Occurrence Of Urinary Incontinence Research Articles

Multifaceted Impact of CO2 Laser Therapy on Genitourinary Syndrome of Menopause, Vulvovaginal Atrophy and Sexual Function.

Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder-urethral regions related to menopause changes, negatively influencing woman's quality of life and sexual activity. Fractional micro-ablative CO2 laser therapy has shown the potential to reinstate the vaginal epithelium to a condition akin to the premenopausal state, thereby ameliorating the subjective symptoms associated with GSM. We conducted a prospective, pilot study in 73 sexually active postmenopausal women treated with CO2 laser for their GSM symptoms, while assessing Vaginal Health Index Score (VHIS) and sexual function through the Female Sexual Function Index (FSFI) Questionnaire. The laser treatment resulted in a decrease in VHIS and patient-reported vulvovaginal atrophy (VVA) symptoms, with a significantly lower prevalence of vaginal itching, dryness, and burning (p < 0.001), as well as dyspareunia (p = 0.002). The occurrence of urinary incontinence, urgency, and vaginal heaviness significantly reduced, with an improvement in the staging of cystocele, either to Stage 1 or complete resolution (p < 0.001). FSFI total and domain scores were significantly higher after the treatment, indicating better sexual function, with a post-treatment score median of 25 (p < 0.001). Therefore, using a three-cycle fractional CO2 laser was an effective choice for reducing urogenital discomfort related to GSM in postmenopausal women.

Knowledge of the Nursing Team about Urinary Incontinence and Fecal Incontinence in Institutionalized Elderly

The increase in life expectancy and the decrease in fertility rates represent the new demographic sense in Brazil and in the world. The main consequence of population aging is mainly the new challenges in the treatment of pathologies resulting from advancing age and how to treat our new elderly. Among the existing geriatric diseases, the occurrence of Urinary Incontinence (UI) and Fecal Incontinence (FI) is common, representing a challenge to health professionals, especially nursing. Given this scenario, how prepared is the nursing team to face these pathologies? Objective: To analyze the knowledge of nurses in the identification of Urinary and Fecal Incontinence in institutionalized elderly people. Method: this is a cross-sectional and descriptive research, with quantitative analysis. It was carried out in a Long-Term Care Institution for the Elderly with nurses, who agreed to participate in the research. Data collection took place in the first week of September 2023, on alternating days and shifts to include all employees of the institution. The data were organized in tables and imported into an Excel file for analysis by the researchers. Results: The sociodemographic results showed that most of the team was composed of nurses with more than 5 years of training, more than 10 years of work experience, and the vast majority did not have postgraduate, master's or doctoral degrees. The specific results showed that most nurses recognize FI and IA, but do not recognize the role of nurses in intervening in the pathological process, considering it as normal due to advancing age. Conclusion : Nurses are involved daily in daily practices aimed at institutionalized elderly people, making it important to have a qualified stomatherapist who can assist in conducting FI and IU. In addition, the need for research to strengthen this theme is highlighted.

De novo urinary incontinence and lower urinary tract symptoms after colpocleisis: A single-center prospective study

