Incontinence Modular Questionnaire Research Articles

The association of fecal incontinence, constipation, and pelvic pain with the course of lower urinary tract symptoms in community-dwelling men and women.

Fecal incontinence, constipation, and pelvic pain are common pelvic floor symptoms (PFS), and frequently coexist with lower urinary tract symptoms (LUTS). However, their association with the longitudinal trajectory of LUTS have not been well described. Our objective was to investigate the association between PFS and the course of LUTS in community-dwelling men and women. Men and women aged ≥16 years were invited to participate in a prospective observational cohort study. At baseline, and after 12 and 24 months, participants filled in the International Consultation on Incontinence Modular Questionnaire (ICIQ-MLUTS and ICIQ-FLUTS) for men and women respectively, the Wexner incontinence and constipation scale, and a questionnaire on pelvic pain. Generalized estimating equations were used to examine the association between change scores in defecation problems and pelvic pain, and LUTS change scores. A total of 694 men and 997 women gave informed consent, with 417 men and 566 women included in the analysis. The mean age was 63.2 ± 12.7 years for men and 58.6 ± 14.8 years for women. The study showed minor changes in LUTS scores over the 0-12 and 12-24-month periods. Generalized estimating equations revealed positive associations between changes in constipation and fecal incontinence and LUTS changes in both sexes. For instance, a one-point increase in Wexner constipation score was associated with 0.376 (0.165, 0.587) points higher LUTS change in men and 0.223 (0.109, 0.336) points in women during the 0-12-month follow-up. However, associations between changes in pain and LUTS scores varied across sexes and time periods. We observed minor changes in LUTS over time and weak associations between PFS and LUTS that sometimes differed between males and females, emphasizing the need for sex-specific considerations. These insights can provide valuable guidance for the development of targeted prevention trials, ultimately aiming to enhance overall pelvic health and patient well-being.

Validity and Reliability of the Thai version of the International Consultation on Incontinence Questionnaire – Female Lower Urinary Tract Symptoms Long Form (ICIQ-FLUTS LF) and Its Correlation with the IPSS

Objective: Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms Long form (ICIQ-FLUTS LF) is a robust psychometric tool to assess the severity of lower urinary tract symptoms (LUTS) in women. A Thai language version of the ICIQ-FLUTS LF is available, but it had not been validated yet. This study aimed to validate the ICIQ-FLUTS LF questionnaire in Thai and to identify the correlation between the ICIQ-FLUTS LF and the IPSS. Materials and Methods: We recruited 130 females, 50 with LUTS were recruited from patients visiting the Urology Clinic to assess the test with known group validity. They completed the ICIQ-FLUTS LF twice, two weeks apart, and the IPSS once. Meanwhile, 80 without LUTS (control group) were recruited from relatives of the patients to increase the consistency of the statistical analysis, completed the ICIQ-FLUTS LF. Then validity and reliability were determined using statistical analysis. Results: Convergent validity showed a moderate correlation between ICIQ-FLUTS LF and IPSS for both storage and voiding symptoms, with Pearson’s correlation coefficient 0.49, 0.66; P<0.001, respectively. Construct validity, using the Wilcoxon signed-rank test, demonstrated statistically significant difference between the target group and the control group (P<0.001). The Thai version of the ICIQ-FLUTS LF showed good internal consistency, with Cronbach’s alpha coefficients 0.76-0.79 and Test–retest reliability strong, with weighted kappa values 0.63 to 0.90. Conclusion: The Thai version of the ICIQ-FLUTS LF shows good validity and reliable measures of females with LUTS, and is simple to use. This questionnaire in the Thai version can be used in clinical practice and academic research.

Effect of Practicing Deep Breathing and Kegel Exercises on Menopausal Urinary Incontinence at Beni-Suef

