International Consultation On Incontinence Questionnaire Short Form Research Articles

Rehabilitation combined with dietary intervention improve urinary incontinence in women with obesity: A proof-of-principle study.

This study aimed to assess the impact of add-on pelvic floor exercises on a weight management rehabilitation program. This proof of principle study was conducted between July 2019 and December 2019. Ninety-three adult female inpatients with obesity and diagnosis of urinary incontinence (UI) were assessed for inclusion, and the suitable patients were randomly assigned to the experimental group and the control group. Both groups underwent a weight management rehabilitation program, while the experimental group also performed pelvic floor exercises. The primary outcome was UI severity, assessed by the 1-h pad test. Secondary outcomes were urinary symptoms, assessed by the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I), and Incontinence Quality of Life Questionnaire (I-QOL). Sixty female inpatients were randomly assigned to the experimental group [n=30; median age: 64.50 (51.25 to 70.50) years] or the control group [n=30; median age: 67.50 (58.50 to 74.75) years]. The experimental group showed a statistically significant reduction in UI severity [pad test: 2.08 (1.21 to 8.85) g vs. 0.54 (0.24 to 1.13) g, p<0.01; ICIQ-SF: 14.00 (10.25 to 17.00) vs. 8.00 (6.25 to 11.75), p<0.01; I-QOL: 56.37 (42.28 to 73.64) vs. 78.64 (64.32 to 90.68), p<0.01]. Statistically significant differences were found in the between-groups analysis [pad test: 0.54 (0.24 to 1.13) g vs. 1.08 (0.83 to 3.86) g, p<0.01; ICIQ-SF: 8.00 (6.25 to 11.75) vs. 12.00 (10.00 to 16.00), p<0.01; I-QOL: 78.64 (64.32 to 90.68) vs. 68.18 (60.00 to 84.32), p<0.01]. Including pelvic floor exercises might provide additional benefits compared to standard rehabilitation in reducing UI symptoms in obese women.

Can nerve monitoring during radical prostatectomy improve functional outcomes? A randomised trial.

To explore how the use of the ProPep® Nerve Monitoring System (ProPep Surgical, Austin, TX, USA) for intraoperative specific sparing of the pudendal nerve fibres influences postoperative functional outcomes after unilateral nerve-sparing (UNS) or non-nerve-sparing (NNS) robot-assisted radical prostatectomy (RARP). We randomised 100 men undergoing UNS or NNS RARP to ProPep nerve monitoring during RARP (intervention) or standard of care RARP (control). Functional outcomes were assessed at 3, 6, and 12 months using the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), the International Prostate Symptom Score, the Danish Prostate Symptom Score, the International Index of Erectile Function, the Erection Hardness Scale, and 24-h pad tests. The primary outcome was the difference in ICIQ-SF score between the groups at 12 months. Secondary outcomes included differences in the remaining outcome measures and continence rates at all time points. Continence was defined as the use of no pads and the answer 'Never' to the question: 'How often do you experience urinary incontinence?' or a urine loss of <8 g on the 24-h pad test. A total of 82 patients were included in the per-protocol analysis at 12 months with 41 in each group. At 12 months the mean ICIQ-SF scores were 5.37 (95% confidence interval [CI] 3.71-7.03) and 5.66 (95% CI 4.05-7.27) for the intervention and control groups, respectively (P = 0.8). There were no statistically significant differences in any of the remaining outcomes. However, the continence rate was higher in the intervention group at 6 months (63% vs 44%, P = 0.09). Intraoperative nerve monitoring did not result in better functional outcomes following UNS or NNS RARP. Larger studies are needed to explore if ProPep can reduce the time to continence after RARP.

Correlation Between Insulin Resistance and Urinary Incontinence in Female Patients with Type 2 Diabetes Mellitus.

