King's Health Questionnaire Research Articles

Pelvic floor dysfunction and its impact on quality of life among female health care employees.

In today's fast-paced world, both men and women have to be equally competent to handle their responsibilities in order to look after their family members and children. In this pace of competency women tend to forget to take care of their own health and face many health issues, including pelvic floor dysfunction. This study aimed to analyse the prevalence rate of pelvic floor dysfunction among the working women in regards to their age and body mass index as well as their quality of life. One hundred sixty one post-partum working female participants from the medical fraternity were involved in this study after their consent was obtained. Pelvic floor muscle strength was assessed and their quality of life measured using King's health questionnaire. There was a strong correlation between the pelvic floor muscle dysfunction and its impact on the quality of life among the females with increasing age. Significant statistical significant difference of P(<0.0001) was noted. Pelvic floor dysfunction among females has a direct impact on their quality of life.

Impact of parity and delivery mode on pelvic floor function in young women: a 3D ultrasound evaluation.

The objectives were to evaluate clinical and anatomical parameters assessed by three-dimensional pelvic floor ultrasound (3D ultrasound) in parous and nulliparous women of childbearing age and to assess underreported symptoms of sexual dysfunction (SD), urinary incontinence (UI) and flatus incontinence (FI). Women without complaints of pelvic floor dysfunction, aged 20-50 years, were eligible for this prospective cross-sectional study. They completed the King's Health Questionnaire, Female Sexual Function Index and St Mark's Incontinence Score adapted for this study. Next, a physical examination and 3D ultrasound were performed. The scores obtained in the questionnaires were compared with the 3D ultrasound data. In total, 326 women were invited to participate. Of these, 203 women met the inclusion criteria, and their cases were classified as nulliparity (NU, 59), vaginal delivery (VD, 80), forceps delivery (FD, 18) and caesarean section (CS, 48). These groups were homogeneous regarding age (p=0.096), parity (p=0.051) and body mass index (p=0.06). The hiatal dimension (HD; p=0.003) and transverse diameter (TD) (p=0.001) were significantly different among the groups. Compared with the NU and CS groups, the VD and FD groups had an increased HD and TD. The frequencies of underreported symptoms identified by questionnaires were as follows: SD (46.3%), UI (35%) and FI (28%). After VD and FD, women were more likely to present UI (p<0.001), FI (p<0.001) and SD (p=0.002) than the women with NU and those who had undergone a CS. UI was related to a greater HD (p=0.002) and anteroposterior diameter (p=0.022), FI was associated with a thinner left pubovisceral muscle (p=0.013), and SD was related to a greater HD (p=0.026). Three-dimensional ultrasound can identify mild morphological changes in young women with apparently normal physical examinations, mainly after VD and FD. In such individuals, these findings are associated with higher incidences of underreported sexual, urinary and anal symptoms.

Bladder training and Kegel exercises on urinary symptoms in female patients with multiple sclerosis

AbstractThis study was designed to determine the effects of bladder training and Kegel exercises on urinary symptoms and the quality of life in female patients with multiple sclerosis. A pretest‐posttest quasi‐experimental study was conducted. The study was composed of 37 participants from two different hospitals in Turkey. The data collection tools included a Patient Information Form, Expanded Disability Status Scale, Multiple Sclerosis Quality of Life Scale‐54, King's Health Questionnaire, and a bladder diary. Participants were followed through phone consultation seven times during a 3 month period. The participants showed a significant improvement in both the physical and mental health of their quality of life scores compared to the baseline regarding the King's Health Questionnaire Scale, there was an increase in patients' general health perception compared to the baseline. There was reduction in the frequency, nocturia, urgency, and urinary incontinence compared to the baseline at much level of symptoms odds. In this sample, bladder training and Kegel exercises improved quality of life in female patients with MS. These techniques increased the patients'general health perception of their urinary symptoms.

Biopsychosocial profile of women with pelvic organ prolapse: A systematic review.