Background: Urinary incontinence (UI) is one of the most common problems in menopausal women; it is defined by the International Continence Society (ICS) as the complaint of any involuntary loss of urine and its classification according to the presence of symptoms and pathophysiological mechanisms of occurrence. The Kegel Breathing technique combines breathing and pelvic floor contraction patterns to increase pelvic floor muscular strength while performing daily activities regularly. Normal breathing occurs when the pelvic floor muscles and the breathing muscle (diaphragm) move up and down in harmony manner. Aim of the study: The study aimed to evaluate menopausal women's urinary incontinence before and after practice of deep breathing and Kegel exercise. Design: A quasi-experimental study design was utilized in this study (one group pre and post-test). Sample: A purposive sample of 100 Menopausal women diagnosed with stress urinary incontinence. Setting: gynecological and urological outpatient clinics Beni-Suef university hospital. Tools: 1) a structure interviewing questionnaire schedule, 2) The International Consultation on Incontinence Modular Questionnaire 3) Pelvic floor muscles exercises checklist. Results: about 45% of the studied women reported that their frequency of urination is several times per day preprogram but it became only 19% post program implementation. Only 32% of the studied women can accurately detect the right muscle group at the 1st week of the 1st month. However, at the end of the 1st month; 82% of them can do. Moreover, at the end of the 2nd month; 90% can do. Additionally, at the end of the 3rd month; 93% of the studied women can accurately detect the right muscle group. Conclusion: Deep breathing and kegel exercise had positive effect on women's urinary incontinence. Recommendations: disseminate brochures and booklet about kegal and breathing exercise to enhance awareness program regarding stress urinary incontinence reliving measures for elderly women.

Effect of Transcutaneous Tibial Nerve Stimulation on the Overactive Bladder in Women with Type 2 Diabetes

Background and Aims Diabetes mellitus is one of the most prevalent metabolic conditions in the world. One of its consequences is overactive bladder (OAB), which is a syndrome whose symptoms appear during the urine storage phase in the form of increased urinary frequency or urinary urgency. The prevalence of this disorder is estimated to be 22.5-24.2 % in people with type 2 diabetes (T2D). Recently, a useful technique for the treatment of OAB, named transcutaneous tibial nerve stimulation (TTNS), has been introduced. This study aims to investigate the effect of TTNS in women with T2D and OAB. Methods This randomized, double-blind clinical trial was conducted on 40 women with T2D and OAB symptoms, who were divided into two control and intervention groups. The control group performed pelvic floor muscle (PFM) training daily for one month, while the intervention group received 12 sessions of TTNS combined with PFM training. Before and after the intervention, the lower urinary tract symptoms were recorded using the Persian version of the International Consultation on Incontinence Modular Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Independent t-test, paired t-test, Wilcoxon test, Mann-Whitney U test, and chi-square test were performed for data analysis using SPSS software, version 24. Results There was no significant difference between the two groups in the ICIQ-FLUTS score, incontinence quality of life, or PFM strength, and endurance (P>0.05). However, their scores were significantly different after treatment in each group compared to the pre-treatment phase (P≤0.05). Conclusion The combination of TTNS and PFM training has no advantage over PFM training alone in managing OAB symptoms and improving PFM strength and quality of life in women with T2D.

Translation and validation into Brazilian Portuguese of the English version of the International Consultation on Incontinence Modular Questionnaire for Male Lower Urinary Tract Symptoms (ICIQ-MLUTS).

To translate and cross-culturally adapt the English version of the International Consultation on Incontinence Modular Questionnaire for Male Lower Urinary Tract Symptoms (ICIQ-MLUTS)into Brazilian Portuguese and evaluate its psychometric properties. Male lower urinary tract symptoms (LUTS)are frequent and commonly assessed with questionnaires. The ICIQ-MLUTSis a robust instrument that investigates the main aspects of LUTS in men and their impact on quality of life. Although highly recommended, Grade A is not as popular as the International Prostate Symptom Score (IPSS)and remained untranslated and unvalidated for Brazilian Portuguese. After authorization by the Advisory Board of the International Consultation on Incontinence (ICIQ) the translation process was conducted according to the standard guidelines and the ICIQ validation protocol. Internal consistency was assessed using Cronbach's ⍺ coefficient and values > 0.7 were considered satisfactory. To assess test-retest reliability and reproducibility, Spearman's correlation coefficient and intraclass correlation coefficient were used. For group data, a Spearman correlation coefficient or an intraclass correlation coefficient of at least 0.70 demonstrates good test-retest reliability. A p < 0.05 was considered significant. One hundred and eighty-six, aged61.41 ± 11.01 years, suffering from LUTS participated in the study between January 2021 and October 2022. Cronbach's ⍺, 0.875, demonstrated the internal consistency of the Portuguese version of ICIQ-MLUTS.The intraclass correlation coefficient of 0.912 (0.882; 0.935 - 95% CI)for the test-retest evidenced the stability and validity of the instrument. Likewise, Spearman's correlation coefficient highlighted the agreement between IPSS and ICIQ-MLUTS,0.906, <0.001. The Portuguese version of the ICIQ-MLUTSdemonstrated internal consistency, stability, and validity, in addition to agreement with the IPSS. The ICIQ-MLUTS,translated and validated into Brazilian Portuguese, is a robust and reliable instrument to assess LUTS in Brazilian men and can be used in the evaluation of treatment and research.