BackgroundColpocleisis is one of traditional surgical procedures for elderly and frail women with advanced pelvic organ prolapse. The occurrence of de novo urinary incontinence following colpocleisis was considered to impair the postoperative quality of life. The incidence of de novo urinary incontinence after colpocleisis has been reported to be ranging from 6.6 % to 27 %. There was an absence of prospective large-sample study to investigate the accurate incidence of de novo urinary incontinence following colpocleisis and the impact on the quality of life till now. Purposes The primary objective was to report the incidence of de novo urinary incontinence after colpocleisis. The second objectives were to evaluate the long-term quality of life in patients with de novo urinary incontinence, and to conduct detailed pre- and post-operative evaluations of lower urinary tract symptoms. MethodsThis prospective study included 253 patients with symptomatic pelvic organ prolapse who underwent colpocleisis between 2009 and 2021. De novo urinary incontinence was defined as the occurrence of urinary incontinence 3 months postoperatively. All patients were required to complete the Urinary Distress Inventory questionnaire and the Urinary Impact Questionnaire for the evaluation of patients' quality of life, and the Patient Global Impression of Improvement questionnaire for the evaluation of patients’ satisfaction. Results245 patients (245/253, 96·8 %) completed the 3-month follow-up, and were included in the final analysis. The incidence of de novo urinary incontinence was 5.4 % (10/185). There was no significant difference in the Urinary Distress Inventory −6 scores (22.50 vs. 10.30, P = 0.276) or the subjective satisfaction rate (100 % vs. 98.9 %, P = 0.250) between the patients with or without de novo urinary incontinence at the long-term follow-up. The incidence of voiding difficulty was significantly reduced after colpocleisis (27.8 % vs. 0.0 %, P < 0.001). The patients’ quality of life indicated by Urinary Distress Inventory-6 and Urinary Impact Questionnaire-7 scores were significantly improved postoperatively (26.27 vs. 13.39, and 19.13 vs. 6.05, P < 0.05). ConclusionThe incidence of de novo urinary incontinence after colpocleisis was very low. Patients’ quality of life, and low urinary tract symptoms were significantly improved after colpocleisis.

L’hydrocéphalie à pression normale idiopathique peut favoriser la survenue d’une fracture du fémur proximal

AimsThe clinical triad of idiopathic normal pressure hydrocephalus (iNPH) includes gait disturbance, dementia, and urinary incontinence. These symptoms are also frequently observed in patients with proximal femoral fracture (PFF). The aim of this study was to investigate the relationship between PFF and iNPH retrospectively. Patients and methodsOf the130 patients over 80 years old with PFF included in this study, 48 were assigned to the PFF group. Forty-eight patients with peripheral vertigo matched with the PFF group for age and sex were included in the control group. We compared the Evans’ index (EI), which is a head computed tomography finding of iNPH, and the percentages of patients with EI>0.3 between the two groups. The PFF group was further divided into two subgroups depending on whether EI was higher or lower than 0.3 (the higher or lower subgroup, respectively). We compared the patient's gait abilities before PFF, causes of PFF, cognitive functions, and occurrence of urinary incontinence between both groups. ResultsThe mean value of EI in the PFF group was significantly higher than that in the control group (PFF group, 0.301; control group, 0.284; p=0.008). The percentages of patients with EI>0.3 in the PFF and control groups were 62.5% and 35.4%, respectively (p=0.014). In subgroup analyses, the gait ability before injury was worse in the higher subgroup than that in the lower subgroup and was prominent among individuals who could walk only with human assistance (p=0.018). There were no significant differences in other parameters. ConclusionElderly patients with PFF may have underlying idiopathic normal pressure hydrocephalus. Level of evidenceIII; case-control comparative study.

Correction to: Relationship between exposure to cadmium, lead, and mercury and the occurrence of urinary incontinence in women

Correction to: Relationship between exposure to cadmium, lead, and mercury and the occurrence of urinary incontinence in women

Idiopathic normal pressure hydrocephalus possibly affects the occurrence of proximal femoral fracture

AimsThe clinical triad of idiopathic normal pressure hydrocephalus (iNPH) includes gait disturbance, dementia, and urinary incontinence. These symptoms are also frequently observed in patients with proximal femoral fracture (PFF). The aim of this study was to investigate the relationship between PFF and iNPH retrospectively. Patients and methodsOf the130 patients over 80-years-old with PFF included in this study, 48 were assigned to the PFF group. Forty-eight patients with peripheral vertigo matched with the PFF group for age and sex were included in the control group. We compared the Evans’ index (EI), which is a head computed tomography finding of iNPH, and the percentages of patients with EI>0.3 between the two groups. The PFF group was further divided into two subgroups depending on whether EI was higher or lower than 0.3 (the higher or lower subgroup, respectively). We compared the patient's gait abilities before PFF, causes of PFF, cognitive functions, and occurrence of urinary incontinence between both groups. ResultsThe mean value of EI in the PFF group was significantly higher than that in the control group (PFF group, 0.301; control group, 0.284; p=0.008). The percentages of patients with EI>0.3 in the PFF and control groups were 62.5% and 35.4%, respectively (p=0.014). In subgroup analyses, the gait ability before injury was worse in the higher subgroup than that in the lower subgroup and was prominent among individuals who could walk only with human assistance (p=0.018). There were no significant differences in other parameters. ConclusionElderly patients with PFF may have underlying idiopathic normal pressure hydrocephalus. Level of evidenceIII; case-control comparative study.