Patients with type 2 diabetes mellitus (T2DM) are at a high risk of developing urinary incontinence; however, its pathogenesis is unclear. The purpose of this study is to explore the relationship between insulin resistance and urinary incontinence and its severity in female patients with T2DM. A total of 366 women with T2DM aged ≥18 years were enrolled in this study. Insulin resistance was evaluated by the homeostasis model insulin resistance (HOMA-IR) index and urinary incontinence was assessed by the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). All subjects were divided into four groups according to HOMA-IR quartiles. Logistic regression analysis was performed to investigate the relationship between insulin resistance and urinary incontinence and its severity. Among the 366 patients, 186 (50.8%) had urinary incontinence. The prevalence of urinary incontinence increased significantly with HOMA-IR quartiles (p < 0.001). Adjusted logistic regression analysis showed that compared with HOMA-IR ≤ 1.76, 2.81 ≤ HOMA-IR ≤ 4.27 was associated with a significantly increased risk of moderate incontinence (OR = 2.197, 95% CI 1.031-4.683, p = 0.041), and HOMA-IR ≥ 4.28 was associated with a significantly increased risk of severe incontinence (OR = 5.699, 95% CI 1.685-19.276, p = 0.005). Binary logistic regression analysis showed that HOMA-IR was the independent risk factor for urinary incontinence (p < 0.001). Higher levels of insulin resistance are associated with urinary incontinence and its severity in female patients with type 2 diabetes mellitus.

Evaluation of tension-free vaginal tape and transobturator tape surgery performed in one year in terms of mesh erosion

Background/Aim: Mesh erosion is one of the feared complications in surgeries performed using mesh, and its frequency is increasing as more and more of these surgeries are performed. This study aims to evaluate transobturator tape (TOT) and tension-free vaginal tape (TVT) surgeries performed in the surgical treatment of stress urinary incontinence (SUI) in our clinic in terms of clinical results and mesh erosion. Methods: This study is a retrospective cohort study. The files of 50 patients who had SUI and underwent TOT and TVT surgery in our clinic between January 2022 and January 2023 were reviewed. Patients diagnosed with pure SUI and for whom surgery was performed were included in our study. The participants were divided into two groups: those who had TOT surgery and those who had TVT surgery. These groups were evaluated and compared in terms of mesh injury, mesh erosion, pelvic pain, dyspareunia symptoms, and urinary retention. The surgical data of patients, incidence of complications, pre- and postoperative incontinence impact questionnaires (IIQ-7) and the scores of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were recorded. Results: The mean follow-up period of the participants was 8.96 (8.47) (range, 6-17 months). TVT surgery was performed on 13 participants and TOT surgery was performed on 37 patients. When the two groups were compared, there was no statistically significant difference in terms of age, body mass index (BMI), parity, menopausal status, duration of incontinence, preoperative IIQ-7 scores, and ICIQ-SF scores (P&lt;0.05). There were no statistically significant differences between surgical durations, length of hospital stay, early surgical complications, postoperative 3rd month IIQ-7, and ICIQ-SF scores (P&lt;0.05). Furthermore, no difference in the rates of mesh erosion and mesh-related complications between the two groups (P&lt;0.05) was observed. Conclusion: TOT and TVT surgeries seem to be quite safe in terms of complications, as well as being satisfactory in terms of patient satisfaction. Although mesh-related complications can be frightening, the rate of regression is low with appropriate management. Our results show that both operations are safe with an acceptable complication rate when performed by surgeons who have experience with anti-incontinence procedures.

Does Significant Weight Loss After Bariatric Surgery Affect Sexual Function and Urinary Symptoms? An Iranian Study.

For sexual dysfunction and lower urinary tract symptoms (LUTS), obesity is identified as an independent risk factor. The current study aimed to evaluate the effect of significant rapid weight loss by bariatric surgery on LUTS and sexual function among men and women with class III obesity. A group of patients who were planned to undergo bariatric surgery was enrolled in the study. Male patients were given the International Index of Erectile Function (IIEF) and the International Prostate Symptom Score (IPSS) questionnaires. In the female group, they filled in the female sexual function index (FSFI) and the International Consultation on Incontinence Questionnaire short form (ICIQ-SF) questionnaires. Patients were followed up 1year after their bariatric surgery. All questionnaires were completed by eighty-one patients. (mean age ± SD: 39.4 ± 9.2years; mean body mass index (BMI) ± SD: 47.15 ± 5.4kg/m2). The total score of the IPSS questionnaire decreased from 5.83 ± 3.01 preoperatively to 2.37 ± 1.66 postoperatively. The weight loss caused significant improvement in the storage phase of LUTS domains, but there were no considerable changes in the voiding phase. In the IIEF questionnaire, domains of sexual desire, overall satisfaction, and orgasmic function improved significantly. There was not a significant change in any FSFI domains after bariatric surgery. Mean ICIQ-SF decreased, but it was not substantial. Bariatric surgery can significantly improve the storage phase in men, but not the voiding phase. Sexual desire, orgasmic function, and overall satisfaction were significantly improved in men. No significant improvement in sexual function and UI in women was observed.

