Incontinence-related Quality Of Life Research Articles

APP-based treatment of urgency and mixed urinary incontinence in women: factors associated with long-term satisfaction

PurposeApp-based treatment of urgency (UUI) and mixed (MUI) urinary incontinence has proved to be effective. To further improve treatment, it will be beneficial to analyze baseline and treatment-related factors that are associated with satisfaction.MethodsA secondary analysis was conducted of data from a randomized controlled trial (RCT) assessing an app for UUI or MUI treatment, encompassing 98 women for whom there was long-term treatment satisfaction data. All participants completed a short-term (15 weeks) and a long-term (15 months) follow-up questionnaire after being given access to treatment. The outcome was a 3-item question on current treatment satisfaction at the long-term follow-up. Factors potentially associated with the outcome were analyzed using the chi-square test, Student’s t test or logistic regression.ResultsAt the long-term follow-up, 58% of the women were satisfied with the treatment. The most important baseline variable associated with satisfaction was incontinence-related quality of life (International Consultation on Incontinence Questionnaire (ICIQ) − Lower Urinary Tract Symptoms Quality of Life Module) (OR 0.91, 95% CI 0.58–0.97). Short-term follow-up variables associated with long-term treatment satisfaction were improvement in the ability to endure urgency (OR 4.33, 95% CI 1.43–13.12), and confidence in pelvic floor contraction ability (OR 2.67, 95% CI 1.04–6.82).ConclusionApp-based treatment for UUI and MUI may be an alternative first-line treatment that is satisfactory to many women over the long-term. Furthermore, short-term treatment that focuses on improving the ability to endure urgency, and confidence in pelvic floor contraction ability, can also be recommended for long-term satisfaction.

Quality of life and sexual function after tension-free vaginal tape and polyacrylamide hydrogel injection for primary stress urinary incontinence: 3-year follow-up from a randomized clinical trial

Introduction and hypothesisTo assess quality of life (QoL) and sexual function outcomes at 3 years after tension-free vaginal tape (TVT) and polyacrylamide hydrogel injection (PAHG) for stress urinary incontinence (SUI).MethodsIn this randomized trial comparing TVT (n = 104) and PAHG (n = 108), we assessed changes in QoL and sexuality using the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire, Short Form (IIQ-7), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and RAND-36 Item Health Survey (RAND-36) at baseline and at 3 years. This is a secondary analysis of a randomized, noninferiority trial comparing patient satisfaction after TVT and PAHG.ResultsIn both groups, incontinence-related QoL improved from the baseline (p < 0.00), except for difficulty emptying the bladder and pain/discomfort. Total scores of UDI-6 and IIIQ-7 were lower for TVT compared to PAHG (p < 0.00) indicating better QoL at 3 years. Urinary incontinence with sexual activity or fear of incontinence restricting sexual activity improved in both groups (p < 0.00), with higher scores for physical section subscale in PISQ-12 (p = 0.02) for TVT. Physical and social functioning (RAND-36) improved from the baseline in both groups (p < 0.01) with a better outcome in the TVT group for physical functioning (p = 0.00).ConclusionsBoth TVT and PAHG improve QoL and sexual function in primary SUI with better incontinence and health-related QoL scores in the TVT group compared to the PAHG group at 3 years.

Long-Term Male Sexual Function and Fecal Incontinence Outcomes for Adult Patients with Hirschsprung Disease or Anorectal Malformation