Female pelvic organ prolapse is a common condition associated with significant impact on women's lives from a biopsychosocial perspective. The aim of this systematic review is to identify, appraise and summarize the biopsychosocial profile of women with pelvic organ prolapse. Searches were completed from inception to October 2022 from PubMed, Web of Science, EMBASE, CINAHL, Cochrane, PsycINFO and PEDro using a search string and in line with the Preferred Reporting Information for Systematic reviews and Meta-Analyses protocol. English language studies (randomized controlled trials, cohort studies, case-control studies, qualitative research) investigating female pelvic organ prolapse and using a validated patient-reported outcome measure and validated pelvic organ prolapse objective measurement were examined. Two reviewers independently screened titles, abstracts and full articles for eligibility. Data extraction included participant characteristics, pelvic organ prolapse grading and outcome measures. Risk of bias was assessed using the appropriate Joanna Briggs Institute Tool. Baseline mean score for each questionnaire or questionnaire domain in each category was presented in tertiles (low, moderate and high impact) to allow simple classification of impact. Of 8341 articles identified, 18 were included (n = 2075 women, age range = 22-85 years, parity range = 0-10). One objective outcome measure graded pelvic organ prolapse: Pelvic Organ Prolapse Quantification measurement. Eleven validated patient-reported outcome measures were utilized; two pelvic organ prolapse-specific (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Pelvic Organ Prolapse Quality of Life Questionnaire), the remainder pelvic health (International Consultation on Incontinence Questionnaire-Vaginal Symptoms, International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, Pelvic Floor Distress Inventory-20, Incontinence Impact Questionnaire-7, Female Sexual Function Index, Urinary Distress Inventory-6, Kings Health Questionnaire, Pelvic Floor Impact Questionnaire-7) or general health questionnaires (Short Form-36). Patient-reported outcome measures included in the review reported moderate levels of pain with sexual intercourse and low levels of bodily pain. Pelvic organ prolapse had a low to moderate impact in sleep/energy and quality of life and sexual function domains. Its impact on physical symptoms and general health perception domains was low. Patient-reported outcome measures results for physical functioning varied from low to high impact. More impact was demonstrated when using pelvic organ prolapse-specific patient-reported outcome measures. There are opportunities for improvement in the use of patient-reported outcome measures in clinical research which would facilitate increased understanding of the biopsychosocial profile of women with pelvic organ prolapse.

Quality of life of patients with microcystis of tuberculous etiology after orthotopic ileocystoplasty

Bladder tuberculosis leads to irreversible reduction of bladder capacity and subsequent shrinkage, which is manifested by persistent impairment of storage function and significant deterioration of the quality of life. Supra-trigonal augmentation ileocystoplasty (AI) and cystecto-my with orthotopic ileocystoplasty (OICP) are standard treatments for microcystis of tuberculous etiology. To date, there is a need for a more detailed study of the qual-ity of life achieved after these methods of treatment and their comparison.Aim: To evaluate quality of life in patients with mi-crocystis of tuberculous etiology after augmentation and orthotopic ileocystoplasty.Materials and methods. Two groups were formed in the study. The first group included 19 patients who underwent bladder resection with preservation of the urothelial triangle and subsequent AI. The second group consisted of 20 patients who underwent cystectomy and OICP. One to six years after the operation the patients were assessed for quality of life. Results. Analysis of the “General health status” scores on the King’s health questionnaire demonstrates a worse quality of life in the group of patients who underwent bladder resection (p=0.013). On the QoL scale, the group of patients who underwent bladder resection showed worse quality of life related to urination than after cys-tectomy (p=0.019). For aspects of quality of life such as: social and physical restriction, personal relationships, general emotional state, sleep, etc., which were assessed by the corresponding domains of the King Health Ques-tionnaire, patients of both groups had similar degrees of severity of restrictions in daily activities and in commu-nication, degradation of personal relationships, deterio-ration of sleep and energy and in general the severity of their condition

Quality of Life of Saudi Women With Chronic Lower Urinary Tract Symptoms.