Relationship between exposure to cadmium, lead, and mercury and the occurrence of urinary incontinence in women.

Cadmium, lead, and mercury are nephrotoxic metals that are commonly found as hazardous pollutants in many areas of the USA. We examined the relationship between exposure to cadmium, lead, and mercury with the occurrence of urgency urinary incontinence (UUI) and stress urinary incontinence (SUI) in women. This study was conducted using data on women > 20years of age, collected between 2005 and 2016, who reported experiencing urinary incontinence in the National Health and Nutrition Examination Survey (NHANES). Restricted cubic spline analysis was used to characterize a dose-response relationship between continuous exposure to different nephrotoxic metals and the occurrence of UUI and SUI. A total of 4406 women were included in this study, with 2624 (59.6%) suffering from SUI and 3177 (72.1%) suffering from UUI in the weighted population. The results of our multivariate analysis indicated that age, race, marital status, body mass index (BMI), and exposure to nephrotoxic metals were risk factors for developing UI. The odds ratio (OR; 95% confidence interval) for developing UI was positively correlated with the exposure to cadmium and lead in women. The OR of SUI occurrence increased with increasing levels of cadmium in blood, with a peak at 4µg/L. The OR of UUI occurrence increased with increasing levels of blood and urinary lead, with peaks at 7µg/dL and 5µg/L, respectively. The presence of mercury was not significantly correlated with the occurrence of SUI or UUI. Exposure to high levels of cadmium and lead, which are nephrotoxic metals, is associated with the occurrence of UI in women.

Factors associated with urinary incontinence in volleyball athletes: a cross-sectional study

The article has the purpose of identify the factors associated with the occurrence of urinary incontinence (UI) among volleyball athletes. This is a cross-sectional study conducted with female athletes of court volleyball. An interview was conducted to identify the factors associated with UI. The presence of urinary loss was identified using the Urinary Distress Inventory 6 (UDI-6). The associated factors found were divided into those related to sociodemographic (education and marital status), behavioral (constipation occurrence), obstetric (previous pregnancies), hereditary (skin color), and sports practice variables (sports level, volleyball position, time of sports practice in years, physical and tactical training routine, and daily water intake). The Chi-square test or Fisher's exact test, Mann-Whitney U test, and binary logistic regression model were used. This study included 83 volleyball athletes with a mean age of 26.6 (± 7.2) years. It was found that 25.3% of the volleyball athletes presented UI and those that reported symptoms of constipation were 10 times more likely to develop UI than those without constipation. Women who practice high-impact sports in a professional manner, such as volleyball, should be aware of the symptoms of pelvic floor dysfunction, since they will be predisposed to urine leakage. The finding that a considerable number of athletes report UI and that long-term sports practice exposes athletes to a higher risk of UI indicates that pelvic exercises should be proposed in order to reduce these symptoms.

URINARY INCONTINENCE IN YOUNG AND NULLIPAROUS WOMEN: ASSOCIATED FACTORS AND PREVALENCE

Objective: To verify the prevalence and risk factors associated with urinary incontinence in nulliparous young women. Methods: Integrative literature review, performed by searching the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), Spanish Bibliographic Index in Health Sciences (IBECS) and in the Nursing Database (BDENF), from March to June 2021, using the descriptors: “urinary incontinence”, “prevalence”, “women”, “students” and “young adult” combined with the Boolean operator “AND”. Results: The initial search resulted in 234 articles and, after applying the eligibility criteria, a final sample of 5 articles was obtained. After the analyses, a prevalence of urinary incontinence in young nulliparous women of 48% was evidenced. Risk factors were: high-impact physical activity, duration of physical activity, concomitant bowel and urinary symptoms. Conclusion: It was observed that the occurrence of urinary incontinence in nulliparous young women is a common condition. The associated risk factors demonstrate the need for health guidance to these women to avoid the chronification of the disease.