Help-seeking behavior for nonsevere stress urinary incontinence among elderly women in communities, Beijing, China.

Stress urinary incontinence (SUI) is a common health problem and influences women'squality of life significantly. In order to enhance health education according to a specific situation, it is essential to identify barriers to seeking help among elderly women with nonsevere SUI. The objectives were to investigate reasons for (not) seeking help for nonsevere SUI among women aged ≥60 years, and to analyze factors affecting help-seeking behavior. We enrolled 368 women aged ≥60 years with nonsevere SUI from communities. They were asked to filled out sociodemographic information, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Incontinence Quality of Life (I-QOL), and self-constructed questiones on help-seeking behavior. Mann-Whitney U tests were used to analyze the different factors between seeking group and nonseeking group. Only 28 women (7.61%) had ever sought help from health professionals for SUI. The most frequent reason for seeking help was urine-soaked clothes (67.86%, 19 out of 28). The most frequent reason for not seeking help was that women thought it was normal (67.35%, 229 out of 340). Compared with the nonseeking group, the seeking group had higher total ICIQ-SF scores and lower total I-QOL scores. Among elderly women with nonsevere SUI, the rate of seeking help was low. Lack of correct perception about the SUI kept women from doctor visits. Women who were bothered by more severe SUI and lower quality of life were more likely to seek help.

Impact of Obesity and Hyperglycemia on Pregnancy-specific Urinary Incontinence.

The lack of data on the impact of hyperglycemia and obesity on the prevalence of pregnancy-specific urinary incontinence (PSUI) led us to conduct a cross-sectional study on the prevalence and characteristics of PSUI using validated questionnaires and clinical data. This cross-sectional study included 539 women with a gestational age of 34 weeks who visited a tertiary university hospital between 2015 and 2018. The main outcome measures were the prevalence of PSUI, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Incontinence Severity Index (ISI) questionnaires. The women were classified into four groups: normoglycemic lean, normoglycemic obese, hyperglycemic lean, and hyperglycemic obese. The differences between groups were tested using descriptive statistics. Associations were estimated using logistic regression analysis and presented as unadjusted and adjusted odds ratios. Prevalence rates of PSUI were no different between groups. However, significant difference in hyperglycemic groups worse scores for severe and very severe PSUI. When adjusted data for confound factors was compared with normoglycemic lean group, the hyperglycemic obese group had significantly higher odds for severe and very severe forms of UI using ICIQ-SF (aOR 3.157; 95% CI 1.308 to 7.263) and ISI (aOR 20.324; 95% CI 2.265 to 182.329) questionnaires and highest perceived impact of PSUI (aOR 4.449; 95% CI 1.591 to 12.442). Our data indicate that obesity and hyperglycemia during pregnancy significantly increase the odds of severe forms and perceived impact of PSUI. Therefore, further effective preventive and curative treatments are greatly needed.

Functional mobility and lumbopelvic rhythm in women with and without stress urinary incontinence: An observational pilot study