Background Chronic lower urinary symptoms (LUTS) are reported to affect more than half of women of all ages and have a significant impact on their quality of life (QoL). We aimed in this study to assess the QoL of adult Saudi women with chronic LUTS. Methods A cross-sectional study was done on 390 female patients diagnosed with LUTS at three tertiary care hospitals in Riyadh, Saudi Arabia, from October to December 2021. LUTS are classified into three categories: symptoms related to bladder storage (increased daytime frequency, nocturia, and urinary incontinence [UI]), symptoms of bladder voiding (hesitancy, extended micturition time, and insufficient emptying), and symptoms involved in the post-urination phase such as post-micturition dribbling. The data was collected using a self-administered questionnaire which comprised demographic characteristics, International Prostate Symptom Score (IPSS) for assessment of LUTS severity, and King's Health Questionnaire (KHQ) for assessment of QoL. Results After analyzing the study results, we found that symptoms were mild, moderate, and severe in 11%, 51%, and 39% of participants, respectively. Increased age and parity were found to have a significant association with increased symptom severity (p-value <0.05). The current study reported a moderate effect of LUTS on QoL. There was a significant correlation between increased symptom severity and negative impact on QoL, excluding the personal relationships domain. The highest scores in KHQ, which indicate worse QoL, were found in the domains of incontinence impact and emotions, while the lowest scores, which indicate better QoL, were found in the domains of social limitations and severity measures. Employed females were found to have worse QoL in the severity measures domain, which refers to the degree of urinary symptoms affecting day-to-day functioning. In addition, younger age, below 45 years, was found associated significantly with better QoL, especially in the domains of general health, personal relationships, and severity measures. Conclusion In the current study, the majority of patients reported moderate symptoms severity. Chronic LUTS have a significant impact on the QoL of Saudi women in many aspects, including physical, social, and emotional health, especially for those who have moderate to severe symptoms. Healthcare providers should assess high-risk women for the presence of LUTS. Furthermore, we recommend evaluating the QoL of patients with LUTS as a part of routine management.

Dfree ultrasonic sensor in supporting quality of life and patient satisfaction with bladder dysfunction

AbstractBladder dysfunction is physically and mentally stressful. Long‐term catheterization is indicated as conservative therapy for chronic urinary retention as well as urinary incontinence; although an indwelling, transurethral catheter still represents a risk factor for ascending urinary tract infection and urosepsis. The primary outcome of this study was the impact of the DFree ultrasonic sensor on the subjectively perceived quality of life and satisfaction of patients. The secondary outcomes evaluated were usefulness, ease of use (user‐friendliness), quality of care, and self‐reported degree of autonomy. In this pilot study, 18 urological patients with various kind of bladder dysfunction were treated with an ultrasonic sensor for at least 12 h a day over a 3‐month period. Assessment was conducted using the Kings Health Questionnaire (KHQ) and the German version of the Client Satisfaction Questionnaire (ZUF‐8) (quantitative data) and guided interviews (qualitative data). Eighteen participants were included in this study. Participants highly appreciated the ideas and concepts of the device. A change in KHQ after treatment could not be statistically confirmed; however, the average value in ZUF‐8 showed satisfaction with Dfree. However, no significant improvement was observed in the quantitative data. During the interviews at the end of the testing phase, the participants provided positive feedback with specific suggestions to improve device usability. The application was described as helpful and easy to use. Data triangulation illustrates that an improvement in technical implementation could increase device usefulness. This would imply higher patient satisfaction when using the device for bladder dysfunction.

Treatment for overactive bladder: A meta-analysis of tibial versus parasacral neuromodulation.

Background:The study aimed to assess the efficacy and safety of parasacral neuromodulation (PNS) versus tibial nerve stimulation (TNS) for patients with overactive bladder (OAB).Methods:Databases including PubMed, Embase, clinicalTrial.gov, and Cochrane Library Central Register of Controlled Trials were systematically searched from January 1, 1999 to September 9, 2022. The improvements in a 3-day voiding diary were set as the primary outcomes. Then, the scores of overactive bladder-validated 8-question awareness tool (OAB-V8), King’s health questionnaire (KHQ), and international consultation on incontinence questionnaire overactive bladder (ICIQ-OAB) were also evaluated.Results:Five articles (4 randomized controlled trials [RCTs] and 1 prospective study) including 255 OAB patients were enrolled. Two kinds of neuromodulations had similar performances in the micturition (mean difference [MD] = 0.26, 95% confidence interval [CI]: –0.51 to 1.04, P = .50), urgency episodes (MD = –0.16, 95% CI: –0.64 to 0.31, P = .50), incontinence episodes (MD = 0.09, 95% CI: –0.41 to 0.59, P = .72), as well as in the nocturia episodes (MD = 0.04, 95% CI: –0.45 to 0.52, P = .89). Furthermore, there was no difference regarding ICIQ-OAB scores (P = .83), KHQ (P = .91), and OAB-V8 scores (P = .83). Importantly, included studies reported no adverse events in the 2 groups.Conclusion:TNS and PNS had similar effectiveness for the treatment of OAB, moreover, without any identified adverse events in both groups. However, well-designed RCTs are stilled needed to verify our results.