URINARY INCONTINENCE AND BODY IMAGE IN HIGH-RISK AND USUAL RISK PREGNANT WOMEN

Pregnancy can be defined as a period of approximately 40 weeks, in which physiological and mechanic adaptations occur, along with strong psychological modifications. Being a moment of vulnerability, it can be negatively influenced by factors such as urinary incontinence (UI), high-risk pregnancy or even a negative body image. Thus, the aim of this study was to compare body image and the occurrence of urinary incontinence in high-risk and usual risk pregnant women. An observational study with a quantitative and cross-sectional approach was conducted to evaluate the occurrence of urinary incontinence and body image of pregnant women. The sample was divided into two groups: high-risk (n=34) and usual risk (n=31) pregnant women. For the data collection, an identification file was applied, collecting data such as obstetric history, followed by the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF), and the Body Image Measurement Scale (BIMS). It was observed that both groups were dissatisfied with body image, and urinary incontinence occurrence was moderately above to what is found in literature. No relationship between urinary incontinence and body satisfaction was observed in either group. There was no relationship between urinary incontinence and body image. The pregnant women from both groups presented dissatisfaction regarding body image, and the occurrence of urinary incontinence was slightly higher than that observed in literature (50% of occurrence according to national estimates, especially during pregnancy and puerperium).

Evaluation of features associated with urinary incontinence in women

AbstractWe aimed to evaluate the features (occurrence, type, severity, risk factors and quality of life) associated with urinary incontinence in women. Urinary incontinence is a global issue. Many factors can lead to urinary incontinence, but some factors remain debatable. It is thought that the rate of urinary incontinence will decrease with the determination of risk factors. According to Abrams et al., urinary incontinence is three times more prevalent in women than in men. In a systematic review including 12 studies conducted by Seshan et al., it was concluded that the main risk factors for urinary incontinence are age, parity, body mass index, menopause, recurrent urinary tract infections, hysterectomy, miscarriage, fetal weight and comorbid conditions such as diabetes, chronic lung disease. Average life expectancy is increasing around the world. According to Milsom and Gyhagen with the increase in average life expectancy, it is predicted that the frequency of incontinence and the rate of women needing treatment will rise in the future and that health expenditures will increase consequently. A descriptive, cross‐sectional study was conducted from September to December 2020 using an online questionnaire. In total, 400 women were recruited. The online questionnaire contains questions to determine the socio‐demographic of women and urinary incontinence for risk factors in women and International Consultation on Incontinence Questionnaire‐Urinary Incontinence Short Form. Data were entered and analysed using SPSS. Chi‐square tests were used to assess associations between categorical variables. Statistically significant variables (p &lt; 0.05 and p &lt; 0.001) were then analysed by logistic regression. Occurrence of urinary incontinence was 39% (156/400). The top three types of urinary incontinence were found to be stress (38.5%), urgency (27%) and mixed (23.7%) incontinence. Frequency of urinary incontinence was once a week or less frequent in 54.5% of the women with urinary incontinence and that the severity of the urinary incontinence was mild in 70.5%. Risk factors for urinary incontinence included age, educational status, body mass index, history of macrosomic baby (birth weight &gt; or =4 kg), consuming acidic beverages and spicy foods, episiotomy, type of birth, menopause, recurrent urinary tract infection, having a member of family with a history of urinary incontinence, and lack of physical activity. It was determined that factors increasing the risk for urinary incontinence the most are age and body mass index. Urinary incontinence is an important public health problem affecting women in the reproductive age, too.Highlights Urinary incontinence is a global issue. Many factors can lead to urinary incontinence, but some factors remain debatable. Urinary incontinence is an important public health problem affecting women in the reproductive age, too. Average life expectancy is increasing around the world. Therefore, the number of women with incontinence problems is expected to increase.

Urinary Incontinence in Climacteric Women With or Without Depressive Symptoms: A Cross-Sectional Study.