ObjectiveTo examine the functional mobility and lumbopelvic rhythm of the continent and incontinent women. DesignAn observational pilot study was performed with two groups of women, who never experienced falls. MethodsParticipants were 27 women with urinary incontinence and 27 matched controls. The incontinent group had urinary incontinence assessed by the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) (score ≥1); and the continent group had an ICIQ-SF score equal to 0. The functional mobility and lumbopelvic rhythm were assessed using G-Sensor® gadget wireless system. With the G-sensor® at the second lumbar vertebra, the participants performed the Walk-Test (functional mobility), Time Up and Go (TUG) (functional mobility), and lumbopelvic rhythm. Student T test, Chi-Square, and Mann-Whitney test were applied to compare continuous variables between groups. p < 0.05 for significance level. Hegdes'g statistic and R2 [Z2/(total n)] were used to effect size. ResultsWalk-test was not different between groups. TUG was different between groups: the continent group (11.0 ± 2.1s) was faster than the incontinent group (12.5 ± 3.3s) (p = 0.03). The sitting-to-standing position knee flexion angle was larger in the continent group (45.0 ± 17.2°) than in the incontinent (34.1 ± 18.8°) (p = 0.03). ConclusionThe incontinent group showed a decrease in functional mobility according to the TUG test. Limiar differences in the flexion angle from sitting to standing suggest incontinent women might have a lower potential for hip flexor moment during hip lifting.

The prevalence and risk factors of different degrees of stress urinary incontinence in Chinese women: A community-based cross-sectional study.

To investigate the prevalence of SUI and explore the factors that could influence the severity of SUI in adult females. A cross-sectional study. A total of 1178 subjects were assessed using a risk-factor questionnaires and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and then divided into no SUI group, mild SUI group and moderate-to-severe SUI group according to the ICIQ-SF score. Univariate analysis between adjacent groups and ordered logistic regression models in three groups were then performed to analysis the possible associated factor with the progressive of SUI. The prevalence of SUI among adult women was 22.2% of them; 16.2% and 6% had mild SUI and moderate-to-severe SUI, respectively. Moreover, logistic analysis revealed that age, BMI, smoking, position preference for urination, urinary tract infections, urinary leaks during pregnancy, gynaecological inflammation and poor sleep quality were independent risk for the severity of SUI. SUI symptoms were mostly mild among Chinese females, specific risk factors such as unhealthy living habits and urination behaviours increased the risk of SUI and the aggravation of symptoms. Therefore, targeted interventions should be formulated for women to delay disease progression.

Impact of Urinary Incontinence on the Quality of Life After Open Retropubic Radical Prostatectomy.

IntroductionRadical retropubic prostatectomy is one of the standard treatments for localized prostate cancer. Evaluating the severity of postoperative urinary incontinence is primordial to guiding the treatment choice, and it still lacks standardization, hence the value of assessing the quality of life.MethodsWe conducted a retrospective study between January 2014 and December 2018 in the Urology Department of La Rabta Hospital, involving 30 patients followed for localized prostate cancer treated with radical prostatectomy for at least one year. Our work aimed to study urinary incontinence after radical retropubic prostatectomy and to evaluate the quality of life of patients who underwent surgery for localized prostate cancer by three validated questionnaires: The International Prostate Symptom Score (IPSS), The International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and the International Continence Society (ICS) scores.ResultsThe preoperative IPSS score ranged from 5-22, averaging 11.13. After the surgery, it ranged between four and 23, with an average of 14.13. This increase was significant, with p = 0.001. The average preoperative ICIQ-SF score was 10.03, and the mean postoperative score was 14.23. The first question dealing with the frequency of episodes of urinary leakage has not demonstrated variation after surgery. In the second question, which deals with the amount of urine loss, we found a significant increase in this parameter with p=0.003. In the third question inherent to perceived discomfort, operated patients reported significant deterioration with p <0.001.We observed an increase in patients with urinary stress incontinence and enuresis on the ICS score after radical retropubic prostatectomy. Wearing protection or padding was required in 23.3% of patients.ConclusionIPSS, ICIQ-SF, and ICS scores are helpful to perform before and after radical retropubic prostatectomy. It helps to study urinary incontinence better, propose to each patient with postoperative complications the appropriate treatment option, and improve the quality of the urinary status.

Efficacy of optimized pelvic floor training of YUN combined with pelvic floor magnetic stimulation on female moderate stress urinary incontinence and sexual function: a retrospective cohort study.