The Effects of Pelvic Floor Muscle Exercise Combined with Core Stability Exercise on Women with Stress Urinary Incontinence following the Treatment of Nonspecific Chronic Low Back Pain.

Aim To compare the combined effects of core stability exercise and pelvic floor muscle exercise (PFME) with the effects of PFME alone on women with stress urinary incontinence (SUI) who experience nonspecific chronic low back pain (NSCLBP). Methods A stratified randomized controlled trial study (RCT) was conducted with 50 women with SUI who experienced LBP, aged 18–60 years and with pad weight ≥2 grams for the one-hour pad test. The respondents were divided into two groups: the intervention group (PFME + core stability exercise) and the control group (PFME). The primary outcomes were the amount and frequency of urine leakage, which were measured using the one-hour pad test and the Bengali-ISI subjective questionnaire. A secondary outcome was quality of life (QoL), which was measured using King's Health Questionnaire (KHQ). An ITT analysis was conducted using repeated measures ANOVA (2 × 2) with Bonferroni's post-hoc analysis. Results/Preliminary Findings. The findings illustrated that 72% (n = 18) of the intervention and 28% (n = 7) of the control group participants showed improvement in UI after 12 weeks of intervention. In addition, the amount and frequency of urine leakage significantly decreased in the intervention group compared to the control group (p ≤ 0.001). Conclusion The RCT-illustrated improvement of SUI in women with nonspecific chronic low back pain, reduction of frequency, and improvement of the QoL were more evident from PFME with core stability exercise than from PFME alone.

Quality of life in elderly women with urinary incontinence who do or do not undergo pelvic physiotherapy

Background: human aging brings with it several chronic conditions, including urinary incontinence, which is more prevalent in women, which can occur due to effort, urgency or both. Pelvic physiotherapy is the gold standard treatment for this pathology, obtaining results quickly and efficiently. Objective: to address and understand the impact of urinary incontinence on quality of life in elderly women. Method: quantitative study, intervening with 20 elderly women divided into GIF and GINF groups, the WHOQOL-OLD, King's Health Questionnaire, MMSE and sociodemographic form were used for data collection. Data were tabulated in a Microsoft Office Excel 2010 spreadsheet and later analyzed by Software Past. Results: better quality of life was observed in the elderly in the GIF group, but not significantly, taking into account that the vast majority of the elderly in the GINF group do not care and believe that urine loss does not interfere with their quality of life. Conclusion: Pelvic physical therapy is essential in the treatment of UI in elderly women, directly improving quality of life.

Frequency of Different Types of Urinary Incontinence and Their impact on Quality of Life of Pakistani Women

The International Continence Society (ICS) defines Incontinence of urine as involuntary loss of urine. Objective: To determine the frequencies of different types of incontinence of urine and their impact on quality of life of Pakistani women. Method: Descriptive observational study was conducted at outpatient department of five centers. Three validated questionnaires were used for quality-of-life assessment, International Consultation Incontinence Questionnaire Short Form (ICIQ-SF), Medical Outcome Study 36 items Short Form (SF-36) and King's Health Questionnaire (KHQ). Result: The study included 436 women. The most frequent type of incontinence of urine was mixed (n=281, 64.45%) followed by stress incontinence (n=129, 29.59%) and urge incontinence (n=26, 5.96%). The women suffering from mixed type of incontinence of urine had maximum effect on quality of life both general and specific. Conclusions: All types of incontinence of urine had an effect on quality of life but the mixed type had more impact.