BackgroundThis study sought to characterize sexual function and fecal incontinence related quality of life (QOL) outcomes for adult males with anorectal malformation (ARM) or Hirschsprung's Disease (HD). MethodsWe conducted a cross-sectional survey study of male patients ≥18 years with ARM or HD. Patients were identified from our institutional database, contacted and consented by telephone, and sent a REDCap survey via email. The International Index of Erectile Function (IIEF-5) and Male Sexual Health Questionnaire (MSHQ) evaluated erectile dysfunction (ED) and ejaculatory dysfunction (EjD), respectively. The Cleveland Clinic Incontinence Score (CCIS) and the Fecal Incontinence Quality of Life Scale (FIQLS) assessed fecal incontinence-related outcomes. A linear regression analysis of IIEF-5 scores compared to CCIS scores was used to evaluate for an association between ED and incontinence. ResultsOf 63 patients contacted, 48 completed the survey. The median age for respondents was 22.5 years (IQR 20–25). There were 19 patients with HD and 29 patients with ARM. On the IIEF-5 survey, 35.3% report some level of ED. On the MSHQ-EjD survey, the median score was 14 out of 15 (IQR 10.75–15), indicating few EjD concerns. The median CCIS was 5 (IQR 2.25–7.75) and the median FIQL scores ranged from 2.7 to 3.5 depending on the domain assessed, demonstrating some QOL challenges secondary to fecal incontinence. On linear regression analysis, IIEF-5 and CCIS scores were weakly associated (B = −0.55, p = 0.045). ConclusionsMale adult patients with ARM or HD may have ongoing concerns with sexual function and fecal incontinence. Level of EvidenceLevel 4. Type of StudyCross-Sectional Survey Study.

Efficacy of intravaginal electrical stimulation with different treatment frequency in women with refractory idiopathic overactive bladder

ABSTRACTObjective The aim of this study is to evaluate the effect of intravaginal electrical stimulation (IVES) therapies with different treatment frequencies (two or five days in a week) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with refractory idiopathic overactive bladder (OAB).Material and Methods Fifty-two women with refractory idiopathic OAB were randomized into two groups as follows: Group 1 (n:26) received BT and IVES, two times in a week, for 10 weeks and Group 2 (n:26) received BT and IVES five times in a week, for 4 weeks. IVES was performed 20 minutes in a day, a total of 20 sessions for both groups. Women were evaluated for incontinence severity (24h pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes, and the number of pads), symptom severity (OAB-V8), quality of life (IIQ-7), treatment success (positive response rate), cure/improvement rate and treatment satisfaction (Likert scale).Results There was no statistically significant differences in all parameters between the two groups at the end of the treatment. It was found that the treatment satisfaction scores, cure/improvement and positive response rates were not significantly different between two groups (p>0.05).Conclusion We concluded that the application of IVES twice a week or 5 times a week added to BT were both effective on incontinence-related QoL and clinical parameters in women with refractory idiopathic OAB. These two IVES frequencies had similar clinical efficacy and patient satisfaction with a slight difference between them; 5 times per week IVES has a shorter treatment duration.

Short-term effect of magnetic stimulation added to bladder training in women with idiopathic overactive bladder: A prospective randomized controlled trial.

To evaluate the efficacy of magnetic stimulation (MStim) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB). Seventy-six women with idiopathic OAB were randomized into two groups using the random numbers generator as follows: Group 1 received BT alone (n: 38), and Group 2 received BT + MStim (n: 38). MStim was performed with MStim therapy armchair (Novamag NT60), 2 days a week, 20 min a day, a total of 12 sessions for 6 weeks. Women were evaluated in terms of incontinence severity (24-h pad test), 3-day voiding diary (frequency of voiding, incontinence episodes, nocturia, and number of pads), symptom severity (OAB-V8), QoL (IIQ-7), positive response and cure-improvement rates, and treatment satisfaction (Likert scale) at the baseline and the end of treatment (sixth week). A statistically significant improvement was found in incontinence severity, frequency of voiding, incontinence episodes, nocturia, number of pads, symptom severity, and QoL parameters for two groups at the end of the treatment compared to the baseline values (p < 0.05). At the end of treatment; incontinence severity, incontinence episodes, nocturia, number of pads, symptom severity, and QoL were significantly improved in Group 2 compared to Group 1 (p < 0.05). No difference was found between the two groups in terms of frequency of voiding (p > 0.05). The positive response and cure-improvement rates, and treatment satisfaction were significantly higher in Group 2 than in Group 1 (p < 0.05). MStim added to BT is more effective than BT alone in women with idiopathic OAB.