BackgroundOwing to its tediousness and monotony, traditional pelvic floor muscle training (PFMT) is difficult to ensure the correctness of exercise, and it is difficult for patients to adhere to treatment. We designed this study to evaluate and analyze the efficacy of optimized pelvic floor training of YUN combined with pelvic floor magnetic stimulation on female moderate stress urinary incontinence (SUI) and sexual function.MethodsThis is a retrospective cohort study. This study was carried out in 95 female patients with moderate SUI. The inclusion criteria were as follows: premenopausal women aged 25–45; moderate SUI; over 3 months of disease duration; informed consent and cooperation with treatment and follow-up. The participants in group 1 (control group, n=46) were treated with pelvic floor magnetic stimulation, while those in group 2 (trial group, n=49) were treated with pelvic floor magnetic stimulation combined with optimized pelvic floor training of YUN. Evaluations were scheduled before the treatment (0 week), after 6 weeks of treatment (6 weeks), and after 12 weeks of treatment (12 weeks). And compare the differences between the two groups.ResultsThere was no significant difference in age, body mass index (BMI), duration of disease, and abdominal leak point pressure (ALPP) between the two groups (P>0.05). The total effective rate of the trial group was higher than that of the control group (89.80%, 44/49 vs. 78.26%, 36/46) (P<0.05). The electromyographic values, the International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) score, physiological factors, and emotional factors were all improved significantly in both groups after active treatment, and the improvement of the trial group was more obvious (P<0.05).ConclusionsOptimized pelvic floor training of YUN combined with pelvic floor magnetic are more effective for the treatment of female moderate SUI and sexual function. It has become a safe, effective, and well tolerated new type of pelvic floor functional reconstruction training method with good patient compliance.

Urinary and sexual dysfunctions in university students in southern Brazil

Background: The pelvic floor is a structure formed by muscles, fascia and ligaments that support the organs in the pelvic cavity, maintaining urinary and fecal continence and sexual function. Aims: To know the incidence of urinary and sexual pelvic floor disorders in female university students from private educational institutions in Guarapuava/PR, a quantitative, descriptive exploratory study. Method: The sample consisted of 320 women, aged between 18 and 35 years, data collection was performed through sample characterization, FSFI (Female Sexual Function Index) and ICIQ-SF (International Consultation on Incontinence Questionnaire - Short Form). The questionnaires were made available through the Google Forms platform and accessed through a link sent by email. Results: Data were descriptively and cross-sectionally analyzed and are presented as mean and standard deviation with regard to FSFI and ICIQ-SF score values. Of the 320, 20 had associated UI and SD. Conclusion: sexual and urinary dysfunction are prevalent in university students in southern Brazil.

Long-term postoperative follow-up results of transobturator autologous rectus fascial sling versus transobturator tension-free vaginal tapes for female stress urinary incontinence: Randomized controlled clinical trial.

To evaluate the outcomes of a new surgical technique for the treatment of stress urinary incontinence (SUI). This randomized study included 132 index patients from January 2017 to May 2021, 60 applied with autologous facia and 60 with transobturator tension-free vaginal tape (TVT-O). The primary endpoint was dryness (negative stress test and 0 pad use per day) and this was assessed at 3, 6, 12, and 24 months. The secondary endpoints were the International Consultation on Incontinence Questionnaire short form (ICIQ-SF) and the urinary incontinence quality of life (QoL) at 3, 6, 12, and 24 months. The dryness rate at 24 months was 92.4% (49/53) for patients with transobturator autologous rectus fascial sling (TO-AFS) and 94.6% (53/56) for those with TVT-O (p = 0.47). No difference was determined between the TO-AFS and TVT-O groups in respect of the ICIQ-SF and QoL scores at 2 years postoperatively (p = 0.87). There were five postoperative complications in the TO-AFS group (one urinary retention, one hematoma at suprapubic incision line, and three intermittent groin pains) and four in the TVT-O group (four persistent groin pain) (p = 0.98). The objective cure rates of the 24-month outcomes of TO-AFS indicate that this novel surgical technique seems to be a highly effective, safe, and feasible procedure for the treatment of SUI, but further studies including long-term follow-up are mandatory to confirm these preliminary data.

PD66-09 PERSISTENCE OF STRESS URINARY IN CONTINENCE IN OBESE AFTER BARIATRIC SURGERY, WHAT ARE THE RISK FACTORS?