Lower urinary tract symptoms and toileting behaviors in Turkish adult women

ABSTRACT This study aimed to investigate lower urinary tract symptoms (LUTS) in Turkish adult women and to compare toileting behaviors in women with and without LUTS. This cross-sectional study was conducted in 815 women. The International Consultation on Incontinence Modular Questionnaire – Female LUTS and a toileting behaviors form, created by the authors, were used in evaluations. Nearly 50 % of the women had at least one LUTS, 45.8 % had storage symptoms, 7.4 % had voiding symptoms, and 20.2 % had incontinence symptoms. The rates of premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS than in women without LUTS (p < .05). The rate of squatting on the toilet while urinating was lower in women with LUTS than those without LUTS (p < .05). Various LUTS were common in adult women. Some toileting behaviors such as premature urination, straining during urination, delayed urination, and sitting on the toilet while urinating were higher in women with LUTS compared to women without LUTS. Since the rate of unhealthy toilet behaviors is higher in women with LUTS, it is important to know unhealthy toilet behaviors in the management of LUTS and to organize training programs to prevent these behaviors and LUTS.

Effect of Deep Breathing and Kegel Exercises on Stress Urinary Incontinence among Elderly Women

History: Stress urinary incontinence is regarded as the most prevalent and upsetting health issue affecting older people, particularly older women, and is linked to a severe negative impact on life. To assess the impact of kegel exercises and deep breathing on urinary incontinence in elder women. A quasi-experimental study approach was applied (one group pre and post-test). Gynecological and urological outpatient clinics at Beni-Suef university hospital served as the study's location. 100 menopausal women who had been diagnosed with stress incontinence and were admitted to the setting stated before served as a purposeful sample. Tool I a structure interviewing questionnaire schedule.2) The International Consultation on Incontinence Modular Questionnaire .3) a list of steps for kegel exercise. There were highly statistically significant differences in the frequency of urinary incontinence (p-value 0.000) and amount of urine loss (p-value 0.004) among the studied women before and after doing deep breathing and Kegel exercises. There were also highly statistically significant improvements in the studied women's physical and psychological conditions (p-value 0.000) after intervention than pre-intervention. Kegel exercises and deep breathing improved physical and psychological circumstances as well as the ability to "do everyday tasks without stress, feel confident, and be fulfilled in a sexual relationship." Suggestions: Creating an awareness program on the significance and advantages of deep breathing and kegel exercises to ease the symptoms of stress urine incontinence in older women.

Is vitamin D replacement effective in the treatment of postpartum urinary incontinence?

The main objective of this study was to compare the effectiveness of pelvic floor muscle training, and vitamin D replacement in the treatment of urinary incontinence in the postpartum period of pregnant women with vitamin D deficiency. The study was planned as an ancillary study of a study on the determination of the relationship between vitamin D deficiency and urinary incontinence in third-trimester pregnant women. Total 61 women who defined urinary incontinence at postpartum 8th week were included in the study. The participants were divided into two groups: the vitamin D replacement group and the pelvic floor muscle training (PFMT) group. Participants in both groups received appropriate treatment for 12 weeks. İnitial evaluations of which Pelvic Organ Prolapse-Quantification stage, International Consultation on Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) query, and pelvic floor muscle strength were repeated after 12 weeks of treatment for each patient. In the vitamin D replacement group, there was a significant increase in Oxford scores measured after treatment compared with pre-treatment and a significant decrease in ICIQ-FLUTS scores. In the comparison of the groups, it was determined that the changes in the Oxford and ICIQ-FLUTS scores of the vitamin D group after treatment were significantly higher than those of the PFMT group. In this pilot study, it was determined that the effectiveness of vitamin D replacement in the treatment of pelvic floor dysfunction in pregnant women with hypovitaminosis D was significantly higher than PFMT. Vitamin D replacement may be useful in the treatment of urinary incontinence in pregnant women with hypovitaminosis D.

