0.05 was used. Results: The mean age of the vaginal total hysterectomy group, abdominal subtotal hysterectomy and abdominal total hysterectomy was 50.08±3.1; 45.47±2.5 and 48.27±2.7 years, respectively (p=0.203). Their average BMI was 26.88±3.45 kg/m2. The average length of the postoperative period was 4.05±2.25 years. Participants had a mean number of children 1.74/person; most of the participants were married (59.44%), and had a college or university degree (37.6%). There was no statistically significant difference in quality of life data between the subgroups. In the subgroup of women with vaginal hysterectomy, significantly higher incidence of pelvic pain was felt once in a while during sexual intercourse (p = 0.047), and there was a significantly higher incidence of urinary incontinence (p = 0.023) as well. Conclusion: Types of hysterectomy did not significantly affect long term quality of life in general, but vaginal hysterectomy was more likely to affect sexual function and to increase the risk of incontinence when compared with abdominal hysterectomy.