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Non-neurogenic Voiding Dysfunction III (PD66)1 Sep 2021PD66-09 PERSISTENCE OF STRESS URINARY IN CONTINENCE IN OBESE AFTER BARIATRIC SURGERY, WHAT ARE THE RISK FACTORS? Antonio Flavio Rodrigues, Fernando Korkes, Gabriel de Castro Bittar, Douglas de Padua Rodrigues, Felipe Araujo Santos, Wilson Rodrigues Junior, and Luis Gustavo Toledo Antonio Flavio RodriguesAntonio Flavio Rodrigues More articles by this author , Fernando KorkesFernando Korkes More articles by this author , Gabriel de Castro BittarGabriel de Castro Bittar More articles by this author , Douglas de Padua RodriguesDouglas de Padua Rodrigues More articles by this author , Felipe Araujo SantosFelipe Araujo Santos More articles by this author , Wilson Rodrigues JuniorWilson Rodrigues Junior More articles by this author , and Luis Gustavo ToledoLuis Gustavo Toledo More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002110.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Stress urinary incontinence (SUI) incontinence is frequently associated with severe obesity in women, and weight loss after bariatric surgery improve the symptoms. Our study aimed to examine variables associated with SUI in morbidly obese women before and after bariatric surgery, and to identify predictive factors to SUI persistence. METHODS: A prospective observational study was designed including 89 women from Santa Casa de São Paulo Bariatric Surgery Program between 2015 and 2018. Patients who did not accept to participate or did not complete the protocol were excluded from the study (n=6). Patients were evaluated, answered the ICIQ-SF (International Consultation on Incontinence Questionnaire – short form), PGI-I (Patient Global Impression of Improvement) and VAS (visual analogic scale), underwent physical examination and stress incontinence test before and 6 months after Y-en-Roux gastric bypass. Women were divided into three groups according to SUI: A-without SUI; B-preoperative SUI with postoperative resolution C-preoperative SUI without resolution. RESULTS: Of the 83 women who completed the study, the mean age was 43.3±7.6 years and BMI reduced from 45.5±5.7 kg/m2 to 34.1±6.9 kg/m2 (25% reduction). Preoperative incontinence rate was 53% (n=44). Observed 70.4% resolution the SUI after surgery (p=0.013). Predictive factors for SUI preoperative diagnosis after logistic regression included age above 44 years (p=0.022), BMI (p=0.038), largest newborn weight (Kg) (p=0.001) and parity number (p=0.003), and the increase of 1 in the value of each variable increases the possibility of SUI by 183%, 8%, 407% and 69%, respectively. All urinary symptoms demonstrated improvement after weight loss, markedly nocturia (p=0.03), SUI (p=0,03) and urinary incontinence (p=0.002). Logistic regression demonstrated that age above 50 years (p=0.004), hypertension (p=0,028), and menopause (p=0.004) were independent risk factors for SUI persistence. Obese women above 50 years burden a 9.5-fold, hypertension 11.2-fold and menopause 9.5-fold increased risk of persisting incontinent after weight reduction. Patient reported outcomes, ICIQ-SF, PGI-I and VAS for satisfaction demonstrated that SUI resolution was associated with significant improvement (p<0.001, p=0.01 and p=0.01 respectively). Predictive factors for SUI persistence after surgery was 9.5-fold higher if 2 factors were present and 13.8-fold for 3 factors (p<0,001). CONCLUSIONS: women above 44 years, high BMI, largest newborn weight and parity are risk factors for developing SUI in obese women. Older age, hypertension and menopause are strongly associated with persistence of SUI even after weight loss, and when these three factors are present, an increment of 13.8-fold occur. If these factors are not present, weight loss achieved through bariatric surgery resolves SUI symptoms and its impacts on quality of life on the majority of women. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1162-e1162 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Antonio Flavio Rodrigues More articles by this author Fernando Korkes More articles by this author Gabriel de Castro Bittar More articles by this author Douglas de Padua Rodrigues More articles by this author Felipe Araujo Santos More articles by this author Wilson Rodrigues Junior More articles by this author Luis Gustavo Toledo More articles by this author Expand All Advertisement Loading ...

Long-term outcomes of Altis® single-incision sling procedure for stress urinary incontinence.