Urinary and Fecal Continence in Adolescent and Adult Patients With Cloacal Exstrophy

ObjectiveTo evaluate the prevalence of urinary (UI) and fecal incontinence (FI) and the incontinence-related quality of life (QoL) in adolescent and adult patients with cloacal exstrophy (CE) in Germany. Patients and MethodsCE-patients of a tertiary care center and the German support group for anorectal malformations (SoMA e.V.) were included (October 2015 until September 2020). Data were assessed using a composed questionnaire consisting of 18 self-generated questions and two validated German questionnaires (King's health questionnaire, Questionnaire on Quality of Life in Fecal Incontinence (FLQAI)). ResultsOut of 23 included patients, 19 had continent and 3 incontinent urinary diversions (UD), 1 was unspecified; 2/23 were on dialysis. 73.7% (14/19) had undergone bladder augmentation, 4/19 had a pouch, 1/19 a neobladder. 94.7% (18/19) had a continent cutaneous channel and performed intermittent self-catheterization. UI was common (71.4%, 15/21). Neither the UD nor the involuntary loss of urine itself had a significant impact on QoL. Comparing the King's health questionnaire results, UI-related QoL of CE-patients was significantly lower than in a published reference group. 78.3% (18/23) had a bowel stoma. 34.8% (8/23) reported involuntary stool-soiling. Neither the way of bowel-emptying nor involuntary stool-soiling itself showed significant influence on FI-related QoL in the FLQAI. FLQAI items showed significant differences only for one of two published reference groups. ConclusionLong-term incontinence rates in adolescent and adult CE-patients are high. Incontinence-related QoL was reduced compared to published reference groups but was minimally influenced by incontinence itself, the type of UD or the way of bowel-emptying, respectively.

Efficacy of intravaginal electrical stimulation added to bladder training in women with idiopathic overactive bladder: A prospective randomized controlled trial.

ABSTRACTPurpose:To evaluate the efficacy of intravaginal electrical stimulation (IVES) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB).Materials and Methods:Sixty-two women with idiopathic OAB were randomized into two groups using the random numbers generator as follows: Group 1 received BT alone (n:31), and Group 2 received BT+IVES (n:31). IVES was performed for twenty minutes three days a week over a course of eight weeks for a total of 24 sessions. Patients were evaluated in terms of incontinence severity (24-hour pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes and number of pads), symptom severity (OAB-V8), incontinence-related QoL (IIQ-7), treatment success (positive response rate), cure/improvement rate and treatment satisfaction (Likert scale).Results:A statistically significant improvement was found in all parameters for all groups at the end of the treatment compared to the baseline values except pelvic floor muscles strength in Group 1 (p <0.05). At the end of treatment, incontinence severity, frequency of voiding, nocturia, incontinence episodes, number of pads, symptom severity, and QoL were significantly improved in Group 2 compared to Group 1 (p <0.05). Treatment satisfaction, cure/improvement, and positive response rates were significantly higher in group 2 compared to Group 1 (p <0.05).Conclusion:We conclude that BT+IVES were more effective than BT alone on both incontinence-related QoL and clinical parameters in women with idiopathic OAB.

Nocturnal bladder emptying and Quality of Life in patients with spinal cord injury.

Little is known about the relationship between sleep disruption due to nocturnal bladder emptying and Quality of Life in patients with spinal cord injury. The aim of this study was to evaluate the possible influence of number of nocturnal bladder emptying, bladder emptying method and nocturnal incontinence on the Quality of Life of patients with spinal cord injury. The design of this paper is a cross-sectional descriptive study. The setting is in- and outpatient. Seventy-nine patients aged between 18 and 77 years with SCI in a first rehabilitation period or follow-up. Patients were asked to complete Short Form-36 and Incontinence Quality of Life questionnaires and a medical information form. Independent samples t-tests and ANOVA were used to compare scores between groups. The response rate was 71 out of 79 (89%; 51 males and 20 females). 16 paraplegic and 4 tetraplegic patients were chronic, 29 paraplegic and 22 tetraplegic patients were in rehabilitation therapy or had finished this treatment recently. The paraplegic group had a significantly better Short Form-36 total score and emotional function score, while the tetraplegic group had a significantly better Incontinence Quality of Life total score and avoidance and limiting behavior score. The paraplegic patients with 0-1 nocturnal bladder emptying had better Short Form-36-derived Quality of Life than those with ≥2 emptying. Quality of Life score was not associated with gender, leg oedema, incontinence, or acute/chronic group. Incontinence Quality of Life score was significantly better for patients with incomplete spinal cord injury. Fully completed questionnaires were returned by 36 patients; at least 1 item was missing for 35 participants. General Short Form-36-derived Quality of Life was better for the paraplegic population. Incontinence-related Quality of Life was better in tetraplegic patients, most of whom used suprapubic catheterization. Paraplegic patients had compromised sleep and Quality of Life when the patient had to wake up two or more times at night to empty the bladder by voiding or intermittent catheterization. The high number of incomplete responders indicates the shortcomings of Quality-of-Life questionnaires for wheelchair-bound patients with spinal cord injury. The use of suprapubic catheterization should be considered to improve Quality of Life for tetraplegic patients. For paraplegic patients, we must focus urological policy on aiming to reduce the number of nighttime bladder emptying to one or none.

Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands.

PurposeTransanal total mesorectal excision (TaTME) was developed to overcome surgical difficulties experienced in distal pelvic dissection. Concerns have been raised about potential worse postoperative functional outcomes after TaTME. Also, the oncological safety was questioned. This study aimed to describe the functional, surgical, oncological outcomes and quality of life (QoL) after TaTME.MethodsAll consecutive TaTME cases for rectal cancer without disseminated disease between December 2016 and April 2019 were included. The Wexner incontinence score, low anterior resection syndrome (LARS) score, fecal incontinence-related QoL, and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-core questionnaire and 29-item module (EORTC QLQ-C30/CR29) were collected. Kaplan-Meier analysis was used to calculate local recurrence-free survival.ResultsThirty patients were eligible for analysis of which 23 received questionnaires. Response rate was 74%. After a median follow-up of respectively 20.0 and 23.0 months for functional and oncological outcomes, the median (interquartile range) of Wexner incontinence and LARS scores were 9.0 (7.0–12.0) and 33.1 (25.0–39.0). Major LARS was present in 73.3%. Fecal incontinence, general and colorectal-specific QoL subdomains that are associated with poor bowel function scored in line with previously reported data. The 2-year actuarial cumulative local recurrence rate was 3.7% (95% confidence interval, 2.4%–5.0%).ConclusionTaTME may lead to significant functional impairments. Patients should receive preoperative counseling on this topic and be fully aware of the potential consequences of their treatment. Oncological data were in line with other short- to moderate-term data and did not show alarming results.

The Effects of Pelvic Floor Muscle Training and Behavioral Training on Sexual Dysfunction, Incontinence, Physical Activity Level and Quality of Life in the Elderly

Alterations in hormonal balance, especially with ageing, cause many pelvic floor problems such as urinary incontinence, lack of interest in or desire for sex and inactivity. The aim of this study was to explore the effects of pelvic floor muscle exercise and behavioral training programs on sexual function, incontinence, quality of life and physical activity level in the elderly. A total of 94 elderly subjects were separated into two groups as the pelvic floor muscle training (PFMT) group and the behavioral training for pelvic floor dysfunctions (BT) group. A (1-h program was applied twice a week for 8 weeks). Evaluations pre and post-training were made using the Female Sexual Function Inventory, the International Index of Erectile Function, International Consultation on Incontinence Questionnaire-Short Form, SEAPI quality of life scale, and Physical Activity Scale for the Elderly. In the post-treatment comparisons, the PFMT group was superior to the BT group in all parameters (z: − 4.21–0.00, p:0.00–0.02). The results of this study suggest that pelvic floor muscle training could be beneficial if added to rehabilitation programs for the elderly to obtain less sexual dysfunction and, incontinence, and better incontinence-related quality of life and physical activity levels.

The Prevalence of Vaginal Flatus in Women With Pelvic Floor Disorders and Its Impact on Sexual Function