Advanced Reconstruction of Vesicourethral Support May Improve Urinary Continence and Quality of Life After Non-nerve-sparing Robot-assisted Radical Prostatectomy.

Postoperative urinary incontinence (UI) after robot-assisted radical prostatectomy (RARP) has a significant impact on patients' quality of life (QOL). Several surgical techniques have been reported to improve postoperative UI. The aim of the study was to investigate the impact of advanced reconstruction of vesicourethral support (ARVUS) on urinary symptoms and QOL after non-nerve-sparing robot-assisted radical prostatectomy (RARP). Patients who underwent non-nerve-sparing RARP from October 2010 to October 2020 at the Division of Urology, Department of Surgery, Tottori University Faculty of Medicine were reviewed. Patients were divided into the ARVUS and non-ARVUS groups, and propensity score matching was performed. Patients were evaluated by the International Prostate Symptom Score (IPSS), Incontinence Modular Questionnaire Short Form (ICIQ-SF), QOL index, and number of pads used before and 1, 3, 6, and 12 months after RARP. The number of patients in the ARVUS and non-ARVUS group were 41 and 41, respectively. On cystography, the distance of the symphysis pubis to the bladder neck was significantly shorter (p<0.001) and the posterior urethrovesical angle was significantly smaller in the AUVUS group (p<0.001). In the ICIQ-SF, the ARVUS group was significantly better at 6 and 12 months postoperatively. In the IPSS, the ARVUS group was significantly better than the non-ARVUS group at 3 months postoperatively. In a multivariable analysis, membranous urethral length [odds ratio (OR)=3.44, p=0.015] and ARVUS (OR=2.72, p=0.046) were significant factors in achieving 0 pads and total ICIQ-SF Question 1 and 2 scores of ≤2 at 12 months postoperatively. ARVUS improved urinary symptoms and QOL. ARVUS seems to be a useful surgical procedure for non- nerve-sparing RARP.

Incontinence outcomes in women undergoing retropubic mid-urethral sling: a retrospective cohort study comparing Safyre™ and handmade sling.

ABSTRACTPurpose This study examined and compared efficacy, safety, satisfaction, and complications of the retropubic Safyre™ sling and a retropubic hand-made synthetic sling (HMS) in a short-, mid- and long-term follow-up.Methods We retrospectively reviewed a prospectively maintained database of women who underwent Safyre™ or HMS between March 7ths 2005 and December 27ths, 2017. Patients had first assessment (7-10 days), second (40-45 days), and third (sixth month) postoperatively. Between September and December 2018, patients who completed at least one year of surgery, received a telephone call. Follow-up compared quartiles of follow-up time to determine complications (Clavien-Dindo), success rates (International Consultation on Incontinence Modular Questionnaire for Urinary Incontinence Short Form – ICIQ-UI SF), and patient satisfaction.Results Three hundred fifty-one patients underwent surgery and 221 (63%) were evaluated after a median of 78.47 (± 38.69) months, 125 (55%) in the HMS, and 96 (45%) in the Safyre™ group. Higher intraoperative bladder injury was observed with Safyre™ (0% vs. 4.2%, p=0.034), and a tendency for urinary retention, requiring indwelling urinary catheter over 24 hours (2.4% vs. 8.3%, p=0.061). Both HMS (p<0.001) and Safyre™ (p<0.001) presented improvements on ICIQ-UI SF. There were no differences in satisfaction, subjective cure rates, ICIQ-UI SF, or complications between groups.Conclusions Both HMS and Safyre™ have similar satisfaction and subjective cure rates, with marked ICIQ-UI SF score improvement. Higher rates of intraoperative bladder injury were seen in patients who received Safyre™ retropubic sling.