In women with predominant stress urinary incontinence (SUI), recent data are still controversial regarding the short-term outcomes of mini-slings and there is a lack of evidence about the outcomes in the long term. Our aim was to evaluate the long-term effectiveness and complication rates of Altis® (Coloplast). A total of 145 women with clinical SUI were implanted with an Altis® sling between April 2012 and December 2015. Women completed the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) before the intervention and in the following consultations. A telephone interview was performed in January 2021 and 131 women (90%) were available for re-evaluation. The main outcome was treatment success, defined as no self-reported SUI symptoms and no reintervention. Secondary outcomes included response to ICIQ-SF (cure defined as ICIQ-SF = 0) and Patient Global Impression of Improvement (PGI-I) questionnaires, de novo overactive bladder (OAB) symptoms and adverse events. The overall treatment success was 73.3% at a median follow-up of 8years. The ICIQ-SF cure rate was 66.1%. In the PGI-I, 70.4% answered that they were much better or very much better. Later postoperative complications included 2 cases (1.5%) of vaginal extrusion (requiring surgical removal of the eroded mesh segment), 3 (2.3%) cases of infravesical obstruction (which led to sling section), de novo urgency in 20 patients (15.3%), and mild dyspareunia in 2 (1.5%) patients. The Altis® sling was safe and effective in a long-term follow-up, improving the quality of life in patients with SUI.

RISK FACTORS FOR STRESS, URGE, AND MIXED URINARY INCONTINENCE

Objective: The aim of the study was to determine the risk factors associated with specific subtypes of urinary incontinence (UI).&#x0D; Materials and Methods: This cross-sectional study was conducted between September 2013 and July 2014. There were 1459 patients included in our study. Of these, 958 women were incontinent, and 501 were continent. The Turkish version of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), urogynecologic and pelvic examination were used for UI diagnosis. Patients' detailed medical histories were obtained. Categorical variables were evaluated using Pearson’s Chi-squared test. One-way Analysis of Variance and Kruskall-Wallis tests were used to analyze continous variables. Multiple logistic regression analysis was used to obtain statistically significant UI-associated risk factors.&#x0D; Results: A history of giving birth to a baby weighing &gt;4000 gr, early age at menarche, menopause, constipation, coffee consumption, asthma, lumbal disc hernia, family history, and recurrent urinary infections were associated with all types of UI. Delivery at home increased the risk of both stress and urge urinary incontinence (SUI and UUI, respectively). Cystocele and rectocele increased the risk of both SUI and mixed urinary incontinence (MUI). The risk of UUI was shown to increase in women who were receiving hormone replacement therapy and who had cuff prolapse. High body mass index was indicated as a specific risk factor for MUI.&#x0D; Conclusions: Determining risk factors and high risk women is very important for development of preventative medical approaches for UI.

Can the inability to contract the pelvic floor muscles influence the severity of urinary incontinence symptoms in females?

The objective was to analyze if the inability to perform a maximal voluntary contraction (MVC) of the pelvic floor muscles (PFMs) in a first assessment can influence the severity of urinary incontinence symptoms in women. A cross-sectional study was carried out using the medical records of women with UI who were referred for pelvic floor physiotherapy after undergoing a gynecological evaluation between May 2013 and December 2019. Records included data referring to age, body mass index (BMI), obstetric history, Modified Oxford Scale (MOS), and the final score of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) from a baseline assessment. Data were divided into women who were unable and those who were able to voluntarily perform an MVC of the PFMs. Statistical analysis was conducted using SPSS version 21. A total of 498 medical records were analyzed and 36.3% of those women were not able to perform a PFM MVC after verbal command and digital stimulus. Homogeneity was observed among groups and no significant difference was found regarding the severity of UI symptoms when the groups were compared. No association was found between the inability to contract the PFMs and the severity of UI symptoms. Other studies should be developed to better understand why some women are incapable of performing a voluntary PFM contraction. Also, it would be relevant to compare women with PFM dysfunction who are not able to contract the PFMs with healthy women with the same PFM condition to analyze whether this muscle condition could be related to dysfunctions such as UI or pelvic organ prolapse.