BackgroundVaginal flatus is involuntarily passing gas from the vagina. Women seldom voluntarily report it, and related data are limited. AimTo investigate the prevalence of vaginal flatus in women with pelvic floor disorders and its impact on sexual function. MethodsThis was an observational study involving women who visited a urogynecologic clinic in a tertiary medical center. Patients were asked about their experience of vaginal flatus. Other evaluations included urodynamics, genital prolapse stage, and quality-of-life questionnaires, including the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. OutcomesClinical characteristics, vaginal anatomic landmarks, stage of prolapse, urodynamic parameters, and quality-of-life scores were compared between women with and without vaginal flatus. ResultsAmong 341 women, 118 (35%) reported vaginal flatus, which was more common in those who were younger (a mean age of 49.3 ± 9.2 years; range 25–74 years vs 49.3 ± 9.2 years; range 25–74 years, P < .001) and sexually active (98% vs 55%, P < .001). Women with vaginal flatus had significantly worse sexual function (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, 16.3 ± 15.9 vs 30.9 ± 8.0, P < .001) and incontinence-related quality of life (Urogenital Distress Inventory, 23.4 ± 10.5 vs 17.8 ± 8.9, P = .039; Incontinence Impact Questionnaire, 25.5 ± 14.5 vs 17.2 ± 12.5, P = .012). For frequency and bother, 48 of 116 (46%) women reported often or always having symptoms during sexual activity, 5 of 34 (15%) when performing daily activities, and 4 of 31 (12%) when exercising, and 70 of 116 (60%) felt least moderate bothersome during sexual activity compared with 2 of 34 (5%) when performing daily activities and 6 of 31 (18%) when exercising. Clinical ImplicationsVaginal flatus is prevalent in women with pelvic floor disorders, particularly in those who are younger and sexually active. Strengths & LimitationsThe strength of this study is to evaluate the sexual function with validated questionnaires. The lack of data after pelvic floor management is the major limitation. ConclusionsAmong women with pelvic floor disorders, those with vaginal flatus reported poorer sexual function. Routine counseling should be considered for these patients.J-H Lau, T-H Su, Y-Y Chen, et al. The Prevalence of Vaginal Flatus in Women With Pelvic Floor Disorders and Its Impact on Sexual Function. J Sex Med 2020;XX:XXX–XXX.

Quality of life and sexual function after TVT surgery versus Bulkamid injection for primary stress urinary incontinence: 1\xa0year results from a randomized clinical trial

Introduction and hypothesisTo assess changes in quality of life (QoL) and sexual function outcomes at 1 year after tension-free vaginal tape (TVT) versus polyacrylamide hydrogel injection (PAHG).MethodsIn a randomized trial comparing TVT (n = 111) and PAHG (n = 113) treatments of stress urinary incontinence (SUI), we compared urinary incontinence and health-related QoL using the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire, Short Form (IIQ-7), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and RAND-36 Item Health Survey (RAND-36) at baseline and 1 year.ResultsUDI-6 and IIQ-7 showed improved incontinence-related QoL (p = 0.001) from baseline in both groups except for difficulty emptying the bladder and pain/discomfort. At 1 year, TVT patients experienced less urinary symptom-related distress compared to PAHG (p < 0.001). Sexual function improved in both groups (p < 0.001 for TVT and p = 0.01 for PAHG) with higher scores for the physical section subscale (p < 0.001) for TVT. Health-related QoL (RAND-36) improved from baseline in both groups in physical and social functioning (p < 0.001) with better outcome in the TVT group for physical functioning (p < 0.001). Increase in pain from baseline (p = 0.02) was detected for TVT, but not for PAHG. However, there was no difference between the groups (p = 0.78).ConclusionsIn primary SUI, TVT and PAHG treatments both improved QoL and sexual function at 1 year. However, incontinence and health-related QoL scores were better in the TVT group. More pain compared to the baseline was reported after TVT, although there was no difference between groups. Clinical significance needs to be evaluated in long-term follow-up.

Which combination is most effective in women with idiopathic overactive bladder, including bladder training, biofeedback, and electrical stimulation? A prospective randomized controlled trial.