Spanish cross-cultural adaptation and validation of the Australian Pelvic Floor Questionnaire in running women

Pelvic floor dysfunctions are a wide range of disorders in the gynaecological, lower urinary and gastrointestinal tracts that affect the structure and/or function of the pelvic organs. The objective of this study was to carry out a cross-cultural adaptation and a psychometric analysis of the Spanish version of the Australian Pelvic Floor Questionnaire. Observational study divided into two main phases: (1) translation and cross-cultural adaptation and (2) psychometric tests. Women runners from all over the Spanish territory, from different federations, clubs and levels were recruited. Participants: 424 female runners, native Spanish, over 18 years of age and who had been practicing running for more than 6 months. The instruments used in this study were the Australian Pelvic Floor Questionnaire, Female Sexual Function Index, King Health Questionnaire, Quality of Life SF-12 and EuroQoL 5-D. The Spanish version of Australian Pelvic Floor Questionnaire has proven to be an understandable and easy-to-use tool. The general internal consistency of the questionnaire was 0.972 and the intraclass correlation coefficient ranged between ICC 0.596–0.960. The Spanish version of Australian Pelvic Floor Questionnaire is a valid and reliable measure that can be used clinically to assess pelvic floor dysfunctions among the female Spanish population.

Non-ablative Er:YAG laser treatment for stress urinary incontinence (SUI)

To evaluate efficacy and safety of the FotonaSmooth device in treatment of SUI (stress urinary incontinence) patients after treating them with Er: YAG laser using both objective and patient-reported outcomes. Stress urinary incontinence (SUI) is a leakage of urine during moments of physical activity that increases abdominal pressure, such as coughing, sneezing, laughing, or exercise. It is most common seen health problem among women of certain age and it is most common type of urinary incontinence in women. Here, SUI is treated using intravaginal laser therapy by using non ablative Er: YAG (erbium-doped yttrium aluminium garnet) laser with SMOOTH mode technology.: The 96 parous women with SUI were treated according to IncontiLaseclinical treatmentprotocol by using non-ablative Er: YAG (erbium-doped yttrium aluminium garnet) laser with SMOOTH mode technology at Vcare laser centre state of art centre for cosmetic gynaecology, Indore, Madhya Pradesh. At baseline, at 2 months and at 9 months after treatment patients were clinically examined, answered questionnaires for SUI severity and sexual function assessment. King‘s Health Questionnaire (KHQ); UDI-6 (Urogenital Distress Inventory, Short Form) Questionnaire; 3D Voiding Diary ;Satisfaction Questionnaire (0-3) which was used for assessment of relief of symptoms (complaints) and satisfaction. Patients were monitored for side-effects and discomfort during treatment period and follow-up period.A total of 96 patients suffering from mild-to-moderate stress urinary incontinence underwent treatment with an Er:YAG (2940 nm) laser in non-ablative fractional mode, which requires 2-3 sessions with one month interval (Out of 96 patients- 96 patients completed the first session; 72 patients completed two sessions and 30 patients completed three sessions). Out of which 75% patients were very satisfied with the treatment and outcome. The Enrolment of study participants was started in September 2017 and completed in April 2019.The non-ablative Er: YAG laser therapy improves the impact of SUI symptoms in parous women significantly better than placebo by improving the quality of life and sexual function; it also provides a promising minimally invasive safe treatment for stress urinary incontinence (SUI) confirmed by the preliminary results.

Impact of Urinary Incontinence on Quality of Life Among Women of Childbearing Age in Al Madinah Al Munawara, Saudi Arabia.

IntroductionUrinary incontinence (UI) is a widely prevalent problem with a great impact on quality of life. It affects a person’s physical, social, occupational, and phycological aspects of life. Our study aimed to estimate prevalence, risk factors, effect on life, and help-seeking behaviors among women with urinary incontinence. Methods This is a cross-sectional analytic study conducted in primary health care centers among women of childbearing age in Al Madinah Al Munawara, Saudi Arabia. A total of 342 women aged between 18 to 50 years were included and interviewed using a previously validated and pretested Arabic version of the King's Health Questionnaire (KHQ). ResultOut of 342 patients, 71 (20.8%) had UI. The mean age of the patients was 31.51 +9.36 years. Risk factors associated with UI were: BMI (p = 0.022, odds ratio = 1.06), multiparity (p = 0.027, odds ratio = 1.16), smoking (p = 0.018, odds ratio = 4.71), and chronic constipation (p = 0.013, odds ratio = 5.83). Only 28.2% of the affected women sought medical consultation. The main reasons for not seeking medical advice were the belief that UI is a common, normal aging process in 45%, while 14.1% were embarrassed by the condition, and 5.6% did not know that there was a treatment. Overall, there was a limitation in all domains of quality of life among patients who suffer from UI. The majority of limitations were slight to moderate. The most affected domain was sleep and energy.Conclusion UI is common and adversely affects the quality of life of women of childbearing age in Al Madinah Al Munawara. Obesity, multiparity, smoking, and chronic constipation are significant risk factors. Less than half of patients with UI sought medical care.