This study aimed to investigate whether the occurrence of urinary incontinence (UI) is associated with increased odds of depression in perimenopausal and postmenopausal women. This cross-sectional study included 208 women with depressive symptoms, confirmed by the Beck Depression Inventory, and 247 patients without depression. All participants were perimenopausal or postmenopausal women aged 35 to 65 years who attended an outpatient clinic from a tertiary-academic hospital in Northeastern Brazil. Urinary incontinence symptoms were assessed using patient's self-report and the validated versions of the International Consultation on Incontinence Questionnaire-Short Form and the Questionnaire for Urinary Incontinence Diagnosis. To investigate the severity of climacteric symptoms, the Blatt-Kupperman Index was used, and menopause-related quality of life was analyzed using the Utian Quality of Life Questionnaire. In univariate analysis, the Beck Depression Inventory-II mean scores for UI and non-UI women were, respectively, 15.5 (95% confidence interval, 14.28-16.72) and 11.83 (10.52-13.13; P < 0.05). Patients with moderate and severe scores of depression reported higher International Consultation on Incontinence Questionnaire-Short Form and Questionnaire for Urinary Incontinence Diagnosis scores when compared with women with mild depression scores and women without depression (P < 0.001). Conversely, in multivariate analysis, having UI was not associated with having depression (odds ratio [OR], 0.85; 0.52-1.37; P = 0.50), after adjusting for confounders. Older age (>55 years) was associated with decreased odds of depression (OR, 0.43; 0.21-0.88; P = 0.02), whereas moderate (OR, 2.28; 1.40-3.71; P = 0.001) and severe (OR, 7.70; 2.79-21.23) intensities of menopause symptoms were associated with increased odds of depression. Urinary incontinence was not associated with depression within climacteric women after multivariate analysis.

Outcomes associated with vaginectomy and vulvovaginectomy in 21 dogs.

To report the outcomes of dogs with lesions of the genitourinary tract treated by vaginectomy or vulvovaginectomy. Multi-institutional retrospective study. Female dogs that underwent vulvovaginectomy, complete vaginectomy, or subtotal vaginectomy from 2003 to 2018 with complete medical records and a minimum of 60 days follow-up. Data collected from medical records included preoperative, intraoperative, and postoperative data, such as the occurrence of urinary incontinence (UIC), disease recurrence, and death/euthanasia. This study included 21 dogs. Four dogs had vulvovaginectomy, six had complete vaginectomy, and 11 had a subtotal vaginectomy performed. The mean age at surgery was 9.2 years (SD, 3.3). Thirteen dogs were intact at presentation. Smooth muscle tumors were diagnosed most commonly (10 leiomyomata, three leiomyosarcomas, two leiomyofibromas). The median duration of follow-up was 520 days (range, 71-1955). Major complications requiring revision surgery were recorded in two dogs. Postoperative UIC occurred in six of 21 dogs, resolving spontaneously within 60 days in three dogs. Dogs with malignant tumors (n = 6) survived at least 71 days (median, 626; 95% CI, 71-1245), and recurrence of disease occurred in two dogs. In dogs with benign tumors (n = 15), the median survival time was not reached. These dogs survived at least 104 days and had no recurrence of the disease. Vaginectomy and vulvovaginectomy resulted in prolonged survival and low rates of major complications and UIC. This study provides evidence to recommend that the risks of this procedure and expectations should be discussed with clients.

Real-World Effects of Mirabegron in Patients with Chronic Neurogenic Detrusor Overactivity - A Retrospective Cohort Study.