To evaluate the efficacy of single and combined use of biofeedback (BF) and electrical stimulation (ES) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB). Seventy women were randomized into four groups as follows: Group 1 received BT alone (n = 18), Group 2 received BT+BF (n = 17), Group 3 received BT+ES (n = 18), and Group 4 received BT + BF + ES (n = 17). BF and ES were performed 3 days a week, 20 mina day, a total of 24 sessions for 8 weeks. All women were evaluated in terms of incontinence severity (pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes, and number of pads), QoL (incontinence impact questionnaire), treatment success (positive response rate), cure/improvement rate, treatment satisfaction (Likert scale), and discomfort level (visual analog scale). At the end of the treatment, severity of incontinence, frequency of voiding, incontinence episodes, and treatment satisfaction significantly improved in Group 3 and Group 4 compared with the other two groups. In Group 3 and Group 4, high statistically significant values were found in cure/improvement and positive response rates as opposed to Group 1 and Group 2. In Group 2 and Group 3, statistically significant improvements were seen in nocturia and QoL compared withGroup 1. Moreover, statistically significant improvements in nocturia and QoL were found in Group 4 compared with the other three groups. There was no difference in the discomfort level of application between the groups. We conclude that in the first-line conservative treatment of women with idiopathic OAB:(i) adding BF and/or ES to BT increases treatment effectiveness, (ii) clinical efficiency is greater when the combination includes ES, (iii) BT + BF + ES (triple combination) is the most effective treatment option in reducing nocturia and improving QoL.

Does a serious game increase intrinsic motivation in children receiving urotherapy?

Urotherapy is considered the treatment of choice for children suffering daytime urinary incontinence (DUI). Urotherapy intends to improve bladder dysfunction for children with DUI. For children with refractory DUI, an intensive inpatient bladder training program exists, which focuses on relearning, concentration on, and awareness of the bladder. Children's motivation and adherence are key determinants of a successful training outcome. It is hypothesized that motivation endurance throughout the treatment process may be enhanced by a serious game training tool, which could make the training more appealing and rewarding. The study explores intrinsic motivation in children receiving bladder training for DUI and whether using a serious game improves their intrinsic motivation. In this pragmatic study, 50 children were allowed to choose among receiving bladder training with (intervention group) or without the application of a serious game (control group). At 4, 8, and 12 weeks of training, children and parents were asked to complete the Intrinsic Motivation Inventory (IMI). Children also completed the Pediatric Urinary Incontinence Quality of Life Tool (PinQ) before the start of the training and 6 months thereafter. At 6-month follow-up, patients were ask to participate in two focus groups, wherein the children discussed how they used the serious game and which improvements they would prefer. Children who received standard bladder training with the addition of a serious game did not differ in terms of intrinsic motivation from children who underwent standard bladder training only. Training results were equal in both the groups, with 80% good or improved. Incontinence-related quality of life (QoL) improved accordingly. In contrast to the study expectations, this game did not increase intrinsic motivation. Findings on training and QoL results are consistent with those of previous studies in both interventions. Although a randomized design could have yielded more valid results than this preference-based approach, the latter is more congruent with clinical practice. In contrast to existing bladder diary apps, this game offers a combination of child-friendly instructions, explanation of bladder (dys)function, and keeping a bladder diary. Mobile devices are playing an increasingly important role in health care; therefore, an urotherapy app can be a complementary therapeutic tool. Most children find it attractive to combine bladder training with a serious game. However, no added value was found regarding intrinsic motivation and training results. All children with persistent DUI in this cohort were highly motivated to complete an intensive bladder training program.

Did surgical failure and complications affect incontinence-related quality of life in women after transobturator sling procedure?

ObjectiveTo report the objective outcome, subjective measurement of incontinence-related quality of life (QoL) for female urodynamic stress incontinence (USI) after transobturator sling surgery (TVT-O) and to evaluate the effects of surgical failure and complications on QoL. Materials and methodsWe analyzed the data from women who underwent TVT-O for USI and completed two validated QoL questionnaires, the Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) preoperatively and at least 12 months postoperatively. We evaluated the subjective results of QoL questionnaires, objective results and compare the effect of QoL on those with surgical failure and complications after TVT-O surgery. ResultsA total of 78 women were followed for a median of 13.5 months (range 12–15 months) after surgery. Within this group, 75 (96%) were considered subjectively cured or improved after TVT-O. There were significant improvements in the IIQ-7 and total UDI-6 scores postoperatively, as well as in the UDI-6 subscales for urge, stress and voiding dysfunction symptoms. Even the 18 women with objective urodynamic failure had significant improvement in QoL scores. For those with surgical related complications, the QoL scores were also significantly improved. ConclusionsTVT-O for USI resulted in improvement of incontinence-related QoL including urgency, stress, and voiding dysfunction symptoms. Surgical failure and complications didn't impair postoperative QoL.