Sexual activity of aged Japanese women who visited a female urological outpatient clinic

ABSTRACT Introduction The previous reports according to sexual activity of aged woman is limited. Sexual activity of aged women would be related to QOL of them. Recently, sexual dysfunction of aged women recognized as Female Sexual Dysfunction (FSD). Objective To clarify the sexual activity of aged Japanese women, sexual activity of the female patients who visited a female urological outpatient clinic was investigated. Methods Between June 2010 and August 2018, 404 aged female patients who visit our female urological outpatient clinic and answered the King's Health Questionnaire (KHQ) were enrolled in this study. The main chief complaint of these patients was pelvic organ prolapse. Self-reported data of KHQ, question number 5a and 5b which ask the patients about the relationship between urine voiding and sexual activity were reviewed retrospectively. Associations between sexual activity (as reported in the questionnaire) and patients’ background, partners status, and change of sexual activity after treatment for pelvic organ prolapse were analyzed. Results The mean age of the patients was 71.0 years, with 80.9% in their 60s and 70s. Sexual intercourse was practiced by 19.7% (n = 77) of all patients with 40.0% in their under 50s, 27.9% in their under 60s, 15.2% in their 70s, and 0% in their 80s. 31.2% (n = 119/381) of patients had their partners. Among the patients with a partner, the percentage who practiced sexual intercourse was 58.0% of all patients with 65.4% and 55.6% of women in their 60s and 70s, respectively. Among the patients who had sexual intercourse, 64.9% had chief complains of pelvic organ prolapse. 71% of patients who had sexual intercourse received surgery and 91% of them was tension-free vaginal mesh (TVM). After the surgery 63.8% of patients continued sexual activity. Conclusion A patient survey revealed the sexual activity of a Japanese older female population who visited a urological outpatient clinic with the chief complaint of pelvic organ prolapse. Disclosure Work supported by industry: no.

The Relationship between Anxiety and Depression Levels and General Health Status before and 12 Months after SUI Treatment in Postmenopausal Women from the Lower Silesian Population.

Menopause is often the cut-off point from which most cases of stress urinary incontinence (SUI) in women begin. This dysfunction affects not only the physical experience of the patient, but is also related to the psychological aspects, leading to a reduced quality of life. Despite the large number of patients with SUI and the frequent use of surgical treatment for this condition, there are few scientific reports evaluating the effectiveness of the procedure in terms of reducing depressive symptoms or improving overall health. The aim of this study was to evaluate the relationship between anxiety and depression and general health status before and 12 months after surgical treatment for SUI in postmenopausal women. Seventy-five patients qualified for the study, but due to the long study duration, both sets of questionnaires were eventually obtained from 60 postmenopausal patients. All patients that qualified for the study had a trans obturator tape (TOT) procedure. All patients enrolled in the project were given the Hospital Anxiety and Depression Scale (hAdS) and King’s Health Questionnaire (KHQ). After 12 months of surgery with midurethral slings, symptoms of depression were present in only a small number of subjects, 11.7%, and anxiety was present in 13.3% of the entire group. The study confirms that patients with a general poor health condition may suffer from depression or anxiety, and therefore may also need psychological treatment. Patients with SUI should therefore receive therapeutic care from a multidisciplinary team, in which therapeutic activities are divided between doctors, nurses, physiotherapists and psychologists. As a result of the treatment, after 12 months, we confirmed a significant improvement in patients with depression and anxiety disorders.

Brazilian version of the King's Health Questionnaire: assessment of the structural validity and internal consistency in female urinary incontinence.