PurposeTo investigate the tolerability and the effects of the β-3-adrenoceptor-agonist mirabegron on urinary incontinence and urodynamic parameters in patients with chronic neurogenic detrusor overactivity (NDO).Patients and MethodsThe patient database of a spinal cord injury rehabilitation center in Switzerland was screened for patients with chronic (>12 months) NDO, who had been prescribed mirabegron. Patient characteristics, data regarding bladder management, urinary incontinence and concurrent medication for NDO as well as urodynamic parameters were collected retrospectively. The changes in the urodynamic parameters and the occurrence of urinary incontinence over time were investigated.ResultsThe data of 63 patients with a median age of 48 years and a median NDO duration of 8.9 years at the initiation of the mirabegron treatment were analyzed. A median 3.0 and 12.7 months had elapsed from the initiation of the mirabegron therapy to the first and second follow-up evaluation, respectively. The majority of patients (73%) received mirabegron in combination with an established antimuscarinic or onabotulinum toxin therapy. The number of patients suffering from urinary incontinence decreased significantly (p≤0.005) from 60.3% (95% CI 47.2/72.4%) to 38.1% (95% CI 23.6/54.4%). Furthermore, the maximum detrusor pressure during the storage phase was significantly (p≤0.04) lower at the second follow-up evaluation (29.5cmH2O, 95% CI 22/40cmH2O) compared to before the mirabegron treatment (35cmH2O, 95% CI 29/41cmH2O). The bladder capacity and detrusor compliance were significantly (p≤0.005) increased during the mirabegron treatment. No patient had discontinued the mirabegron treatment as a result of side effects.ConclusionMirabegron demonstrated a clinically relevant effect and a good safety profile. Concomitant treatment of NDO with mirabegron may allow reduction in the dose of antimuscarinic medication and thus, improve the long-term persistence of NDO treatment.

The Influence of Vaginal Native Tissues Pelvic Floor Reconstructive Surgery in Patients with Symptomatic Pelvic Organ Prolapse on Preexisting Storage Lower Urinary Tract Symptoms (LUTS).

The aim of this study was to assess the effectiveness of vaginal native tissue repair (VNTR) on preexisting Lower Urinary Tract Symptoms (LUTS) in women with symptomatic pelvic organ prolapse (POP). Two hundred patients who underwent VNTR for symptomatic POP from January 2018 to February 2019 were followed up for 6 months. All patients underwent VNTR, but in the posterior compartment, the rectovaginal fascia was reconnected to the uterosacral ligaments and additionally sutured to the iliococcygeus fascia and muscle. To assess the severity and change in storage phase LUTS before and after surgery, all participants were asked to complete 3 questionnaires: the International Consultation on Incontinence Questionnaire- Short Form (ICIQ-SF), Urogenital Distress Inventory-6 (UDI-6), and Incontinence Impact Questionnaire-7 (IIQ-7). The data were assessed with Statistica package version 12.0, using Kalmogorow–Smirnoff, W Shapiro–Wilk tests. Furthermore, one-way analysis of variance was applied with post-hoc Tukey test. The study results indicate that the majority of patients with advanced POP suffered from various LUTS. Among storage symptoms, the occurrence of urinary incontinence (UI) and urgency decreased significantly after surgery. Moreover, ICIQ-SF, UDI-6, and IIQ-7 results showed statistically significant improvement in the impact of UI on the quality of life (QoL) in the vast majority of patients after surgery. VNTR is an effective way to treat not only anatomical, but also functional problems in such patients.

Pelvic floor muscle function in women with and without urinary incontinence: are strength and endurance the only relevant functions? a cross-sectional study

ObjectivesTo investigate if pelvic floor muscle functions (PFMFs), besides strength and endurance, are associated with the occurrence of urinary incontinence (UI) in women, and to investigate which functions predict the occurrence of UI. DesignCross-sectional study. SettingPublic health service and community. ParticipantsTwo hundred and ten women (101 with UI and 109 without UI). Main outcome measuresPFMF was investigated by the Pelvic Floor Sensory and Muscle Function Exam (Exame das Funções Sensoriais e Musculares do Assoalho Pélvico), a valid and reliable instrument that measures the following functions: tone, reaction, control (contraction), control (relaxation), coordination, strength and endurance. The International Consultation on Incontinence Questionnaire-Short Form was used to document the occurrence and type of UI. Sociodemographic and clinical data were collected through the questionnaire. Chi-squared test, Student’s t-test and Mann–Whitney test were used to evaluate the association of each function with UI. Two logistic regression models tested the predictive value of each function for UI: Model a included all of the above PFMFs and Model b included all of the above PFMFs except strength and endurance. ResultsMost sociodemographic and clinical risk factors differed between women with UI and women without UI. On univariate analysis, tone, reaction, control (contraction), coordination, strength and endurance were found to be significantly associated (P<0.05) with the occurrence of UI. On multivariate analysis, Model a explained 69% and Model b explained 61% of the likelihood of UI, respectively. ConclusionsBesides strength and endurance, pelvic floor muscle tone, reaction, control (contraction) and coordination were significantly associated with the occurrence of UI, and should be investigated further.