A mobile app for the treatment of female mixed and urgency incontinence: a cost-effectiveness analysis in Sweden

Introduction and hypothesisA previous randomized controlled trial (RCT) demonstrated that the app Tät II, for self-management of mixed urinary incontinence (MUI) and urgency urinary incontinence (UUI), yielded significant, clinically relevant improvements in symptom severity and quality of life (QoL) compared with a control group. We aimed to assess the cost-effectiveness of Tät II.MethodsA cost–utility analysis with a 1-year societal perspective was carried out, comparing Tät II with an information app. Data were collected alongside an RCT: 122 community-dwelling women aged ≥18 years with MUI or UUI ≥2 times/week were randomized to 3 months of Tät II treatment focused on pelvic floor muscle training (PFMT) and bladder training (BT; n = 60), or to an information app (n = 62). Self-assessed data from validated questionnaires were collected at baseline and at 3-month and 1-year follow-ups. Costs for assessment, treatment delivery, incontinence aids, laundry, and time for PFMT and BT were included. We calculated quality-adjusted life-years (QALYs) using the International Consultation on Incontinence Modular Questionnaire Lower Urinary Tract Symptoms Quality of Life. The incremental cost-effectiveness ratio (ICER) between the groups was our primary outcome. Sensitivity analyses were performed.ResultsThe mean age was 58.3 (SD = 9.6) years. Annual overall costs were €738.42 in the treatment group and €605.82 in the control group; annual QALY gains were 0.0152 and 0.0037 respectively. The base case ICER was €11,770.52; ICERs in the sensitivity analyses ranged from €−9,303.78 to €22,307.67.ConclusionsThe app Tät II is a cost-effective treatment method for women with MUI and UUI.

The Clinical Features and Predictive Factors of Nocturnal Enuresis in Adult Women.

ObjectiveOur current knowledge on nocturnal enuresis (NE) in adults is scarce due to its uncommon nature. The present study was designed to investigate symptom characteristics and risk factors of NE in adult women to improve the current clinical understanding and management of this rare disease.MethodsOver a 3-year period, we enrolled 70 adult women who complained of bedwetting, with a frequency of at least once per week and a symptom duration of 3 months or longer. Patients were excluded if they had known pregnancy, current urinary tract infection, untreated malignancies, anatomical abnormalities, and irregular sleep cycle. The International Consultation on Incontinence Modular Questionnaire—female lower urinary tract symptoms and bladder diary were employed to appraise lower urinary tract symptoms and voiding behavior. Urodynamics was performed to assess the bladder function. A linear regression analysis was applied to determine potential risk factors for NE frequency.ResultsAmong the recruited subjects, comorbidities and lower urinary tract symptoms were frequently reported. On bladder diary, patients commonly presented with nocturnal polyuria (NP), reduced nocturnal voided volumes (RNVVs), or both. Urodynamics revealed multiple dysfunctions, namely, detrusor overactivity (DO), urodynamic stress incontinence (USI), reduced compliance, bladder outlet obstruction, detrusor underactivity (DU), and simultaneous DO and DU. Patients with more frequent NE (≥4/week) demonstrated markedly increased body mass index, more comorbid conditions, worse incontinence symptoms, NP or NP plus RNVVs, reduced compliance, and poorer voiding possibly owing to DU. Whereas, RNVVs alone and worse overactive bladder-related parameters were associated with milder NE. Multivariate analysis indicated that frequency/urgency quality of life, incontinence symptom, NP + RNVVs, poor flow, increased bladder sensation, USI, and simultaneous detrusor overactivity plus DU were independent risk factors for NE severity.ConclusionNE in adult women may have both urological and non-urological pathophysiology. Imbalanced circadian urine production, jeopardized continence mechanisms, overactive bladder, and DU-induced poor voiding are major factors that contribute to the pathogenesis of NE in adult women. Focused treatments on restoring these functions should be individually considered.

Prevalence of lower urinary tract symptoms and association with shift working in hospital staff

AbstractWhat is the prevalence of lower urinary tract symptom (LUTS) among public hospitals staff and association with shift working? The aim of the current study was to evaluate the prevalence and bothersomeness of LUTS and the impact of shift working on its symptoms among the staff of public hospitals. Job condition is one of the main risk factors for LUTS, and almost about three‐quarters of nurses/nursing assistants do not have time to use the toilet during the shift work. Non‐standard shiftwork intensely is associated with various urological complications. Our study reveals new insights on the prevalence of LUTS with more frequency in women shift workers when compared with men. We conducted a descriptive cross‐sectional survey from October 2019 to January 2020. The data were collected from three public hospitals. A total of 228 individuals, 148 females (64.9%), and 80 males (35.1%) were enrolled in the study. After considering the inclusion criteria, for women, the validated version of the International Consultation on Incontinence Modular Questionnaire for Female Lower Urinary Tract Symptoms (ICIQ‐FLUTS) and for men, the validated version of the International Consultation on Incontinence Questionnaire for Male Lower Urinary Tract Symptoms Module (ICIQ‐MLUTS) were used. LUTS was more prevalent in women (61.1% vs. 44.2%, p = 0.016). In both men and women, the most bothersome symptom was urgency and the most prevalent symptom was nocturia (58.9%, and 43.9%, respectively). A significant relationship was observed between LUTS and shift working in female staff (p = 0.037). Nocturia was found to be the most prevalent symptom in both genders. The highest bothersome issue in men was related to urgency, and in women in addition to urgency, nocturia was another common symptom. However, the bother scores of most symptoms relatively were low. Although the percentage of women with shift working was low the prevalence of LUTS was high in this gender.