The use of valid patient-reported outcome measurements is essential in clinical and research settings. The structure of the Brazilian version of the King's Health Questionnaire (Br-KHQ) has not been evaluated. Thus, this study sought to evaluate the structural validity and internal consistency of the multi-item domains of the Br-KHQ in women with urinary incontinence (UI). A total of 462 Brazilian Portuguese speakers with UI aged 18 years or older were included in this study. Participants answered the Br-KHQ, and a questionnaire containing demographic and personal information. The structure of the Br-KHQ was examined through Exploratory Factor Analysis (EFA) with the implementation of parallel analysis and evaluated using confirmatory factor analysis (CFA). For the latter, several goodness-of-fit indices were considered to evaluate the model fit of the structures tested in this study. Internal consistency was assessed using Cronbach's alpha, composite reliability, and coefficient omega. The EFA showed that the questionnaire has a five-factor structure, i.e., limitations of daily life, personal relationship, emotions, sleep/energy, and severity measures. The CFA demonstrated that this structure presented the most adequate goodness-of-fit indices and the lowest values of Akaike information criterion and Bayesian information criterion, compared with the original and Portuguese structure. High values (>0.70) of internal consistency were found. The Brazilian version of the KHQ is composed of a five-factor structure. Further studies should evaluate other measurement properties of the Br-KHQ to ensure reliable interpretation of this patient-reported outcome measure in clinical practice.

Influence of background characteristics in responders of regenerative therapy by periurethral injection of adipose-derived regenerative cells for male stress urinary incontinence.

To determine if the male responders with post-prostatectomy incontinence in the ADRESU study, which is a clinical trial of regenerative therapy by periurethral injection of adipose-derived regenerative cells, are influenced by any background characteristics. Briefly, autologous adipose-derived regenerative cells isolated from abdominal adipose tissue and a mixture of adipose-derived regenerative cells with fat tissue were transurethrally injected into the rhabdosphincter and submucosal space of the urethra, respectively. Sixteen out of 43 patients (37.2%) responded to treatment (responders) and exhibited improvement in the urine leakage volume, defined as >50% reduction from baseline determined by the 24-hour pad test at 52 weeks of treatment (or last visit within 52 weeks). Background data such as age, body weight, method of prostatectomy, baseline frequency of leaks, number of leaks, number of pad changes, International Consultation on Incontinence Questionnaire-Short Form, King's Health Questionnaire, urodynamic urethral function including functional profile length and maximum urethral closure pressure, and abdominal leak point pressure were collected and compared between responders and nonresponders. None of the background factors influenced improvement in the responders as compared with the nonresponders. However, a significant between-group difference in the rates of decrease in urine leakage volume was noted in patients of younger age (<70 years), compared with those of older age (≥70 years) from 2 to 26 weeks of treatment. A greater decrease in urine leakage volume was noted in the younger patient group than in the older patient group.

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.

Cross-cultural adaptation and measurement property analysis of the Brazilian Portuguese version of the Three Incontinence Questionnaire.

The differential diagnosis of urinary symptoms may allow health professionals to establish a therapeutic objective and to choose the appropriate treatment for the patient's complaint. The aim of this study was to cross-culturally adapt the Three Incontinence Questionnaire (3IQ) into Brazilian Portuguese (3IQ-Br) and to analyze test-retest reliability, construct, and criterion validity in women. The cross-cultural adaptation of the 3IQ-Br included forward-translation, back-translation, and consensus among an expert committee. Participants with and without urinary incontinence (UI) completed the 3IQ-Br, King's Health Questionnaire (KHQ), and Questionnaire for Female Urinary Incontinence Diagnosis (QUID-Br). Only women with UI answered 3IQ-Br after 7-10days. Test-retest reliability and construct validity were analyzed using the Cohen linear kappa (k). The 3IQ-Br accuracy was analyzed using the area under the curve (AUC) of the receiver-operating characteristic (ROC) curve, considering the sensitivity and specificity to correctly classify women with and without UI. The reliability of each question from the 3IQ-Br was considered substantial in the test-retest. The agreement among 3IQ-Br, QUID-Br, and KHQ was almost perfect for UI diagnosis (k > 0.8). The 3IQ-Br was considered to have good accuracy in distinguishing women with UI considering the KHQ (AUC 0.83, 95% confidence interval [CI] 0.78 to 0.87, p < 0.001), and fair to the QUID-Br (AUC 0.73, 95% CI 0.68 to 0.78; p < 0.001). The results of this study showed that this version of the 3IQ-Br has acceptable measurement properties for identifying and differentiating UI symptoms in Brazilian women.