Prevalence and factors associated with the occurrence of urinary incontinence during pregnancy

Abstract Objectives: to determine the prevalence of urinary incontinence (UI) during pregnancy, to identify and quantify the factors associated with gestational UI. Methods: a cross-sectional study carried out with women admitted for deliveries in all maternity wards in the city of Botucatu (São Paulo). Data were collected through a structured questionnaire, based on the literature, containing questions about the occurrence of UI, its types, risk factors and moments when urinary losses occurred. Associations between UI and the predictive variables were analyzed with logistic regression models. Results: 950 women were interviewed, out of which 472 complained of urinary losses during pregnancy, resulting in a prevalence of 49.68% (CI95%= 46.51 - 52.86). The majority (61.8%) were classified as mixed UI. Among the covariates investigated, smoking (OR= 4.56), illicit drugs use (OR= 25.14), stimulant foods (OR= 1.84), constipation (OR=1.99), hypertensive disorders during gestation (OR= 3.23), gestational diabetes mellitus (OR= 2.89), parity (OR= 1.52) and previous caesarean sections (OR= 2.56) increased the chance of urinary losses during pregnancy. Conclusions: there was a high prevalence of UI during pregnancy. This condition was strongly associated with lifestyle habits and gestational morbidities. Finally, it is worth high-lighting the fact that delivery via caesarean section increased the chance of UI in subsequent pregnancies.

Impaired Mobility and Urinary Incontinence in Nursing Home Residents: A Multicenter Study.

The purpose of this study was to evaluate associations among use of walking aids, mobility status, and occurrence of urinary incontinence (UI) in geriatric patients residing in nursing homes, and to examine associations between UI severity (frequency and amount) and its impact on health-related quality of life (QoL). Multicenter descriptive cross-sectional prevalence study. A total of 2044 patients from nursing homes were included in the study. A majority were female (72.0%), the mean age of participants was 82.1 years (SD 11.2), their mean body mass index was 26.1 (SD 5.4), and their mean Care Dependency Scale score was 46.0 (SD 18.2), indicating a medium to high care dependency. The study setting was 30 nursing homes throughout Germany from 2014 to 2015. Data were collected by trained nurses using a standardized data collection form to collect information about demographic characteristics, health conditions, mobility status measured according to the Elderly Mobility Scale (EMS), UI, and QoL measured using the International Consultation of Incontinence Questionnaire Short Form (ICIQ-SF). The prevalence of UI was 69.7% (n = 1804). Analysis of variance showed that, in 1659 nursing home residents with information on UI, 572 reported a medium amount of leakage with a mean impact on health-related QoL of 2.2 (SD 2.2, P < .001) on a scale from 0 (no impact) to 10 (very high impact). The mean of the impact on QoL in 235 residents who reported a large amount of leakage was 2.4 (SD 3.0, P < .001). In 1741 residents with information on the frequency of UI, 637 reported being urinary incontinent more than once a day with a mean impact on QoL of 2.2 (SD 2.1, P < .001) and 359 residents with permanent UI stated a mean impact on QoL of 2.1 (SD 2.8, P < .001). According to the bivariate association of UI with use of walking aids, the highest prevalence of UI (61.2%) was in patients who did not use any walking aids. The Chi-square Automatic Interaction Detector (CHAID) of the relationship between mobility according to the EMS and UI indicated that 71.1% of all patients with UI did not use any walking aids, although their mobility status had been reduced. Findings indicate a significant association between impaired mobility and UI in nursing home residents. Chronic, severe urinary incontinence exerted the greatest impact on health-related QoL. Therefore, we recommend measures to preserve or regain mobility to minimize or prevent UI in geriatric residents and patients and, thus, increase their health-related QoL.