Effect of Urinary Incontinence on Quality of Life and Self Esteem of Postmenopausal Women

Background: Urinary incontinence (UI) is the debilitating condition with impact on physical and psychological aspect of life with consequent effect on the quality of life (QoL). Aim of the study was to determine the effect of urinary incontinence (UI) on quality of life and self esteem of postmenopausal women. A descriptive design was adopted to fulfil the aim of this study. The study was conducted at obstetric & gynaecological outpatient clinic and Urological outpatient clinic at Benha University Hospital. A purposive sample of 75 postmenopausal women who had complain of UI attending gynaecological outpatient clinic and Urological outpatient clinic. Data were collected through three main tools Structured interviewing questionnaire sheet, Rosenberg's Self-Esteem Scale and Incontinence-related quality of life (I-QOL). The study Results showed that there were positive statistically significant correlation between total self esteem and total Incontinence-Related Quality of Life. Also there is no significant relation between Incontinence-Related Quality of Life and items of socio-demographic characteristics (age, occupation, and source of income). While there were significant relation between Incontinence-related quality of life and (marital status, and educational level). Based on the result of this study it was concluded that UI symptoms directly affect HRQoL, which subsequently impacts negatively on self steam .The present study Recommended that continuous assessment for all QOL domains for incontinent women should be a part of the nursing care. Further research is required to improve our understanding of psychological and economic impact of this condition.

Quality-of-Life Outcomes Following Surface Electromyography Biofeedback as an Adjunct to Pelvic Floor Muscle Training for Urinary Incontinence: A Case Report.

A non-invasive treatment for urinary incontinence (UI) is surface electromyography (sEMG) biofeedback with pelvic floor muscle (PFM) training. A lack of consensus and evidence exists on the Quality of Life (QoL) outcomes following sEMG biofeedback using surface electrodes at the perineum compared to the more invasive intravaginal probe. This case report examines QoL using sEMG biofeedback at the perineum with PFM training for UI. Single subject case report. The patient was a 61-year-old woman diagnosed with UI. Her chief complaints were nocturia, urine leakage with urgency, and urine leakage with sneezing and coughing. Physical therapy (PT) treatment focused on behavioral modification, PFM strengthening with and without sEMG biofeedback, and therapeutic exercises with PFM contractions. At four weeks from baseline, the patient's PFM strength increased from 2/5 to 4/5 based on the Modified Laycock Scale. Her PFM endurance contraction improved from two seconds to ten seconds. The International Continence Impact Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF) score decreased from 6 to 0, the Incontinence Impact Questionnaire - Short Form (IIQ-7) score decreased from 14.3 to 0, and the 3 Incontinence Questions (3IQ) responses did not change. The outcomes from this case report demonstrate a brief course of PT treatment consisting of perineal sEMG biofeedback in conjunction with PFM training demonstrated clinically meaningful improvements in incontinence-related QoL, in addition to improvements in motor function in a woman with mixed UI and nocturia.