Reliability of The King's Health Questionnaire and the International Consultation on Incontinence Modular Questionnaire (ICIQ-SF) Short Form in assessing urinary incontinence effects in Polish women.

The King's Health Questionnaire (KHQ) and the International Consultation on Incontinence Modular Questionnaire (ICIQ-SF) Short Form are widely used in clinical practice. The aim of this study was to assess the reliability of KHQ and ICIQ-SF in Polish women. One hundred fifty-five women with urinary incontinence (UI) aged between 19-82 years underwent urodynamic investigation and completed both KHQ and ICIQ-SF. We performed Principal Component Analysis (PCA) using VARIMAX rotation for all questionnaire pieces to estimate the factor structure and construct the validity of the KHQ and ICIQ. PCA results were also confirmed by Spearman's correlations between KHQ and ICIQ items. Moreover, by Cronbach's alpha coefficient (α) we assessed the internal consistency of the KHQ and ICIQ. STATISTICA version 13.1 software (StatSoft, Poland), and open-source R software (version 3.4.4) were used for statistical analysis. Of the study group, 77 (49.6 %) patients had stress urinary incontinence (SUI), 9 (5.8%) patients had Urgency, 10 (6.45%) had OAB and 21 (13.5 %) had MUI. The factor analysis of the KHQ questions showed four main components, and ICIQ-SF- two main components. Correlations between KHQ and ICIQ-SF were from weak (0.1-0.3) to high (0.5-0.7). The KHQ's Cronbach's alpha was 0.93 and the ICIQ- 0.7. The results obtained from the questionnaire forms did not differ among study groups. The Polish versions of the KHQ and ICIQ-SF questionnaires have good psychometric values and are useful diagnostic tools in the population of urinary incontinent women.

Magnetic resonance neuroimaging promotes the preservation of pelvic autonomic nerves in laparoscopic total mesorectal excision: a comparative study.

BackgroundHow to preserve pelvic autonomic nerves system (PANS) in total mesorectal excision (TME) is still a technical challenge for gastrointestinal surgeons, and nerve preservation according to preoperative magnetic resonance imaging (MRI) is a hot topic in pelvic surgery. The purpose of this study was to assess the postoperative urogenital function of patients with rectal cancer (RC) who underwent preoperative and postoperative neuroimaging of PANS vs. patients who did not.MethodsPatients meeting the inclusion criteria were prospectively enrolled in a magnetic resonance neuroimaging (MRN) group from June 2018, while primary RC patients from January 2016 to May 2018 who met the inclusion criteria were enrolled in a non-MRN group. Patients in the MRN group underwent MRN examination before operation and 6 months after operation, while those in the non-MRN group were collected and analyzed retrospectively.ResultsBased on International Prostate Symptom Score (IPSS) and International Index of Erectile Function 5 (IIEF5) scores at 6 months, the postoperative urinary and sexual function of male patients in the MRN group were significantly better than that in the non-MRN group (P<0.05). In addition, based on International Consultation on Incontinence modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Female Sexual Function Index (FSFI) scores at 6 months, the postoperative sexual function of female patients in the MRN group was significantly better than that in the non-MRN group (P<0.05).ConclusionsIn the present study, we constructed a three-dimensional (3D) presentation of PANS based on preoperative MRN which showed in vivo pelvic autonomous innervation. This may promote the preservation of PANS during TME and reduce the postoperative urogenital dysfunction rate.

Barriers and Facilitators Associated With App-Based Treatment for Female Urinary Incontinence: Mixed Methods Evaluation.