Estado cognitivo e incontinência urinária em idosos institucionalizados

O objetivo deste estudo foi verificar a relação entre o estado cognitivo e a ocorrência de incontinência urinária (IU) em idosos institucionalizados. Trata-se de um estudo observacional, transversal e com abordagem quantitativa. A coleta de dados ocorreu entre os meses de novembro de 2017 e janeiro de 2018. Foram investigados idosos, com idades variando de 60 a 90 anos, de ambos os sexos, residentes em duas Instituições de Longa Permanência para Idosos (ILPIs) de um município do sul do Brasil. Os instrumentos de pesquisa foram compostos pelos questionários International Consultation on Incontinence Questionnaire - Short Form(ICIQ-SF) e pelo Mini Exame do Estado Mental (MEEM). As análises estatísticas foram realizadas por meio do software SPSS 17.0. Para verificar a normalidade dos dados, foi realizado o teste de Shapiro-Wilk. Para a correlação das variáveis, foi utilizado o Coeficiente Correlação de Spearman, admitindo-se o nível de significância de 5%. Foram avaliados 36 idosos, 29 (80,55%) do sexo masculino e 7 (19,45%) do sexo feminino, com média de idade de 69,64 ± 5,87 anos. A média do escore do MEEM do total de participantes do estudo foi 24,78 ± 4,12 pontos. A média do escore do ICIQ-SF foi 5,36 ± 6,97 pontos. Em relação à ocorrência de IU, 18 (50%) idosos relataram perder urina, sendo 14 (77,77%) homens e 4 (22,23%) mulheres. Não foi observada correlação entre os escores do ICIQ-SF e do MEEM. Não houve correlação entre estado cognitivo e IU na amostra de idosos deste estudo. É possível que diversos fatores não investigados estejam envolvidos nestes resultados.

Assessing Myo‐mechanicals Characteristic of Rectus Abdominis Muscle after Stem Cell Therapy

Hyperglycemia during gestation have the deleterious effect in the skeletal muscle leading to occurrence of urinary incontinence and pelvic floor muscle dysfunctions in women. Induces functional, metabolic and structural changes in skeletal muscle; decreasing the functional capacity of the muscle, currently there is not therapies in diabetic gestational myopathy and the new proposal of muscle regeneration is based in stem cell therapy in biodevice use. To evaluate the functionality of the muscle in the new therapies to investigate the effectiveness of the muscle regeneration by assessing myo‐mechanicals characteristic of rectus abdominis muscle after therapeutic application of biodevice with mesenchymal stem cells in experimental model in diabetic and non‐diabetic pregnant rats. 20 postpartum rats of the Sprague Dawley® specific pathogen free strain, composing IV groups as follows: I. Diabetic group without biodevice (GD), II. Diabetic group with biodevice (GD ‐Bio), III. Non‐diabetic group without biodevice (GND) and IV. Non‐diabetic group with biodevice (GND‐Bio). The study was approved by the Botucatu Medical School Ethics Committee on the Use of Animals (CEUA) No. 1234/2017. After the euthanasia of the animals, the rectus abdominis samples will be removed and immediately mounted on the supports inside the isolated organ chambers of the Myograph equipment (Model 820MS; Danish Myo Technology®), the segments will be attached and connected to isometric transducers, submerged in solution physiological composition of Krebs [(mM): NaCl, 130; NaHCO3, 14.9; dextrose, 5.5; KCl, 4.7; KH2PO4, 1.18; MgSO47H2O, 1.17 e CaCl22H2O, 1.6]. Maintained at 37 ° C and constantly bubbled with 95% O2 / 5% CO2 mixture being fixed between a force transducer and a fixed unit. Application of stabilization protocol and then electrical stimulation. The parcial results show that the treated group has an increase of 3mN more than the untreated group; this indicates a better myo‐mechanicals condition in non‐diabetic rats. The Biodevice treatment is effective for the development of muscle regeneration therapy, being able to increase the contractile capacity of the rectus abdominis muscle in the model of diabetic and non‐diabetic pregnant rats.Support or Funding InformationThis project is funded for Sao Paulo Research Foundation, FAPESP (number grant 2016/01743‐5)This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.