MP96-18 IMPACT OF PROSTATE CANCER THERAPY ON URINARY INCONTINENCE AND QUALITY OF LIFE

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety III1 Apr 2017MP96-18 IMPACT OF PROSTATE CANCER THERAPY ON URINARY INCONTINENCE AND QUALITY OF LIFE Andrew Wang, Paul McClain, and Robert Given Andrew WangAndrew Wang More articles by this author , Paul McClainPaul McClain More articles by this author , and Robert GivenRobert Given More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3041AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer therapy is known to affect urinary symptoms in men, and its effect on quality of life can depend upon which type of treatment is received. This study is a retrospective review of a large database of men who underwent surgical prostate cancer treatment to assess the impact of therapy on quality of life in prostate cancer patients. METHODS A total of 501 patients who underwent treatment for prostate cancer at a single institution from 2004-2014 were reviewed. The patients in this database were stratified into three groups with respect to the type of therapy received--robot-assisted laparoscopic radical prostatectomy (RLP), brachytherapy, and cryotherapy. Urinary incontinence related quality of life (HRQoL) was assessed at baseline and again at 1-60 months after therapy using the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Preoperative and postoperative urinary incontinence scores were compared using a Student's t-test. RESULTS Baseline patient characteristics were similar between each treatment group. Diabetes was the only comorbidity correlated with urinary symptoms. Baseline urinary incontinence scores were 93.3, 94.5, and 88.2 in the RLP, brachytherapy, and cryotherapy groups, respectively with a significant difference between the RLP and cryotherapy groups (p = 0.046). Urinary incontinence worsened in all three groups at the first follow-up (2.2 months) after treatment (p < 0.0001). The corresponding scores at long term follow-up were 72.0 (p < 0.0001), 78.1 (p < 0.0001), and 83.1 (p = 0.165). The RLP group urinary incontinence improved over time, while the brachytherapy group incontinence did not change significantly after short term follow-up. Only the cryotherapy group achieved a return to baseline at mean follow-up of 17.3 months. No significant difference was found between mean urinary incontinence for RLP and brachytherapy at long-term follow-up (p = 0.128). CONCLUSIONS Due to the high survival of patients who receive treatment for prostate cancer, quality of life is a major concern when choosing therapy. All three types of prostate cancer treatment studied above cause a short-term worsening of urinary incontinence. Long term, RLP and brachytherapy are associated with worsening of urinary incontinence, whereas cryotherapy is associated with the least impact. Comparatively, RLP and brachytherapy yield similar post-therapy urinary incontinence outcomes. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1301-e1302 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Andrew Wang More articles by this author Paul McClain More articles by this author Robert Given More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

The TRUST (EvaluaTion of Bladder Function in Relapsing-Remitting MUltiple Sclerosis Patients Treated with Natalizumab) Observational Study

Bladder dysfunction is a common symptom of multiple sclerosis (MS). This study was designed to evaluate effects of natalizumab on bladder function in patients with relapsing-remitting MS. The TRUST (EvaluaTion of Bladder Function in Relapsing-Remitting MUltiple Sclerosis Patients Treated with Natalizumab) study was an open-label, single-arm, two-center study. Natalizumab-naive MS patients with disabling bladder dysfunction and initiating natalizumab were enrolled and followed for 6 months. The primary endpoint was change in the Urogenital Distress Inventory short form (UDI-6) score from baseline. Change in Incontinence Impact Questionnaire short form (IIQ-7) score from baseline was a secondary endpoint. Thirty patients were enrolled. Mean baseline characteristics were age 49.9 years, Expanded Disability Status Scale score 4.6, number of relapses in previous year 2.4, UDI-6 score 10.4, and IIQ-7 score 12.3. Mean changes in UDI-6 and IIQ-7 scores were significantly improved from baseline beginning at week 4 and up to week 24; mean improvements at 24 weeks were 4.4 (P < .0001) and 4.9 (P = .0005) points, respectively. At week 24, 85.7% and 78.6% of patients demonstrated improvements from baseline in UDI-6 and IIQ-7 scores, respectively. Incontinence-related quality of life as measured by UDI-6 and IIQ-7 scores improved significantly during natalizumab treatment.

Treatment success of transobturator tape compared with tension free vaginal tape for stress urinary incontinence at 24 months: A randomized controlled trial

Objective: To compare the long term efficacy of transobturator Tape (TOT) with tension free vaginal tape (TVT) at 24 months postoperatively. Patients & Methods: 160 women with stress urinary incontinence (SUI) were randomly allocated to either TVT or TOT procedures and reviewed at 24 months after surgery. The primary outcomes were objective cure (a negative cough stress test, and a negative 1-hour pad test), and subjective cure (defined as “very much better” or “much better” improvement in the Patient Global Impression of Improvement scale). The secondary outcomes included incontinence related quality of life (using Urogenital Distress Inventory Questionnaire, and Incontinence Impact Questionnaire), and complications. Results: No statistical difference was reported in objective and subjective cure rates between both groups. Objective cure rate was 85.6% and 81.6% in the TOT and TVT groups respectively (P = 0.55). Subjective cure rate in the TOT and TVT groups were 87% and 83% respectively (P = 0.68). There were no significant differences in postoperative complications and incontinence related quality of life. However, the operating time was significantly shorter in the TOT group compared with the TVT group (22.6 ± 3.9, 27.1 ± 3; respectively, P