BackgroundApp-based treatment for urinary incontinence is a proven effective and cost-effective alternative to care as usual, but successful implementation requires that we identify and address the barriers and facilitators associated with app use.ObjectiveThe goal of the research was to explore the factors influencing app-based treatment for urinary incontinence and identify which barriers or facilitators are associated with treatment success or failure.MethodsWe used a sequential explanatory mixed methods design to connect the results of a randomized controlled trial with data from semistructured interviews. This previous RCT had shown the noninferiority of app-based treatment compared with care as usual for urinary incontinence over 4 months. Participants who reported success or failure with app-based treatment, as measured by the change in International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form symptom score, were selected for telephone interview by purposive sampling (n=17). This study reports mainly on the qualitative component of our mixed methods study. Qualitative analyses were conducted in two ways. First, we analyzed the qualitative data of all interviewed participants and discussed the relationships between the main themes. Second, the experiences between the success (n=9) and failure group (n=8) were compared and contrasted to explore factors that were positively or negatively associated with the quantitative effect of app-based treatment. These factors were then interpreted as barriers to and facilitators of successful app-based treatment.ResultsFour interrelated themes were identified as affecting the app based treatment effect: adherence, personal factors, app factors, and awareness. Qualitative analyses of the relationships between the themes showed that adherence-related factors directly influenced treatment effect in both a positive and negative matter. In turn, adherence was also positively and negatively influenced by the other 3 themes. Additionally, awareness was positively influenced by the treatment effect. Within these themes, several factors were identified that acted as barriers (eg, unrealistic expectation of time investment and interfering personal circumstances), facilitators (eg, strict integration of exercises and prior pelvic floor muscle therapy), or both (eg, personality traits and increased awareness of symptoms).ConclusionsThis study shows that the effect of app-based treatment for urinary incontinence is mainly influenced by adherence, which in turn is affected by personal factors, app-based factors, and awareness. The identified factors could function as both facilitators and barriers depending on the user and interaction with other themes. Insight into these facilitators and barriers could lead to improved implementation and increased treatment effectiveness by targeting women most likely to benefit and through further development of the app.International Registered Report Identifier (IRRID)RR2-10.1002/nau.23507

Polish versions of the ICIQ-FLUTS and the ICIQ-FLUTS LF: translation, adaptation, and validation of female-specific instruments for evaluation of lower urinary tract symptoms.

Previously, there was no specific questionnaire in the Polish language for overall assessment of lower urinary tract symptoms (LUTS) in women. The aim of this study was to translate, culturally adapt, and validate Polish versions of the International Consultation on Incontinence Modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS and ICIQ-FLUTS LF, short and long forms) for use in clinical practice and research in Poland. The original English ICIQ-FLUTS and ICIQ-FLUTS LF were adapted to Polish according to international standards and recommended procedures. Adult women with LUTS who were seen at the Department of Urology at the Jagiellonian University, Krakow, Poland, completed the ICIQ-FLUTS and ICIQ-FLUTS LF at baseline and 2weeks later. Control participants completed the questionnaires once. Validity and reliability were determined. One hundred and eighty Polish-speaking women who had LUTS completed the questionnaires. Content validity was high. Significant differences between women with LUTS and controls for both ICIQ-FLUTS and ICIQ-FLUTS LF confirmed optimal construct validity. An intercorrelation analysis revealed that internal consistency was good for ICIQ-FLUTS and ICIQ-FLUTS LF (Cronbach's alpha >0.7). Test-retest reliability (reproducibility) demonstrated strong stability (intraclass correlation coefficient > 0.7). Floor and ceiling effects were absent from women with LUTS, whereas a floor effect was detected in the control group. The Polish ICIQ-FLUTS and ICIQ-FLUTS LF are valid, reliable, and consistent measures of overall evaluation of LUTS in women. They are equivalent to the original English versions, and they retained the psychometric properties of the original questionnaires.