Pengaruh Kegel Exercise terhadap Inkontinensia Urine pada Ibu Postpartum Multipara

Introduction: One of problems experienced post-partum mothers is urine incontinence. Kegel exercise effects on urine incontinence post-partum mothers and elderly. However, limited study search for its effect on multiparous post-partum mothers. This study aims to determine the effect of Kegel exercise on urinary incontinence in multiparous post-partum mothers.Methods: The research design used was a quasi-experiment with a post-test with control group design which was divided into an experimental group and a control group. The research was conducted in the work area of Rejosari Public Health Center with a sample size of 34 respondents with the criteria of multiparous postpartum mothers who experienced urinary incontinence in normal labor with a purposive sampling technique. The measuring instrument used was the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF). Data analysis used dependent and independent t-test.Results: The results of the dependent t-test statistic with α 0.05 showed that Kegel exercise was effective against urinary incontinence in the experimental group p value (0.000) and the control group p value (0.033) and the results of the independent t-test showed that there was an effect of Kegel exercise on urinary incontinence in the experimental group and the control group p value (0.004). The results of this study can be used as a reference for using Kegel exercises as a way to deal with complaints of urinary incontinence in multiparous post-partum mothers.

Determination of comfort levels of women with urinary incontinence

Purpose: This descriptive study was planned to investigate the comfort levels of women with urinary incontinence. Materials and methods: The study comprised 219 women with a complaint of urinary incontinence admitted to the outpatient clinic of Obstetrics and Gynecology Department of a university hospital between June – December 2015. The Sociodemographic Characteristics Questionnaire, Urinary Incontinence &amp; Frequency Comfort Questionnaire (UIFCQ), and International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were used. Results: The study results demonstrated that the mean score the participants obtained from the UIFCQ was 4.20 ± 0.74 and that their comfort levels were moderate. Their mean score for the ICIQ-SF was 10.41± 4.98, and urinary incontinence adversely affected their quality of life in 74% of them. While the mean UIFCQ scores were KW = 48.673, p=0.00 for the frequency of urinary incontinence, t=2.33, p=0.02 for receiving treatment, KW = 58.267, p = 0.00 for the amount of urinary leakage, KW=26.37, p=0.00 for the educational attainment, t=7.04, p=0.03 for the number of births, the mean ICIQ-SF scores were KW = 13.74, p =0.00 for the educational attainment and t = 24.02, p=0.00 for the number of births (p &lt;0.05). Conclusions: It was determined that the comfort level of the participants with urinary incontinence was moderate, that urinary incontinence affected the quality of life and that as their comfort level increased, so did their quality of life.

Age at surgery is not a prognostic factor for the AdVance-XP male sling efficacy: A post-hoc analysis of a prospective 7-year multicentric study.

To evaluate the factor age at the surgery on long-term postoperative outcomes in patients with postprostatectomy incontinence (PPI) after AdVance XP transobturator male sling implantation. A total of 115 male patients with PPI, who had undergone AdVance XP sling implantation, were included. Patients had PPI with endoscopically confirmed good sphincteric-contractility and a positive coaptive response. Kruskal-Wallis test with Dunn post-hoc tests were used to analyze the postoperative outcome differences between the patient groups aged less than 66, 66-75, and over greater than 75 years. Outcome measures were the 24 h pad test, the number of daily pads used, the International Consultation on Incontinence Questionnaire short form (ICIQ-SF), International Quality of Life Score (IQOL), Patient Global Impression of Improvement (PGI-I), International Index of Erectile Function-5 (IIEF-5), International Prostate Symptom Score (IPSS), and Visual Analog Scale scores. Observation time points were 3, 6, 12, 24, 36, 48, 60, and 84 months after surgery. Between the age groups, there was no difference in the success rate of the procedure (defined as 0 pads/24 h and less than 5 g in the 24-h pad test) at any point in time. Subjective parameters measures using the ICIQ-SF, PGI-I, IQOL, and IPSS scores showed no differences between the two cohorts. Only erectile function (IIEF-5 score) was lower in older patients in comparison to the cohort aged less than 66 years (p < 0.05 at 3, 6, 12, 24, 36, and 48 months). The present study complements the European multicentre AdVance XP follow-up study. Here, we show that age at surgery does not affect the objective success, subjective success, or the complication rate. Thus, we do not recommend factoring in chronological age into surgical selection criteria for the AdVance XP implantation.