Involuntary reflexive pelvic floor muscle training in addition to standard training versus standard training alone for women with stress urinary incontinence: a randomized controlled trial

Introduction and hypothesisAlthough involuntary reflexive pelvic floor muscle contractions seem crucial during stress urinary incontinence-provoking situations, hitherto existing guidelines feature voluntary pelvic floor muscle training only. Two pelvic floor muscle protocols were compared regarding their effect on stress urinary incontinence in women: one focusing on standard physiotherapy with voluntary pelvic floor muscle training, the other additionally including involuntary reflexive pelvic floor muscle training.MethodsThis study was designed as a triple-blind prospective randomized controlled trial with women suffering from stress urinary incontinence with two physiotherapy intervention groups (control group: standard physiotherapy, n = 48, experimental group: standard physiotherapy plus involuntary reflexive pelvic floor muscle training triggered by whole-body movements such as jumps n = 48). Both interventions lasted 16 weeks (9 personal physiotherapy consultations and 78 home training sessions). Group differences and development over time were analyzed concerning the primary outcome International Consultation on Incontinence Modular Questionnaire Urinary Incontinence short form (ICIQ-UIsf) by mixed effect regression models.ResultsThe ICIQ-UIsf score decreased significantly over time for both groups by about 3 points from about 10 to about 7 points with no group differences at any point in time.DiscussionThis trial did not find any additional benefit for stress urinary incontinence by adding involuntary reflexive pelvic floor muscle training to standard training. Both training protocols showed similar clinically relevant improvements; however, there was still moderate incontinence after interventions. Future studies should test and apply pelvic floor muscle function-oriented training methods for pelvic floor muscle hypertrophy, intramuscular coordination, and power, which are more in line with conventional skeletal muscle training, i.e., performed with higher intensities and workout.

Urinary dysfunction after colorectal cancer treatment and impact on quality of life-a national cross-sectional study in males.

Despite advances in the treatment of colorectal cancer, postoperative urogenital dysfunction is still a problem although its exact extent remains unclear. The aim of this study was to identify the prevalence and patterns of urinary dysfunction in men following treatment for colorectal cancer and the impact of urinary dysfunction on quality of life. A retrospective national Danish cross-sectional study was performed in patients treated for colorectal cancer between 2001 and 2014. Patients answered questionnaires on urinary function and quality of life including the International Consultation on Incontinence Modular Questionnaire-Male Lower Urinary Tract Symptoms measuring voiding and incontinence. Results were analysed based on data on demographics and treatment-related factors obtained from the Danish Colorectal Cancer Group database. A total of 5710 patients responded to the questionnaire (response rate 52.8%). In both crude analysis and after adjusting for patient-related factors (age, time since surgery and American Society of Anesthesiologists score), both voiding (P<0.0001) and incontinence scores (P<0.0001) were significantly higher after rectal cancer than after colon cancer. In the rectal cancer group, abdominoperineal excision was found to be a significant risk factor for both voiding (P<0.0001) and incontinence (P=0.011), while radiotherapy only impaired continence (P=0.014). Significant correlations between high voiding and incontinence scores and impaired quality of life were found in both groups. We found a high prevalence of urinary dysfunction following treatment for colorectal cancer, especially in the rectal cancer group. Abdominoperineal excision was the most significant risk factor for both voiding and incontinence. Urinary dysfunction significantly impairs patients' quality of life.

The Relation Between BMI and Polypharmacy with Urinary Incontinence in Diabetic Geriatric Patients

Objective: In our study, we aimed to examine the effects of body mass index (BMI) and multiple drug use on urinary incontinence (UI) in diabetic geriatric patients. Materials and Methods: Our study included 246 type 2 diabetes mellitus patients aged 65 and over who applied to our outpatient clinic between October and December 2019 and remained after the exclusion criteria were applied. The relationship between the frequency of UI and age, diabetes age, HbA1c, BMI, number of drugs and gender was investigated. UI described as any involuntary incontinence complaint. The questionnaire contained socio-demographic questions and the International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF). Results: Most (82.2%) of the patients with UI were women. Diabetes age and HbA1c level did not differ significantly between those with and without UI. There was a statistically significant relationship between BMI and the number of drugs used with the indication of UI (Mann-Whitney U; p &lt;0.05). Incontinence was more common in those with high BMI (average BMI 30.27 kg/m2 ). While 47.7% of those with UI were obese patients. The number of drugs used was found significantly higher in those patients with UI (p=0.008). Conclusion: UI causes social isolation, depressive mood and introversion. In our study, we found that obesity and polypharmacy are associated with incontinence and triggered urinary incontinence. This indicates that UI is a problem that needs to be questioned and focused on in this patient population.